PERILAKU MASYARAKAT DALAM MENGGUNAKAN JAMBAN SEHAT DI DESA MAMBULU BARAT, KECAMATAN TAMBELENGAN, KABUPATEN SAMPANG

Pencapaian sasaran Sustainable Development Goals SDGs salah satunya tujuannya merupakan tentang air bersih serta sanitasi, pada prilaku hidup sehat salah satunya bisa diwujudkan dengan membuang kotoran manusia( feses)/ buang air besar dengan metode yang sehat ataupun pada tempatnya, semacam jamban. World Health Organization tahun 2018, memperkirakan sebanyak 2, 4 miliyar ataupun 1 dari 3 penduduk dunia tidak mempunyai jamban, serta tidak menyesuikan hidup bersih serta sehat. Permasalahan minimnya pemakaian jamban dipengaruhi oleh minimnya sikap kesehatan area warga. Riset ini bertujuan buat mendeskripsikan prilaku warga dalam memakai jamban bersih serta sehat di Desa Mambulu Barat, Kecamatan Tambelengan, Kabupaten Sampang. Riset ini memakai tata cara riset deskriptif. Populasi dalam riset ini merupakan segala kepala keluarga di Desa Mambulu barat yang bersedia. Terdapat 50 responden dalam riset ini. Pengumpulan informasi memakai kuesioner. Hasil riset menampilkan kalau prilaku warga Desa Mambulu Barat, Kecamatan Tambelengan, Kabupaten Sampang dalam memakai jamban bersih serta sehat dari 50 responden( 54%) ataupun 27 responden berperilaku negatif, sebaliknya( 46%) ataupun 23 responden berperilaku positif. Buat tingkatkan kepemilikan, pemanfaatan serta pemakaian jamban bersih serta sehat di Desa Mambulu Barat, Kecamatan Tambelengan, Kabupaten Sampang dibutuhkan motivasi serta pembinaan

Case Report: Priapism as the clinical presentation of chronic myeloid leukemia in accordance with reports created during last twenty years: a case report and literature review

Priapism in chronic myeloid leukemia (CML) appears to be an infrequent manifestation as well as a crucial emergency. Here, we report an 18-year-old male presenting with a persistent erection of penis for 20 days. We evaluate and compare the reported cases during the past 20 years discussing the management of CML patients experiencing priapism. Cytoreductive therapy followed by leukapheresis, the administration of tyrosine kinase inhibitor, and intra-cavernosal blood aspiration may resolve the symptoms of priapism. Early intervention for cytoreduction and aspiration are the pivotal keys to successfully impeding the complications

Optimal use of tocilizumab for severe and critical COVID-19: a systematic review and meta-analysis

Background: Several studies have revealed the potential use of tocilizumab in treating COVID-19 since no therapy has yet been approved for COVID-19 pneumonia. Tocilizumab may provide clinical benefits for cytokine release syndrome in COVID-19 patients. Methods: We searched for relevant studies in PubMed, Embase, Medline, and Cochrane published from March to October 2020 to evaluate optimal use and baseline criteria for administration of tocilizumab in severe and critically ill COVID-19 patients. Research involving patients with confirmed SARS-CoV-2 infection, treated with tocilizumab and compared with the standard of care (SOC) was included in this study. We conducted a systematic review to find data about the risks and benefits of tocilizumab and outcomes from different baseline criteria for administration of tocilizumab as a treatment for severe and critically ill COVID-19 patients. Results: A total of 26 studies, consisting of 23 retrospective studies, one prospective study, and two randomised controlled trials with 2112 patients enrolled in the tocilizumab group and 6160 patients in the SOC group, were included in this meta-analysis. Compared to the SOC, tocilizumab showed benefits for all-cause mortality events and a shorter time until death after first intervention but showed no difference in hospital length of stay. Upon subgroup analysis, tocilizumab showed fewer all-cause mortality events when CRP level ≥100 mg/L, P/F ratio 200-300 mmHg, and P/F ratio <200 mmHg. However, tocilizumab showed a longer length of stay when CRP <100 mg/L than the SOC. Conclusion: This meta-analysis demonstrated that tocilizumab has a positive effect on all-cause mortality. It should be cautiously administrated for optimal results and tailored to the patient's eligibility criteria

The clinical impact of bacterial co-infection among moderate, severe and critically ill COVID-19 patients in the second referral hospital in Surabaya [version 2; peer review: 2 approved]

Background: Data on the prevalence of bacterial co-infections among COVID-19 patients are limited, especially in our country, Indonesia. We aimed to assess the rate of bacterial co-infections in hospitalized COVID-19 patients and report the most common microorganisms involved and the antibiotic use in these patients. Methods: This study is a retrospective cohort study, among COVID-19 adult patients admitted to Universitas Airlangga Hospital Surabaya from 14 March-30 September 2020. The bacterial infection is defined based on clinical assessment, laboratory parameters, and microbiology results. Results: A total of 218 patients with moderate to critical illness and confirmed COVID-19 were included in this study. Bacterial infection was confirmed in 43 patients (19.7%). COVID-19 patients with bacterial infections had longer hospital length of stay (17.6 ± 6.62 vs 13.31±7.12), a higher proportion of respiratory failure, intensive care treatment, and ventilator use. COVID-19 patients with bacterial infection had a worse prognosis than those without bacterial infection (p<0.04). The empirical antibiotic was given to 75.2% of the patients. Gram-negative bacteria were commonly found as causative agents in this study (n = 39; 70.37%). Conclusion: COVID-19 patients with bacterial infection have a longer length of stay and worse outcomes. Healthcare-associated infections during intensive care treatment for COVID-19 patients must be carefully prevented

Kombinasi Terapi Cermin dan Menggenggam Bola Karet terhadap Kekuatan Otot Ekstremitas atas pada Pasien Pasca Stroke: Tinjauan Sistematik

Stroke yang juga dikenal sebagai penyakit serebrovaskular merupakan penyakit dengan manifestasi klinis yaitu hemiparesis sehingga penderita tidak mampu melakukan aktivitas atau mobilisasi. Upaya yang dapat dilakukan adalah dengan memberikan kombinasi terapi cermin dan mencengkeram bola karet. Tujuan: Penelitian ini bertujuan untuk mengetahui pengaruh terapi kombinasi cermin memegang bola karet terhadap kekuatan otot ekstremitas atas pada pasien pasca stroke berdasarkan penelitian selama 10 tahun terakhir. kata kunci “Terapi Cermin DAN Mencengkeram Bola Karet DAN Kekuatan Otot DAN Pasca Stroke”. Hasil yang diperoleh adalah 872 artikel dari 4 database: Scopus, Web of Science, Science Direct, dan Pro Quest. Artikel yang memenuhi syarat berdasarkan penilaian risiko bias menggunakan penilaian kritis JBI untuk uji coba kontrol acak dan daftar periksa eksperimental diperoleh dari 15 artikel. Fungsi ekstremitas atas pada sisi hemiparetik setelah intervensi meningkat secara signifikan setelah intervensi terapi cermin dan karet terapi mencengkeram bola. Terapi cermin yang dikombinasikan dengan latihan mencengkeram bola karet dilakukan selama 2 minggu dengan dosis 1 kali sehari pada pagi hari, dengan durasi 5-7 menit. Terapi cermin merupakan terapi yang dapat meningkatkan kekuatan otot yang mengalami hemipaeresis melalui umpan balik visual, serta grip bola karet yang dapat merangsang serat otot untuk berkontraksi sehingga dapat meningkatkan kekuatan otot pada pasien pasca stroke yang murah, sederhana dan dapat dilakukan di rumah

Correlation between anti-hypertensive drugs and disease progression among moderate, severe, and critically ill COVID-19 patients in the second referral hospital in Surabaya: A retrospective cohort study [version 2; peer review: 2 approved]

Background: Hypertension, as the comorbidity accompanying COVID-19, is related to angiotensin-converting enzyme 2 receptor (ACE-2R) and endothelial dysregulation which have an important role in blood pressure regulation. Other anti-hypertensive agents are believed to trigger the hyperinflammation process. We aimed to figure out the association between the use of anti-hypertensive drugs and the disease progression of COVID-19 patients. Methods: This study is an observational cohort study among COVID-19 adult patients from moderate to critically ill admitted to Universitas Airlangga Hospital (UAH) Surabaya with history of hypertension and receiving anti-hypertensive drugs. Results: Patients receiving beta blockers only had a longer length of stay than angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ACEI/ARB) or calcium channel blockers alone (17, 13.36, and 13.73 respectively), had the higher rate of intensive care unit (ICU) admission than ACEi/ARB (p 0.04), and had the highest mortality rate (54.55%). There were no significant differences in length of stay, ICU admission, mortality rate, and days of death among the single, double, and triple anti-hypertensive groups. The mortality rate in groups taking ACEi/ARB was lower than other combination. Conclusions: Hypertension can increase the severity of COVID-19. The use of ACEI/ARBs in ACE-2 receptor regulation which is thought to aggravate the condition of COVID-19 patients has not yet been proven. This is consistent with findings in other anti-hypertensive groups

Hubungan Pengetahuan Hepatitis B dan Perilaku Berisiko Tinggi dengan Kejadian Hepatitis B pada Remaja

Hepatitis B is a disease caused by Hepatitis B virus (HBV) and the most common type of Hepatitis in Indonesia at 21.8%. High-risk behaviors such as unsafe sexual intercourse and indiscriminate use of syringes can cause Hepatitis B. This study aimed to analyze the relationship between knowledge of Hepatitis B and high-risk behaviors with the incidents of Hepatitis B among adolescents. The study was conducted by using a cross-sectional design and 50 adolescents as the respondents. The data collection was carried out by using a questionnaire. Correlation analysis was performed by Fisher’s exact test. 62% of adolescents had a low level of knowledge about Hepatitis B, 54% of adolescents never engaged in high-risk behavior, and 70% of adolescents claimed that they were never exposed to Hepatitis B. This study did not show any relationship between knowledge of Hepatitis B and the incidents of Hepatitis B (p 0.086 &gt; α 0.05) and there was a relationship between high-risk behaviors in adolescents and the incidents of Hepatitis B (p 0.002 &lt; α 0.05). Adolescents' knowledge of Hepatitis B and high-risk behaviors in adolescents are important factors that need to be controlled to decrease Hepatitis B rates. Socialization of Hepatitis B knowledge is needed to understand the virus, causes, transmission channel, how to stop the spread, and treatments should be taken when being infected by Hepatitis B virus.Hepatitis B merupakan penyakit yang disebabkan oleh virus Hepatitis B (HBV) dan merupakan jenis Hepatitis terbanyak di Indonesia yaitu sebesar 21,8%. Perilaku berisiko tinggi seperti hubungan seksual yang tidak aman dan penggunaan jarum suntik sembarangan dapat menyebabkan Hepatitis B. Penelitian ini bertujuan untuk menganalisis hubungan pengetahuan Hepatitis B dan perilaku berisiko tinggi dengan kejadian Hepatitis B pada remaja. Penelitian dilakukan dengan desain cross-sectional dengan responden sebanyak 50 remaja. Pengumpulan data dilakukan dengan kuesioner. Analisis hubungan dilakukan dengan uji Fisher exact. Sebanyak 62% remaja memiliki tingkat pengetahuan kurang tentang Hepatitis B, 54% remaja tidak pernah melakukan perilaku berisiko tinggi, dan 70% remaja mengaku tidak pernah terpapar Hepatitis B. Hasil penelitian tidak menunjukkan adanya hubungan antara pengetahuan Hepatitis B dengan kejadian Hepatitis B (p 0,086 &gt; α 0,05) dan terdapat hubungan antara perilaku berisiko tinggi remaja dengan kejadian Hepatitis B (p 0,002 &lt; α 0,05). Pengetahuan remaja terhadap Hepatitis B dan perilaku berisiko tinggi yang dilakukan remaja merupakan faktor penting yang perlu dikendalikan untuk menurunkan angka Hepatitis B. Sosialisasi pengetahuan Hepatitis B diperlukan untuk memperoleh pemahaman tentang virus, penyebabnya, saluran penyebarannya, bagaimana menghentikan penyebarannya, dan penanganan apa yang harus dilakukan jika terjangkit virus Hepatitis B

Correlation between anti-hypertensive drugs and disease progression among moderate, severe, and critically ill COVID-19 patients in the second referral hospital in Surbaya: A retrospective cohort study

Background: Hypertension, as the comorbidity accompanying COVID-19, is related to angiotensin-converting enzyme 2 receptor (ACE-2R) and endothelial dysregulation which have an important role in blood pressure regulation. Other anti-hypertensive agents are believed to trigger the hyperinflammation process. We aimed to figure out the association between the use of anti-hypertensive drugs and the disease progression of COVID-19 patients. Methods: This study is an observational cohort study among COVID-19 adult patients from moderate to critically ill admitted to Universitas Airlangga Hospital (UAH) Surabaya with history of hypertension and receiving anti-hypertensive drugs. Results: Patients receiving beta blockers only had a longer length of stay than angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ACEI/ARB) or calcium channel blockers alone (17, 13.36, and 13.73 respectively), had the higher rate of intensive care unit (ICU) admission than ACEi/ARB (p 0.04), and had the highest mortality rate (54.55%). There were no significant differences in length of stay, ICU admission, mortality rate, and days of death among the single, double, and triple anti-hypertensive groups. The mortality rate in groups taking ACEi/ARB was lower than other combination. Conclusions: Hypertension can increase the severity of COVID-19. The use of ACEI/ARBs in ACE-2 receptor regulation which is thought to aggravate the condition of COVID-19 patients has not yet been proven. This is consistent with findings in other anti-hypertensive groups

Triglycerides/HDL-Cholesterol Ratio is Correlated with Insulin Resistance in Patients with Type 2 Diabetes Mellitus

Background: Diabetes has long been recognized to be an independent risk factor for cardiovascular disease (CVD). Cardiovascular complications are now the leading causes of diabetes-related morbidity and mortality. Prognosis of patients with diabetes is highly dependent on the presence of CVD. Insulin resistance (IR) plays an important role for development and progression of diabetes, and also may act as a predictor for development of CVD. Insulin resistance is thought to be a common finding in several metabolic disorders, such as type 2 diabetes mellitus (T2DM), impaired glucose tolerance (IGT), metabolic syndrome (MetS), hypertension, hypertriglyceridemia, low HDL cholesterol, hypercholesterolemia, hyperuricemia, obesity, and low serum testosterone. Evaluations of IR and b-cell function are important for understanding the disease status and selection of pharmacologic treatment. Triglyceride/HDL-cholesterol (TG/HDL) ratio is a new surrogate marker for IR. Diagnostic value of TG/HDL ratio is as good as HOMA-IR and could be used as an indicator of IR in clinical setting. Because IR plays important role in development of CVD and the TG/HDL-c ratio was significantly associated with these conditions, we conducted this study to determine whether the TG/HDL-c ratio is associated with IR in patients with T2DM. HOMA-IR value more than 2.0 is considered to be positive for IR. Method: This is a cross-sectional study, which includes men and women with T2DM who were on routine follow up in private out patient diabetic clinic. Informed consent was obtained from all patients. Exclusion criteria for this study are: history of alcohol use, history of having cardiovascular disease or cerebrovascular disease. Patients with end stage renal disease or on dialysis and with active hepatic disease are also excluded from the study. Insulin Resistance was measured using HOMA-IR and TG/HDL ratio measured using simple laboratory measurement. TG/HDL-c ratio more than 3.5 for male and more than 2.5 for female is considered abnormal. Statistical analysis was performed using SPSS 17.0 and Pearson’s correlation test. Result: a total of 227 subjects, 165 males and 62 females were enrolled. Mean value of TG/HDL-c ratio was 4.56, mean value of HOMA-IR was 6.3967. From the statistical analysis we found that TG/HDL-c ratio was significantly associated with HOMA-IR (p < 0.05. 95% CI) respectively. Conclusion: In our study, TG/HDL-c ratio was significantly correlated with IR in patients with T2DM

Fasting Plasma Insulin Level is Correlated with the Beta Cells Function in Patients with Type 2 Diabetes Mellitus

Background: Insulin Resistance (IR) is a common finding in diabetes mellitus and may serve as a measure of efficacy of therapies (exercise, exogenous insulin, sulfonylureas, and PPAR gamma agonists) for diabetes mellitus and as a possible marker for risk of developing type 2 diabetes mellitus (T2DM). Insulin Resistance is widely believed to be able to be predicted using measurement of plasma insulin level and usually marked by existence of fasting hyperinsulinemia. However, recently fasting hyperinsulinemia itself was found to have a primary pathogenic role in the development of diabetes, independent of insulin resistance. Further analyses revealed that individuals with a high relative fasting plasma insulin concentration (for their degree of adiposity and insulin resistance) are at increased risk for a decline in early phase insulin secretion, but not in insulin sensitivity, before the onset of diabetes. Since beta cell dysfunction is the core of the pathogenesis of T2DM, therefore the aim of this study is to determine whether fasting plasma insulin level correlates with residual beta-cell function. Method: The study was a cross-sectional study, which had enrolled men and women subjects with type 2 diabetes (T2DM) that were on routine follow up in a private outpatient diabetic clinic. The study included T2DM patients with age >40 years old. Informed consents were obtained from all patients. Exclusion criteria for the study group were: history of alcohol use, history having cardiovascular or cerebrovascular disease. Patients with end stage renal disease or on dialysis and with active hepatitis disease were also excluded from the study. Fasting Plasma Insulin Levels were measured as well as beta-cell function using HOMA-B. Fasting plasma insulin was considered within normal range if the value was <25mIU/L, above that was considered hyperinsulinemia. Statistical analysis was performed using SPSS for Windows 17.0 and Spearman’s correlation rank test. Result: A total of 206 subjects were enrolled, consisting of 144 (69.9%) males and 62 (30.1%) females. Mean laboratory result for fasting plasma insulin level was 13.7±4.1, while mean result for HOMA-B was 65.17±3.34. Fasting plasma insulin level is significantly correlated with HOMA-B (p < 0.05 95% CI), respectively. Conclusion: Fasting plasma insulin level was significantly correlated with beta cell function, however further study is needed to clarify