High Case Research Articles

Analysis of Spatial Distribution of Maternal Death Cases in the Special Region of Yogyakarta Province

Maternal mortality is an important indicator of improving health in a country which is included in the target of achieving the Subtainable Development Goals (SDGs). The Maternal Mortality Rate (MMR) in Indonesia in 2018 was still high at around 305/100,000 KH. Maternal mortality in the Yogyakarta Special Region Province experienced a significant increase in 2021. Objective: to analyze the Maternal Mortality Rate (MMR) in the Yogyakarta Special Region Province and determine the relationship between spatial accessibility of Community Health Centers. Method: This is a quantitative descriptive study to see the pattern of distribution of maternal mortality cases using GIS using ArcGis. Results: Maternal deaths in 2020-2022 have a spreading pattern with the highest cases being in Banguntapan sub-district and the distribution of health centers has been evenly distributed in each sub-district. Conclusion: Maternal death cases occur almost in all sub-districts, with a widespread distribution pattern. The highest case in the last three years occurred in 2021 due to exposure to Covid-19. The distribution of health centers is evenly distributed, but hospitals are still concentrated in Sleman district and Yogyakarta city.

Role of Magnetic Resonance Spectroscopy and Diffusion-weighted Imaging in the Evaluation of Supratentorial Brain Tumours with Histopathology Correlation at a Tertiary Care Hospital: An Observational Study

Abstract Background: Traditional magnetic resonance imaging (MRI) may face challenges in accurately discerning supratentorial malignancies. However, advanced techniques such as diffusion-weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) have significantly enhanced diagnostic accuracy. Thus, the study aimed to evaluate the effectiveness of these non-invasive diagnostic methods in patients with suspected intracranial lesions. Materials and Methods: In this prospective observational study at Osmania General and Allied Hospitals, 40 eligible patients were enrolled. After applying the inclusion and exclusion criteria, MRI examinations were conducted at two hospitals utilising GE 1.5T and PHILIPS 1.5T 32-channel machines. Standardised brain sequences, encompassing T1- and T2-weighted scans, DWI, gradient-recalled echo and fluid-attenuated inversion recovery imaging, were systematically performed. In addition, post-contrast administration and contrast-enhanced MRS were employed. Results: In this study, a higher tumour incidence was observed in males (52%) compared to females (48%). The choline/creatine (CHO/Cr) ratio revealed more cases below 1.5 and fewer at the 3.1–3.5 level. Perilesional CHO/Cr ratio had the highest cases (21) at 1.1–2.0 and the lowest (2) at 3.1–4.0. Further analysis revealed significant differences in the mean CHO/Cr ratio amongst primary low-grade (1.8), primary high-grade (3.91) and metastatic tumours (7.23). The mean choline/N-acetyl aspartate (NAA) ratio also differed significantly amongst these tumour types, with choline/NAA and CHO/Cr ratios indicating statistical significance in distinguishing primary low-grade tumours. In addition, mean apparent diffusion coefficient values showed significant differences between primary low-grade tumours (1.1), primary high-grade tumours (0.87) and metastasis (0.855). Conclusion: This study underscores gender-related differences in supratentorial tumour susceptibility and highlights distinct tumour distributions based on grades. These findings emphasise the significance of considering gender, age and histopathological attributes when evaluating supratentorial tumours.

The current diagnosis and treatment situation of rare disease in the pediatric intensive care unit

Objective: To analyze the diagnosis and treatment of children with rare diseases in the pediatric intensive care unit (PICU), the distribution of disease types and populations, clinical characteristics, and the use of orphan drugs. Methods: A retrospective case summary was conducted. Data were collected from 105 children aged 29 days to <18 years with a confirmed diagnosis of rare diseases according to the "First Batch of Rare Disease Catalogue in China" who were admitted to the PICU of Beijing Children's Hospital, Capital Medical University from January 2020 to December 2022. Data including general information, auxiliary examinations, and treatment details for each patient were collected from the hospital's electronic medical record system. Patients were divided into age groups: infancy (29 days to<1 year), early childhood (1 to <3 years), preschool age (3 to<7 years), school age (7 to<13 years), and adolescence (13 to<18 years). The chi-square test was used to compare gender distribution differences among various rare diseases. Results: A total of 105 patients with 130 cases meeting the diagnostic criteria were included, accounting for 4.7% (130/2 754) of the total admissions to the PICU. The age at PICU admission was 5.3 (0.8, 9.5) years and there were 81 cases in male. The 3 most common types of diseases were endocrine, nutritional, and metabolic diseases (37 cases); followed by neurological disorders(32 cases); and congenital malformations, deformities, and chromosomal abnormalities(17 cases). The 5 most common rare diseases were methylmalonic acidemia (14 cases), mitochondrial encephalomyopathy (14 cases), atypical hemolytic uremic syndrome (12 cases), autoimmune encephalitis (12 cases), and idiopathic cardiomyopathy (9 cases). The distributions of common rare diseases varied among different age groups. In infants, atypical hemolytic uremic syndrome was most common (6 children). There was no statistically significant difference regarding gender among children with mitochondrial encephalomyopathy (13.6% (11/81) vs. 6.1% (3/49), χ2=1.77, P=0.184). Respiratory failure (36 cases) was the primary reason for rare diseases children to be admitted to the PICU. A total of 95 cases underwent mechanical ventilation, 39 cases received multidisciplinary collaborative diagnosis and treatment, and only 6 children received orphan drug therapy during their stay in the PICU. Conclusions: Rare diseases are not uncommon in PICU. Endocrine, nutritional and metabolic disorders, neurological disorders, congenital malformations, deformities, and chromosomal abnormalities were common. Methylmalonic acidemia, mitochondrial encephalomyopathy, atypical hemolytic uremic syndrome and autoimmune encephalitis have higher cases. Many children with rare diseases in the PICU have complex conditions those are challenging to treat, requiring multidisciplinary collaboration. The utilization rate of orphan drugs among children with rare diseases in PICU needs to be improved.

Mapping spatial analysis of fish disease incidence and antibiotic resistance trends in selected provinces of Indonesia

Abstract Monitoring and visiting farmers affected by fish mortality is imperative. It offers insights into fish disease mapping and the trend of antibiotic resistance, serving as a fundamental for future strategies for preventing and treating fish diseases. The data collection was carried out by visiting farmers who suffered from fish mortality in 2022 in East Java, South Kalimantan, and Bali provinces. A total of 128 samples of infected fish were collected and analyzed using PCR and standard microbiological methods, and the findings were analyzed using spatial analysis and visual interpretation. Based on PCR results, the prevalence of fish diseases showed 65% iridovirus cases in gourami and tilapia, 31% in tilapia was TiLV, and 4% were Francisella sp. infection in tilapia. According to the results of microbiological tests, 86% of Edwardsiella tarda samples in pangasius were resistant to Oxytetracycline. Aeromonas sp. infection was the highest case in catfish, 58% were sensitive to Sulfamethoxazole. Streptococcosis was a typical tilapia disease that was 62% susceptible to Enrofloxacine and Sulfamethoxazole. Cases of Nocardia sp. and Staphylococcus sp. infection in gourami were found to be 71% intermediate to Enrofloxacine and Oxytetracycline, respectively.

A situational analysis of model holistic-comprehensive and integrated approaches to handling stunting in Buleleng Regency, Bali, Indonesia

Background: Policies and strategies for handling stunting cases effectively and efficiently vary in different regions, depending on their situation and conditions. There has yet to be an empirical study of stunting management with a holistic-comprehensive and integrated approach in Indonesia, especially in Buleleng Regency, Bali. Thus, conducting initial research to analyze the policy and determine the right stunting management strategy to implement is essential.Purpose: This study aims to map stunting cases, explore their causal factors, analyze the suitable policy model for overcoming stunting and describe the effective and efficient stunting management strategy in Buleleng Regency based on a holistic, comprehensive, and integrated approach.Methods: This is a situation analysis case study. Respondents were stunted children and related governmental agencies in Buleleng Regency, Bali. The incidence of stunting, risk factors suspected as the cause, policy models and appropriate stunting handling strategies were analyzed in depth using qualitative and quantitative methods.Results: There were 1040 cases of stunting in the regency, with the highest cases in Banjar District. Significant risk factors influencing the stunting incidence in the region include the lack of good complementary feeding (OR: 2.6722; p &lt;0.05) and low family income (OR: 7.6667; p &lt;0.0001). The results of the analysis of stunting handling policies, based on a holistic-comprehensive and integrated approach model by regional needs, are categorized into two policy areas: Policies in the Medical and Non-Medical fields. In contrast, the handling strategy is divided into two stages: the screening and the handling stages.Conclusion: Poor-quality complementary foods and low family income are the main risk factors for high stunting rates in Buleleng Regency, Bali. These factors must be considered in an effective and efficient policy and strategy model for handling stunting cases in the regency.

Evaluation of Surgical Reconstruction of Old Tendo Achilles Injury by Bosworth Technique

Background: Chronic Achilles tendon rupture in the watershed hypovascular region (zone II) makes end-to-end repair less feasible. Bosworth's technique, involving gastrocnemius-soleus turndown, was studied to determine its efficacy and functional outcome in repairing chronic tendon in zone II. Objective: To evaluate surgical reconstruction of old Tendo Achilles injury by Bosworth technique. Methods: This prospective study was carried out in Dhaka Medical College Hospital (DMCH) form July 2006 to December 2007. 20 cases were selected as non-randomized purposive sampling technique who came to the out patients department of DMCH. All cases were diagnosed as old neglected Tendo Achilles injury and treated by surgical reconstruction by Bosworth technique. Two cases were lost from follow up and discarded from the study. Finally the study was done on 18 patients. Results: The mean age of the patients was 31.7 years and the lowest and highest cases were 17 and 47 years respectively. The male female ratio was 5:1. One-third (33.3%) patients were day labourer, 22.2% service holders, 16.7% house wives and the rest 27.8% students. Two-Third of the patients (67%) had involvement of left Tendo Achilles and the rest (33%) had right Tendo Achilles. Nearly 40% of patients’ injury was caused by the overhanging edge of the toilet Pan, 27.8% by traumatic rupture, 11.1% assaulted by sharp weapon, another 11.1% by sharp edge of a metallic plate, 5.6% accidentally by sharp cutting knife and 5.5% by broken glass. The mediun level of injury was 3.5 cm above from the insertion of Tendo Achilles, while the lowest and highest level were 2.5 and 6 cm. Minimum delay from injury to operation was 6 weeks and maximum 32 weeks. 5 patients (27.8%) gained normal range of ankle movement, 6 patients (33.3%) decreased by 5° of unaffected side, 4 (22.2%) by 10° and 3 (16.7%) by more than 10⁰. Mean power of planter flexion, mean calf width and mean score to stand on tip toe on injured side relative ........

Opening-Wedge High Tibial Osteotomy with a Cancellous Strut Bone Allograft Is Inadequate for Achieving Satisfactory and Lasting Correction in Neglected Infantile Tibia Vara: Results from a Cohort of 29 Patients.

Background: Infantile tibia vara (ITV) is a rare proximal tibia deformity in infancy, leading to progressive knee varus. High tibial osteotomy is commonly practiced but has high recurrence rates. This study analyzed factors affecting treatment failure and recurrence in children undergoing opening-wedge high tibial osteotomy (OWHTO) for ITV. Methods: We retrospectively studied children with ITV who had OWHTO with a press-fit cancellous bone allograft between 2000 and 2020, with ≥2-year follow-up. Outcomes included recurrence (knee varus with tibiofemoral angle > 10°), complications, and reintervention. Results: We analyzed 39 knees in 29 patients (mean age: 4.8 ± 1.9 years; median follow-up: 7.4 years). Recurrence occurred in 22 cases (56%). Age at surgery significantly influenced recurrence, with rates of 16% before age 5 versus 95% later (hazard ratio: 12.0, p = 0.001). Langenskiöld stage also affected recurrence (β-coefficient: 2.7, 95% C.I. 1.0-4.5, p = 0.002; pseudo-R-squared: 0.50, p = 0.001), with recurrence in all stage IV or higher cases. Conclusions: Early diagnosis and treatment before age 5, ideally with Langenskiöld stage III or lower, are crucial for stable correction with OWHTO alone. Late, high-grade ITV may require combined, acute or gradual, and/or staged correction. Further evidence is needed for optimal management.

Predictive analysis on the factors associated with birth Outcomes: A machine learning perspective

BackgroundRecent studies reveal that around 1.9 million stillbirths occur annually worldwide, with Sub-Saharan Africa having among the highest cases. Some Sub-Saharan African countries, including Ghana, failed to meet Millennium Development Goal 5 (MDG5) by 2015 and may struggle to meet Sustainable Development Goal 3 (SDG3) despite maternal healthcare interventions. Concerns arise about Ghana’s ability to achieve the World Health Organization’s neonatal mortality goal of 12 per 1000 live births by 2030. This study aims to identify key factors influencing childbirth outcomes and create a predictive method for high-risk pregnancies. MethodsWe compared four machine learning classifiers (Extreme Gradient Boosting, Random Forest, Logistic Regression, and Artificial Neural Network) in predicting childbirth outcomes using data from a tertiary health facility in Ghana. To address class imbalance, we employed the Synthetic Minority Over-sampling Technique (SMOTE). ResultsOur findings show that fetal heartbeat, gestation age at birth are the most influential factors on birth outcome (stillbirth or live birth), while there is no significant association with maternal age, number of babies, and type of delivery method. Among the machine learning models considered, Random Forest emerged as the optimal model achieving an accuracy, F1-score, and AUC values of approximately 0.98, 0.99, and 0.90 respectively. ConclusionOur study identifies key factors affecting childbirth outcomes and highlights the potential of machine learning for early high-risk pregnancy detection in clinical settings. These findings are crucial for Ghana and other Sub-Saharan African countries striving to meet maternal and neonatal healthcare goals. Further research and policy initiatives can use these results to improve healthcare in the region and work toward the World Health Organization’s objectives by 2030.

Edukasi tentang HIV/AIDS pada Siswa SMA Negeri 1 Ternate

Human Immunodeficiency Virus (HIV) was a virus who infected white blood cells caused human immune system deficiency. Acquired Immune Deficiency Syndrome (AIDS) was a disease with syndrome caused by Immunodeficiency Virus (HIV). Even fluctuative but Indonesian data of HIV/AIDS keep increase every year. In the past eleven years, cases of HIV in Indonesia been in the highest cases at 2019 with 50.282 cases. In North Maluku, new cases of HIV/AIDS on September become 140 cases and cumulative data was 1.325 cases. In Ternate, there were 641 cases of HIV/AIDS which 135 people died. Data shows that HIV/AIDS cases increase on household and productive ages. If the incubation of HIV/AIDS was 8-10 years than infection must be on school ages. Therefore, education on school period become a determinant factor to prevent HIV/AIDS.

Edible Long-Afterglow Photoluminescent Materials for Bioimaging.

Confining luminophores into modified hydrophilic matrices or polymers is a straightforward and widely used approach for afterglow bioimaging. However, the afterglow quantum yield and lifetime of the related material remain unsatisfactory, severely limiting the using effect especially for deep-tissue time-resolved imaging. This fact largely stems from the dilemma between material biocompatibility and the quenching effect of water environment. Herein an in situ metathesis promoted doping strategy is presented, namely, mixing ≈10-3 weight ratio of organic-emitter multicarboxylates with inorganic salt reactants, followed by metathesis reactions to prepare a series of hydrophilic but water-insoluble organic-inorganic doping afterglow materials. This strategy leads to the formation of edible long-afterglow photoluminescent materials with superior biocompatibility and excellent bioimaging effect. The phosphorescence quantum yield of the materials can reach dozens of percent (the highest case: 66.24%), together with the photoluminescent lifetime lasting for coupes of seconds. Specifically, a long-afterglow barium meal formed by coronene salt emitter and BaSO4 matrix is applied into animal experiments by gavage, and bright stomach afterglow imaging is observed by instruments or mobile phone after ceasing the photoexcitation with deep tissue penetration. This strategy allows a flexible dosage of the materials during bioimaging, facilitating the development of real-time probing and theranostic technology.

Enhanced Labor Management: Implementing WHO Recommendations in Oyo State Nursing Practice

Introduction: An increase in the incidence of Urinary tract infections due to Candida species has been observed. The higher rate of Candiduria due to Non albicans Candida is now being reported than due to Candida albicans.The emergence of drug resistance in Candida species has complicated the patient management. Aim: to observe the prevalence of Candida species in UTIs and their antifungal susceptibility pattern in a tertiary care hospital. Materials and Methods: An observational study was conducted fora period of three months in NIMS, Jaipur. Symptomatic patients belonging to all age groups were included in the study. Catheterized or clean catch midstream urine were centrifuged and the sediment was plated on Sabouraud’s Dextrose Agar slants with and without Chloramphenicol. A wet mount preparation was also made and looked for the presence of pus cells, yeast cells, pseudohyphae, etc. Yeast were identified by using germ tube, Chromogenic agar, chlamydospore formation and carbohydrate assimilation tests. Antifungalsusceptibility testing was performed on Muller Hinton Methylene Blue Agar. Result: The Candida species were isolated in only 24 (4.8%) samples. Only 8 cases yielded Candida albicans(33.33%). The highest cases were found to be of Candida tropicalis (n=14) while remaining two cases has growth of Candida krusai (n=1) and Candida glabrata (n=1). Keywords: WHO guidelines, labor management, and patient care &amp; outcomes.

Prediction Model for Pregnancy Success in IVF Program in the Poor Prognosis Group

Introduction: An increase in the incidence of Urinary tract infections due to Candida species has been observed. The higher rate of Candiduria due to Non albicans Candida is now being reported than due to Candida albicans.The emergence of drug resistance in Candida species has complicated the patient management. Aim: to observe the prevalence of Candida species in UTIs and their antifungal susceptibility pattern in a tertiary care hospital. Materials and Methods: An observational study was conducted fora period of three months in NIMS, Jaipur. Symptomatic patients belonging to all age groups were included in the study. Catheterized or clean catch midstream urine were centrifuged and the sediment was plated on Sabouraud’s Dextrose Agar slants with and without Chloramphenicol. A wet mount preparation was also made and looked for the presence of pus cells, yeast cells, pseudohyphae, etc. Yeast were identified by using germ tube, Chromogenic agar, chlamydospore formation and carbohydrate assimilation tests. Antifungalsusceptibility testing was performed on Muller Hinton Methylene Blue Agar. Result: The Candida species were isolated in only 24 (4.8%) samples. Only 8 cases yielded Candida albicans(33.33%). The highest cases were found to be of Candida tropicalis (n=14) while remaining two cases has growth of Candida krusai (n=1) and Candida glabrata (n=1). Keywords: Infertility, prediction model, In Vitro Fertilization, Logistic Regression, Endometrial Thickness, Poor Prognosis, Clinical Pregnancy

The Dynamics of COVID-19 in Hiroshima Prefecture Compared to Japan and Its Association With Meteorological Factors: A Comparative Analysis.

Introduction Despite the implementation of countermeasures and mass vaccination programs, the COVID-19 pandemic incidence was a vital public health concern. This study aimed to explore the dynamics of COVID-19 cases and assess the association of COVID-19 pandemic epidemiological data with meteorological factors in Hiroshima Prefecture compared to Japan. Methods We analyzed COVID-19 pandemic data in Japan's Hiroshima Prefecture from January 16, 2020, to May 9, 2023. Meteorological factors were examined at different time frames, and Spearman correlation coefficients were calculated for COVID-19 variables and variants based on GISAID whole genome analysis. Results Hiroshima Prefecture reported 816,788 COVID-19 cases and 1,371 fatalities, with a city-to-rural case ratio of 0.97:1. Infection rates were 17.42% for Japan and 15.83% for Hiroshima. Gender-wise, the ratio was 99:1, and the 30-39 age group in Hiroshima had the highest cases (15.5%). Among all meteorological factors, daily and 14-day average wind speed showed a weak correlation with incidence (-0.1954, P < 0.01; 0.3669 P < 0.01), fatalities (-0.1148, P < 0.01; -0.2232 P < 0.01), and incidence rate (-0.2042, P < 0.01; -0.3751, P < 0.01), respectively. Clade GRA was most frequent (39.7%), and among 61 variants, B.1.1.7, AY.29, and BA.1.1.2 were predominant. Precipitation was associated significantly with the Alpha variant (0.3373, P<0.01), while the Delta variant (0.2934, <0.05) weakly correlated with humidity. Conclusion COVID-19 pandemic trends in Hiroshima Prefecture paralleled Japan's, yet with lower incidence and fatalities compared to most prefectures. Significant associations were found between meteorological factors and COVID-19 metrics, including incidence, fatalities, incidence rate, and mutations in Hiroshima.

The Prevalence and Vaccination Coverage Rates of COVID-19 in Asia: A Cross-sectional Study after Four Years

Asia is the largest and most populous continent and is divided into five regions: Eastern Asia, South-eastern Asia, Central Asia, Southern Asia, and Western Asia. Understanding the pattern of the coronavirus disease 2019 (COVID-19) prevalence in Asia could help researchers and decision-makers learn how to respond to public health emergencies more effectively. By the end of 2023, it would have been nearly four years since the first cases of COVID-19 were detected. In this article, COVID-19 data, including the vaccination coverage rate, were used to examine the COVID-19 prevalence across Asia by the end of 2023 based on income and geographic division. Data on COVID-19, including the vaccination coverage rates, for various Asian countries were collected from reliable, publicly available websites. Then, COVID-19 data were analyzed based on income and geographic division. An analysis of variance (ANOVA) test and an Independent Samples t-test were also performed to assess the variation of the means of COVID-19 data across the continent. As of January 1, 2024, COVID-19 data across Asia's five regions were inconsistent. West Asia was most affected, with the highest cases and deaths per million and most tests performed per population. Eastern Asia had the lowest deaths per million, tests per population, and case-fatality rates (CFRs). The COVID-19 vaccination rates range between 2.39% and 105.7%, while the booster vaccination rates varied from 0% in Kyrgyzstan and Laos to 141.7% in Japan. The ANOVA test showed significant variance in the mean, median age, mean vaccination coverage rates, and mean booster vaccination rates, where Eastern Asia had higher averages than the other parts. The independent t-test revealed significant differences in COVID-19 data means, except for CFRs, where low- and lower-middle-income countries had lower averages than upper-middle and high-income countries. Inconsistent COVID-19 data, including vaccination coverage, across Asia highlights the need for uniform standards in case identification and diagnosis, ensuring equitable vaccine distribution, and providing essential diagnostic resources to all countries for future emergencies.

The Effect of Obesity, Carbohydrate, and Fat Intake on the Incidence of Type 2 Diabetes Mellitus at the Age of 30-50 Years in Medan

&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p&gt;&lt;em&gt;Diabetes Mellitus (DM) is a disease that is synonymous with elevated blood glucose levels that have an impact on vascular and nervous system disorders. In 2013, the prevalence of DM in Indonesia was 6.8 percent and increased to 8.5 percent in 2018. North Sumatra is in the twelfth position of provinces in Indonesia with a prevalence of 2 percent and Medan is the city with the highest cases with a total of 249.000 cases. In 2022 in Medan, the number of DM cases is known to be 21,515 cases. This study aims to analyze the effect of obesity, carbohydrate, and fat intake on the incidence of type 2 DM at the age of 30&lt;/em&gt;&lt;em&gt;–&lt;/em&gt;&lt;em&gt;50 years in Medan. The research method used a case-control unmatching design. The study subjects were aged 30-50 years consisting of 65 DM cases and 65 non-DM as controls. Data analysis was carried out univariate, bivariate, and multivariate with SPSS software using multiple logistic regression tests. The results showed that there was an effect between overweight (p=0.014), carbohydrate intake (p= 0.013), and fat intake (p= 0.032) on the incidence of type 2 DM. Multivariate analysis shows that carbohydrate intake is the most influential variable in the incidence of type 2 DM with an Odds Ratio value of 5.696. It is recommended for the community to carry out a healthy lifestyle by maintaining a diet, and an ideal weight, and exercising regularly. It is hoped that the Posbindu and Prolanis programs can be implemented massively at the community health center.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt; &lt;/em&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Keywords: Carbohydrate, Fat, Obesity, Type 2 Diabetes Mellitus&lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;

Description of the COVID-19 epidemiology in Malaysia.

Since the COVID-19 pandemic began, it has spread rapidly across the world and has resulted in recurrent outbreaks. This study aims to describe the COVID-19 epidemiology in terms of COVID-19 cases, deaths, ICU admissions, ventilator requirements, testing, incidence rate, death rate, case fatality rate (CFR) and test positivity rate for each outbreak from the beginning of the pandemic in 2020 till endemicity of COVID-19 in 2022 in Malaysia. Data was sourced from the GitHub repository and the Ministry of Health's official COVID-19 website. The study period was from the beginning of the outbreak in Malaysia, which began during Epidemiological Week (Ep Wk) 4 in 2020, to the last Ep Wk 18 in 2022. Data were aggregated by Ep Wk and analyzed in terms of COVID-19 cases, deaths, ICU admissions, ventilator requirements, testing, incidence rate, death rate, case fatality rate (CFR) and test positivity rate by years (2020 and 2022) and for each outbreak of COVID-19. A total of 4,456,736 cases, 35,579 deaths and 58,906,954 COVID-19 tests were reported for the period from 2020 to 2022. The COVID-19 incidence rate, death rate, CFR and test positivity rate were reported at 1.085 and 0.009 per 1,000 populations, 0.80 and 7.57%, respectively, for the period from 2020 to 2022. Higher cases, deaths, testing, incidence/death rate, CFR and test positivity rates were reported in 2021 and during the Delta outbreak. This is evident by the highest number of COVID-19 cases, ICU admissions, ventilatory requirements and deaths observed during the Delta outbreak. The Delta outbreak was the most severe compared to other outbreaks in Malaysia's study period. In addition, this study provides evidence that outbreaks of COVID-19, which are caused by highly virulent and transmissible variants, tend to be more severe and devastating if these outbreaks are not controlled early on. Therefore, close monitoring of key epidemiological indicators, as reported in this study, is essential in the control and management of future COVID-19 outbreaks in Malaysia.

Edukasi Dan Mengatasi Nyeri Bahu Dengan Terapi Latihan di Pos Lansia Banyuanyar Surakarta

Banyuanyar Village is located in Banjarsari District, Surakarta City. Banyuanyar Village is included in the status of urban areas and has a Puskesmas which plays an important role in public health. Patient visits at the Banyuanyar Health Center physiotherapy clinic for shoulder pain cases from 2022 were 25 patients while in 2023 they increased to 50 patients. The most common case is shoulder pain with the third highest case. Characterized by complaints of pain in the shoulder that hinder daily activities. The purpose of this program is to provide education and demonstrate exercises in cases of shoulder pain in order to reduce and prevent complaints. The method used was education in the form of counseling and distributing leaflets to the elderly at the Banyuanyar RW 03 elderly post. The results obtained from measuring the increase in understanding using the pre-test and post-test questionnaires were a significant increase in understanding regarding exercise with a pre-test average value of 10 and a post-test average value of 85.5

Gambaran Kasus Difteri di Provinsi DKI Jakarta Tahun 2015-17 Desember 2017

Background: Diphtheria is a contagious disease whose transmission is very fast and can cause death especially in children. In 2017 it was reported, there were 11 provinces in Indonesia experiencing diphtheria outbreaks, one of which is DKI Jakarta Province. This study aims to see an overview of diphtheria cases in DKI Jakarta in 2015 - December 17, 2017.Methods: This research is a descriptive study with a case report design. The sample in this study amounted to 59 cases. The implementation was carried out on 25 to 29 December 2017.Result: DKI Jakarta Province reported 7 diphtheria cases in 2015, 14 new cases in 2016 and 38 cases in January to 17 December 2017. Where the highest cases were in East Jakarta with the number of 18 cases from 2015 – December 17, 2017. And the number of diphtheria cases is more common in men, especially in children aged 0 - 9 years. In the 46th week of 2017 was the peak report on the incidence of diphtheria as many as 12 new cases in 1 week so that DKI Jakarta Province was declared to have an outbreak of diphtheria.Conclusion : Cases of diphtheria in DKI Jakarta from 2015 - December 17, 2017 continue to increase so special efforts are needed to prevent transmission of this disease.

Community Diagnosis Activities in Efforts to Reduce Hypertension Cases in the Working Area of Legok Health Center, Legok District, Tangerang District, Banten Province

Background: Hypertension is one of the most common causes of heart disease, stroke, and kidney failure. Hypertension cases in Indonesia until 2018 were recorded at around 34.1%. There was an increase compared to 2013 which was 25.8%. The number of new cases of hypertension during July to September 2023 at the Legok Health Center is known to increase every month, from 63 to 77 cases with the highest cases in Babakan Village. From the mini-survey, it was found that knowledge about hypertension was still lacking. Objective: To increase public knowledge about hypertension as a whole in the working area of the Legok Health Center. Methods: A community diagnosis approach was used to identify problems using Blum's Paradigm. Problem prioritization was determined using non-scoring Delphi technique and the root cause of the problem was determined through fish-bone diagram. Data on intervention outcomes were obtained through pre and post test questionnaires. Monitoring was conducted using the plan-do-check-action (PDCA) cycle. Results: Based on the results of the analysis using the fishbone diagram, the main problem is lifestyle. The results of the activity obtained all participants scored ≥70 points on the post-test and blood pressure screening ≥140 and / or ≥90 was obtained in 10 people (35.71%). The nutritional status of under-weight was found in 2 people (7.14%), normal in 5 (17.86%), overweight in 3 (10.71%), obesity level 1 in 12 people (42.86%), and obese level 2 in 6 people (21.43%) and abdominal circumference ≥80 cm in 21 people (75%). Conclusion: Based on our intervention, it can be stated that our intervention is successful so that it is expected to reduce hypertension cases at the Legok Health Center

Bovine anaplasmosis in Zimbabwe: spatio-temporal distribution and environmental drivers

Understanding the spatial and temporal distribution of Bovine anaplasmosis is crucial for identifying areas of high prevalence for targeted disease control. This research was aimed at modelling and mapping the B. anaplasmosis potential distribution, and identify hotspots as well as significant variables explaining the occurrence of the disease. The Getis Ord G i * statistic for Hotspot analysis was used as well as MaxEnt ecological niche modelling. The effects of time, land-use, and agro-ecological regions on B. anaplasmosis occurrence were tested using Analysis of Variance (ANOVA). Results showed that several districts in Zimbabwe are suitable for the occurence of the disease for example Binga, Seke, Buhera, Kwekwe, Gweru, Mhondoro, Chegutu, Sanyati, and in the North: Mbire, Muzarabani, Mt Darwin, Shamva, Bindura, Zvimba and Makonde. Morbidity and mortality hotspots were detected in Gokwe-south, Kwekwe, and Chirumhanzu districts. Binga, Gokwe-south, Gutu, Hurungwe, Mazoe, Nkayi, Shamva, and Kwekwe districts also experienced high disease incidences. Temperature seasonality, precipitation seasonality, mean diurnal range, and isothermality were the most important variables in explaining 93% of B. anaplasmosis distribution. Unlike land-use and agro-ecological regions, time (months) had a significant effect on B. anaplasmosis occurrence with July and September having significantly (p < 0.05) higher cases and deaths than the rest of the months. The results of this study provide insights into the management strategies and control of B. anaplasmosis in Zimbabwe. It is thus concluded that geo-spatial techniques, combined with ecological niche modelling can provide useful insights into disease prevalence and distribution and hence can contribute to effective management and control of B. anaplasmosis in Zimbabwe.