FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN ISPA PADA BALITA DI SEKITAR WILAYAH TPA SAMPAH: Factors Associated with the Incidence of ARI in Toddlers Around Waste Disposal

Infeksi Saluran Pernapasan Akut (ISPA) merupakan penyebab utama tingkat kesakitan dan kematian akibat penyakit menular di dunia yang memiliki gejala seperti demam, batuk kurang dari dua minggu, pilek atau hidung tersumbat dan sakit tenggorokan. WHO menyatakan pada tahun 2016 insiden ISPA di negara berkembang sekitar 15%-20% kematian pada anak balita, pada tahun 2017 sekitar 24%-49% kematian dan tahun 2018 sekitar 21,7%- 40% kematian pada balita akibat ISPA. Penelitian ini bertujuan untuk mengetahui faktor yang berhubungan dengan kejadian ISPA pada balita di sekitar wilayah TPA sampah Antang Kota Makassar. Desain penelitian cross sectional. Besar sampel penelitian sebanyak 251 sampel. Penelitian berlangsung selama 1 bulan yaitu 6 Desember 2021-9 Januari 2022 di Kelurahan Tamangapa Kota Makassar, sekitar wilayah TPA sampah Antang. Instrumen penelitian yang digunakan adalah kuesioner penelitian. Teknik analisis data yang digunakan yaitu analisis univariat dan analisis bivariat menggunakan uji chi-square. Hasil peneltian ini menunjukkan bahwa BBLR (p=0,016), status imunisasi (p=0,031), dan kebiasaan merokok keluarga (p=0,001) memiliki hubungan dengan kejadian ISPA pada balita. Sedangkan jenis kelamin (p=0,648), pemberian ASI eksklusif (p=0,096), penggunaan obat anti nyamuk (p=0,169), pengeluaran rumah tangga (p=0,746), dan paparan bau sampah (p=0,068) menunjukkan tidak ada hubungan dengan kejadian ISPA pada balita. BBLR, status imunisasi, dan kebiasaan merokok keluarga memiliki hubungan dengan kejadian ISPA pada balita. Ibu sebaiknya melakukan pemeriksaan Antenatal Care (ANC) di fasilitas pelayanan kesehatan untuk meningkatkan kesehatan fisik dan mental ibu sehingga dapat melahirkan bayi dengan normal dan selalu memperhatikan kebutuhan-kebutuhan balita seperti rutin melakukan imunisasi dan menjauhkan dari asap rokok keluarga

A qualitative study on healthcare professionals’ perceived barriers to insulin initiation in a multi-ethnic population

Background: Nationwide surveys have shown that the prevalence of diabetes rates in Malaysia have almost doubled in the past ten years; yet diabetes control remains poor and insulin therapy is underutilized. This study aimed to explore healthcare professionals’ views on barriers to starting insulin therapy in people with type 2 diabetes. Methods: Healthcare professionals consisting of general practitioners (n = 11), family medicine specialists (n = 10), medical officers (n = 8), government policy makers (n = 4), diabetes educators (n = 3) and endocrinologists (n = 2) were interviewed. A semi-structured topic guide was used to guide the interviews by trained facilitators. The interviews were transcribed verbatim and analysed using a thematic analysis approach. Results: Insulin initiation was found to be affected by patient, healthcare professional and system factors. Patients’ barriers include culture-specific barriers such as the religious purity of insulin, preferred use of complementary medication and perceived lethality of insulin therapy. Healthcare professionals’ barriers include negative attitudes towards insulin therapy and the ‘legacy effect’ of old insulin guidelines; whilst system barriers highlight the lack of resources, language and communication challenges. Conclusions: Tackling the issue of insulin initiation should not only happen during clinical consultations. It requires health education to emphasise the progressive nature of diabetes and the eventuality of insulin therapy at early stage of the illness. Healthcare professionals should be trained how to initiate insulin and communicate effectively with patients from various cultural and religious backgrounds

Periodontal conditions, oral Candida albicans and salivary proteins in type 2 diabetic subjects with emphasis on gender

<p>Abstract</p> <p>Background</p> <p>The association between periodontal conditions, oral yeast colonisation and salivary proteins in subjects with type 2 diabetes (T2D) is not yet documented. The present study aimed to assess the relationship between these variables in type 2 diabetic subjects with reference to gender.</p> <p>Methods</p> <p>Fifty-eight type 2 diabetic subjects (23 males and 35 females) with random blood glucose level ≥ 11.1 mmol/L were investigated. Periodontal conditions (plaque index [PI], bleeding on probing [BOP], probing pocket depth [PD] (4 to 6 mm and ≥ 6 mm), oral yeasts, salivary immunoglobulin (Ig) A, IgG and total protein concentrations, and number of present teeth were determined.</p> <p>Results</p> <p>Periodontal conditions (PI [<it>p </it>< 0.00001], BOP [<it>p </it>< 0.01] and PD of 4 to 6 mm [<it>p </it>< 0.001], salivary IgG (μg)/mg protein (<it>p </it>< 0.001) and salivary total protein concentrations (<it>p </it>< 0.05) were higher in type 2 diabetic females with <it>Candida albicans </it>(<it>C. albicans</it>) colonisation compared to males in the same group. Type 2 diabetic females with <it>C. albicans </it>colonisation had more teeth compared to males in the same group (<it>p </it>< 0.0001).</p> <p>Conclusion</p> <p>Clinical and salivary parameters of periodontal inflammation (BOP and IgG (μg)/mg protein) were higher in type 2 diabetic females with oral <it>C. albicans </it>colonisation compared to males in the same group. Further studies are warranted to evaluate the association of gender with these variables in subjects with T2D.</p

Practical steps to improving the management of type 1 diabetes: recommendations from the Global Partnership for Effective Diabetes Management

The Diabetes Control and Complications Trial (DCCT) led to considerable improvements in the management of type 1 diabetes, with the wider adoption of intensive insulin therapy to reduce the risk of complications. However, a large gap between evidence and practice remains, as recently shown by the Pittsburgh Epidemiology of Diabetes Complications (EDC) study, in which 30-year rates of microvascular complications in the ‘real world’ EDC patients were twice that of DCCT patients who received intensive insulin therapy. This gap may be attributed to the many challenges that patients and practitioners face in the day-to-day management of the disease. These barriers include reaching glycaemic goals, overcoming the reality and fear of hypoglycaemia, and appropriate insulin therapy and dose adjustment. As practitioners, the question remains: how do we help patients with type 1 diabetes manage glycaemia while overcoming barriers? In this article, the Global Partnership for Effective Diabetes Management provides practical recommendations to help improve the care of patients with type 1 diabetes

Insulin resistance, lipotoxicity, type 2 diabetes and atherosclerosis: the missing links. The Claude Bernard Lecture 2009

Insulin resistance is a hallmark of type 2 diabetes mellitus and is associated with a metabolic and cardiovascular cluster of disorders (dyslipidaemia, hypertension, obesity [especially visceral], glucose intolerance, endothelial dysfunction), each of which is an independent risk factor for cardiovascular disease (CVD). Multiple prospective studies have documented an association between insulin resistance and accelerated CVD in patients with type 2 diabetes, as well as in non-diabetic individuals. The molecular causes of insulin resistance, i.e. impaired insulin signalling through the phosphoinositol-3 kinase pathway with intact signalling through the mitogen-activated protein kinase pathway, are responsible for the impairment in insulin-stimulated glucose metabolism and contribute to the accelerated rate of CVD in type 2 diabetes patients. The current epidemic of diabetes is being driven by the obesity epidemic, which represents a state of tissue fat overload. Accumulation of toxic lipid metabolites (fatty acyl CoA, diacylglycerol, ceramide) in muscle, liver, adipocytes, beta cells and arterial tissues contributes to insulin resistance, beta cell dysfunction and accelerated atherosclerosis, respectively, in type 2 diabetes. Treatment with thiazolidinediones mobilises fat out of tissues, leading to enhanced insulin sensitivity, improved beta cell function and decreased atherogenesis. Insulin resistance and lipotoxicity represent the missing links (beyond the classical cardiovascular risk factors) that help explain the accelerated rate of CVD in type 2 diabetic patients

Multicomponent cystals of selected Hydroxycinnamic Acids

Thesis (Master of Applied Sciences in Chemistry)--Cape Peninsula University of Technology, 2019.The solid-state modification of a given active pharmaceutical ingredient is a desired way to alter its physicochemical properties, such as solubility or bioavailability. Multicomponent crystals constructed with p-coumaric acid (pCA) and trans-ferulic acid (TFA) were investigated with the amines (2-amino-4-picoline (2A4MP), 2-amino-6-picoline (2A6MP), 4,4’-bipyridine (BIPY) and pyridine (PYR)) and 1,4-dioxane (DX). Eight compounds were prepared using the slow evaporation technique. pCA formed one co-crystal, two salts and two solvates while TFA formed a co-crystal, a salt and a solvate. The crystal structures were determined using single crystal Xray diffraction crystallography. Further characterisations were done using thermal analysis and FTIR spectroscopy. Z’ > 1 was observed for some of the crystal structures of pCA. The solvent assisted grinding method for preparation of these compounds was not successful as they all resulted in unknown compounds. The Hirshfeld analysis confirmed that the crystal structures generated in this study were dominated by hydrogen bonding (O-H•••O, O-H•••N and C-H•••O) and the π-π stacking had minimal contribution in the packing arrangement of the new solid forms