Nevin Manimala

J Basic Clin Physiol Pharmacol. 2021 Jun 25;32(4):693-700. doi: 10.1515/jbcpp-2020-0453.

ABSTRACT

OBJECTIVES: The incision method operation with a high risk of infection in a clean and clean-contaminated operation requires the use of prophylactic antibiotics to minimize the risk of infection. This study was designed to analyze the effectiveness of prophylactic antibiotics in patients with digestive and oncology surgeries.

METHODS: The statistical method used was chi-square to determine the risk factors for infection at surgical site infections (SSI) in patients with digestive and oncology surgeries. This study had received ethical approval from the Ethics Committee of Dr. H. Slamet Martodirdjo Hospital, Pamekasan.

RESULTS: There were 67 patients consisted of 48 digestive surgeries (71.6%) and 19 oncology surgeries (28.4%). The criteria of observation on day 30 showed that as 1 (1.5%) SSI patient experienced purulence, inflammation, and erythema around the surgical wound so an analysis of p>0.05 was carried out so that there was no association with the incidence of SSI during hospitalization, but other factors originating from the patient, such as a lack of personal hygiene at home and lack of nutritious food intake was measured in temperature, pulse, respiration, and white blood cells examination before surgery and 24 h after surgery, all within normal ranges. The qualitative analysis of prophylactic antibiotics using the Gyssen method showed that 31 (46.3%) rationales needed an improvement process.

CONCLUSIONS: The widely used prophylactic antibiotics, namely cefazolin and cefuroxime are recommended antibiotics used in incision surgery and rationale used.

PMID:34214340 | DOI:10.1515/jbcpp-2020-0453

J Basic Clin Physiol Pharmacol. 2021 Jun 25;32(4):583-587. doi: 10.1515/jbcpp-2020-0402.

ABSTRACT

OBJECTIVES: This study aimed to evaluate the variation concentration effect of propyleneglycol, glycerin, and polyethyleneglycol 400 as a nonvolatile solvent on the physical properties and dissolution rate of the loratadine liquisolid tablet.

METHODS: The tablet was formulated into 10 formulas, where nine were liquisolid and one was conventional (CT). The concentration of propyleneglycol, glycerin, and polyethyleneglycol used in liquisolid tablets were 14, 15, and 16%. Furthermore, the mixture was evaluated based on flow properties and compressibility index. The tablet was evaluated based on hardness, friability, disintegration time, and dissolution, and the data obtained was evaluated with ANOVA or Kruskal-Wallis statistic program.

RESULTS: The result showed that flow properties, disintegration time, and dissolution have a significant value less than 0.05. The tablet friability for all concentration solvents, hardness at 14 and 15% solvent concentration, and compressibility index at 15 and 16% have significant value more than 0.05. The 16% propyleneglycol type solvent concentration tablet has the physical properties and contains the best solution.

CONCLUSIONS: From the result, it is reasonable to conclude that F7 is the tablet with all the physical properties and the best dissolution.

PMID:34214337 | DOI:10.1515/jbcpp-2020-0402

J Basic Clin Physiol Pharmacol. 2021 Jun 25;32(4):595-601. doi: 10.1515/jbcpp-2020-0469.

ABSTRACT

OBJECTIVES: Fever is a condition when the body experiences an increase in average body temperature above normal level. Maja fruit (Crescentia cujete L.) contains chemical compounds including alkaloid, flavonoid, saponin, and terpenoid, suspected as potential antipyretics.

METHODS: The study aimed to determine the antipyretic activity of ethanol extract of Maja fruit. A total of 25 male white mice of the DDY strain (20-30 g). These treatments divided into three groups with a dose extract of 125, 250, 500 mg/kg BW, standard groups of ibuprofen 400 mg/kg BW, and control groups of CMC-Na 1%. Mice were injected intraperitoneally with 0.1 cc of DPT vaccine-induced. Observations were made by measuring the rectal temperatures of mice using a digital thermometer before DPT vaccine injected or average temperatures, at 0 min (after DPT vaccine injected), 60, 120, 180, and 240 min after administering the test material. The differences between the positive control group, test group, and the negative control group were compared using statistical analysis using one-way variance analysis (ANOVA). The results were considered statistically when the value is (p<0.05).

RESULTS: The above phytochemical screening results showed that alkaloids, flavonoids, and saponins were present in the Maja fruit powder and extract (C. cujete L.). Based on the results of the statistical analysis obtained, i.e., Group II was not significantly different from Group III and Group IV (p≤0.05) and was significantly different from Group I and Group V. Group I was significantly different from Group II, Group III and Group IV and was not significantly different from Group V (p≥0.05).

CONCLUSIONS: The study showed that Maja fruit mice’s antipyretic behavior at doses of 125, 250, and 500 mg/kg BW was confirmed as a result in reducing the body temperature of male mice. The 500 mg/kg BW dosage of Maja fruit extract (C. cujete L) effectively reduced fever.

PMID:34214325 | DOI:10.1515/jbcpp-2020-0469

J Basic Clin Physiol Pharmacol. 2021 Jun 25;32(4):421-427. doi: 10.1515/jbcpp-2020-0415.

ABSTRACT

OBJECTIVES: Indonesia is one of the top 20 countries with the highest prevalence of drug resistant tuberculosis (DR-TB) worldwide with a percentage of new cases of 2.4% and retreatment of 13%. Bedaquiline (BDQ) is one of the drugs that used in the individual long regimen treating DR-TB. BDQ is also combined with levofloxacin (LFX) and/or clofazimine (CFZ) that can cause QTc interval prolongation. The aim was to study the differences in the use of BDQ regimens to the lengthening of the QTc interval and to study risk factors (diabetes, hypokalemia, sex, BMI, and age) in BDQ regimen.

METHODS: This study was an observational retrospective study with a total sampling method, which was conducted at Dr. Soetomo General Hospital Surabaya. Samples from this study were patients diagnosed with DR-TB at Dr. Soetomo General Hospital Surabaya in the period of January 2015-December 2019 who used BDQ regimen and met the inclusion criteria. The ECG data were analyzed from the mean of each group (BDQ regimen and risk factors), also analyzed using statistical analysis.

RESULTS: Data obtained from total sample in this study were 73 patients. The most widely used different regimens in this study were the combination of BDQ + LFX by 36 patients (49.3%), BDQ + LFX + CFZ by 16 patients (21.9%), BDQ by 11 patients (15.1%) and BDQ + CFZ 10 patients (13.7%). Out of 73 patients, 52 patients (71.2%) experienced lengthening of the QT interval and grade 1 of QTc interval prolongation occurred in most patients and also the onset was mostly one month after using BDQ regimen. The side effects of QTc interval prolongation from groups of combination and risk factors were no difference in each month (p>0.05).

CONCLUSIONS: This study can be concluded that there were no differences in the QTc prolongation between the groups of BDQ regimen (BDQ, BDQ + LFX, BDQ + CFZ and BDQ + LFX + CFZ) and the groups of risk factors.

PMID:34214323 | DOI:10.1515/jbcpp-2020-0415

J Basic Clin Physiol Pharmacol. 2021 Jun 25;32(4):447-451. doi: 10.1515/jbcpp-2020-0465.

ABSTRACT

OBJECTIVES: Heart disease is a clinical condition characterized by specific signs such as joint inflammation, weakness, and shortness of breath. Left ventricular remodeling can be experienced by patients with heart failure wherein a change in myocyte and nonmyocyte components occurs. One of the biomarkers in heart disease with myocardial fibrosis is matrix metalloproteinase-9 (MMP-9). Common therapy that is often given to patients with heart failure is ACE inhibitors. This main objective of this research is to investigate the effect of ACE inhibitor therapy on the degrees of MMP-9 as a biomarker among patients with heart disease.

METHODS: This research applied one group pretest-posttest design to analyze the variation in the levels of MMP-9 as a biomarker for heart function. Twenty-three subjects with acute heart disease met that inclusion also exclusion criteria, who were selected using nonrandom sampling. Statistical analysis was conducted to specify the levels of MMP-9 before, after the administration of therapy.

RESULTS: The most widely used ACE inhibitor drug was ramipril for 15 patients (65%), and the least used ACE Inhibitor drug was captopril for two patients (9%). Meanwhile, the mean MMP-9 levels before therapy was (1,915.26 pg/mL ± 260.84), and the mean MMP-9 levels after therapy was (1,916.93 pg/mL ± 383.12). The statistical analysis result revealed no significant difference in the degrees of Matrix Metalloproteinase-9 accumulation (p=0.378).

CONCLUSIONS: There was no significant reduction in the levels of Matrix Metalloproteinase-9 after pretest and posttest.

PMID:34214315 | DOI:10.1515/jbcpp-2020-0465

J Basic Clin Physiol Pharmacol. 2021 Jun 25;32(4):403-413. doi: 10.1515/jbcpp-2020-0485.

ABSTRACT

OBJECTIVES: The aim of this study was to identify the patterns of medication load, its medication burden, coordination of healthcare and patient’s understanding of their conventional cardiac medications and related herbal-derived preparations.

METHODS: The study is a mixed-method both, quantitative and qualitative approach, which involved Filipino elderly patients (n=69) enrolled in the outpatient service of the National Center for Geriatric Health, Manila. Data were gathered through face-to-face surveys and interviews using a semi-structured questionnaire. Descriptive statistics were used during data analysis. Thematic analysis was also used to emphasize patterns in the responses of the participants.

RESULTS: Respondents were knowledgeable on the name (86.9%), visual characteristics (78.3%), and indication and administration of their medicine (88.4%). The frequency of their doctor’s information on the possible side effects of the medicines was noted. The almost negligible difference in the proportions of those who asserted during the information dissemination on the medication side effect by their doctors was observed (<10.5%). Association on the age and awareness of any interaction on the drugs they are taking (p=0.032) and an association between the gender and awareness of the doctor/pharmacists about other drugs the patient is taking (p=0.033) were observed. During thematic analysis, elderly respondents were keen on the physician’s advice than that of the pharmacist. This is due to the limited knowledge of elderly patients on the role of pharmacists to conduct medication counseling.

CONCLUSIONS: The majority of the elderly patients recognized the purpose and extent of medication. It was noted that pharmacists play a limited role in understanding selected Filipino elderly patients on their medication. Lack of communication between the patient and the pharmacist was noted as preliminary findings in the study. Respondents were not yet informed of the responsibility of the pharmacist to provide information regarding their medication. Integration of pharmacists’ care for geriatric health must be strengthened and highly recommended. Supervision by the healthcare professionals, particularly by the pharmacists, must be fully established.

PMID:34214303 | DOI:10.1515/jbcpp-2020-0485

Invest Educ Enferm. 2021 Jun;39(2). doi: 10.17533/udea.iee.v39n2e11.

ABSTRACT

OBJECTIVES: To evaluate the effects of application of a manual on the improvement of alarms management in Intensive Care Units (ICU).

METHODS: This quasi-experimental study evaluated the effectiveness of the introduction into of a manual for alarm management and control in the ICU of a hospital in southeastern Iran. The intervention was a 4-hour workshop was on topics related to the adverse effects of alarms, standardization of ECG, oxygen saturation and blood pressure monitoring systems, and the use of ventilators and infusion pumps. Data were collected thorough 200 hours of observation of 60 ICU nurses (100 hours’ pre-intervention and 100 hours’ post-intervention). Response time, type of response, customization of alarm settings for each patient, the person responding to an alarm, and the cause of the alarm were analyzed. Alarms were classified into three types: false, true and technical.

RESULTS: The results showed a statistically significant difference between the pre- and post-intervention frequency of alarm types, frequency of monitoring parameters, customized monitoring settings for patients, and individuals who responded to alarms. The percentage of effective interventions was significantly higher for all parameters after the intervention (46.9%) than before the intervention (38.9%).

CONCLUSIONS: The employment of a manual for management of alarms from electronic equipment in ICUs can increase the frequency of appropriate responses to alarms in these units.

PMID:34214288 | DOI:10.17533/udea.iee.v39n2e11

Invest Educ Enferm. 2021 Jun;39(2). doi: 10.17533/udea.iee.v39n2e07.

ABSTRACT

OBJECTIVES: This research sets out the effects of a training method based on peer tutoring, aimed at developing empathy among nursing students at the University of Barcelona (Spain).

METHODS: After initial training, students are matched in pairs with similar level of empathy, exchanging the role of tutor and tutee in every session, during 12 sessions. Before the session, the tutor prepares the activities to work with his or her tutee, following this structure: exploration of prior knowledge, explanation, practical activities, feedback, and reflection. Jefferson Scale of Empathy was administered as pre-test and post-test to 76 nursing students, 40 in the intervention group, and 36 in the comparison group. Following a mixed-methods sequential explanatory design, a quantitative study (a quasi-experimental design with a comparison group) was combined with a qualitative study (interaction analysis of the 12 videotaped sessions).

RESULTS: The results revealed statistically significant improvements in empathy in the intervention group. Subsequent analysis of the peer tutoring interaction highlighted the specific actions that had resulted in these improvements and generated a context in which the tutee was able to understand complex concepts, while enabling both students to participate, reflect and discuss.

CONCLUSIONS: Peer tutoring is an effective method for the development of empathy in nursing students.

PMID:34214284 | DOI:10.17533/udea.iee.v39n2e07

Invest Educ Enferm. 2021 Jun;39(2). doi: 10.17533/udea.iee.v39n2e05.

ABSTRACT

OBJECTIVES: To estimate the combined effect of educational interventions (EI) on decreased readmissions and time of hospital stay in adults with heart failure, compared with usual care.

METHODS: Systematic review (SR) and meta-analysis (MA) of randomized controlled trials that followed the recommendations of the PRISMA statement. The protocol was registered on PROSPERO (CRD42019139321). Searches were made from inception until July 2019 in the databases of PubMed/Medline, Embase, Cochrane CENTRAL, Lilacs, Web of Science, and Scopus. The MA was conducted through the random effects model. The effect measure used for the dichotomous outcomes was relative risk (RR) and for continuous outcomes the mean difference (MD) was used, with 95% confidence intervals (CI). Heterogeneity was evaluated through the inconsistency statistic (I2).

RESULTS: Of 2369 studies identified, 45 were included in the SR and 43 in the MA. The MA of studies with follow-up at six months showed a decrease in readmissions of 30% (RR: 0.70; 95% CI: 0.58 to 0.84; I2: 0%) and the 12-month follow-up evidenced a reduction of 33% (RR: 0.67; 95% CI: 0.58 to 0.76; I2: 52%); both analyses in favor of the EI group. Regarding the time of hospital stay, a reduction was found of approximately two days in patients who received the EI (MD: -1.98; 95% CI: -3.27 to -0.69; I2: 7%).

CONCLUSIONS: The findings support the benefits of EI to reduce readmissions and days of hospital stay in adult patients with heart failure.

PMID:34214282 | DOI:10.17533/udea.iee.v39n2e05

Transbound Emerg Dis. 2021 Jul 2. doi: 10.1111/tbed.14214. Online ahead of print.

ABSTRACT

In Brazil, notification of toxoplasmosis outbreaks and epidemiological investigation is a mandatory activity of health surveillance. We investigated the risk factors for toxoplasmosis during outbreaks, notifications of outbreaks by the Health Secretary, and reports in the literature. Other factors related to the municipalities were determined through the Institute of Geography and Statistics portal. We found that fruits and vegetables were the most described transmission routes in outbreaks, and oocysts were the most common parasitic form; in recent years, there has been an increase in outbreak notifications. We also found that municipalities with high IDHM have higher numbers of toxoplasmosis infections during outbreaks. There is a need to raise awareness among the population and producers regarding good water management and quality practices and to facilitate the acquisition of complex data to improve preventive strategies. This article is protected by copyright. All rights reserved.

PMID:34214245 | DOI:10.1111/tbed.14214