Pre Group Research Articles

Deliberate Practice with Motivational Interviewing: Basic Listening Skills for Undergraduates

Background Training in professional psychology is moving beyond knowledge-based education and toward competency-based education. Similarly, experiential learning, focused more on skills than facts, is emphasized in undergraduate education. Few studies, however, have investigated the use of skill-based learning for clinically relevant skills in undergraduate psychology courses. Objective This study investigated deliberate practice as a skill-based method for training undergraduates to use basic Motivational Interviewing and reflective listening skills. Method In an upper-level undergraduate clinical psychology course, students were randomly assigned to an MI workshop that included deliberate practice to learn basic reflective listening skills or a waitlist control group. Results In both between (workshop versus waitlist) and within (pre versus post) group comparisons, students’ ability to use reflective listening improved as evaluated by raters, blind to condition, and in self-report measures of MI knowledge and skill. Conclusion Deliberate practice may be effectively incorporated into undergraduate courses to prepare novice helpers with basic listening skills. Teaching Implications Competency-based training in listening skills may help undergraduate students prepare for graduate school in the helping professions or any of multiple post-graduation professions not requiring professional training and licensure.

Routine Transvaginal Ultrasound at the Time of the Anatomy Scan: To Do or Not To Do?

There are no universal guidelines for transvaginal ultrasound (TVUS) at the time of the anatomy scan. TVUS can provide information on placental location and cervical length (CL) but may lead to more interventions. As a quality assurance initiative, a universal TVUS (UTVUS) protocol at the time of the anatomy scan was started at our institution. This study was conducted to assess whether there was a decrease in preterm birth (PTB), postpartum hemorrhage (PPH), and neonatal intensive care unit (NICU) admission once UTVUS was implemented. This was a retrospective cohort study performed on singleton gestations from February 2021 to January 2022. In the first 6 months of the study period, patients only had TVUS based on risk factors (pre group). In the second half of the study period, UTVUS was implemented at the time of the anatomy scan (post group). A total of 2,118 patients were included in the study. There were 1,037 patients in the pre group, of which 161 underwent TVUS based on high-risk factors (history of the cervical procedure, history of prior PTB, and placenta appearing low lying or cervix appearing short on abdominal ultrasound). The post group/UTVUS included 1,081 patients. Patients in the pre group had statistically significantly earlier gestational age at first TVUS (p < 0.0001), were less likely to have had a prior PTB <36 weeks (p = 0.03), and were more likely to have a history of cervical procedure (p = 0.0006) than patients in the post group. There was an increased use of vaginal progesterone in the UTVUS with 33 patients (as opposed to 10 patients in the pre group; p = 0.0007). The proportion of patients with PTB, PPH, or NICU admission did not significantly differ between the two groups even after adjusting for cofounders (p > 0.05). Our data show that UTVUS did not decrease the adverse pregnancy outcomes. In addition, the implementation of UTVUS adds more discomfort for a patient, more time to the patient's scan, and is an additional cost. Therefore, surveillance by abdominal ultrasound and adding TVUS based on risk factors may be a reasonable alternative. · UTVUS showed no difference between CLs.. · There is not sufficient evidence to conclude a difference between PTB or PPH in the two groups.. · There was significantly more placenta previa diagnosed in the post group, yet most resolved..

Implementation of a Standardized Protocol for Postpartum Anemia: A Prospective Cohort Study.

Implementation of standardized protocols for antepartum anemia increases intravenous iron (IVFe) use and improves predelivery hemoglobin (Hb). However, this condition is often overlooked and inadequately treated in postpartum care settings. We aimed to determine if implementation of a standardized protocol for postpartum anemia increases postpartum IVFe use and affects clinical outcomes. We performed a prospective cohort study evaluating implementation of a standardized inpatient protocol for postpartum anemia. This protocol, implemented in December 2021, recommends (1) IVFe for postpartum Hb 7.0 to 8.9 g/dL and (2) oral iron for postpartum Hb 9.0 to 9.9 g/dL. We compared all postpartum inpatients at a single site from April 2021 (preimplementation period [PRE]) to April 2022 (postimplementation period [POST]). The primary outcome was any IVFe use. Secondary outcomes included number of IVFe doses, oral iron supplementation at discharge, postpartum complications, and length of stay. A total of 805 patients were included (PRE = 401; POST = 404). Patients in the PRE and POST groups differed in ethnicity (PRE: 8.2% Hispanic vs. POST: 14.9% Hispanic, p = 0.003). IVFe use significantly increased from PRE to POST (PRE: 6.0% vs. POST: 11.1%, p = 0.009) even when controlling for differences between groups (adjusted odds ratio: 2.48, 95% confidence interval: [1.08-5.67]). Patients receiving IVFe in the POST group were more likely to receive the recommended three doses of IVFe compared with patients receiving IVFe in the PRE group (POST: 29% vs. PRE: 4%, p = 0.04). Patients in the POST group had shorter lengths of stay than in the PRE group (POST: 1.69 days vs. PRE: 1.81 days, p < 0.001). There were no significant differences in blood transfusion, oral iron supplementation, or postpartum complications. Implementation of a standardized protocol for postpartum anemia increased IVFe use without increasing length of stay. · Postpartum anemia is associated with postpartum depression, fatigue, impaired cognition, and altered maternal-infant bonding.. · IVFe is more effective and better tolerated than oral iron.. · Implementation of standardized protocols for antepartum anemia has been shown to increase IVFe use.. · Implementation of a standardized protocol for postpartum anemia increased IVFe use without increasing length of stay..

Effect of standardized hypnotic bundles on insomnia during hospitalization and reducing fall rate: A single-center retrospective cohort study.

Although the use of benzodiazepine receptor agonists is a risk factor for falls and fractures, whether benzodiazepine-avoiding hypnotic bundles are beneficial in clinical settings remains unclear. A new hospital-wide standardized hypnotic bundle for insomnia, with suvorexant as the first choice, was created for clinical purposes. This single-center retrospective cohort study involved a pre-post design and adult inpatients who had had falls. The primary outcome was the total fall rate in the pre-post groups. Additionally, the level change in the fall-rate trend for each month at standardization of the new hypnotic bundle was analyzed. The numbers of hypnotic-related falls and injuries requiring treatment were evaluated. There were no differences in baseline characteristics between the two groups, except for patients with COVID-19. Overall, 31 736 patients were included in this study. The total number of falls was 924 (3.42‰) in the pre-standardization group and 837 (3.31‰) in the post-standardization group, with no significant difference. An interrupted time-series analysis of the level change in the fall rate revealed that the gap in trend at standardization was -11%, with no significance. Hypnotic-related falls were 300 (1.11‰) versus 213 (0.84‰), and the injury incidences were 251 (0.93‰) versus 181 (0.71‰) in the pre and post groups, respectively, showing a significant reduction. The standardization of the new hypnotic bundle for insomnia did not help achieve a significant reduction in total falls. However, our findings suggest that this bundle has the potential to reduce hypnotic-related falls and injuries in inpatients who have had falls. Geriatr Gerontol Int 2024; ••: ••-••.

Antibacterial periodontal ligament stem cells enhance periodontal regeneration and regulate the oral microbiome

BackgroundThe transplantation of periodontal ligament stem cells (PDLSCs) has been shown to enhance periodontal regeneration in animal models and clinical trials. However, it is not known whether PDLSCs are antibacterial and whether this affects oral microbiota and periodontal regeneration.MethodsWe isolated human PDLSCs from periodontal ligament of extracted teeth. Rats’ periodontal fenestration defects were prepared, and treated with PDLSC injections (Cell group), using saline injections (Saline group) as the control. The oral microbiota was explored by 16 S rDNA sequencing and compared with that before surgery (PRE group). The antibacterial property of PDLSCs and its underlying mechanism were tested in vitro.ResultsMicrobiome analyses reveal a decreased biodiversity, a changed community structure, and downregulated community functions of the oral microbiome in the Saline group. PDLSCs injections enhance periodontal regeneration, reverse the decrease in diversity, and increase the abundance of non-pathogenic bacterial Bifidobacterium sp. and Lactobacillus sp., making the oral microbiome similar to that of the PRE group. In vitro, PDLSCs inhibit the growth of Staphylococcus aureus, Escherichia coli, and Fusobacterium nucleatum. The main mechanism of action is postulated to involve production of the cationic antimicrobial peptide LL-37.ConclusionsOur findings reveal that PDLSC injections enhance periodontal regeneration and regulate the oral microbiome to foster an oral cavity microenvironment conducive to symbiotic microbiota associated with health.

WP1.18 - A Surgical Post-Take Ward Round Checklist Proforma: A Prompt for Improved Documentation

Abstract Aims Surgical ward rounds are often swift, therefore documentation of diagnostic and management decisions is frequently incomplete. The Royal College of Surgeons of Edinburgh (RCSEd) devised a ward round checklist toolkit to improve documentation of surgical post-take ward rounds. Methods We conducted a baseline audit of our district general hospital general surgery post-take ward round documentation, based on the RCSEd checklist. Documentation in each domain was recorded for each ward round entry for both pre and post intervention groups. Control patients were identified from the surgical take list across 7 different days in a month. The checklist toolkit was then adapted into a proforma for our institution and used on post-take ward rounds for a trial period of 7 days. Results 40 patients were included in the pre-intervention group, 17 in the post intervention group. Following the introduction of the post take ward round proforma, documentation of most recent observations improved from 40% to 82%, admission blood results from 27.5% to 94%, and imaging results from 42% to 90%. Areas of existing good practice improved; history and examination findings were documented in 100% of patients, an improvement from 80% pre-intervention. Nil by mouth status was documented in 80% of cases, up from 50%, and IV fluid requirement in 58%, up from 10%. Conclusions A proforma for post take ward rounds improved documentation of key diagnostic and management information. As a result, we recommend a standardised approach to documentation to encourage consistency of recording key information in the patient record.

Vaginal microbiota, menopause, and the use of menopausal hormone therapy: a cross-sectional, pilot study in Chinese women.

To compare the vaginal microbiota of premenopausal and postmenopausal women and postmenopausal women undergoing menopausal hormone therapy (MHT) and examine the association between vaginal microbiota and genitourinary syndrome of menopause (GSM). This cross-sectional study classified 94 women aged 40 to 60 years into three groups: premenopausal (Pre, n = 32), postmenopausal (Post, n = 30), and postmenopausal women who received MHT orally (Post + MHT, n = 32). Neither the Pre nor the Post group received hormone therapy within the past 6 months. Postmenopausal women who received vaginal MHT were not included. Vaginal swabs were obtained, and microbial composition was characterized by 16S rRNA gene sequencing targeting the V3 to V4 region. Clinical data were collected and serum sex hormones were measured. The most bothersome symptom approach and vaginal health index were used to evaluate GSM. Mann-Whitney U or Kruskal-Wallis ANOVA followed by multiple comparison tests were performed for comparison between or across groups. The correlations between GSM symptom scores and vaginal microbiota were determined using Spearman's correlation analysis. The vaginal community of postmenopausal women was characterized by a decreased abundance of Lactobacillus (Post 18% vs Pre 69%); an increased abundance of several anaerobic bacteria, including Prevotella, Escherichia-Shigella, and Bifidobacterium; and a higher microbial diversity (P < 0.001 for Shannon and Simpson indexes) than those of premenopausal women. The vaginal community of postmenopausal women who received MHT had an increased abundance of Lactobacillus (54%) and lower microbial diversity (P < 0.001 for Shannon and Simpson indexes) than the postmenopausal women. The vaginal microbial community composition of the Pre group shared more similarity with that of the Post + MHT group (Adonis P = 0.051) than with that of the Post group (Adonis P < 0.001). A decreased abundance of Lactobacillus and high diversity in the vaginal community were found in women with moderate to severe GSM symptoms. Among Chinese postmenopausal women, those receiving MHT had higher Lactobacillus abundance but lower abundance of diverse anaerobes and diversity of the vaginal microbial community compared to non-MHT women. MHT in postmenopausal women may potentially contribute to reestablishing vaginal microbiota homeostasis. Findings in this pilot study, however, need to be examined in larger, prospective studies.

Cleft lip and palate surgery in the Otolaryngology and Head-neck surgery department of a Medical College Hospital in Bangladesh

Background: Cleft lip and palate (CLP) are one of the most common developmental anomalies in orofacial region. CLP surgery lies in the anatomical domain of Ear Nose Throat and Head - Neck Surgery. In Bangladesh specialty of plastic surgery is still in developing stage and plastic surgeons are not easily available everywhere. ENT and Head-Neck surgeon had to take up the responsibility of some of cleft patients. This article is a retrospective analysis of a series of 200 cases of cheiloplasty and palatoplasty done in ENT and Head-Neck Surgery department of Khulna City Medical College Hospital, Bangladesh. Results were satisfactory in our, patient and parent's consideration. Objective: Our aim is to discuss the demographic profile, presentations, degree &amp; type of cleft and outcome of CLP surgery in Otolaryngology and Head-Neck Surgery department of a Medical College Hospital of Bangladesh. We will also discuss the embryology of face &amp; historical background of the cleft surgery. Materials and Methods: This is a retrospective analysis of CLP surgery for 200 cleft patients. We based on inclusion and exclusion criteria for selection of patients. Majority of cleft lip patients were operated following the Millard modified rotation advancement technique and isolated cleft palate patients were operated following Von Langenbeck bipedicle flap and Veau-Wardil-Kilner V-Y pushback technique in the ENT and Head-Neck Surgery Department of a Medical College Hospital. Patients were advised for periodic follow up. Results: Total of 200 patients of CLP were operated in our department out of which male was 92 (46%) and female was108 (54%)), male and female ratio being 1:1.08. The age range was 3 months to 40 years with a mean of 8.38 years. Pre alveolar group both male and female comprised of 134 (67%) and alveolar group 66 (33%) patients and that of isolated cleft palate 7 (10.60%) patients. Pre alveolar unilateral CLP was high. The results of surgery were satisfactory in our postoperative evaluation. Patients and parents were also satisfied with the outcome. Conclusion: Majority of CLP patients don’t suffer functional problem apart from facial disfigurement. Restoration of normal anatomy, facial appearance and function can be achieved by surgery in appropriate time and age. Few cases may be associated with feeding difficulties, dental and hearing problems. Some cases are associated with other congenital anomalies and syndromes. Those cases demand team approach of different specialty.

KAPSUL EKSTRAK KULIT PISANG AMBON MENINGKATKAN KADAR NITRIT OKSIDA PADA WANITA HIPERTENSI USIA SUBUR

Hypertension affects individuals of all ages, including women. One of the contributing factors to hypertension is oxidative stress. Banana peel contains high levels of flavonoids, which increase antioxidant activity. This study aimed to analyze the effect of ambon banana peel extract capsules on increasing nitric oxide levels and reducing blood pressure hypertensive women. This research employed quasi experimental design with purposive sampling, non randomized pre and post test control group design. The sample included 32 hypertensive women divided into two groups 16 in the intervention group and 16 in the control group. The intervention group received 2,500 mg of banana peel extract capsules addition to antihypertensive drugs, the control group received only antihypertensive drugs. Both groups were treated for 14 days. The results indicated that the mean systolic blood pressure the intervention group decreased average of 16.32 mmHg, compared to decrease of 7.49 The results indicated that the mean systolic blood pressure in the intervention group decreased an average of 16.32 mmHg, compared decrease of 7.49 mmHg in the control group. Mean diastolic blood pressure the intervention group decreased by 12.56 mmHg, compared decrease 4.68 mmHg in the control group. Nitric oxide levels increased by 61.06 points in the intervention group and decreased by 19.75 points the control group. Conclusion, the study found significant differences in pretest-posttest systolic and diastolic blood pressure between the intervention and control groups, indicating that ambon banana peel extract capsules effectively increase nitric oxide levels and reduce blood pressure in hypertensive women

Growth Differentiation Factor -15 (GDF-15) Levels in Diabetic Conditions: Animal Model

Diabetes mellitus (DM) is a disease characterized by increased blood sugar levels, consisting of Diabetes Mellitus type I (DMT1) and Diabetes Mellitus type II (DMT2). Chronic increases in blood glucose levels will cause oxidative stress through the accumulation of Reactive Oxygen Species (ROS). Oxidative stress will induce the secretion of pro- and anti-inflammatory mediators, including Growth Differentiation Factor-15 (GDF-15). GDF-15 levels can be used to predict the risk and progression of DM disease. In exploring diabetes, several studies were carried out on experimental animal models of diabetes, both T1DM and 2DMT models. This research is an experimental study with a Pre and Post-Test Control Group Design approach using rat animals divided into four groups (I=Control group; II=Alloxan group; III=Streptozotocin group and IV=Streptozotocin and high fat diet group) with the aim of to see the levels of Growth Differentiation Factor-15 (GDF-15) in diabetic animal model. Based on this research, there was an increase in levels of Growth Differentiation Factor-15 (GDF-15) before and after diabetic animal model in the Streptozotocin group P value 0.010; and Streptozotocin with a High Fat Diet group with P value of 0.043 (significance value P &lt; 0.05).

Impact of an updated venous thromboembolism prophylaxis guideline in critically ill trauma patients on rates of venous thromboembolisms

IntroductionThe objective of this analysis was to evaluate differences in incidence of venous thromboembolisms (VTE) in critically ill trauma patients between pre- and post-implementation of updated VTE prophylaxis guidelines. MethodsThis was a pre-post analysis of critically ill trauma patients receiving pharmacologic VTE prophylaxis. Trauma patients were included if they had an intensive care unit admission during their hospitalization. The primary outcome was incidence of detected VTE and was analyzed using a Chi-Squared test. A multivariate analysis assessed the effects of guideline implementation on VTE development when controlling for confounders. ResultsThere were 220 patients included. There was a significant increase in low molecular weight heparin use in initial (p ​= ​0.003) and final (p ​= ​0.004) prophylactic regimens between groups. There was no significant difference in VTE incidence between the pre and post groups (6.3% vs 1.9%, p ​= ​0.10). The multivariate analysis showed guideline implementation was independently associated with an 88% reduced odds of VTE (p ​= ​0.04). ConclusionThis analysis suggests the updated VTE prophylaxis guideline implementation was associated with a trend toward reduced VTE development among critically ill trauma patients.

Pengaruh Penyuluhan Cara Menyikat Gigi dengan Metode Ceramah dan Simulasi Terhadap Peningkatan Pengetahuan dan Keterampilan Siswa SD Negeri 4 Babahan Tahun 2024

Dental and Oral Health is a condition where the oral cavity including the teeth and also the supporting tissue structure is free from disease and can function optimally. Efforts to increase knowledge can be through health counseling. Counseling with various targets that are more focused on vulnerable groups of school children. The aim of this research is to to find out the effect of counseling on how to brush teeth using lecture and simulation methods on increasing the knowledge and skills of students at SD Negeri 4 Bahanan in 2024. This type of research is Quasi-experimental with a pre and postest control group design. The data used in this study were primary and secondary data using questionnaires and observation checklists. The results of the study obtained an average level of knowledge before being given counseling of 71.89 with sufficient criteria and increased after being given counseling to 90.56 with good criteria. Tooth brushing skills obtained an average before being given counseling of 67.22 with sufficient criteria and increased after being given counseling of 96 with very good criteria and the results of the influence test show that the sig value (2-tailed) = 0.00 is smaller than 0.05, then Ho is accepted. The conclusion of this research that, there is an influence of counseling on how to brush your teeth using lecture and simulation methods on increasing knowledge and skills on how to brush your teeth in class IV and V students at SD Negeri 4 Babahan in 2024 before and after being given the counseling.

The impact of cancer patient pathway on timing of radiotherapy and survival: a cohort study in glioblastoma patients.

Glioblastoma (GBM) is an aggressive brain tumor in which primary therapy is standardized and consists of surgery, radiotherapy (RT), and chemotherapy. However, the optimal time from surgery to start of RT is unknown. A high-grade glioma cancer patient pathway (CPP) was implemented in Norway in 2015 to avoid non-medical delays and regional disparity, and to optimize information flow to patients. This study investigated how CPP affected time to RT after surgery and overall survival. This study included consecutive GBM patients diagnosed in South-Eastern Norway Regional Health Authority from 2006 to 2019 and treated with RT. The pre CPP implementation group constituted patients diagnosed 2006-2014, and the post CPP implementation group constituted patients diagnosed 2016-2019. We evaluated timing of RT and survival in relation to CPP implementation. A total of 1212 patients with GBM were included. CPP implementation was associated with significantly better outcomes (p < 0.001). Median overall survival was 12.9 months. The odds of receiving RT within four weeks after surgery were significantly higher post CPP implementation (p < 0.001). We found no difference in survival dependent on timing of RT below 4, 4-6 or more than 6 weeks (p = 0.349). Prognostic factors for better outcomes in adjusted analyses were female sex (p = 0.005), younger age (p < 0.001), solitary tumors (p = 0.008), gross total resection (p < 0.001), and higher RT dose (p < 0.001). CPP implementation significantly reduced time to start of postoperative RT. Survival was significantly longer in the period after the CPP implementation, however, timing of postoperative RT relative to time of surgery did not impact survival.

Effect of Coenzym Q10 on Doxorubicin-induced Cardiotoxicity in Non Hodgkin's Lymphoma Patients

BACKGROUND : Non-Hodgkin's Lymphoma is a primary malignancy in the Lymph Nodes and lymphoid tissue originating from B lymphocytes, T lymphocytes and Natural Killer (NK) cells. Therapy for Non-Hodgkin's Lymphoma chemotherapy can be given alone or combined with radioactive therapy. Doxorubicin is a chemotherapy drug used for lymphoma with side effects, one of which is cardiotoxic effects. AIMS : To prove that coenzyme Q10 can reduce the cardiotoxic effect of doxorubicin chemotherapy in non-Hodgkin's lymphoma patients METHOD : Intervention study with a randomized pre and post test double blind control group design with 34 NHL patients undergoing chemotherapy. The treatment group received additional therapy with coenzyme Q10 300mg/day for 12 weeks while the controls received placebo. The cardiotoxic effects examined were assessed based on the results of Electrocardiography and Echocardiography. RESULT : The treatment group with coenzyme Q10 supplementation after the 4th chemotherapy showed a decrease in echocardiography results in 3 patients (18%) and in the control group 17 patients (100%). There was a significant difference in the echocardiography results of the treatment and control groups (p=0.001). There were no drug side effects in both groups CONCLUSION : Coenzyme Q10 supplementation provides an improvement in the cardiotoxic effects of doxorubicin in non-Hodgkin's lymphoma patients, on echocardiography, but not on Electrocardiography.

Cognitive Behavioral Therapy: A Quasi-Experimental Study of Self Care Activity with Type 2 Diabetes Mellitus Patients

Individuals diagnosed with diabetes mellitus require a multi-faceted approach to treatment. Key aspects of self-care for these patients include maintaining a proper diet, engaging in regular physical activity, adhering to prescribed medications, consistently monitoring blood glucose levels, caring for the legs, and managing smoking habits. Among the therapeutic interventions used in nursing, Cognitive Behavioral Therapy (CBT) is noteworthy. The purpose of this study was to examine the impact of CBT on self-care behaviors in patients with Type 2 diabetes mellitus. Utilizing a quasi-experimental design, this study implemented a pre and post-test control group methodology. A total of 32 participants were selected based on specific criteria and probability sampling methods were employed to determine the sample. Data was gathered using the Summary of Self-Care Diabetic Activity questionnaire. Findings from the study indicate that CBT significantly enhanced dietary compliance (p-value = 0.02), increased physical activity (p-value = 0.001), and improved independent blood glucose monitoring (p-value = 0.003). Additionally, CBT enhanced adherence to medication (p-value = 0.004), leg care (p-value = 0.004), and reduced smoking behaviors (p-value = 0.021). CBT effective in enhancing various self-care activities among diabetic patients by fostering changes in mindset and encouraging positive behavioral shifts

Uji Toksisitas Akut Ekstrak Etanol Daun Alpukat (Persea americana Mill.) dan Pengaruhnya Terhadap Hepar Mencit BALB/c

Avocado leaf ethanol extract as a traditional medicine has been proven to have various pharmacological activities, but the safety of its use is not yet known. This study aims to determine the range of LD50 values, toxic symptoms, changes in body weight, and SGPT SGOT levels of Balb/c mice. The research was carried out experimentally using a fixed dose toxicity test method with a randomized matched pre and post-test control group design. EEDA is made by 70% ethanol maceration. The acute toxicity test consists of 2 stages: preliminary and main tests. Preliminary tests were carried out with a dose of extract 300 mg/kg BW once administered. After 24 hours of observation, there were no toxic symptoms, the test dose was increased to 2000 mg/kg BW. The main test was carried out using 10 test animals which were divided into 2 groups, each given a dose of extract 2000 mg/kg BW once and CMC Na 1% (negative control). Observation of toxic symptoms and death was carried out for 14 days. The LD50 value is determined from the results of toxic symptoms and death of test animals. Toxic symptoms were analyzed descriptively, and changes in body weight and SGOT SGPT levels were analyzed statistically (95% confidence level). The research results show that avocado leaf ethanol extract has an LD50 value range of &gt;2000 mg/kg BW. The test dose of 2000 mg/kg BW did not cause toxic symptoms and death. SGOT and SGPT levels were still within normal limits, however, changes in SGPT levels were significantly different from controls. Thus, an extract dose of 2000 mg/kg BW has an acute toxic effect on the liver of mice.

THE CORRELATION OF COGNITIVE FUNCTION TO BRAIN GYM IN THE ELDERLY

Background: A decline in cognitive function is often considered normal in the elderly, but the advanced stages of cognitive decline can decrease the ability to perform functional activities. Brain gym is one of the physical activity therapies that is proven to improve cognitive function. The purpose of this study is to know the effect of brain gym on cognitive function. Objective: This study aims to determine the correlation of cognitive function to brain gym in elderly. Methods: This is a queasy experimental study in 70 respondent with a pre and post-test group design. The subjects were elderly who were examined with Montreal Cognitive Assessment Indonesian (MoCA-Ina) and Visual Reproduction Test (VRT) on the first day and given brain gym 13 times, which was done 2 times in 1 week and re-examined MoCA-Ina and VRT after the intervention. Results: The research results show improvement in the MoCA-Ina and VRT pre and post-examinations after being given intervention. In the MoCA-INA examination, the mean score of the pretest was 23.30 and the mean score of the post-test was 24.50, while in the VRT examination, the mean score of the pretest was 10.08, and the post-test mean score was 10.83. However, there was no significant difference between MoCA-Ina or VRT in pre- and post-interventional brain gym (p&gt;0.05). Conclusion: There is a relationship between cognitive function which is marked by an increase in the results of Moca INA and VRT with brain gym in the elderly at Balearjosari Malang

Evaluation of a PTSD group intervention in a secondary care mental health service

Introduction: Secondary care mental health services in the United Kingdom are under increasing pressure to meet the demand for support for Post-Traumatic Stress Disorder (PTSD), however, there is a lack of clear guidance for treating complex cases of PTSD. Therefore, an evaluation was conducted to investigate the effectiveness of a pilot stabilisation group programme for clients with PTSD in a secondary care mental health service. Method: Attendees of the group (n = 64) were asked to complete routinely collected outcome measures of wellbeing (WEMWBS) and PTSD symptoms (PCL-5). A repeated-measures t-test analysed the pre and post group scores for statistical significance, whilst Reliable Change Indices analysed the data forreliable improvement and clinically significant change. Results: There was a significant difference between the pre and post group scores on the measures of wellbeing and PTSD symptoms. A large proportion of clients demonstrated reliable and clinically significant improvements in wellbeing. A small proportion of service users demonstrated clinically significant improvements in PTSD symptoms. Conclusion: The intervention shows promise as an initial stage of trauma treatment due to the improvements in wellbeing. However, a large proportion of clients are likely to require further intervention to reduce symptoms of PTSD.

Effects of Adding Brown Sugar In Young Coconut Water Post High-Intensity Interval Training on Plasma Osmolarity, Oxygen Saturation, and Pulse Rate

This study analyzes the effect of adding brown sugar to young coconut water post-High Intensity Interval Training (HIIT) on plasma osmolarity, oxygen saturation, and pulse rate. Utilizing a pre and post-test control group design, the experiment involved 20 male subjects aged 19-22 with a normal body mass index. The participants were divided into three groups: (K1) receiving mineral water, (K2) receiving young coconut water, and (K3) receiving young coconut water with added brown sugar. Each subject underwent a 30-minute ergo cycle HIIT session. Blood samples were collected at three intervals: before exercise, immediately after, and an hour post-rehydration. The results indicated plasma osmolarity levels showed no significant change from Pre-HIIT (0.939) to Post-HIIT (0.780). However, Post-Rehydration, an increase was observed across the three groups (p=0.004). Pulse rate measurements revealed no significant difference from Pre-HIIT (0.788) to Post-HIIT (0.411), but Post-Rehydration, a significant decrease was noted between the groups (p=0.034). Oxygen saturation levels remained consistent Pre-HIIT (0.902), Post-HIIT (0.602), and 1-hour post-HIIT (0.611) within the third group. In conclusion, adding brown sugar to young coconut water post-HIIT resulted in higher plasma osmolarity, did not affect oxygen saturation levels, and contributed to a lower pulse rate. Keyword: Plasma osmolarity; oxygen saturation; pulse rate; brown sugar; young coconut water

Assessment of Biological Damage Induced during Multidetector Computed Tomography (MDCT) Examination.

Computed tomography (CT) is known for its non-invasiveness, fast procedure, and also for providing detailed diagnostic information to physicians. It also utilises low-dose-rate ionising radiation (X-rays) as a source for imaging. Multidetector computed tomography (MDCT) is an advanced system that uses iodinated contrast media for more accurate diagnostic results. Studies suggest using these contrasts will lead to greater radiation adsorption with significant DNA damage. No studies have been taken comparing the physical dose with the biological effect. The present study sheds light on the same by assessing the biological effect of CT with and without contrast intervention. The present study is timebound; thus, 21 participants attending for CT thorax and abdomen with no history of any cancer were included. The same participants underwent both pre-contrast and post-contrast studies. The blood sample was taken before the procedure and used as a control. Physical parameters like DLP and CTDI obtained from the instrument were compared with the MN frequency obtained (CBMN Assay). The study showed a significant increase (p-value < 0.05) in the Physical and MN frequency in the Post-Contrast group compared to the pre-contrast group. Although a positive correlation was observed between pre and post-contrast groups, the results were not found to be statistically significant (p-value < 0.05). The study confirms increased physical dose and MN frequency upon contrast intervention. This study recommends the judicial use of MDCT in disease diagnostics.