Mild Category Research Articles

Prevalence of Vitamin B12 deficiency in patients with type 2 diabetes mellitus on Metformin therapy at a single centre in Johannesburg, South Africa

Abstract Introduction: Metformin is a first-line oral hypoglycaemic agent for treating patients with type 2 diabetes mellitus (T2DM). Studies suggest that metformin use is associated with B12 deficiency. There is a paucity of data regarding this association in South Africa. The current study aimed to determine the prevalence of B12 deficiency in a South African cohort of T2DM patients on metformin therapy. Methods: The study was a retrospective clinical audit of patients recruited from a medical outpatient setting. A consecutive sampling technique was employed; T2DM patients who were 40 years or older and on metformin for a minimum of 6 months were recruited. B12 deficiency was defined as severe (<150 pmol/L), moderate (150–169 pmol/L) or mild (170–200 pmol/L). Results: One hundred and one (n = 101) patients were enrolled, most of whom were females (65%). The prevalence of B12 deficiency was 14.9%, with most patients in the mild category. The majority of B12 deficient patients were female (67%), elderly (70.2 ±10.7 years) and of Coloured race (67%). The median duration of metformin use in B12 deficient and non-deficient patients was 10.9 (6–13) and 7 (3–12) years respectively (p =0.179). The median metformin dosage was 1700 mg. Older age (Adjusted odd ratio (AOR) 6.67 (1.16–38.3), p = 0.033) and Coloured race (AOR 7.8(1.78–34.2) p = 0.006) were associated with vitamin B12 deficiency. Conclusion: In our setting, vitamin B12 deficiency is prevalent amongst T2DM patients on metformin therapy. Older age and the novel finding of Coloured race were associated with B12 deficiency. We recommend screening for B12 deficiency amongst T2DM patients on metformin therapy.

Markers of oxidative stress in children with iron deficiency anemia

BackgroundOxidative stress can occur in iron deficiency anemia (IDA), causing cellular injury. The primary objective of the study was to assess serum malondialdehyde (MDA), protein carbonyl as oxidants and glutathione reductase catalase, superoxide dismutase (SOD), and vitamin C levels as antioxidants in patients with IDA and healthy controls; and secondary objectives were to observe the levels among the mild, moderate and severe category of IDA and their correlations with serum iron and ferritin. Material and methodsFifty-five patients of IDA and 50 healthy controls were enrolled. Diagnosis of IDA was made based on the cut-off values of low hemoglobin as per age, serum iron <30 μg/dL, ferritin <12 ng/mL, and transferrin saturation <16 %. Serum levels of MDA, protein carbonyl, glutathione reductase, catalase, SOD, and vitamin C were estimated. ResultsThe median age of patients and controls was 6 years. IDA patients had significantly raised mean levels of MDA (p < 0.001) and protein carbonyl (p < 0.001) and decreased glutathione reductase (p < 0.001), catalase (p < 0.001), SOD (p = 0.014) and vitamin C (p = 0.010) than controls. Parameters were comparable among mild, moderate, and severe degrees of IDA. Significantly negative correlations of MDA (r = −0. 713, p < 0.001, −0.683 p < 0.001) and protein carbonyl (r = −0.500, p < 0.001, - 0.519, p < 0.001) and positive correlations of glutathione reductase (r = 0.607, p < 0.001, 0.629, p < 0.001), catalase (r = 0.447, p < 0.001, 0.436, p < 0.001), SOD (r = 0.209, p = 0.032, 0.175, p = 0.075) and vitamin C (r = 0.233,p = 0.017, 0.197, p = 0.044) were observed with serum iron and ferritin, respectively. ConclusionOxidative stress exists in patients with IDA, unaffected by the severity of anemia, and has significant correlations with serum iron and ferritin concentrations.

Safety and efficacy of 30% hydrogen peroxide in seborrheic keratoses – A prospective and interventional study

Background: Seborrheic keratosis (SK) is a skin condition affecting the keratinocytes. Although various treatment options are available, the need for a simpler topical treatment approach is unmet. Hydrogen peroxide (HP) acts by forming free radicals and initiates apoptosis in cells. Aims and Objectives: The aim of this study was to evaluate the safety and efficacy of 30% HP in SK. Materials and Methods: This study was conducted on patients attending the Dermatology, Venereology, and Leprology at MGM Hospital attached to Kakatiya Medical College, Warangal and Government Medical College Mahabubabad, Telangana, during the period from December 2019 to May 2021. In total, 80 adult patients with SKs were enrolled. The study was approved by the Research Ethics Committee of the MGM Hospital attached to Kakatiya Medical College. This is a prospective and interventional study. Eighty patients will be treated with 30% of HP topically. A photographic record of the pre- and post-treatment appearance of lesions was maintained. Physician’s lesion assessment (PLA) score was evaluated on day 15th and 106th day after treatment. Local skin reactions (LSRs) were divided into mild, moderate, and severe categories. LSR was observed immediately after 2 weeks and 106 days of treatment. Results: Most of the patients were of middle to elderly age group. SK lesions were most common seen over the head and trunk. The dermatosis papulosa nigra variant was the most common. PLA 0 was observed by day 15 in some patients after application. Of 30% HP, faster healing rates were observed in lesions over the face, and middle aged. Conclusion: About 30% HP is a promising option for the treatment of SK.

Incidence and Outcome of Spontaneous Alveolar Air Leak Events in COVID-19 Pneumonia: A Prospective Cohort Study

Introduction: Coronavirus Disease 2019 (COVID-19) has increased the burden of hospitalised pneumonia cases and related complications. Spontaneous Pneumothorax (PT) and Pneumomediastinum (PM) have been reported in both spontaneously breathing and ventilated patients with COVID19 pneumonia. Aim: To determine the incidence and outcomes of spontaneous alveolar air leak events in COVID-19 pneumonia. Materials and Methods: This prospective cohort study was carried out from June 2020 to June 2021 at a tertiary care centre in Western India. All incident cases of alveolar air leaks in COVID-19 pneumonia were included. Clinical and demographic data were collected, and statistical analysis was performed. The Chi-square test or Fisher’s exact test were used to assess the differences in subgroup proportions. Results: A total of 79 patients (63 males and 16 females) experienced spontaneous alveolar air leaks in the form of PT, PM (mediastinal emphysema), or Subcutaneous Emphysema (SE), either isolated or in combination. A total of 58 patients (73.41%) had PT, while 8 patients (10.12%) had isolated PM and 2 patients (2.53%) had isolated SE. Of the total events, 35 (44.30%) occurred in spontaneously breathing patients, among them vigorous coughing was an important precipitating factor. At the time of the incident, 1.27%, 21.52%, and 77.21% of the affected cases belonged to mild, moderate, and severe COVID19 categories, respectively. Male patients (n-63, 79.74%) in the age group of 30-60 years were predominantly affected. A total of 38 events (48.10%) occurred within two weeks (early) of symptom onset. The PaO2 :FiO2 ratio at the time of the alveolar leak showed a significant association with the outcome. Patients with PT had a poorer outcome compared to those with other types of alveolar leaks (p-value&lt;0.005). Major bleeding occurred in 2 (3.33%) of the total 60 Intercostal Drainage (ICD) procedures. Prolonged alveolo-pleural fistula healed spontaneously in four out of five cases. The cumulative incidence for air leak events was 1.55%, and for barotrauma, it was 6.47%. The overall mortality in this cohort was 74.68% (n=59), while it was 29.41% (5 out of 17) in the moderate severity group. Patients with lateonset events had a better outcome (p-value&lt;0.005). Conclusion: In this cohort of COVID-19 pneumonia from Western India, the cumulative incidence of spontaneous alveolar air leaks was 1.55%, predominantly affecting males. The early occurrence of PT in severely hypoxic patients on mechanical ventilator was associated with higher mortality.

Cognition and Psychomotor Performance in Premenstrual Syndrome with Negative Emotions

Background: Women with premenstrual syndrome are known to experience high negative emotions which is known to drastically affect cognition and psychomotor performance thereby impairing their executive function. Objective: To assess the relationship between cognition and psychomotor skill with self-reported symptoms of negative emotions like depression, anxiety and stress in women with different grades of premenstrual syndrome. Methodology: Study was conducted among 100 female nursing students in the age group 18 -20 years. Data collection tool included a questionnaire of demographic and menstruation characteristics, Menstrual Distress Questionnaire (MDQ), and Depression, Anxiety, and Stress Scale Questionnaire (DASS). Cognition and psychomotor performance were assessed based on reaction time (both visual &amp; auditory) using PC1000Hz Reaction timer. The study received ethical approval from the Institutional Ethical Committee. Every participant gave their informed written consent before participating in the study. Results: Among the 100 female students, 50 each belonged to mild and moderate PMS category. Independent t test revealed a significantly high DASS scores and reaction time scores (both visual &amp; auditory) in mild when compared to moderate PMS category. A favourable association between the severity of PMS and depression, anxiety and stress scores (DASS), and reaction time (RT) scores was discovered using the Pearson correlation test, with p significant at 0.01. Additionally, there was a substantial positive association between DASS scores and RT duration. This suggests that, as there is an increase in the severity of PMS, there was an increase in the negative emotional states scores and increase in the RT duration (both visual and auditory) thereby proving a decline in cognition and psychomotor execution. Conclusion: The results demonstrated that, woman with PMS had high negative emotion effects leading to decline in cognition and psychomotor execution which is a need of the hour to look into their lifestyle modification and treatment modality so as enhance the executive performance.

Depressive disorder among the end-stage renal disease patients undergoing maintenance hemodialysis at Chitwan medical college

Background: Patients with End stage renal disease (ESRD) suffer from a variety of losses, including renal function, family role, work role, sexual function, as well as time and mobility, all of which have a substantial influence on their lives. Physical manifestation of the End-Stage Renal Disease patients receiving dialysis treatment may be obvious but studies have found that they are also at increased risk of clinical and subclinical Depressive Disorder for a variety of reasons; which might be overlooked in our routine clinical assessment. Depressive Disorder has been associated with impaired recovery and increased mortality in many diseases including End-Stage Renal Disease patients. Objectives: To assess the magnitude of depressive disorder among the patients undergoing hemodialysis of duration &gt;3 months at Chitwan Medical College Teaching Hospital (CMCTH) and to determine the association between explanatory variables with depressive disorder. Methods: Patients undergoing maintenance hemodialysis at CMCTH after meeting inclusion criteria were enrolled by consecutive sampling technique. Diagnoses were assessed on the basis of the ICD-10 Classification of Mental and Behavioral Disorders- Diagnostic Criteria for Research (ICD-10 DCR). To stratify the severity of the Depression into mild, moderate and severe categories, we used Hamilton Depressive Disorder rating scale. Seventy-four (74) patients undergoing maintenance hemodialysis were assessed. Interviews with patients and informants were taken and filled in a self-designed demographic datasheet. Obtained data were analyzed by using descriptive and inferential statistics. Results: The prevalence of the depressive disorder among patients undergoing maintenance hemodialysis was 75.70%. Positive correlations were found between depressive disorder and gender, age group and occupation(p&lt;0.05). Conclusion: The present study showed that the prevalence of depressive disorder was higher in ESRD patients compared to study done in Nepal where prevalence of depressive disorder in ESRD patients was 51.8%.

Workplace Stress of Special School Teachers at Three Schools in Bali Province

Workplace stress is often seen as a threat or a problem that comes from the work environment. Stress is a feeling resulting from the interaction between the individual and the work environment. Work stress can happen to anyone at any time, including special school teachers. This research aims to describe the workplace stress of special school teachers at three schools in the Bali Province. This research was conducted in October-December 2022. Researcher used quantitative research method with cross-sectional design and descriptive approach. Data collection is carried out using the Copenhagen Psychosocial Questionnaire-III and the Occupational Diagnosis Survey from the Ministry of Manpower Indonesia. The sample of this research was 95 participants. Researcher use total sampling technique. The results showed that 52.63 percent of respondent experience workplace stress in the moderate categories and 44.21 percent in the mild categories. Based on the diagnosis to what extent work conditions are a source of stress, 14.74 percent of respondents are moderately stressed due to ambiguity of roles, 15.74 percent are due to role conflict, 37.89 percent are due to quantitative overload, 57.89 percent are due to qualitative overload, 13.68 percent are due to career development, and 62.11 percent are due to responsibility towards others.

Promosi Kesehatan Untuk Meningkatkan Pengetahuan Dan Keterampilan Ibu Hamil Dalam Mengatasi Mual Muntah Pada Kehamilan Di Tiyuh Makarti Kecamatan Tumijajar Kabupaten Tulang Bawang Barat

Nausea and vomiting is a common complaint made during early pregnancy, but the result of underestimating the feeling of nausea and vomiting felt during pregnancy can objectively impact the fetus being born with LBW. For this reason, to minimize the occurrence of pathological nausea and vomiting, it is necessary to provide antenatal care. Pregnant women are advised to undergo antenatal check-ups 4 times, namely in each trimester, while in the last trimester twice. The benefits of antenatal care are very large because it can identify various risks and complications of pregnancy so that pregnant women can be directed to make referrals to hospitals (Manuaba, 2011). Complementary therapy is a method of dealing with disease that is carried out as a support for conventional medical treatment or as another treatment option outside conventional medical treatment (Rufaida, Lestari and Sari, 2018). Acupressure at pericardium point 6 produces good evaluations in mothers who experience nausea and vomiting in the mild and moderate categories (Maheswara et al., 2020). Based on the results of a preliminary survey conducted by interviews with 20 pregnant women in Tribe 3 Tiyuh Makarti, Tumijajar District, West Tulang Bawang Regency in 2021, as many as 18 people (80%) were unable to do acupressure to reduce nausea and vomiting. This shows that only 2 people (20%) of pregnant women can do acupressure to reduce nausea and vomiting. The aim of this community service is to provide education to pregnant women to be able to perform acupressure during pregnancy to treat nausea and vomiting. The community service method is carried out through lectures and direct demonstrations for pregnant women. The materials used in this community service were counseling materials, leaflets and demonstration tools. Participants in the activity were 20 pregnant women. There were enthusiastic participants when the activity took place. Participants know the benefits and methods of acupressure. Pregnant women should continue to apply acupressure to reduce nausea and vomiting, and families should provide motivation and encouragement to pregnant women to reduce nausea and vomiting.

The Relationship Between the Severity of Acne Vulgaris and the Quality of Life of Prima Indonesia University Medical Faculty Students

Acne vulgaris or acne is a chronic inflammatory disease of the pilosebaceous follicles which is characterized by the appearance of open and closed comedones, papules, pustules, nodules, seborrhea and cysts. Acne vulgaris can occur in teenagers and young adults, such as medical school students, which can affect their quality of life. The aim of this research was to determine the relationship between the severity of acne vulgaris and the quality of life of students. This type of research is analytical observational research with a cross sectional design. The population in this study were students from the Faculty of Medicine, Prima Indonesia University class 2020 – 2021 who suffered from acne vulgaris. The research sample obtained was 38 people. Sampling was purposive sampling. Data was obtained from a questionnaire filled out via the Google Form link. Data were analyzed univariately and bivariately using the Spearman Rho Rank test at a confidence level of 95% (=0.05). The results showed that the severity of acne vulgaris of students at the Faculty of Medicine, Prima Indonesia University students (71.1%) was in the mild category, the quality of life of students was in the mild disorder category (52.6%). The severity of acne vulgaris in students is significantly related to the quality of life of students at the Faculty of Medicine, Prima Indonesia University (p = 0.001 &lt; 0.05), with the close relationship (correlation coefficient) of the two variables in the medium category (r = 0.522).

Deep learning prediction of curve severity from rasterstereographic back images in adolescent idiopathic scoliosis.

Radiation-free systems based on dorsal surface topography can potentially represent an alternative to radiographic examination for early screening of scoliosis, based on the ability of recognizing the presence of deformity or classifying its severity. This study aims to assess the effectiveness of a deep learning model based on convolutional neural networks in directly predicting the Cobb angle from rasterstereographic images of the back surface in subjects with adolescent idiopathic scoliosis. Two datasets, comprising a total of 900 individuals, were utilized for model training (720 samples) and testing (180). Rasterstereographic scans were performed using the Formetric4D device. The true Cobb angle was obtained from radiographic examination. The best model configuration was identified by comparing different network architectures and hyperparameters through cross-validation in the training set. The performance of the developed model in predicting the Cobb angle was assessed on the test set. The accuracy in classifying scoliosis severity (non-scoliotic, mild, and moderate category) based on Cobb angle was evaluated as well. The mean absolute error in predicting the Cobb angle was 6.1° ± 5.0°. Moderate correlation (r = 0.68) and a root-mean-square error of 8° between the predicted and true values was reported. The overall accuracy in classifying scoliosis severity was 59%. Despite some improvement over previous approaches that relied on spine shape reconstruction, the performance of the present fully automatic application is below that of radiographic evaluation performed by human operators. The study confirms that rasterstereography cannot be considered a valid non-invasive alternative to radiographic examination for clinical purposes.

Pelaksanaan Stimulasi Mencegah Lansia Pikun Dan Kurang Teliti Melalui Latihan Aktivitas Brain Gym Di Program Sekolah Lansia Desa Sliyeg Kecamatan Sliyeg Kabupaten Indramayu

Everyone who is blessed with a long life will definitely experience old age. One of the problems that occurs in the elderly is dementia. Dementia is a disorder that occurs as a result of physiological changes in the form of cognitive decline. To overcome this, include brain exercises. Brain gym is a series of simple and fun movements that are used to improve learning abilities by using the whole brain.&#x0D; This research is quantitative research using a quasi-experimental method with a one group pretest - posttest approach. The population is 56 elderly people in the elderly school program in Sliyeg Village, Sliyeg District, Indramayu Regency. Samples were taken using accidental sampling. The research was carried out from April 3 – June 30 2023.&#x0D; Research results: the level of dementia before the Brain Gym Stimulation action was carried out was 19 people (73.1%) experiencing moderate levels and the level of dementia after the Brain Gym Stimulation action was carried out as many as 23 people (88.5%) were in the mild category and the results of the Paired Samples t Test The test shows that the average difference between the level of dementia before and after the brain gym stimulation was 2.615. This means that there was a decrease in the level of dementia after the intervention with an average decrease of 2.6 points. The result of calculating the "t" value is that a p-value is 0.000 &lt; 0.005 (2-way test). This means that Ho is rejected and concludes that statistically there is a significant difference in the level of dementia in the elderly before and after brain gym stimulation in Sliyeg Village, Sliyeg District, Indramayu Regency.&#x0D; The conclusion is that there is a significant effect between the level of dementia in the elderly before and after Brain Gym Stimulation in Sliyeg Village, Sliyeg District, Indramayu Regency.

Increasing the capacity of health cadres to prevent and self-management of Osteoarthritis

Osteoarthritis (OA) is a clinical syndrome characterized by joint pain with varying degrees of functional limitations that impact quality of life. Data in Indonesia shows that the national prevalence of osteoarthritis is 7.3%. Several factors in the high prevalence of OA that can be modified require lifestyle modification to prevent OA. Self-management in OA can help maintain the individual's functional capacity, improve self-image, and improve the quality of life of the patients. This community service is health education for health cadres and the general public over the age of 35 years in one of the areas in Godean, Sleman, Yogyakarta. The team measured the level of participants' knowledge about osteoarthritis and self-screening for osteoarthritis in community service. Results obtained the majority of respondents were in the mild osteoarthritis category (36.5%). The results of the respondents' knowledge scores were the difference in average knowledge before and after providing education, there was an increase in knowledge scores of 17.87. Providing health education can increase public knowledge about osteoarthritis before and after health education about prevention and self-management of osteoarthritis.

Intervensi Family Triple Support (FTS) Berpengaruh terhadap Respon Bayi pada saat Imunisasi DPT

This study aims to determine whether the FTS intervention affects the baby's pain response when DPT immunization is given at the Community Health Center. This type of research is pre-experimental with a one-group pretest-posttest design. The results of the study showed that the frequency of responses to pain in babies before treatment was the highest, namely seven babies with a pain scale of 3, a percentage of 46.7% in the moderate pain category, the frequency of responses to pain in babies after treatment was the highest, six babies with a pain scale of 2, percentage 40% with the mild category. At the same time, the results of the bivariate analysis show that the p-value is 0.000 &lt; 0. In conclusion, family triple support intervention has a significant effect on the baby's pain response when DPT immunization is given at the Community Health Center.&#x0D; &#x0D; Keywords: Family Triple Support, DPT Immunization, Baby Response

Do FIQR Severity Categories and Symptoms, Differentiate Between Continuous, Intermittent and Non-Opioid Users in the Treatment of Fibromyalgia?

BackgroundMany fibromyalgia patients utilize opioids to treat symptoms. It is important to better understand nuances regarding this treatment option and any stigma associated with this treatment modality. AimThis study: (1) assessed the prevalence of opioid use among continuous, intermittent, and non-opioid users in fibromyalgia patients; (2) determined whether the Revised Fibromyalgia Impact Questionnaire (FIQR) was useful in distinguishing opioid use and symptom burden; and (3) assessed whether fibromyalgia patients encountered stigma and/or invalidation. DesignA cross-sectional, observational study of 1,105 participants’ responses to validated fibromyalgia and invalidation scales and demographic questions. MethodsThe study employed online survey methodology. ResultsA total of 45% of patients reported utilizing opioids (27% continuous, 18% intermittent, 55% non-users). FIQR disease categories (mild to most severe) strongly distinguished between opioid and non-opioid users with 59% of users falling in the most severe category and 68% of non-users falling in mild disease category (p < .0001). Interestingly, intermittent users were similar to non-users on FIQR severity (65.9 versus 65.7; p <0.60, 0-100) while continuous users reported greater severity than the former (73.9, p < .0001). Continuous users particularly reported more problems with daily activities (p < .0001), being overwhelmed (p < .0001), and being unable to accomplish goals (p < .0001). Stigma related to being ‘drug seeking’ and being ‘judged’. Invalidation was infrequent. ConclusionsOpioid use is common in fibromyalgia and increases monotonically with FIQR severity. Multidisciplinary approaches which help patients perform daily activities, decrease feelings of overwhelm, accomplish goals, and reduce stigma may be beneficial.

The Relationship Between the Severity of Acne Vulgaris and the Quality of Life of Prima Indonesia University Medical Faculty Students

Acne vulgaris, or acne, is a chronic inflammatory disease of the pilosebaceous follicles, characterized by the appearance of open and closed comedones, papules, pustules, nodules, seborrhea, and cysts. Acne vulgaris can occur in teenagers and young adults, such as medical school students, affecting their quality of life. This research aimed to determine the relationship between the severity of acne vulgaris and the quality of life of students. This type of research is analytical observational research with a cross-sectional design. The population in this study were students from the Faculty of Medicine, Prima Indonesia University, class 2020 – 2021, who suffered from acne vulgaris. The research sample obtained was 38 people. Sampling was purposive sampling. Data was obtained from a questionnaire filled out via the Google Form link. Data were analyzed univariately and bivariately using the Spearman Rho Rank test at a % confidence level of 95% (a=0.05). The results showed that the severity of acne vulgaris of students at the Faculty of Medicine, Prima Indonesia University (71.1%) was mild. The quality of life of students was in the mild disorder category (52.6%). The severity of acne vulgaris in students is significantly related to the quality of life of students at the Faculty of Medicine, Prima Indonesia University (p = 0.001 &lt; 0.05), with the close relationship (correlation coefficient) of the two variables in the medium category (r = 0.522). The majority of respondents indicated the presence of mild acne vulgaris, reflecting the potential for awareness of good skin health practices.

Begomoviruses on two chili types in Southeast Sulawesi Indonesia: variation of symptom severity assessment and DNA-betasatellite identification

The association of viral satellite DNA with Begomoviruses influences symptom expression in infected plants. Normalized Difference Vegetation Index (NDVI) is an image processing method used to assess plant health based on the plant’s ability to absorb sunlight for photosynthesis. Therefore, this study aims to assess symptom severity based on symptom variation and NDVI, as well as to detect and identify the presence of beta-satellite DNA associated with chili plants. The study was conducted in North Kolaka Regency, Southeast Sulawesi Province, Indonesia. It involved observations and image recording of symptom variations in the sampled cayenne and big red chili plants, followed by the detection of beta-satellite DNA in the samples using the polymerase chain reaction (PCR). The results confirmed the presence of non-coding satellite DNA associated with the Pepper yellow leaf curl Indonesia virus (PepYLCIV) in all severe, mild, or asymptomatic plant samples. In the phylogenetic tree, the non-coding satellite DNA isolates from Southeast Sulawesi are included in the betasatellite group and exhibit different genetic characteristics from other isolates available in the GenBank database. The cayenne chili with severe symptoms had lower NDVI values than the mild and asymptomatic categories, indicating that this type of chili with severe symptoms had a lower ability to absorb light. Further studies are needed to characterize the alpha-satellite type in the Southeast Sulawesi region for potential use in cross-protection mechanisms against plant virus infections.

Abstract 17102: Establishing Outcome-Based Severity Partitions for LV Dilation

Background: The 2015 American Society of Echocardiography chamber quantification guideline 1 included healthy population-based normal controls for left ventricular (LV) size, but not severity partitions due to the lack of data to support mild, moderate, and severe categories. In this study, we propose using adverse outcomes to define “severe” in non-ischemic dilated cardiomyopathy (DCM). Methods: 778 adults with DCM were enrolled prospectively and underwent CMR from June 2012 to August 2020 at West China Hospital and followed for a median of 49 months 2 . 72 healthy Chinese adults served as controls. We evaluated “severe” increase in LV end-diastolic volume indexed to body surface area (EDVi), LVEDV/right ventricular (RV) EDV, and “severe” decrease in LV ejection fraction (EF) using receiver operator characteristic (ROC) and area under the curve (AUC) analysis based on cardiovascular outcome. We defined “moderate” as control mean +½ the standard deviation (SD) distance between control mean and “severe” and “mild” as between control mean +2 SD and “moderate”. Results: Of 778 participants, 190 experienced heart failure death, sudden cardiac death, or heart transplant. For LVEDVi, the “severe” dilation cut point was 184 mL/m 2 , 10.9 SD from control mean (71 ml/m 2 ). Thus, “moderate” dilation starts at 128 ml/m 2 (control mean +5.4 SD) and “mild” starts at 92 ml/m 2 (control mean +2 SD). The LVEDV/RVEDV ratio partitions are similar to RVEDV/LVEDV partitions for pulmonary arterial hypertension 3 . It is well known that LVEDVi and LVEF have sex-based differences with females having smaller hearts and higher EF 4 . the volume ratio is slightly lower in females as compared to the males (Table 1). Conclusion: Severity of LV dilation and dysfunction based on LVEDVi, LVEF, and LVEDV/RVEDV can be determined by finding upper limits of normal, using outcomes to determine “severe” category, and using the SD distance between severe and control mean to determine mild and moderate categories.

Misdiagnosis of Asthma in Patients with Anxiety/Depression

Objective: Anxiety/depression may lead to misdiagnosis of asthma if respiratory symptoms are prominent. In this study, we aimed to evaluate misdiagnosis due to anxiety and depression among patients diagnosed with asthma.&#x0D; Material and Methods: This prospective study included patients who were previously diagnosed with asthma and evaluated by a psychiatrist through the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). The patients were divided into two groups in terms of their BDI/BAI status as positive (mild, moderate or severe category) or negative (normal category). The groups were compared in terms of clinical characteristics, pulmonary function tests, asthma control tests (ACT), and atopy parameters. &#x0D; Results: We identified 54 patients (32.7%) in BDI/BAI(+) group. Compared to that in BDI/BAI(+) group, patients in the BDI/BAI(-) group were more likely to have family history of asthma (37.0% vs. 65.7%, p

Methods of Islamic Religious Education for Children with Special Needs in Muslim Families in Banjarmasin, Indonesia

Children with Special Needs have different problems from children in general. They need special attention because of their limitations. Parents should pay attention to methods of Islamic Religious Education for Children with Special Needs to support children's development. The research method used is field research with a multi-site-based qualitative approach. The subjects in this study were 5 Muslim families from 5 sub-districts in the city of Banjarmasin, who had children with special needs in the mild category and had applied various methods of Islamic religious education and were accepted at the Inclusion State Elementary School in the city of Banjarmasin. The results of this study indicate that the Islamic religious education methods applied to children with special needs in Muslim families in Banjarmasin City are exemplary methods, advice, habituation, motivation and attention, punishment, communication-oriented, task analysis, direct instruction methods, and Method Prompts

Analysis of Factors Affecting the Level of Anxiety Stroke Patients at Dr. M. Djamil Padang

Stroke disease can cause decreased mobility, physical strength, work difficulties, hobbies, and cognitive abilities in patients which causing anxiety. This study was conducted to assess the level of anxiety in stroke patients at RSUD Dr. M. Djamil Padang. This research is a categorical analytic study using a cross-sectional design with the Depression Anxiety Stress Scales questionnaire instrument (DASS-42). The sample in this study was selected by consecutive sampling technique with a total sample of 85 stroke patients. In this study, it was found that the highest level of anxiety was in the mild category, namely 25 patients (45.5%) of the 55 stroke patients who had anxiety, while the other 30 stroke patients had no anxiety. The most age group of stroke patients was 46-55 years, namely 28 patients (32.9%), with a correlation test value of anxiety levels based on age, namely 0.396 (p &lt;0.05). Males were the most gender, namely 47 patients (55.3%) with a correlation test value of anxiety levels based on sex, namely 0.017 (p &lt;0.05), the majority of patient education was college educated, namely 42 patients (49.4%) with a correlation test value anxiety level based on education is 0.564 (p &lt;0.05). The occupation of the most patients was PNS/TNI/Polri, namely 31 patients (36.5%), with a correlation test value of anxiety levels based on work, namely 0.044 (p&lt;0.05).