Penerapan Sistem Monitoring Terapi Arv(antiretroviral) dengan Metode Client Server Berbasis Smartphone pada Rsup Dr. Sardjito

AIDS (Acquired Immune Deficiency Syndrome) adalah salah satu penyakit yang menyita perhatian yang besar dalam dunia medis. AIDS merupakan suatu penyakit yang berupa sekumpulan gejala dan infeksi atau sindrom yang ditimbulkan oleh rusaknya sistem kekebalan tubuh manusia akibat infeksi virus HIV (Human Immunodeficiency Virus). Penangan penyakit AIDS dalam dunia medis adalah dengan terapi pengobatan ARV. Dalam menjalankan terapi ARV harus meminum obat harus disiplin ketat dan terus menerus seumur hidup ODHA(Orang Dengan HIV / AIDS) untuk menghambat replikasi virus HIV, namun dalam Kenyataanya banyak pasien penyakit AIDS yang tidak mendapatkan hasil yang optimal dalam menalankan terapi HIV, karena kurangnya tingkat kepatuhan pasien dalam mengkonsumsi obat dalam menjalani terapi ARV. Subjek yang menjadi penelitian ini adalah penerapan sistem monitoring untuk pemantauan pelaksanaan terapi pengobatan ARV. Metode penelitian yang digunakan dengan studi pustaka dan wawancara dengan petugas klinik pengobatan HIV/AIDS. Tahap analisis dilakukan untuk menentukan spesifikasi sistem monitoring agar sesuai dengan kebutuhan. Tahap analisis meliputi perancangan sistem, perancangan database dan perancangan antarmuka. Metode yang digunakan pada tahap implementasi adalah client server, dimana aplikasi server dikembangkan menggunakan PHP dengan Framework Codeigniter, sedangkan aplikasi client menggunakan bahasa pemrograman JAVA untuk mengembangankan aplikasi berbasis smartphone Android. Sistem yang dihasilkan diuji dengan dua metode yaitu Black Box Test dan Alfa Test.Hasil dari penelitian ini adalah sebuah sistem monitoring yang terdiri dari aplikasi server berbasis web dan aplikasi client berbasis Android yang dapat membantu proses pemantauan kepatuhan dan pemantauan pekembangan CD4 pasien HIV/AIDS ARV untuk mensukseskan pelaksanaan terapi ARV

Risk Factors of Diarrhoea in Malnourished Children Under Age of 5 Years

Background: Acute infectious enteritis remains one of the commonest causes of death among infants and children in developing countries. Acute enteritis is defined as a loss of stool consistency with pasty or liquid stools, and/or an increase in stool frequency to more than three stools in 24 hours with or without fever or vomiting. Human survival depends on the secretion and reabsorption of fluid and electrolytes in the intestinal tract. The objective of the study is to evaluate the risk factors of diarrhoea in children under age of 5 years. Methodology: It was an observational study. Study was completed in about six months. Non-probability purposive sampling technique was used. In this study, 270 samples were taken from Diarrheal ward of The Children Hospital Lahore, Pakistan. Results: In this study, out of 270 patients, 58.52% were males and 41.48% were females. 90.37% patients were vaccinated. 54.81% had weaning history. 91.85% patients had feeding history. 29.26% had blood in stool. 96.67% patients were dehydrated. 95.56% patients had loose watery diarrhoea. 62.96% patients used boiled water. 58.52% patients consumed less than half litre of water, 30.00% patients consumed 1 litre of water and 11.48% patients consumed > 1 litre of water. 49.18% patients had proper hygiene. 38.15% mothers of patients were well educated. 40.37% patients had model household condition. 57.41% patients lived in rural area and 42.59% patients lived in urban area. Conclusion: The variation in the level of diarrheal morbidity was well explained by maternal education, income, personal hygiene, refuse disposal system and the effect of health extension programme

Prevalence and patterns of physical activity among school aged adolescents in Pakistan: A systematic review and meta-analysis

Less than one fifth of Pakistani adolescents, aged 13–15, years achieve recommended activity levels. This systematic review and meta-analysis was conducted to determine a pooled estimate of the prevalence of PA, and to systematically evaluate the literature available on PA among adolescents in Pakistan. A systemic search of databases was conducted. In addition, hand search of references of all the included relevant publications was performed. Random effects meta-analysis was used to get weighted prevalence of PA among adolescents. Quality of undertaken studies was assessed using New-Castle Ottawa Scale. After removing duplicates, reviewing titles and abstracts and screening full texts, 15 articles were included for analysis. All studies were conducted in school setting, with a total sample size of 10,651. Weighted pooled prevalence of PA among adolescents was 36.0% with high heterogeneity (99.28%). Most of the studies met study quality assessment criteria except for comparability of subjects in different outcome groups and assessment of outcome. Prevalence of PA among adolescents is low in Pakistan. Formal strategies are needed for promoting PA among adolescents for their improved health and for reducing future burden of NCDs

Frequency of Predisposing Factor of Nausea and Vomiting After Chest Surgery Under General Anaesthesia

Background: Postoperative nausea and vomiting are common and distressing postsurgical symptoms. These symptoms are of particular concern in outpatient surgery because they may require additional direct resources, such as supplies and antiemetic drugs, and may delay discharge. The objective of this study was to measure the frequency of factors which can cause nausea and vomiting under general anaesthesia after chest surgery. Methodology: This descriptive case series evaluated frequency of predisposing factor of nausea and vomiting in patients of anaesthesia department of Gulab Devi Hospital Lahore. Questionnaire is made and patients were asked about their age, fever, previous surgery, NPO status, smoking history and hospital stay. This study included 140 patients with post-operative nausea and vomiting. Results: In this study, 140 patients were taken in which  65 (46.43%) were female and 75 (53.57%) were male. In 140 patient 134 (95.7%) were NPO and 6 (4.3%) were not  NPO, 25 (17.9%) were obese and 115 (82.1%) were not obese, 88 (62.9%) patients were suffering fever and 52 (37.1%) were not suffering fever, 80 (57.1%) were infected and 59 (42.1%) were not infected, 53 (37.9%) patients had previous surgery and 87 (62.1%) had no previous surgery, 94 (67.1%) patients had received nitrous oxide and 46 (32.9%) didn\u27t, 97 (69.3%) received volatile gases and 43 (30.7%) not received, 29 (20.7%) received ketamine and 111 (79.3%) not received, 87 (62.1%) received suxamethonium and 53 (37.9%) not received, 119 (85.0%) received propofol and 21 (15.0%) not received, 110 (78.6%) received naluphine and 28 (20.0%) not received. Out of 140 patients, there were 122 (87.1%) who were suffering from pain and 18 (12.9%) were not. 91 (65.0%) patients had gastric distention and 49 (35.0%) patients didn\u27t. Opioids were given to 34 (24.3%) patients and not given to 106 (75.7%) patient. Conclusion: It is concluded that the nausea and vomiting after surgey under genral anesthesia is due to patient related factors in which most frequent is NPO. Drug related factors include propofol and nalbupin administration. Post operative factors include pain. In whole study of 140 patients, the  most frequent is patient related factor (NPO) other than drug related factors and post-operative factors

Strategi Kampanye Sudrajat-syaikhu Mendapat Dukungan Masa Populisme Islam dalam Pilgub Jawa Barat 2018

Populisme Islam telah menjadi diskusi hangat di Indonesia pasca munculnya Fenomena Ahok dalam Pilkada DKI Jakarta 2017. Pada waktu itu, masa populisme Islam yang kecewa terhadap sistem karena telah melahirkan kesenjangan melampiaskan kekecewaannya pada serangkaian Aksi Bela Islam I, II, dan III. Fenomena gerakan populisme Islam tidak hanya terjadi di Jakarta, diskusi populisme Islam juga berkembang dalam konstestasi Pemilihan Gubernur Jawa Barat 2018. Salah satu pasangan calon yang disinyalir memanfaatkan gelombang populisme Islam ini adalah Sudrajat dan Ahmad Syaikhu (Asyik). Pasangan yang diusung oleh Gerindra dan PKS ini diuntungkan untuk mendapat suara masa populisme Islam karena partai pengusung pasangan Asyik adalah partai yang mendapat citra sebagai partai pro umat Islam. Namun sayangnya keuntungan ini belum terkonsolidasi secara masif. Ujaran tagar 2019 Ganti Presiden yang dibawa oleh pasangan Asyik dalam debat kedua Pilgub Jabar diyakini sebagai salah satu upaya untuk mengkonsolidasikan dukungan masa populisme Islam. Pada tulisan ini akan dianalisis bagaimana strategi pasangan Asyik untuk mengkonsolidasikan dukungan dari masa populisme Islam yang sebelumnya dalam kasus Pilkada DKI Jakarta, masa populisme Islam berada dalam barisan Gerindra dan PKS sebagai oposisi penguasa

Measurement of the spin temperature of optically cooled nuclei and GaAs hyperfine constants in GaAs/AlGaAs quantum dots

Deep cooling of electron and nuclear spins is equivalent to achieving polarization degrees close to 100% and is a key requirement in solid state quantum information technologies. While polarization of individual nuclear spins in diamond and SiC reaches 99% and beyond, it has been limited to 60-65% for the nuclei in quantum dots. Theoretical models have attributed this limit to formation of coherent "dark" nuclear spin states but experimental verification is lacking, especially due to the poor accuracy of polarization degree measurements. Here we measure the nuclear polarization in GaAs/AlGaAs quantum dots with high accuracy using a new approach enabled by manipulation of the nuclear spin states with radiofrequency pulses. Polarizations up to 80% are observed - the highest reported so far for optical cooling in quantum dots. This value is still not limited by nuclear coherence effects. Instead we find that optically cooled nuclei are well described within a classical spin temperature framework. Our findings unlock a route for further progress towards quantum dot electron spin qubits where deep cooling of the mesoscopic nuclear spin ensemble is used to achieve long qubit coherence. Moreover, GaAs hyperfine material constants are measured here experimentally for the first time

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. Methods We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. Findings Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. Interpretation As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed. Funding Bill & Melinda Gates Foundation

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed