BACKGROUND: The purpose of this study is to compare the duration of sensory and motor block in elective lower limb and abdominal procedures following intrathecal administration of bupivacaine along with adjuvants either clonidine or dexmedetomidine. METHODS: A prospective randomised double blinded study. 120 study participants were randomly allocated to three groups-Group A was given 12.5 mg of hyperbaric bupivacaine, Group B was given 3 mcg dexmedetomidine along with 12.5 mg hyperbaric bupivacaine and Group C was given 30 mcg of clonidine along with hyperbaric bupivacaine. The duration of sensory and motor block was recorded. RESULTS: Group B and C study participants showed significantly longer duration of sensory and motor block when compared to Group A. The mean duration of sensory block in Group A was 92.5 minutes, Group B 124.5 minutes Group C (119.4 minutes) (A vs B, A vs C p<0.001). The mean duration of motor block in group A 149.1 min, group B 252.5 min, Group C 217 min (A vs B, A vs C, B vs C P<0.001) CONCLUSION: By adding 3 mcg dexmedetomidine or 30 mcg clonidine to hyperbaric bupivacaine duration of sensory and motor block was significantly prolonged.

There is an urgent need for new supportive treatment options against infectious viral diseases, given the rapid spread and huge number of individuals affected worldwide by these diseases, so cost-effective, globally available and safe options with minimal side effects and simple application are highly assured. This study will therefore discuss the potential of vitamin D supplementation as a preventive and therapeutic agent in combination with other strategies, as this vitamin meets all the criteria described above. A variety of data are available on the association of vitamin D with respiratory infections and viral infections, as well as on the immune response by supplementation with this vitamin.Vitamin D deficiency adds to the variables that make people more susceptible to infection and the damaging development of COVID-19, as there is a correlation between its levels in the body and the severity of COVID-19 infections. Due to its direct antiviral and anti-inflammatory properties, it can be assumed that maintaining it within normal levels in the body is necessary to maintain the health of the body, and when its level in the body is below the optimal level, this can be compensated for with vitamin D supplements.

Type 2 diabetes mellitus (T2DM) is a global health issue that affect around 643 million people in 2030. Estimated prevalence of T2DM in adults aged 20–79 years has more than tripled, from an estimated 151 million (4.6% of the global population at the time) to 537 million (10.5%) today. This study analyze direct medical costs of insulin treatment with in T2DM outpatients. This retrospective descriptive economic evaluation was conducted in April 2023 on the basis of payer (called as Badan Penyelenggara Jaminan Sosial abbreviated as BPJS) perspective, then only direct costs were included in this study. Component of direct medical cost of this research include drug acquisition costs, physician service, laboratory examination, medical execution and administration. 58 T2DM outpatients met inclusion criteria in Universitas Sumatera Utara was recruited by simple random sampling. Result of this study show that most of respondent were aged 56-65 years (58.89%). Cost/year/patient of drug acquisition costs was Rp.4,7228,970.14; physician service was Rp.1,865,172.41; laboratory examination was Rp.443,379.31; and medical execution was Rp.31,030.48 and administration was Rp.300,000.00, respectively. Drug acquisition costs was the largest cost in treating T2DM patients with insulin treatment.

Background: There are several efforts to address impacted teeth, one of which is through a minor surgical intervention called Odontectomy. There are also several complications that may arise after Odontectomy is performed, but this usually only occurs for a few days, and patients will experience a more comfortable feeling compared to before the Odontectomy. This research aims to analyze the difference in the quality of life of patients before and after the Odontectomy surgical procedure. Material and Methods: The method employed in this research was analytical observational, using a Cross-Sectional design. The sampling technique used was Accidental sampling, which involved patients who underwent Odontectomy at Bhayangkara Hospital Semarang Indonesia in October 2023. The total sample size was 10 patients based on inclusion criteria. The research was conducted using the OHIP-14 (Oral Health Impact Profile 14) questionnaire, consisting of 14 questions from 7 dimensions. Data analysis was performed using the Wilcoxon test because the data scale was ordinal. Results: The results of this study indicated that before undergoing Odontectomy, the quality of life of patients at a moderate level was 3 individuals (30%), while those at a low level were 7 individuals (70%). After Odontectomy was performed, the quality of life of patients improved, with 1 individual (10%) at a moderate level, 9 individuals (90%) at a good level, and 1 individual (10%) at a very good level. The statistical analysis results showed that the significance value (P) was 0.005, indicating that p < 0.05. Conclusion: The conclusion that can be drawn from this research is that there was a significant difference in the quality of life of patients before and after undergoing the Odontectomy procedure.

Objective: The project aimed to call to mind the exploration of health management and information systems among healthcare workers at Kenyatta National Hospital, Kenya. Design setting: The investigation deployed a cross-sectional study. Subjects or participants: A sample total of 263 respondents was calculated using the Krecie and Morgan formula for the quantitative study. A strict inclusion criterion was followed to select the respondents from all trained health personnel in Kenyatta National Hospital. The study utilized an interview schedule. Data were analyzed using SPSS version 21 while qualitative data was analyzed on themes developed. Data presentation was in the form of quantitative statistics such as frequency distribution, percentages and tables. Qualitative results were presented in verbatim form. Results: A total of 263 respondents were engaged in the quantitative study. The study utilized a questionnaire and a key informant interview guide. Before processing quantitative data, data was cleaned, coded and keyed into MS Excel database computer and analyzed using SPSS version 21. Descriptive statistics were used to describe measures of central tendency and dispersion. Findings were presented using frequency distributions and summary tables. Associations between predictor and outcome variables were run through Correlational statistics. Of the 263 respondents, 193 (72.6%) were optimistic that HMIS had brought about better up-dating and expertise in healthcare service delivery and 40(15%) were neutral while, 33(12.4%) were pessimistic about the concept. A weak positive correlation (r = 0.3345, p =0.03) between self-confidence in productivity and HMIS implementation was observed. Conclusion: The KNH management needs to ensure that there is system thinking, where each staff is not only motivated but also feels part and parcel of a robust and cohesive HIMS process

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T2DM is a chronic disease characterized by high blood glucose levels due to insulin resistance or insufficient insulin production. Aim of this study was to analyze the direct medical costs of outpatient T2DM management with cardiovascular disease complications. 58 T2DM patients at the Universitas Sumatera Utara Hospital, in Sumatera Utara, Indonesia were recruited in this study in April-May 2023. This study analyze based on payer prespective named as Badan Penyelenggara Jaminan Sosial (BPJS). This quantitative research was carried out by collecting data retrospectively. Result of this study show that phycian service IDR 8,715,000, drug acquisition cost IDR 13,081,242, laboratory examination IDR 2,531,000, medical execution IDR 410,000, and administration IDR 1,425,000. Conclusion of this study, that drug acquisition cost was the highest cost IDR 13,081,242.

(IBS) or Irritable bowel syndrome is a complicated health condition with different causative factors, including inflammation and infection, that have recently acquired as significant triggers of IBS. Inflammatory response might serve as a critical pathway in the progression of IBS, beside inequality in cytokines within the plasma and/or intestinal mucosal lining. Many biomarkers have been associated to possible mechanisms underlying IBS and are used to make differentiation between IBS and non-IBS subjects. Incorporation of these biomarkers into routine clinical work is important for fast and accurate diagnosis and effective treatment. Because IBS patients often experience ambiguous and overlapping symptoms, the creation of precise biomarkers for IBS could significantly enhance both diagnosis and patient care. This review examines the cytokines used in the diagnosis and treatment of IBS, Classifying these cytokines as either pro-inflammatory or anti-inflammatory and understanding their involvement in the development of irritable bowel syndrome.

Disasters, whether natural or human-made, can have profound and lasting impacts on individuals’ mental health and well-being. In recent years, there has been increasing recognition of the importance of addressing psychological impact of disasters and incorporating psychological first aid (PFA) in disaster preparedness policies and plans. This research paper explores the opportunities and challenges associated with integrating PFA into community disaster preparedness plans. Drawing on a review of existing literature, this paper examines the theoretical underpinnings of PFA, its core principles and components, and its effectiveness in promoting psychological resilience and recovery following disasters. Additionally, this paper explores the practical considerations and logistical challenges involved in implementing PFA within the context of community disaster preparedness, including issues related to training, resource allocation, coordination with existing emergency response systems, and cultural sensitivity. Through a comprehensive analysis of the opportunities and challenges associated with integrating PFA into community disaster preparedness plans, this paper aims to inform policymakers, emergency responders, and mental health professionals about the importance of prioritizing psychological support in disaster preparedness efforts and offers recommendations for enhancing the effectiveness and sustainability of PFA initiatives at the community level.

The Effect of Varying Concentrations and Soaking Time of Moringa Oleifera Leaf Extract on the Bioavailability of Nutritional Content and Antioxidant Response of Breadfruit Flour (Artocarpus Communis) as Raw Material for Making MP-ASI Biscuits. The first 2 years are characterized by very rapid physical and social development and growth which is influenced by food and nutritional intake. The aim is to analyze the effect of variations in concentration and soaking time of Moringa leaf extract on the bioavailability of nutritional content in making MP-ASI biscuits. The research used a multi-factor Completely Randomized Design (CRD). Factor x variation of Moringa leaf extract concentration 0%; 10%; 20% and 30% and the y factor is the soaking time for 6 hours; 12 hours and 18 hours, each treatment was repeated 3 times. Data Analysis Using Analysis of Variance (ANOVA). significant differences in treatment in DMRT analysis. The research results show that the treatment with a concentration of Moringa leaf extract of 30% with a soaking time of 18 hours because the average shows an increase in the antioxidant response and good nutritional content, the antioxidant response is 77.51 ppm (strong), vitamin A 356.08 µg/100, iron (Fe) 9.03 mgFe/ 100. For protein, carbohydrates, fat, water and ash, the best results were obtained from a combination treatment of 30% Moringa leaf extract with a soaking time of 6 hours, namely, 10.13% protein, 41.43% carbohydrates, 8.71% fat, 4.95% water and 1.64% ash. There is an influence of variations in concentration and soaking time on the response of antioxidants, protein, carbohydrates, fat, in MP-ASI biscuits as shown by the ? value 0.000 < a 0.05.

Introduction: The mother’s role is crucial in shaping a child’s behavior, providing guidance, understanding, reminders, and facilitation in maintaining oral hygiene. The aim of this study was to determine the relationship between the mother’s role in dental care and the status of oral hygiene in children in Peuniti Village, Banda Aceh Materials & Methods: This research adopted an analytical approach with a cross-sectional design. The research sample consisted of 40 children aged 3-12 years and their mothers as respondents, selected using cluster sampling method from those who had resided in Peuniti village for at least one year. The research instruments included questionnaires, diagnostic sets, the PHP-M index, disclosing agents, and patient status cards (KSP). Results: The study was conducted in January 2024, and statistical analysis was performed using the SPSS software with a chi-square test (a=0.05). The results indicated a significant relationship between the mother’s role as an educator (p=0.018), motivator (p=0.016), and facilitator (p=0.015) in dental care and the status of oral hygiene in children in Peuniti Village, Banda Aceh City Conclusion: there is a correlation between the mother’s role as an educator, motivator, and facilitator in dental care and the status of oral hygiene in children in Peuniti Village, Banda Aceh City.

The level of adequate nutrition and iron availability in pregnant women can cause anemia, and inadequate food intake during pregnancy can affect Hb levels. The research formulation is about the incidence of anemia in pregnant women and whether there is a relationship between the level of adequate nutrition of energy, protein, vitamin A, vitamin C, iron, and bioavailability and the incidence of anemia in pregnant women. This research aims to analyze the level of adequacy and bioavailability of iron with the incidence of anemia in pregnant women. This type of observational research uses a cross-sectional design. This research was carried out at 10 Community Health Centers in Gorontalo City. The sample in this study consisted of 165 pregnant women using cluster random sampling techniques with bivariate analysis using the Chi-square test and multivariate analysis using the multinominal logistic regression test. The results of data analysis on the prevalence of anemia in pregnant women were 52.7%. The relationship between the level of nutritional adequacy and the incidence of anemia in pregnant women is energy ( P value = 0.029 = a = 0.05), protein (P value = 0.045 = a = 0.05), vitamin A ( P value = 0.108 = a = 0 .05), vitamin C ( P value = 0.003 = a = 0.05), Iron ( P value = 0.004 = a = 0.05), bioavailability ( P value = 0.016 = a = 0.05). There is a relationship between adequate levels of the nutrients energy, protein, vitamin C, iron, and iron bioavailability with the incidence of anemia in pregnant women, and there is no relationship between adequate levels of the nutrient vitamin A and the incidence of anemia in pregnant women. Pregnant women increase their need for good nutrition during pregnancy to prevent anemia.

Introduction: The mother’s role is crucial in shaping a child’s behavior, providing guidance, understanding, reminders, and facilitation in maintaining oral hygiene. The aim of this study was to determine the relationship between the mother’s role in dental care and the status of oral hygiene in children in Peuniti Village, Banda Aceh Materials & Methods: This research adopted an analytical approach with a cross-sectional design. The research sample consisted of 40 children aged 3-12 years and their mothers as respondents, selected using cluster sampling method from those who had resided in Peuniti village for at least one year. The research instruments included questionnaires, diagnostic sets, the PHP-M index, disclosing agents, and patient status cards (KSP). Results: The study was conducted in January 2024, and statistical analysis was performed using the SPSS software with a chi-square test (a=0.05). The results indicated a significant relationship between the mother’s role as an educator (p=0.018), motivator (p=0.016), and facilitator (p=0.015) in dental care and the status of oral hygiene in children in Peuniti Village, Banda Aceh City Conclusion: there is a correlation between the mother’s role as an educator, motivator, and facilitator in dental care and the status of oral hygiene in children in Peuniti Village, Banda Aceh City.

The term acute coronary syndrome represents a group of signs and symptoms in a patient who exhibits clinical and/or laboratory evidence of the occurrence of acute myocardial ischemia. This concept encompasses acute myocardial infarction, which represents the most important cause of death in Brazil and the world. Pituitary adenomas, in turn, are benign tumors, and are among the most common intracranial tumors, corresponding to 9 to 15% of intracranial tumors detected in autopsy series, and in radiological series, they can reach up to 22 to 23%. of cases. This study is a case report of the simultaneous occurrence of an acute myocardial infarction and an acute compressive neurological syndrome, due to pituitary adenoma, both serious, and the challenges encountered in making medical decisions regarding treatment priority. In daily practice, differentiating between urgency and emergency can be complex. In the case in question, although neurological compression implied the risk of irreversible vision loss, the team decided to prioritize the cardiac approach, to the detriment of the immediate attempt to preserve vision. The decision considered the imminent risk of death due to hemodynamic instability due to any decompensation during the neurological procedure.