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Abstract : To determine whether tamsulosin monotherapy, or combined with flavoxate improves storage symptoms brought on by benign prostatic hyperplasia (BPH). At our teaching hospitals in Iraq, from July 2020 to July 2022, 164 patients older than 50 years with BPH who had persistent storage symptoms despite taking tamsulosin monotherapy were participated in the prospective study. The patients were divided into two groups at random: group A, which contains 82 patients who got flavoxate hydrochloride in addition to their daily dose of tamsulosin, and 82 individuals made up the second group, who additionally received placebo tablets in addition to their once daily tamsulosin dosage. Of the 164 patients who initially participated in the trial, 15 patients were eliminated due to noncompliance and missing follow-up, leaving 75 patients in group A and 74 patients in group B. Patients in groups A and B ranged in age from 52 to 78 and 54 to 77 respectively. The age and other fundamental features of the patients in the two study groups were matched and did not differ statistically (p value > 0.05). After 10 weeks of treatment, there were statistically significant improvement in group A's total IPSS, storage subscore, and quality of life (p value>0.05), with no significant improvement in voiding subscore and Q max. Tamsulosin monotherapy with the addition of flavoxate significantly reduced the persistence of storage symptoms in BPH patients.

Abstract : Tuberculosis remains an old contagious disease that still has an impact on humanity. Despite the development of new diagnostic tools and drugs, the annual tuberculosis death rate remains high. It is known that, statistically, around 5–10% of people infected by MTB will actually develop active TB, due to the balance of immune system between host and the mycobacterium. Nucleotide-binding oligomerization domain-containing protein 2 (NOD2) is part of the Pattern Recognition Receptors (PRR) which play the first role in recognizing invasion from MTB through NLRs (NOD-like Receptors). Specific role of NOD2 is the response to a fragment of the bacterial cell wall, muramyl dipeptide (MDP), and in turn activated NF-κB to release pro inflammatory cytokine e.g TNF-α. Several studies have reported on the activity of this NOD2 gene, but there are still not many that link it to the effect of treatment on pulmonary TB. This study was conducted to determine the expression of the NOD2 gene and the levels of the pro-inflammatory cytokine TNF-α in pulmonary TB patients before and after 2 months of treatment. This study was a cohort study that followed patients for two months of treatment. This study included 36 patients diagnosed as new cases of pulmonary tuberculosis, all of whom were over the age of 18 and willing to sign informed consent. TNF- levels were investigated using the ELISA method, and NOD2 gene expression was investigated using the PCR method. There was a tendency to decrease NOD2 gene expression and TNF-α levels after 2 months of treatment, although it was not statistically significant. NOD2 gene expression was found to be significantly higher after 2 months of treatment with TNF-α (p = 0.029). Changes in TNF-cytokine serum levels vary in this study, but tend to decrease after 2 months of ATT. This study also shows a decrease in NOD2 gene expression, and we discovered the possibility of TNF- against NOD2 gene regulation after 2 months of ATT.

Abstract : Atrial septal defect (ASD) is one of the three most common types of congenital heart disease (CHD) in children. With the development of transcatheter closure technology is widely used in clinical practice. It is necessary to assess the quality of life of CHD patients besides mortality and morbidity. The aim of this study is to determine the quality of life children with ASD before and after transcatheter closure of ASD. An one group pretest-posttest study in 36 childrens with ASD where the defect was closed by transcatheter at H. Adam Malik hospital Medan from March 2021 to December 2021 and assessed the quality of life of the subject before and after transcatheter closure of ASD. All components of quality of life showed a significant difference between before and after transcatheter closure of ASD (p<0.05). After transcatheter closure of ASD only two people (5.6%) still showed impaired quality of life. By using the Spearman correlation test, it was shown that the quality of life with the domain of school function had a significant correlation with the size of the septal defect diameter (p=0.006). The correlation value (r) obtained is -0.446, but not with other function domains. There is a strong correlation between the age of septal defect closure and quality of life. There was difference between the quality of life children with ASD before and after transcatheter closure of ASD.

Abstract : Ventilator associated pneumonia (VAP) is pneumonia in mechanically ventilated patients that develops at 48 hours or later after the patient on mechanical ventilation. Ventilator associated pneumonia is the second most common cause of nosocomial infections (20% of nosocomial infections) in the neonatal intensive care unit (NICU). To investigate risk factors, causative bacteria, and outcome of VAP in the neonatal intensive care unit (NICU). The research was conducted from March 2022 to June 2022 with a cross-sectional design in the NICU of Prof. RSUP. R. D. Kandou Manado. Causative bacteria were isolated from endotracheal tube (ETT) Data were analyzed using logistic regression with significance of p<0.05. Of the 50 subjects, 34 neonates (68.0%) were diagnosed with VAP. The mortality rate in the VAP group was 36.4% and the non-VAP group was 35.3%. There was no relationship between sex, duration of mechanical ventilation and duration of stay in the NICU on the incidence of VAP in neonates. Whereas, age, gestational age and birth weight associated with the incidence of VAP in neonates. The median (IQR) of age in the VAP group was 5(1.7-7.2) and 2(0-3) in the non-VAP group with a p of 0.003. The median (IQR) of gestational age in the VAP group was 35.5 (32-38) and 38(37-38) in the nno-VAP group with a p of 0.05. Birth weight <2500 gr was associated with the incidence of VAP in neonates with a p of 0.001. The most common type of bacteria found was Klebsiella Pneumoniae sp. with a proportion of 26.4% and Acinetobacter Baumannii with a proportion of 23.5%. VAP causes a high rate of neonatal mortality. Age, gestational age, and birth weight are associated with the incidence of VAP in neonates. The most common bacteria that cause VAP are Klebsiella Pneumoniae sp and Acinetobacter Baumannii.

Abstract : Non-Communicable Diseases (NCDs) are the leading cause of death for 36 million (63%) of all deaths worldwide. About 29 million (80%) occur in developing countries. The increasing prevalence of Non-Communicable Diseases cannot be separated from the risk factors that are not avoided by the Indonesian people which began to occur during adolescence. Jika teenagers never do physical activity and regulate diet, they will be at risk of developing Non-Communicable Diseases such as Obesity and diabetes mellitus. The purpose of this study was to identify behavioral factors to prevent the risk of non-communicable diseases of DKI Jakarta High School students. The type of quantitative research used is using a quasi-experimental method with a non-equivalent control group pretest and posttest design. The total sample of 220 students in four DKI Jakarta schools. Sampling carried out by Purposive Sampling. The test used is chi Square with univariate, bivariate and multivariate data analysis. The intervention carried out by providing modules and Application, School-based PTM Posbindu can improve Student PTM Risk Prevention Behavior. School-based PTM Posbindu Application improves Student Non-Communicable Disease Risk Prevention Behavior. Dietary attitudes, physical activity attitudes and student self-efficacy influence the prevention behavior of the risk of Non-Communicable Diseases. The most dominant variable influencing Non-Communicable Disease risk prevention behavior is the student's dietary attitude. It is necessary to further develop the Posbindu model that already exists in the school setting to improve the Risk Prevention Behavior of PTM student.