Efektifitas Perbandingan Buerger Allen Exercise dan Senam Kaki terhadap Nilai ABI pada Penderita DM Tipe II

The purpose of this study is to obtain a comparison of the effectiveness of the Buerger Allen Exercise and foot exercises on the value of the Ankle Brachial Index (ABI) in patients with Type II Diabetes Mellitus. This research method is a quantitative method with a research design Quasi Experiment pre and post test two groups. The results showed that there was a significant difference in the value of the Ankle Brachial Index (ABI) before and after being given Buerger Allen Exercise and foot exercises, namely p <0.05 with the difference in the average difference in the increase in ABI values in the Buerger Allen Exercise group of 0.0820, while in the leg exercise group, the difference in the average increase in the ABI value was 0.0726. In conclusion, Buerger Allen exercise is more effective than leg exercises in increasing the value of the Ankle Brachial Index (ABI).   Keywords: Ankle Brachial Index, Buerger Allen Exercise, Type II Diabetes Mellitus, Foot Exercis

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

PERBANDINGAN PENGARUH RANGE OF MOTION (ROM) UPPER EXTREMITY DENGAN CONSTRAINT INDUCED MOVEMENT THERAPY (CIMT) TERHADAP KEKUATAN MENGGENGGAM PADA PASIEN POST STROK DI RSI ASSYIFA KOTA SUKABUMI

ABSTRAKStrok merupakan gambaran perubahan neurologis yang disebabkan oleh adanya gangguan suplai darah ke bagiandari otak. Kondisi strok dapat menimbulkan defisit motorik yaitu kelemahan dari satu sisi bagian tubuh(hemiparesis). Penatalaksanaan gangguan tersebut salah satunya dengan pendekatan rehabilitasi melalui terapifisik dan okupasi dengan jenis Range of motion (ROM) dan Constraint induced movement therapy (CIMT) yangbertujuan memperbaiki kekuatan dan koordinasi otot terutama dalam meningkatkan kekuatan menggenggampasien. Tujuan dari penelitian ini untuk mengetahui perbedaan pengaruh ROM dan CIMT untuk meningkatkankekuatan menggenggam pada pasien post strok dengan hemiparesis. Desain penelitian ini adalah QuasiExperiment the randomized pretest – posttest design, using matched subjects posttest two grups dengan 18responden kelompok intervensi ROM dan 18 responden kelompok intervensi CIMT. Hasil penelitian adapengaruh ROM dan CIMT terhadap kekuatan menggenggam pada pasien post strok, ROM lebih baik disbandingCIMT. Saran : dapat diaplikasikan dalam praktek keperawatan dengan melakukan intervensi minimal 4 jamsehari bisa lebih dari 2x, lebih memperhatikan faktor-faktor perancu

LHFPL5 mutation: A rare cause of non-syndromic autosomal recessive hearing loss

Hearing loss is a debilitating disorder that impairs language acquisition, resulting in disability in children and potential isolation in adulthood. Its onset can have a genetic basis, though environmental factors, which are often preventable, can also cause the condition. The genetic forms are highly heterogeneous, and early detection is necessary to arrange appropriate patient support. Here we report the molecular basis of hereditary hearing loss in a consanguineous family with multiple affected members from Oman. Combining homozygosity mapping with whole exome sequencing identified a novel homozygous nucleotide substitution c.575T > C in the lipoma HMGIC fusion partner-like 5 gene (LHFPL5), that converted the 192nd amino acid residue in the protein from a leucine to a proline, p.(Leu192Pro). Sanger sequencing confirmed segregation with the disease phenotype as expected for a recessive condition and the variant was absent in 123,490 subjects from various disease-specific and population genetic studies as well as 150 unrelated individuals and 35 deaf patients of Omani ethnicity. This study, which describes a novel LHFPL5 mutation in a family of Omani origin with hereditary hearing loss, supports previous clinical descriptions of the condition and contributes to the genetic spectrum of mutations in this form of deafness