Uji Diagnostik Pemeriksaan C-reaktif Protein (Crp) Pada Neonatus Tersangka Sepsis Yang Dirawat Di Instalasi Neonatus RSUD Arifin Achmad Provinsi Riau

Neonatal sepsis is a collection of clinical symptoms and laboratory associated with infection due to the invasion of microorganisms during the first 28 days of a child\u27s life time. The certain diagnosis of neonatal sepsis is the isolation of bacteria from blood or body fluids. However, this method takes at least 72 hours. Therefore, It is necessary an investigation with a relatively short time. One of methods is C-Reactive Protein (CRP) examination. Even though CRP examination has been done in many of diagnosis of sepsis,however this examination also has some limitations. This research designusing a diagnostic test with retrospective approach. The sampling technique is performed by consecutive sampling method and amount of sample is 313 people. The results showed that the characteristics of the neonatal sepsis suspect in accordance with age is early neonatal (0-6 h), which amount to 235 (75%), and majority is male by 182 (58%). The most risk factor for gestational age <37 weeks is 133 samples with a median value is 11.4 mg / dl. Late Onset Neonatal Sepsis (LONS) is the highest classification of sepsis group at 93 (82%) with a median value is 192 mg/dl. The diagnostic value of CRP examination are sensitivity 65.7%, specificity 79.3%, positive predictive value 64.6%, negative predictive value 80.2%, positive contingency ratio 3.25, negative contingency ratio 0.43 and accuracy of 74.4%. As the result, we obtain cut off the recommended point is ≥10,2 mg / dl

Sustained seizure freedom with adjunctive brivaracetam in patients with focal onset seizures

The maintenance of seizure control over time is a clinical priority in patients with epilepsy. The aim of this study was to assess the sustained seizure frequency reduction with adjunctive brivaracetam (BRV) in real-world practice. Patients with focal epilepsy prescribed add-on BRV were identified. Study outcomes included sustained seizure freedom and sustained seizure response, defined as a 100% and a ≥50% reduction in baseline seizure frequency that continued without interruption and without BRV withdrawal through the 12-month follow-up. Nine hundred ninety-four patients with a median age of 45 (interquartile range = 32–56) years were included. During the 1-year study period, sustained seizure freedom was achieved by 142 (14.3%) patients, of whom 72 (50.7%) were seizure-free from Day 1 of BRV treatment. Sustained seizure freedom was maintained for ≥6, ≥9, and 12&nbsp;months by 14.3%, 11.9%, and 7.2% of patients from the study cohort. Sustained seizure response was reached by 383 (38.5%) patients; 236 of 383 (61.6%) achieved sustained ≥50% reduction in seizure frequency by Day 1, 94 of 383 (24.5%) by Month 4, and 53 of 383 (13.8%) by Month 7 up to Month 12. Adjunctive BRV was associated with sustained seizure frequency reduction from the first day of treatment in a subset of patients with uncontrolled focal epilepsy

Adjunctive Brivaracetam in Focal Epilepsy: Real-World Evidence from the BRIVAracetam add-on First Italian netwoRk STudy (BRIVAFIRST)

Background: In randomized controlled trials, add-on brivaracetam (BRV) reduced seizure frequency in patients with drug-resistant focal epilepsy. Studies performed in a naturalistic setting are a useful complement to characterize the drug profile. Objective: This multicentre study assessed the effectiveness and tolerability of adjunctive BRV in a large population of patients with focal epilepsy in the context of real-world clinical practice. Methods: The BRIVAFIRST (BRIVAracetam add-on First Italian netwoRk STudy) was a retrospective, multicentre study including adult patients prescribed adjunctive BRV. Patients with focal epilepsy and 12-month follow-up were considered. Main outcomes included the rates of seizure‐freedom, seizure response (≥&nbsp;50% reduction in baseline seizure frequency), and treatment discontinuation. The incidence of adverse events (AEs) was also considered. Analyses by levetiracetam (LEV) status and concomitant use of strong enzyme-inducing antiseizure medications (EiASMs) and sodium channel blockers (SCBs) were performed. Results: A total of 1029 patients with a median age of 45&nbsp;years (33–56) was included. At 12 months, 169 (16.4%) patients were seizure-free and 383 (37.2%) were seizure responders. The rate of seizure freedom was 22.3% in LEV-naive patients, 7.1% in patients with prior LEV use and discontinuation due to insufficient efficacy, and 31.2% in patients with prior LEV use and discontinuation due to AEs (p&nbsp;&lt;&nbsp;0.001); the corresponding values for ≥&nbsp;50% seizure frequency reduction were 47.9%, 29.7%, and 42.8% (p&nbsp;&lt;&nbsp;0.001). There were no statistically significant differences in seizure freedom and seizure response rates by use of strong EiASMs. The rates of seizure freedom (20.0% vs. 16.6%; p&nbsp;=&nbsp;0.341) and seizure response (39.7% vs. 26.9%; p&nbsp;=&nbsp;0.006) were higher in patients receiving SCBs than those not receiving SCBs; 265 (25.8%) patients discontinued BRV. AEs were reported by 30.1% of patients, and were less common in patients treated with BRV and concomitant SCBs than those not treated with SCBs (28.9% vs. 39.8%; p&nbsp;=&nbsp;0.017). Conclusion: The BRIVAFIRST provided real-world evidence on the effectiveness of BRV in patients with focal epilepsy irrespective of LEV history and concomitant ASMs, and suggested favourable therapeutic combinations

Neuromechanical response of the upper body to unexpected perturbations during gait initiation in young and older adults

Background: Control of upper body motion deteriorates with ageing leading to impaired ability to preserve balance during gait, but little is known on the contribution of the upper body to preserve balance in response to unexpected perturbations during locomotor transitions, such as gait initiation. Aim: To investigate differences between young and older adults in the ability to modify the trunk kinematics and muscle activity following unexpected waist lateral perturbations during gait initiation. Methods: Ten young (25 ± 2 years) and ten older adults (73 ± 5 years) initiated locomotion from stance while a lateral pull was randomly applied to the pelvis. Two force plates were used to define the feet centre-of-pressure displacement. Angular displacement of the trunk in the frontal plane was obtained through motion analysis. Surface electromyography of cervical and thoracic erector spinae muscles was recorded bilaterally. Results: A lower trunk lateral bending towards the stance leg side in the preparatory phase of gait initiation was observed in older participants following perturbation. Right thoracic muscle activity was increased in response to the perturbation during the initial phase of gait initiation in young (+ 68%) but not in older participants (+ 7%). Conclusions: The age-related reduction in trunk movement could indicate a more rigid behaviour of the upper body employed by older compared to young individuals in response to unexpected perturbations preceding the initiation of stepping. Older adults’ delayed activation of thoracic muscles could suggest impaired reactive mechanisms that may potentially lead to a fall in the early stages of the gait initiation

Bond strength of concrete-filled hollow section with modified fibrous foamed concrete

The concrete-filled section of columns has been widely in construction used due to its structural elements. As a result, the usage of composite columns has recently increased all over the world. However, using foamed concrete alone does not result in much improvements in strength. Therefore, this paper examines the use of foamed concrete containing fibre to improve the strength of composite columns. Specifically, this study aims to determine the bond strength of concrete-filled hollow section (CFHS) with modified fibrous foamed concrete. Two types of fibre are used in this work, namely, steel fibre and polypropylene fibre, with rice husk ash (RHA) as a sand replacement to improve the compressive strength of foamed concrete. The CFHS with modified fibrous foamed concrete is tested by using the push-out method, and the results show that CFHS with steel fibre has a highest bond strength

Application of IoT Using NodeMCU ESP8266 on the Syringe Pump Device to Increase Patient Safety

Nowadays, health care has turned out to be more technology-oriented. Today's technology is demanded to be practical and easy to use. The number of mobile devices based on the Android operating system has increased significantly based on data. The open-source nature of android helps in programming applications easily according to user requirements. The syringe pump is a medical device that functions to enter the medicinal fluid into the patient's body at a specific dose and time automatically in mL/hour. The syringe pump is generally equipped with an alarm. Alarms have a vital function to provide information to nurses or doctors on duty. Medical officers cannot hear alarms outside the patient monitoring room. This paper aims to design a syringe pump that is equipped with a NodeMCU8266 WiFi module to provide notifications via a smartphone so that nurses or doctors can know the alarm even though they are outside the patient monitoring room. So, this is expected can improve patient safety. In addition, this paper also aims to verify the size of the syringe against the drug flow rate. Based on the test results, the syringe pump can control the drug flow rate with a sensor accuracy of 0.0217 and an error rate of 0.6% at a target volume of 5mL. The syringe pump can also send alarm notifications to smartphones in real-time