We will present the case of a 63-year-old male patient who underwent extensive neurological and cardiological treatment over a period of several years due to a history of unresolved syncopes. It was only after the installation of the loop recorder that the cardiologic etiology of the syncope was established in the form of a recorded pause of 70 seconds with rhythm disturbances in the form of non-sustained ventricular tachycardia. After an ICD device (implantable cardioverter defibrillator) was installed, the patient’s symptoms completely resolved.

The number of dengue fever incidents in 2020 was 111, a decrease compared to the year previously it was 45 Bandung City Health Profile in 2020, 176 per 100,000 population. Proportion type sex dengue fever cases in 2020 show that cases of dengue fever in men are more Lots compared to women. Type of research This that is a descriptive-analytic qualitative (exploratory study) using a cross-sectional design, Research was carried out in Bandung City, West Java Province. The sampling technique used is non-probability of use Purposive Sampling method where method uses criteria that have been chosen by the researcher in choose sample. The Chi-square test was obtained Where There is a significant relationship between knowledge cadre p-value of 0.070, giving counseling with a p-value of 0.006 with role cadre in give prevention of dengue fever. Related factors with activity prevention fever dengue bleeding is level knowledge cadres and activities counseling. second factor This has enough influence big on activities prevention fever dengue bleeding. Factors that don’t relate is inspection flick mosquito because society has capable of doing it yourself in the environment or each other’s house.

Scrub typhus is one of the endemic diseases leading to acute febrile illness in the topical countries. It can present with its various manifestations ranging from asymptomatic illness to serious multiorgan dysfunctions. The most common pathophysiology behind this multisystem manifestation is the systemic vasculitis due to exaggerated immune response. Early diagnosis and aggressive treatment along with close monitoring of vitals with best supportive measures may be the satisfactory response to the physician. Here, in this case series we are discussing five cases of scrub typhus presented with various atypical and uncommon manifestation HLH (Case 1), Encephalopathy, Pancytopenia, AKI, Intrahepatic cholestasis, Pancreatitis (Case 2), meningoencephalitis (Case 3), myocarditis (Case 4) and Leukemoid reaction, ALF (Case 5).

Background: Based on the result data release received on the official website of the Organizing Body Social Security on March 1, 2022 is available as many as 10,234 souls BPJS participants as user facility health the most that are (BPJS Health, 2022). Based on Perpres Number 12 of 2013 Article 21 states that, the First Level Health Facility (FKTP) is a service handling health stage beginning at the health center as the primary level in gift service health. In the Health Center JKN/BPJS system owns a sufficient role for all BPJS Health participants. Methods; Study This is a study descriptive analytic qualitative with an approach cross-sectional. The sampling technique purposive sampling is a sampling technique with certain considerations. Results; Education Variables with a p- p-value of 0.383 which means No There is no significant relationship and variables Type sex with an value p-value of 0.043 which means There is a meaningful relationship between type sex on satisfaction Health BPJS services. Conclusions; Conclusion from study This is an influential variable with Satisfaction patients with BPJS service is a type variable Sex.

According to data from the World Health Organization (WHO) diarrhea is a disease that affects 1.5 million children every year, which means almost all geographical regions in the world. Every year there are around 1.7 billion cases of diarrhea with a mortality rate of 760,000 children. Diarrheal disease is still one of the main problems in society which is very difficult to overcome. The purpose of this study was to determine the effect of counseling on diarrhea prevention on the knowledge of grade 3 and 4 students at Budi Sastra Elementary School. Research This type of research is Quantitative. Pre-experimental design With the One Group Pre-Post Test Design. The population in this study were grades 3 and 4 of SD Budi Sastra totaling 104 people. The samples taken amounted to 84 respondents with the Proportional Random Sampling technique. The research instrument used a video and a questionnaire with a total of 20 questions about knowledge which was tested for validity with results obtained at 0.138 and a reliability test with a value of 0.87. Univariate data analysis using the frequency distribution and bivariate analysis using the Wilcoxon Signed Rank Test. The results of the study showed that most of the respondents had a sufficient level of knowledge in the pre-test (55%) and in the post-test, most of the respondents had a good level of knowledge (70%). The results of the Wilcoxon Signed Rank Test obtained a significance value of P-value 0.000 <0.05, which means that there is an influence of counseling on prevention of diarrhea on the knowledge of grade 3 and 4 students. It is hoped that schools can work together with local health centers regarding diarrhea.

Background: The African leaf (Vernonia amygdalina Delile) is one of the plants used as a traditional medicine, one of which is anti-cancer. Aim: The study aims to identify compound groups, toxic effects and LC50 values of African leaf extracts with variations in the leaf fluid. Method: In this study, African leaves were extracted using a maseration method with three fluids namely n-hexane, ethyl acetate and 70% ethanol. The extract was qualitatively studied by the group of chemical compounds and toxicity tests were conducted using the method of Brine Shrimp Lethality Test. (BSLT). Result: The results of this study showed that n-hexane extract contains flavonoid and glycoside compounds. Ethyl acetate extract has a flavonoid compound, saponins and glucosides. The results of a linear regression analysis showed that 70% ethanol extract was an extract with the highest LC50value with a LC50 value of 31.80 ppm, an ethyl acetate extracts with LC50 values of 51.70 ppm and n-hexane extracts with LC50, with a 91.88 ppm value of LC50. Conclusion: This study showed that the three extracts included a strong toxic ketegori with a range of 0-100 ppm.

GIST – Gastrointestinal stromal tumor is the most common mesenchymal tumor of the gastrointestinal tract with an annual incidence of 11-20% per 1 million people. In GIT, the most common site of presentation is the stomach (70%) followed by the small intestine (20-30%), remaining (10%) in the colon, rectum, and oesophagus. GIST occurs due to mutations in the receptor tyrosine kinase KIT gene. Few cases have mutations in the PDGFRA gene. Here we report a rare case of Duodeno-Jejunal (DJ) flexure GIST with a history of pain in the abdomen and melena.

Objective: Uterine sarcomas are rare tumors arising from mesenchyme of uterus and th are diagnosed late because of confusing clinical and radiological presentation as urerine fibroids .In post hysterectomy pateints uterine sarcomas can present as pelvic or abdominal tumors causing confusion with tumors of bladder , bowel or other abdominal/pelvic malignancies. Histopathological examination and immuno histochemistry aids in diagnosis of uterine sarcoma and proper management of pateints. Hence 20 cases are studied in detail for better understanding of this rare entity. Methods: A retrospective study of 20 cases of uterine sarcoma was done. Details of patient are collected from departments of surgical oncology, medical oncology, pathology, radiology and outpatient records. Results: Uterine sarcomas are rare tumors and are usually diagnosed late. Most common types of uterine sarcoma are endometrial stromal sarcoma. leimyosarcoma, undifferentiated uterine sarcoma and adenosarcoma Abnormal uterine bleeding is the most common complaint and there are no specific complaints or radiological findings.Endometrial stromal sarcomas are known for their indolent course,in our study 6 pateints had hysterectomy in the past and years later presented as pelvic or abdominal masses causing diagnostic dilemma .Histopathology and immunohistochemistry aids in diagnosis and timely management of uterine sarcomas. Conclusion: In 20 cases of uterine sarcoma, patients presented with complaints of abnormal uterine bleeding, pain abdomen, mass per abdomen, hematuria and constipation, radiological findings revealed either fibroid uterus or degenerated fibroid or ovarian cyst or bladder tumor or bowel tumor or retroperitoneal tumor in none of the cases uterine sarcoma was in list of differential diagnosis. Diagnosis was made only after histopathological examination and immuno histochemistry. Cases of Uterine sarcomas diagnosed at early stage through proper suspicion for this rare tumor and confirmation with histopathology and immunohistochemistry have better survival and quality of life compared to cases which are mis managed. Hence study was done.

The study aimed at carrying out the inventory, distribution and analysis of healthcare facilities in Nasarawa state using remote sensing and geographic information system (GIS) techniques. Field mapping was conducted and coordinates with attributes of these healthcare facilities were recorded. GIS analysis using multiple ring buffer and cluster extension of the spatial analysis tool in ArcGIS 10.8 version was used. Result revealed a total of 1,119 healthcare facilities distributed across the state. Out of which 807 are government primary healthcare, while 227 are private primary and 24 government secondary whereas 60 are private secondary and one tertiary healthcare facility. Result also revealed significant disparities in the distribution of government tertiary healthcare facilities across the local government areas with only having such facility in the whole of Nasarawa State. This indicates limited access to specialized healthcare services. The general trend of health facilities in Nasarawa state is towards clustering because these facilities are intended to reside close to settlements and thus will present some degree of clustering though the level may differ between different types of facilities. The buffer analysis in secondary healthcare showed a wide number of settlements by local government that need more present of secondary healthcare facility in Nasarawa state showing good accessibility of health care facility to the settlement within 1 km and 10 km radius. The government own primary healthcare facilities record a z-score of -17.52725 and 0.677488 nearest neighbour ratio suggesting a very strong trend towards clustering, and from the analysis, there is a less than 1% chance of randomness or dispersion. This indicates that there is a lot needs to be done to ensure a more dispersed and competitive distribution of these facilities. The private primary healthcare facilities have a z-score of -18.527370 and nearest neighbour ratio of 0.357209, which shows very significant clustering alongside an identical 1% probability of random distribution. This clearly indicates that there is need for strategic planning and resource allocation to the health sector to ensure an equitable, dispersed and competitive distribution of these facilities. The findings from this study have implications for the actualization of the United Nations’ health-related Sustainable Development Goal (SDG-3) and also to achieve the Universal health coverage.

The global incidence and prevalence of type 2 diabetes mellitus has continued to increase over the past three decades and is expected to triple by 2030.1 Based on data from the World Health Organization (WHO), in 2021, 1.28 billion adults worldwide have hypertension.4 In relation to type 2 DM therapy, patient non-compliance in undergoing treatment can cause failure to control blood sugar levels and can cause cardiovascular complications.5 Objective: To determine the relationship between adherence to medication consumption in people with type 2 diabetes mellitus and the incidence of hypertension. Methods: This study used an analytical descriptive method with cross sectional design. Sampling used consecutive sampling techniques with the sample size obtained using the Slovin formula, where the population was 447, resulting in a total sample of 218 respondents who made the inclusion and exclusion criteria. Primary data was obtained from the Medication Adherence Rating Scale-10 (MARS-10) questionnaire which was filled in by the respondent and the respondent’s blood pressure was checked by automatic sphygmomanometer Kenz AC-05P. Data was analyzed using SPSS-25 software with the chi- square test. Results: From 218 respondents, 80 respondents were non-adherent in taking medication and suffered from hypertension (90.9%) and 8 respondents were non-adherent in taking medication and did not suffer from hypertension (9.1%). There were 29 respondents who adhered to taking medication and suffered from hypertension (22.3%) and 101 respondents who adhered to taking medication and did not suffer from hypertension (77.7%). These results obtained a p-value of 0.000 <0.05, which means there is a relationship between adherence to drug consumption in patients with type 2 diabetes mellitus and the incidence of hypertension. Conclusion: There is a relationship between adherence to drug consumption in patients with type 2 diabetes mellitus and the occurrence of hypertension at Puskesmas Sentosa Baru and Puskesmas Sering in Medan City.