Eviscerated ileum passing through a traumatic tear on the sigmoid wall is a rare case and all the cases reported previously showed that the eviscerated intestines were necrotic. However, in this case, although the huge size of eviscerated intestine had already exceeded the intestinal ischemic time, the small intestine outside the anus was not necrotic. Here we report the case of a 73-year-old female who presented with evisceration of the small intestine out of her anus as long as 200 cm 7 h before. The eviscerated small intestine (ileum) appeared still viable and there were no signs of pain, obstruction, or peritonitis. An intermittent rectal concomitant with uterovaginal prolapse had been experienced by the patient before. On surgery, the ileum was not necrotic and pulled back out of the sigmoid wall tear. The cardinal uterosacral ligament may have an important role in maintaining the uterovagina in place. When this ligament loses its ability to anchor the uterovagina to the sacrum, both the uterovagina and the rectum will lose their fixation to the sacrum and prolapse will occur. Hence, the rectum located posterior to the uterovagina also relieves its squeeze pressure so that it will not disrupt the blood supply of the ileum when the ileum enters through the rectal lumen. Rectal concomitant with
Hypertension crisis is one of the most common disease problems; it will cause complications and death. Therapeutic management guidelines that the calcium channel blocker group, one of which is nicardipine, can increase the achievement of goals in mean arterial pressure (MAP) in preventing the progression of organ damage. This study aimed to evaluate the use of nicardipine therapy on the MAP and blood pressure (BP) in patients with hypertension crisis. The research design was cross-sectional with statistical analysis—retrospective data collection at Hajj General Hospital Surabaya for August to December 2021. The number of samples in this study matched the inclusion criteria; 20 patients were obtained, 16 with a diagnosis of hypertension emergency, and four with hypertension urgency who received single or combined intravenous nicardipine therapy <0.005 with an average BP decrease of pre 20.375±31.492/103.50±10.400 mmHg and post 121.34±14.364/81.80±11.186 so that intravenous nicardipine therapy was significant in reducing systolic and diastolic BP. In the profile of the MAP value statistically using the paired T-test, it was found that the P-value was 0.000 < 0.005 with a decrease in the MAP pre-value of 135.028±13.8857 mmHg and post 93.650±8.9499 mmHg, showing a reduction in MAP as expected. In conclusion, using nicardipine intravenously at a 5 mg/hour dose has shown an optimal decrease in BP and MAP in hypertensive emergency and urgency patients.
Hypertension is a disease that occurs due to increased blood pressure. GERMAS and healthy family program through a family approach. The purpose of this community service activity is to provide counseling and know community knowledge about treatment therapies and healthy lifestyles, especially about the management hypertension therapy in Keboan Sikep Village, Gedangan Sidoarjo. The implementation method is by counseling, pre-post questionnaire and checking blood pressure and blood sugar level of participants. The results of this community service got 43 participants with a high blood pressure profile of 32 participants (74.42%), normal as many as 11 participants (25.58%) and none were classified as low. The profile of random blood sugar levels was classified as high as 6 participants (13.95%), normal as many as 36 participants (83.72%) and as low as 1 participant (2.33%). The results of the pre-test and post-test questionnaire showed that 28 participants (65.12%) (pre-test) had high adherence increased by 41 participants (95.35%) (post-test), and low adherence of 15 participants (34.88%) (pre-test) decreased by 2 participants ( 4.65%) (post test) this shows that an increase in the level of knowledge after the provision of health education.
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