Search Results

Abstract : Klebsiella pneumoniae infections are challenging to treat because the high prevalence of klebsiella pneumoniae resistance, which restricts the selection of medications for this illness therapy. This research aims to analyze the risk factors and how they relate to the prevalence of carbapenem antibiotic resistance in infections caused by the Klebsiella pneumoniae. This is an analytic observational research with a cross-sectional design and was carried out at H.Adam Malik Hospital, Medan, Indonesia. The frequency distribution of the demographic data was determined using descriptive statistical analysis. After that, an inferential analysis using Chi Square test was carried out to examine the correlation of the data on a categorical scale. If the bivariate test yielded a p value < 0.25, a multivariate logistic regression test would be conducted. With a p value of ≤0.001 (p <0.05), there was a link between a prior hospitalization history and carbapenem resistance. The patient was 14,840 times more likely to develop carbapenem resistance (95% CI: 1,945-113,327) if they had a history of being hospitalized within the previous three months. Among others, the most significant factor influencing Klebsiella pneumoniae resistance is a prior hospitalization history.

Abstract : The waste sector (solid waste, domestic wastewater, and industrial wastewater) in Palembang City, which is one of the big cities in Indonesia, is still a serious problem. The high rate of waste accumulation and the composition of the waste have an effect on greenhouse gas emissions which can have an impact on health. A descriptive and analytic observational study was conducted to examine the impact of generation rate and composition on GKR emission estimates and public health. The results showed that the waste generation rate in Palembang City in 2022 was 0.72 kg/person/day, there was an increase in the volume of waste from 2010 to 2019. The highest composition of household waste was in the form of organic matter, namely food waste, which increased from 2019 until 2021, namely 51.20%, 55.00% and 56.90%. The estimated result of GHG emissions = 10,680,215.78 kg CH4/year, if this condition is allowed to continue to increase. The high emission of GKR has an impact on public health, which is dangerous for people with asthma, damages lung tissue, respiratory disorders, stroke, ischemic heart disease, chronic obstructive pulmonary disease (COPD) and lung cancer and can even cause death.

Abstract : Primary care physicians’’ ability to identify the high-risk elderly can help reduce the burden of falls among elderly. This study aimed to assess the knowledge and practice of falls among elderly in Qassim, Saudi Arabia. A cross sectional study was conducted among primary health care physicians. Data were collected using a semi-structured questionnaire. Questionnaire assesses the level of knowledge and practices regarding falls among elderly. A total of 97 participants were included in the study. Mean age was 29.0 years (SD = 3.26). Majority (91.8%) were Saudi nationals. Regarding the knowledge about risk factors, 34.0% of the participants did not identify any risk factors. The most often mentioned risk factors were environmental factors (30.0%). Thirty-nine percent of individuals did not name any preventive. On a scale from 1 to 10, the participants' self-rated knowledge score had a mean of 4.73 (SD = 2.01). Only 19.6% of the participants used the MORSE Fall Assessment instrument. About 15.5% of respondents said they almost never or never inquire about a history of falls. Practice of offering intervention to address fall risk factors, 25.8% said they never or nearly never did so, while 48.5% said they did it occasionally. These findings can be used to guide interventions and training initiatives that aim to improve primary care physicians' skill sets in preventing falls among the elderly. Further research is also needed to assess the effectiveness of physicians training programs.

Abstract : A pelvic fracture involves damage to the hip bones, sacrum, or coccyx - the bony structures forming the pelvic ring. Fracture of the pelvis occurs most commonly in the setting of a high-impact trauma and are often associated with additional fractures or injuries elsewhere in the body. This fracture has several complications. No literature systematically gives data about complications of pelvic fracture. This article attempts to encompass all available data to provide us with awareness about the intricacy of this injury. An extensive literature review was conducted on PubMed/Medline, Cochrane, and Science Direct databases with the eligibility criteria of 1) Retrospective study, observational study, or case report study. 2) Full article available for the last ten years. 3) Article in English. The search was done under PRISMA guidelines and gradually filtered down to relevant articles, which were 16 in number. There are several complications of pelvic fracture, with incidence varying in the literature. We divide the complications after pelvic fracture into three groups: early, intraoperative, and post-operative. Early complications are shock due to vascular injury, nerve injury, and urogenital injury. Intraoperative complications include lateral femoral cutaneous nerve (LFCN) damage, femoral nerve injury, mal-reduction, screw malposition, and vascular injury. Post-operative complications are chronic pelvis pain, surgical site infection, pneumonia, urinary tract infection (UTI), decreased sexual function, thromboembolic accident, pressure ulcer, and fixation failure. Pelvic fracture surgery has several complications. Complications divide into early, intraoperative, and post-operative complications. Awareness of complications is essential for the comprehensive management of pelvic fractures.

Abstract : Managing oronasal fistulae presents challenges for both patients and surgeons, with variations in defect size and surgical approaches. Fistulae are classified based on size and location, and the anteriorly based lingual flap is a preferred choice due to patient acceptance and adequate blood supply to the tongue. Ensuring flap stability is crucial for successful fistula closure. Various methods, such as suturing, splints, arches, and wire stabilization of the tongue sides, as well as gingiva and teeth suturing, have been employed for flap stabilization. This study aims to assess the effectiveness of stabilizing the anteriorly based lingual flap by suturing the tongue tip to the upper lip mucosa for closing oronasal fistulae. A clinical study design was implemented to achieve the research objective. The sample comprised 12 patients with anterior oronasal fistulae who underwent the surgical procedure for evaluating the efficacy of lingual flap stabilization. Preoperative consultations, including blood tests and medical assessments, were conducted. The surgical technique, encompassing incision, dissection, and suturing procedures, was thoroughly described. Various surgical instruments were employed during the procedure. The study involved 12 patients, including 7 males (58.2%) and 5 females (41.7%). Analysis of the data, presented in tables, focused on the presence of fistulae and the healing process. No significant differences were observed between genders regarding the presence of fistulae or successful closure. Furthermore, there were no significant variations in patient age or fistula diameter among the different groups. Suturing the tip of the tongue to the upper lip mucosa for stabilizing the anteriorly based lingual flap proves to be an effective technique for closing oronasal fistulae.