Cold Sweat Research Articles

Application of Bayes Method to Predicting Vertigo Disease

Health is very important in life. However, sometimes awareness of a healthy lifestyle and regular diet is still neglected. Many diseases and symptoms arise due to irregular lifestyle and diet, one of which is vertigo. Vertigo is a different type of headache from regular headaches and migraines. It involves a sensation of movement or a feeling of motion of the body or surrounding environment, caused by a disturbance of the body's balance. Symptoms include a feeling of spinning, a swaying sensation, or a spinning environment, often accompanied by nausea, vomiting, cold sweat, and the urge to lie down to feel better. From the Bayes method calculation process in this study, it can be seen that the patient suffers from Vertigo disease, namely Vertigo Central (P02) with a value of 0, 7212 or 72.12%.

Formulation of adult food-protein–induced enterocolitis syndrome diagnostic scoring system differentiating from immediate-type food allergy

BackgroundAdult food-protein–induced enterocolitis syndrome (FPIES) has recently been recognized, and there are no international diagnostic criteria for this disease. Differentiating adult FPIES from immediate-type food allergy reactions and providing specific treatment for each in an emergency are important, but methods have not been developed. ObjectiveTo develop a diagnostic scoring system for adult FPIES by comparing it with an immediate-type food allergy (IgE-mediated food allergy [IgE-FA]). MethodsThis retrospective cohort study of food-avoidant adults based on diagnostic criteria for adult FPIES was conducted through telephone interviews. We compared the clinical profiles of the patients with FPIES and IgE-FA. Adult FPIES-associated factors were extracted using multivariate analysis, and a diagnostic scoring system was developed based on odds ratios. ResultsA total of 48 (16.7%) of 288 adults with food allergies were diagnosed with FPIES; of these, 240 (83.3%) had IgE-FA. Seafood was the most common cause of FPIES in adults (68.8%). Multivariate analysis identified an age of onset older than 26 years, more than 10 episodes, a longer latency period, cold sweat, abdominal distention, and vomiting as adult FPIES-associated factors. An adult FPIES diagnostic scoring system was developed using odds ratios with a high area under the curve (0.978), 100% sensitivity, and 87.0% specificity. ConclusionClinical profiles and an adult FPIES diagnostic scoring system were developed for the first time. This scoring system can be useful in differentiating adult FPIES and IgE-FA when treating food-related acute reactions.

Cardiac Hemangioma Mimicking Infective Endocarditis

Cardiac hemangiomas are rare and often misdiagnosed due to their nonspecific clinical presentations. We report a case of a 70-year-old man presenting with chills and cold sweats, initially suspected of having infective endocarditis based on echocardiographic findings of a mobile mass on the mitral valve. Laboratory results showed leukocytosis and elevated C-reactive protein, but blood cultures were negative. Transesophageal echocardiography later revealed a well-defined mass with characteristics suggestive of a tumor. Surgical excision confirmed the diagnosis of hemangioma. Postoperative recovery was uneventful, with no mitral regurgitation. This case highlights the importance of considering cardiac tumors in the differential diagnosis of intracardiac masses.

Awareness of Myocardial Infarction in Nangarhar Residents: A Community Based Study

Myocardial infarction is the leading cause of morbidity and mortality worldwide. The overall aim of the study was to evaluate community awareness about myocardial infarction. It was a community-based cross-sectional study conducted during one month including both male and female participants aged 18 years and over in Nangarhar province of Afghanistan. The percentage of awareness for risk factors was as follows: Diabetes (56.4%), Hypertension (43.4%), Elderly (42.1%), Obesity (39.8%), Physical inactivity (38.5%), Hyperlipidemia (37.6%), and Family history (33.8%). Furthermore, knowledge about symptoms and signs was as the following: chest pain (67.4%), pain in neck and jaw (57.8%), Dyspnea (50.7%), pain in arms (46.1%), weakness/fainting (40.1%), cold sweats (38.2%), nausea and vomiting (34.5%), anxiety (29.6%), fever (22.7%), hypotension/shock (20.1%), and silent myocardial infarction (11.3%). Moreover, 24% of participants did not know about the prevention strategies for myocardial infarction. Regarding treatment, 80.3% of participants exactly knew to go to the emergency room, 11.9% of participants would intend to go to a general practitioner (GP), 5.6% of participants would ask others for advice on what to do, and 2.2% of participants would wait to see if the symptoms go away spontaneously or if the symptoms were due to other diseases. The current awareness level about myocardial infarction especially atypical symptoms, risk factors, prevention, and treatment strategies in Nangarhar residents was insufficient, especially in females and healthy individuals, and warrants designing and implementing immediate awareness programs in order to avoid delay of treatment-seeking, misbeliefs about the disease and subsequent morbidity and mortality.

An Analysis of STEMI Cases in the Postgraduate Hospital in Khost, Afghanistan

Myocardial infarction, specifically ST elevation myocardial infarction (STEMI), involves the development of localized ischemic necrosis in the heart muscle due to an acute disruption of coronary blood flow. It clinically presents as burning, pressing, or squeezing chest pain that radiates to the left arm, collarbone, scapula, or jaw, along with symptoms such as shortness of breath, a feeling of fear, and cold sweat. Immediate hospitalization in a cardiac intensive care unit is crucial for patients with a developed myocardial infarction, as delays in treatment can be fatal. This study is a descriptive case series conducted in the year 1397 of the Islamic calendar. Out of 1602 inpatients admitted to Khost Postgraduate Hospital during this period, 50 patients were diagnosed with STEMI. The primary objectives of this research were to determine the frequency and pattern of STEMI cases at Khost Postgraduate Hospital during the year 1396 of the Islamic calendar.

Psychophysiological Responses to High-Intensity Interval Training Exercise over Menstrual Cycle Phases: An Exploratory Study.

Although there is potential for the menstrual cycle to impact psychophysiological responses to exercise, there has been a paucity of studies investigating this aspect, specifically in the context of high-intensity interval training (HIIT). This exploratory study aimed to examine the psychophysiological responses to HIIT over the menstrual cycle. Twenty-three healthy and physically active young women were recruited. Each woman completed a cycle ergometer HIIT session in the menstrual, follicular, and luteal phases of the menstrual cycle in a random order. Psychophysiological variables of interest were collected at baseline, and during and after exercise. Primary variables of interest were anxiety, mood, motivation, enjoyment, arousal, affect, and menstrual distress. Higher pain, water retention, behavior change (related to social interactions, eating habits, and self-performance), and autonomic reactions (consisting of nausea, dizziness, hot flashes, and cold sweats) were observed before HIIT during the menstrual phase compared with the follicular phase ( P < 0.05). Participants exhibited worse psychological responses to HIIT sessions during the menstrual phase, followed by the luteal phase. Findings also noted participants arrived to the laboratory with lower motivation to initiate HIIT sessions during the luteal and menstrual phases compared with the follicular phase. This difference was observed before and during HIIT. Motivation and depressive symptoms showed a significant reduction from pre-HIIT to post-HIIT ( P < 0.05), regardless of menstrual phase. The findings revealed that the menstrual cycle had a significant impact on psychophysiological responses. Moreover, HIIT could be adopted to improve motivation and depressive symptoms; however, further research is needed to explore the effects of HIIT across the menstrual cycle in women with clinical depression.

Pediatric Life Support in Prehospital Emergency Medicine: An Empirical Investigation in the Context of Taiwan's Critical Shortage of Pediatric Emergency Specialists.

This study aims to facilitate parental identification of designated emergency facilities for expeditious pediatric care within the framework of Taiwan's newly implemented "regional joint defense" approach to pediatric emergency services. The research seeks to elucidate the mechanisms by which this novel system can enhance timely access to appropriate emergency care for children, potentially improving health outcomes and resource utilization in acute pediatric situations. Factor analysis (FA) and triangular entropy matrix (TEM) analyzed the appearance, breathing and skin of pediatric assessment triangle (ABC of PAT), three types of prehospital pediatric emergence condition (PPEC), five levels of Taiwan's pediatric emergency triage (TPET), and applied the social learning theory (SLT) in educational doctrine, using experts' weighted questionnaires. Firstly, to address deficiencies in Taiwan's pediatric prehospital emergency medicine (PEM) system, integrating emergency medical knowledge (EMK) and pediatric life support (PLS) into medical education, staff training, and the national handbook for new parents is crucial. This equips parents to manage children's illnesses and prevent emergencies. Then, in life-threatening situations, immediate emergency room (ER) transport is vital for symptoms like whitish or purple lips, cold limbs, mottled skin, cold sweat, convulsions, dyspnea, chest dimples, weak consciousness, and oxygen saturation below 94%. Finally, for non-life-threatening emergencies, seek medical evaluation if symptoms include wheezing, chest tightness, chest pain, persistent high fever over 39 degrees with convulsions, chills, cold sweats, not eating or urinating for over 12 hours, or fever lasting more than 48 hours. Parents must remain calm and provide their baby with a sense of security while observing the development of physical symptoms. This approach enables them to effectively determine the most appropriate time to take their children to the emergency room, thereby avoiding life-threatening emergencies. Prompt and proper measures and treatments not only alleviate various discomforts caused by illness or medical emergencies but also reduce systemic distress, life-threatening situations, and unfortunate incidents before hospitalization.

Public Awareness of Early Symptoms of Acute Myocardial Infarction in Arar, Saudi Arabia

Background: A significant factor in patient delays is a lack of understanding of MI symptoms. Denial, fear, and an undue reliance on self-management could be the causes of more delays. This study aimed to assess the level of public awareness concerning the early symptoms of acute myocardial infarction (MI) and the appropriate actions to be taken when these symptoms manifest in the population of Arar, Saudi Arabia. Methods: A cross-sectional design employing a quantitative approach was used. Data were collected through an online self-administered questionnaire distributed to 390 participants using convenience sampling. The collected data were analyzed using descriptive and inferential statistics. Results: The study revealed mixed awareness levels among participants. While 63.6% correctly recognized chest pain as a symptom of MI, only 61.8% identified radiating pain to the shoulder, arm, back, neck, and jaw as an alarming symptom. Additionally, 74.9% recognized shortness of breath, and 64.6% identified fatigue as potential MI symptoms. Other symptoms, such as cold sweats (57.2%) and nausea (40.3%), were less well-known. Among the recognized risk factors, smoking (86.7%), diabetes (64.1%), and hypertension (79%) were relatively well-acknowledged, while obesity (84.4%) and sedentary lifestyles (86.9%) were recognized to a lesser extent. Age, education, income, city of residence, personal or family history of MI, history of MI among acquaintances, and exposure to AMI information in media and books significantly influenced awareness scores (p &amp;lt; 0.05). Conclusion: The study underscores the importance of tailored public health interventions to enhance MI awareness, especially among younger individuals, those with higher education, and those with lower incomes. It highlights the need for addressing lesser-known risk factors, such as obesity and sedentary lifestyles, to comprehensively prevent MI.

The prevalence of seasickness in a population of French civilian sailors.

Motion sickness, is the onset of a series of clinical signs when travelling in a means of locomotion. Boats are the most common source of kinetosis, causing seasickness. Although this condition is often benign, it can severely affect the quality of life of seafarers, as well as the quality of their work. The aim of this study is to focus on the point prevalence and characteristics of seasickness in a population of French civilian seafarers from all shipping sectors. During two months in 2023, we conducted a cross-sectional study based on a questionnaire containing 28 questions. One hundred nine men and 10 women completed the questionnaire. Of these, 34% said they were seasick. The main symptoms described by the sailors were nausea and cold sweats in 87.5% and 50% of cases, respectively. The prevalence of naupathy appears to be higher in women (60% compared with 31% in men). Women also seem to be less accustomed to the marine environment than men, with 71% of men and only 33% of women indicating that they get accustomed to life at sea. However, the symptoms of seasickness seem to disappear more slowly in men than in women. In terms of treatment, men (38%) were more likely to take medication than women (17%). Our study shows a greater susceptibility to seasickness among women. This interpretation should be treated with caution given the small number of women who took part in the study. The relatively low point prevalence of seasickness (34%) could be due to under-reporting. Although ways of thinking are changing, seasickness is still a taboo subject for many sailors. Yet seasickness has major professional and personal repercussions. So it's important to raise the subject and discuss strategies for improving well-being at work.

Semantics of Conscience in Richard III: “Worm”, “Coward”, “Witness”

The article surveys a number of meanings of the polysemantic word “conscience”, which defines the religious and moral concept of Shakespeare’s Richard III. The biblical roots of these meanings are shown, to which Shakespeare returned his public over well-known idioms, including the origins of the proverb from Erasmus Adagia “Conscientia mille testes“. Studying Shakespeares three early correlations of conscience with cowardice (“coward”), which will become a part of proverbial language only after Hamlet, the author reveals the original content of this comparison, its connection with the theme of “conscience” and the “thoughts” of the pagans as a “witness” in the Epistle to the Romans (Rom. 2:15). We come to the conclusion that it is this dual complex (separation of conscience leading to repentance, and thoughts as awareness without repentance) that predetermined two divergent vectors of reading the “conscience – coward” verbal link in Richard III, then in Hamlet and after. This duality often leads to ambiguity, paradoxical interpretations, misunderstandings. Meanwhile, of the two vectors for Shakespeare only one is true in each case, and it depends on the meaning of the word “conscience”. Mentioned with annoyance by the Murderer “conscience” which “makes a man a coward” (I, 4, 133–134), is a person’s susceptibility to the divine (moral) law named “conscience”. The same with “Conscience is but a word that cowards use” (V, 3, 309) – the teaching of Christ that irritates the usurper-Richard. Whereas the “coward conscience” (V, 3, 179) of a tyrant who wakes up in a cold sweat is no longer conscience, but a “coward”-mind that gives rise to fear of retribution. The article also provides arguments for interpreting the corresponding expression in Hamlet (III, 1, 83).

Terapi Bermain Puzzle Untuk Meningkatkan Kemampuan Kognitif Pada Anak Tunagrahita Ringan

Acute Coronary Syndrome (ACS) is a major cardiovascular problem because it causes high rates of hospitalization and mortality. The clinical manifestations of ACS are that the patient feels pain and discomfort that is not specific in the chest and legs radiating to the neck, left shoulder and arms and back then accompanied by cold sweat, nausea, vomiting, weakness and dizziness and can faint which occurs suddenly with high intensity. Objective: To find out the results of applying Thermotherapy therapy to relieve chest pain in patients with Acute Coronary Syndrome. Moewardi Surakarta. Method: This type of research is a descriptive case study. The application was carried out on 2 patients selected by purposive sampling method with inclusion and exclusion criteria. Thermotherapy is carried out for 10-20 minutes 1x/day for 3 days. The research instrument used SOP foot massage, hemodynamic status observation sheets, and informed consent. Results: After being given the application to both respondents for 1 time a day for 3 consecutive days, a decrease in the level of the chest pain scale was found in the patient Mr. S with a pain scale level before being carried out by Thermotherapy therapy, severe pain and after being carried out by Thermotherapy therapy for 1 time in 3 consecutive days to mild pain. Meanwhile, in the patient Mr. A with the level of pain scale before the Thermotherapy therapy is severe pain and after the Thermotherapy therapy is done for 1 time in 3 consecutive days it becomes mild pain. Conclusion: there is a reduction in the chest pain scale in patients with Acute Coronary Syndrome at RSUD Dr. Moewardi Surakarta after being given thermotherapy.

Penerapan Thermoterapy Untuk Meredakan Nyeri Dada Pada Pasien Acute Coronary Syndrom Di RS Dr.Moewardi Surakarta

Acute Coronary Syndrome (ACS) is a major cardiovascular problem because it causes high rates of hospitalization and mortality. The clinical manifestations of ACS are that the patient feels pain and discomfort that is not specific in the chest and legs radiating to the neck, left shoulder and arms and back then accompanied by cold sweat, nausea, vomiting, weakness and dizziness and can faint which occurs suddenly with high intensity. Objective: To find out the results of applying Thermotherapy therapy to relieve chest pain in patients with Acute Coronary Syndrome. Moewardi Surakarta. Method: This type of research is a descriptive case study. The application was carried out on 2 patients selected by purposive sampling method with inclusion and exclusion criteria. Thermotherapy is carried out for 10-20 minutes 1x/day for 3 days. The research instrument used SOP foot massage, hemodynamic status observation sheets, and informed consent. Results: After being given the application to both respondents for 1 time a day for 3 consecutive days, a decrease in the level of the chest pain scale was found in the patient Mr. S with a pain scale level before being carried out by Thermotherapy therapy, severe pain and after being carried out by Thermotherapy therapy for 1 time in 3 consecutive days to mild pain. Meanwhile, in the patient Mr. A with the level of pain scale before the Thermotherapy therapy is severe pain and after the Thermotherapy therapy is done for 1 time in 3 consecutive days it becomes mild pain. Conclusion: there is a reduction in the chest pain scale in patients with Acute Coronary Syndrome at RSUD Dr. Moewardi Surakarta after being given thermotherapy.

Penerapan Hidroterapi dan Relaksasi Otot Progresif Pada Asuihan Keperawatan Lansia dengan Hipertensi

The Causes Hypertension is a condition in which systolic and diastolic pressure increases beyond normal limits, an increase in blood pressure both systolic and diastolic with symptoms such as dizziness accompanied by a stiff neck, unable to sleep, aching bones, often tingling, and sometimes cold sweats. In dealing with the problem of increased blood pressure, namely by doing hydrotherapy and progressive muscle relaxation. The purpose of the study was to determine the application of hydrotherapy and progressive muscle relaxation to reducing blood pressure in nursing care for elderly people with hypertension in the Pandiri village. The research method is descriptive with a case study approach. Research Results: in the study the patient complained of dizziness and pain in the head to the back of the neck, the pain felt like stabbing, intermittent pain, blood pressure 160/100 mmHg, pulse 90x/minute, heart palpitations and difficulty getting to sleep and often waking up at night. Nursing diagnoses (1) risk of ineffective cerebral perfusion (2) Acute pain (3) Sleep pattern disturbance. Nursing interventions: monitoring of vital signs, pain management. Nursing implementation examines TTV, assesses the patient's pain scale, provides hydrotherapy and progressive muscle relaxation. Evaluation after nursing actions for 3 days the patient said the pain in the head to the nape was reduced, the patient looked relaxed, the patient's blood pressure was 130/80 mmHg, the patient was calm, the patient slept well. Conclusion: the application of hydrotherapy and progressive muscle relaxation can reduce blood pressure. Keywords: Elderly, Hypertension, Hydrotherapy, Progressive Muscle Relaxation

Abstract 15838: To Tear Again: Recurrent and Complicated Spontaneous Coronary Artery Dissection

Background: SCAD is as an infrequent cause of ACS with a predominance affecting a mean age of 42.6 years and 82% of patients being female. SCAD can be classified as primary or secondary, where primary dissections occur spontaneously, and secondary causes involve the aortic root and are a direct consequence of coronary interventions, surgery, or trauma. Case: 26-year-old female with no previous cardiac or significant family history presented with severe mid-sternal chest pain, radiating to both arms and back, and associated with nausea and cold sweats. Cardiovascular exam was unremarkable. Troponins were elevated at 0.18 and 0.59. Echo showed anteroseptal wall hypokinesis, consistent with Takotsubo cardiomyopathy. ECG showed anterolateral ST elevations. The patient went for cardiac catheterization and had spontaneous dissection of the left main into the LAD/diagonal with 100% occlusion of the LAD and 99% occlusion of the ramus/circumflex. Impella device was implanted due to persistent shock, V. fib., and cardiac arrest. Stents were placed in the proximal, mid, and distal LAD, ramus/circumflex, and LCA. The patient had an LVEF of 25%. Follow-up echo showed an LVEF of 30%, with subsequent Impella removal. Following week, LVEF increased to 45-50%. The patient began aspirin 81 mg, atorvastatin 10 mg, bisoprolol 5 mg, prasugrel 10 mg, and rivaroxaban 10 mg. Over the next few years, she had recurrent chest pain, syncope, palpitations, and a non-viable pregnancy at 12 weeks of gestation due to premature bleeding complications. 3 years after the initial SCAD, the patient presented with spiral dissection of the RCA, requiring three stents. LVEF was 30%. She is being managed with aspirin 81 mg, atorvastatin 20 mg, bisoprolol 10 mg, and prasugrel 10 mg. Discussion: The initial age of presentation of this patient makes this case unique. Risk of recurrent SCAD was present in 17% of patients at a median age of 2.8 years after the initial episode. Triggers for recurrent SCAD include extreme emotional/physical stress and pregnancy. Pregnancy it is not recommended in this patient population. Beta-blockade and adequate BP control are mainstay in medical management and reduce the reoccurrence of SCAD.

Sonographic Assessment of Carotid Artery Stenosis in Atherosclerotic Patients by Color Doppler Ultrasound

Mostly patients with neck pain, cold sweats, chest pain, high blood pressure and heart palpitations are assessed by sonography. Because major blood vessels supplying the brain and face through carotid arteries. Mostly, intima media thickness is one of the markers of atherosclerotic patient that is widely used. The aim of study is to find out stenosis with carotid arteries with the help of color Doppler scan. The data was included in literature review from several search engines. In this literature review, olny 20 articles were used for extraction of data related to topic statement. The current study looked sonographic assessment of carotid artery in atherosclerotic patients. It is concluded that Color Doppler ultrasound is a non-invasive and easier modality of choice for evaluating the patient with atherosclerosis, it helps in diagnosis of flow as well as prediction of carotid artery stenosis.

Recovery of Gerd Disease in The Working Area of The Ciamis Health Center

GERD is a condition that often manifests as increased stomach acid, causing the mouth to become sour and bitter and burning or burning in the chest and solar plexus. This condition results in a psychological situation that ranges from anxiety to depression and is accompanied by physical symptoms such as shortness of breath, cold sweats, and if not treated will cause the patient's condition to get worse. Purpose: This study aims to describe the recovery of GERD in the Working Area of the Ciamis Health Center. Methods: This research was conducted using a survey method. This research was conducted by directly observing the research object and filling out the provided questionnaires. The population in this study were the people in the working area of the Ciamis Health Center who had a history of GERD, there were 57 respondents. Sampling was carried out using a total sampling technique, namely making the entire population as a research sample with a total of 57 people. Results: Out of 39 people who recovered from GERD, 25 people did not have GERD symptoms. Conclusion: Most of the people in the working area of the Ciamis Health Center recover from GERD.

Successful conservative treatment for left ventricular free wall rupture after acute myocardial infarction

Left ventricular free wall rupture (LVFWR) is a rare but fatal complication of acute myocardial infarction (AMI). An 81-year-old female patient with several cardiovascular risk factors presented to the emergency department with symptoms of developing a chronic stomachache and cold sweat. An echocardiograph showed wall motion abnormalities from the lateral to posterior wall, as well as pericardial effusion containing clots of up to 17 mm in the posterior wall that indicated LVFWR after AMI. Although she was conscious after being brought to the initial care unit, she suddenly lost consciousness and fell into electromechanical dissociation (EMD). Endotracheal intubation was immediately initiated and her pericardial drainage and intra aortic balloon pump (IABP) placement, and hemodynamics recovered. Although she had 100% obstruction in the left circumflex artery (LCX) #12 on coronary angiography (CAG), she was discharged to the Intensive Care Unit (ICU) without percutaneous coronary intervention (PCI). Conservative treatment such as intubation, sedation, pericardiocentesis and strict blood pressure management as well as treatment by IABP long-term support led to the patient being uneventfully discharged after 60 days.

SAT141 A Case Of Non-islet Cell Tumor Hypoglycemia Which Was Ameliorated By Pazopanib Treatment

Abstract Disclosure: N. Yamamoto: None. M. Yamamoto: None. N. Kiyota: None. Y. Inaba: None. K. Kanie: None. S. Urai: None. M. Suzuki: None. Y. Sasaki: None. Y. Oi: None. Y. Tsujimoto: None. Y. Motomura: None. Y. Ohmachi: None. H. Bando: None. G. Iguchi: None. M. Nagao: None. I. Fukuda: None. H. Fukuoka: None. W. Ogawa: None. Introduction: Non-islet cell tumor hypoglycemia (NICTH) is a rare paraneoplastic syndrome caused by insulin-like growth factor II (IGF-II) hypersecretion from the tumors. It is characterized by incompletely processed big IGF-II with potent insulin-like activity. We present a case of NICTH complicated with solitary fibrous tumor (SFT) which was ameliorated with the administration of pazopanib, a multi-targeted tyrosine kinase inhibitor. Clinical Case: A 57-year-old man went into a coma and was hospitalized. His plasma glucose levels were 26 mg/dL, and he regained consciousness after glucose administration, leading to a diagnosis of hypoglycemic coma. Moreover, a contrast-enhanced CT scan showed multiple tumors in his liver and right kidney. He was referred to our hospital for further management. After 5 hours of fasting, he had a cold sweat, and his plasma glucose levels dropped to 32 mg/dL with suppressed serum insulin levels of 0.2 U/mL. Serum 3-hydroxybutyrate levels were as low as 21 μmol/L, and plasma glucose levels increased to 83 mg/dL after glucagon administration, suggesting an agent mimicking insulin. Percutaneous liver biopsy was performed, and the tumors were diagnosed with SFT. Immunoblotting for his serum showed big IGF-II, leading to a diagnosis of NICTH, and hypoglycemia due to hypersecretion of IGF-II. Due to multiple metastases, surgery was not indicated and pazopanib was administered. Hypoglycemia during the night was prevented by glucose infusion through the central venous port, and he was discharged. Three months later, when he was re-hospitalized for thrombophlebitis of the right jugular vein, hypoglycemia did not occur even after 10 hours of fasting and CT scan showed the necrotic change of the tumor. Two weeks later of pazopanib discontinuation due to the thrombogenic adverse effect, hypoglycemia recurred accompanied by the tumor enlargement. When the anticoagulation therapy regressed the thrombosis and pazopanib was re-administered, hypoglycemia improved reproducibly and remained stable for more than 2 years although the tumor showed gradual progression. Conclusion: This is the first case in which pazopanib was effective in suppressing NICTH associated with SFT. Presentation: Saturday, June 17, 2023

The Effectiveness of Group Counseling with Rational Emotive Behavior Therapy (REBT) in Reducing Student Anxiety in Facing Exams

The background of this research is based on the anxiety problems that often occur in students when facing an exam. This can be seen in students when taking exams‚ students often experience anxiety symptoms such as cold sweats‚ tremors‚ sleeping difficulty when exam day is near. Efforts made in dealing with this challenge are group counseling using a rational emotive behavior therapy approach. This research aims to see the effectiveness of group counseling with a rational emotive behavior therapy approach in reducing anxiety in facing exam students. This study uses an experimental design with a pretest and post-test control group design. The subjects in this study were students of SMAN 13 Padang. This study uses an experimental design with a pretest and post-test control group design. The subjects in this study were students of SMAN 13 Padang, who revealed sixteen students with high and moderate anxiety categories. The instrument used in this study is the instrument to face the test with a Likert scale. The population in this study are students of SMAN 13 Padang, with seven samples in the control group and 7 in the experimental group. The technique used is the Purposive sampling technique. The data were analyzed using the Wilcoxon Signed Rank Test and the Kolmogorov Smirnov 2 Independent Sample test with the help of SPSS version 20.00. The results of this study indicate that group counseling with a rational emotive behavior therapy approach effectively reduces students' anxiety in facing exams.

Evaluating Ubrogepant-related adverse events using the FDA adverse event reporting system

ABSTRACT Background Migraine has a high prevalence in the population and accounts for 12% of primary headaches. Ubrogepant is used for the treatment of acute migraine, and although some clinical trials have demonstrated the safety of Ubrogepant, its long-term safety in a large sample of the population remains to be investigated. Methods We collected data from the US Food and Drug Administration Adverse Event Reporting System (FAERS) database. We used reporting odds ratio (ROR), the proportional reporting ratio (PRR), the information component (IC) and the empirical Bayes geometric mean (EBGM) to evaluate Ubrogepant-induced adverse events (AEs). Results We screened out 2,067 reports of Ubrogepant as primary suspected (PS) and 6,190 reports of Ubrogepant-induced AEs as PS. Our results showed that Ubrogepant-induced AEs targeted 4 system organ classes (SOCs), detected 32 Preferred terms (PTs) signals in 9 SOCs, including common Ubrogepant label consistent with Migraine, Nausea, Somnolence, Paraesthesia oral and Dizziness, It also includes the AEs of Hemiparesis, Mental impairment, Dysstasia, Tinnitus, Chest pain, Cold sweat, Neck pain, etc. that have not been demonstrated in previous studies. Conclusions Our study identified new AEs that have not been reported, which provides a new guidance to deepen the comprehension of the safety of Ubrogepant.