Introduction: Vital signs are important physiological signs of the body. Autonomous Sensory Meridian Response (ASMR) is an experience of calm and tingles, a tingling sensation like electricity radiating from the head and neck, which affects the autonomic nervous system. This study aims to determine heart rate changes, blood pressure, and respiratory rate before and after watching the ASMR video.Methods: Double-blind pre-experimental study with a one-group pretest-posttest design. The sample consisted of 30 students who met the inclusion and exclusion criteria. All samples were asked to rest for 30 minutes before treatment and then watch the ASMR video for 3 minutes. Heart rate, blood pressure, and respiratory rate data were calculated before and after treatment. The data analysis was carried out using the Wilcoxon test.Results: Vital sign data of all samples before treatment were obtained within normal limits. After watching the ASMR video, the results of data analysis using the Wilcoxon test showed that there were significant differences in heart rate (p = 0.013), systolic blood pressure (p = 0.026), and diastolic blood pressure (p = 0.00) after watching the ASMR video. While the p-value on the respiratory rate data is 0.349 which means there is no significant difference in the respiratory rate after watching the ASMR video.Conclusion: In this study, evidence has been obtained that watching ASMR videos can reduce heart rate and blood pressure. However, the respiratory rate did not give significant results because several factors. More research is needed to determine the exact effects of watching ASMR videos.
Introduction and Importance: Ventriculoperitoneal shunt (VPS) is the most common procedure performed on children with hydrocephalus. Migration of VPS outside the peritoneal cavity is rare, especially fallopian tube migration with vaginal extrusion without organ perforation. Presentation of Case: A 3-year-old girl came to the hospital with the main complaint of having a white tube exposed from her vagina 4 days before admission. A history of frequent clear watery discharge from the vagina since one week before the admission alongside intermittent pain in the suprapubic area was obtained from the parents. A laparotomy was conducted on the patient. We found the distal shunt catheter had adhered to the omentum and it appeared that the catheter tube entered the right fallopian tube before it went into the uterus and out to the vagina. We replaced the distal catheter with a new one. The patient came home on the fourth day of the post-surgery in a good condition. Clinical Discussion: The etiology of distal shunt catheter migration into the vagina remains unclear. Our patient is the third documented case of fallopian tube migration with vaginal extrusion without organ perforation, suspected due to postsurgical adhesions to the fallopian tube. An evaluation of vaginal discharge associated with abdominal pain is an important clue for distal migration of the VPS to the vagina. Conclusion: The migration of catheter to the vagina should be considered of profuse watery discharge from vagina alongside intermittent abdominal colicky pain. The surgical goal is to re-establish a new VP shunt system.
Introduction and importance Esophageal foreign body mostly occurs in children aged 6 months to 5 years old. In neonates (babies less than 28 days old), such report is extremely rare. In this case, we report the first esophageal foreign body in neonates without any symptoms. Case presentation A 28-day-old baby boy, with normal body weight, from a low socio-economic status family, came to us with a history of ingested foreign body. No sign of unconsciousness, excessive saliva, dysphagia, and respiratory distress. The chest X-ray revealed a radiopaque foreign body in the upper third of the esophagus. The patient underwent extraction of the foreign body using a flexible endoscope under general anesthesia. We found a 1.9 cm in diameter pendant with no sign of bleeding nor inflammation in the esophageal lumen. After the foreign body removal, the patient is in good condition and recovered uneventfully. Clinical discussion Foreign body in children under 6 months old is very rare. A high index of suspicion for foreign body ingestion must be considered in unattended children from lower socio-economic status, primarily if witness statements are present and confirmed with radiological examination. Most common impaction site is at the level of the cricopharyngeus muscle. Currently, flexible endoscopy is the standard for foreign body removal in children. Conclusion High index suspiciousness, witness statements and radiological examination are the important points in diagnosing ingested foreign body in neonates. Clinicians are required to provide education to parents to supervise their children when playing together.
Introduction Intraperitoneal adhesion is a pathological condition of adhesion between the omentum, intestine and abdominal wall. The purpose of this study was to determine the effect of adding dexamethasone into normal saline fluid to prevent intra peritoneal adhesion. Materials and methods This study used experimental post-test only control group design. There were four treatment groups using six white rats in each group: group I without administration of normal saline and dexamethasone, group II with administration of normal saline irrigation, group III by adding dexamethasone dose 0.2 mg/BW into 5 cc normal saline, and group IV by adding 0.5 mg/BW into 5 cc normal saline. Laparotomy was performed to all samples followed by excoriation and abrasion in cecum and terminal ileum using gauze. Intra peritoneal adhesion assessment was carried out on the 10th day post laparotomy. Macroscopic and microscopic assessments were performed to evaluate formation of collagen, fibrin and the spread of inflammatory cells of each group. Results From macroscopic observations, it was found that the average adhesion that occurred was 3.333; 2.333; 0.666; 0.333 by using statistical calculations with one-way ANOVA with P value of 0.000. Post-Hoc analysis showed that the administration of dexamethasone 0.5 mg/BW is proven to minimize the occurrence of adhesion between the 3 groups. Microscopic assessment of the formation of collagen, fibrin and the spread of inflammatory cells by one-way ANOVA produced P 0.000 in all three parameters, but the dose of dexamethasone administration between 0.2 mg/BW and 0.5 kg/BW did not prove significant in either group. Conclusion There is evidence that the addition of dexamethasone to normal saline as an irrigation liquid during laparotomy can reduce the occurrence of adhesion. However, the dose difference was not proven to be better in this study. Further studies are suggested to use more experimental animals.
Backgrounds: Mechanical bowel preparation (MBP) was almost considered dogmatic in colorectal surgery. There are several methods known to perform MBP. Anastomotic leakage is considered higher in patients who had MBP, and it is thought due to alteration colonic morphologic, electrolyte and fluid imbalance.Methods: This is an experimental study divided into two groups. This study aims to determine the difference in collagen density, amount of fibroblast and histopathologic features in the anastomotic site between Wistar rats that had MBP and without MBP to the colonic anastomosis. The first group consists of 6 Wistar rats who had colonic anastomosis without MBP, and the second group consists of 6 Wistar rats who had colonic anastomosis with BMP. On the 10th day after surgery, histopathology examination is performed with regards to collagen density, the number of fibroblasts, infiltration of inflammatory cells and the degree of bowel wall damage at the anastomotic site. Independent t-test is used to analyze the data if it is normally distributed and Mann-Whitney test is used if the data is not normally distributed.Results: The amount of fibroblast was significant difference between two groups (p=0.02), which is amount of fibroblast in the second group (3.83 ± 0.408) is higher than the first group (2.33 ± 0.816). Meanwhile, there is no significant difference regarding collagen density, infiltration of inflammatory cells and the degree of bowel wall damage (p=0.59, p=0.082 dan p=1.00).Conclusion: The conclusion of this research is by performing MBP prior to colonic anastomosis will exert the effect of more abundant fibroblast.
Background: One-stage pull-through operation has become increasingly popular for the treatment of Hirschsprung's disease. The advantages of total transanal pull-through include minimal resection of the dilated ganglionic part of the colon, shorter hospital stay, decreased total cost, lower risk of adhesive intestinal obstruction.Methods: A retrospective study of patients with HD underwent transanal endorectal pull-through (TERPT) procedure treated at Dr. Zainoel Abidin Hospital Banda Aceh, Indonesia between January 2010 – December 2013. We assessed patients characteristic, outcome and complication including Hirsch sprung associated enterocolitis (HAEC).Results: A total 77 patients were included in this study. The mean age was 13.01 months (range from 11 days – 8 years old). Most of the patients (55.8%) were male and female (44.2%). Clinical classification of HD: short segment 74 patients (96.1%) and ultra-short segment 3 patients (3.9%). The mean of bowel resection length in TERPT procedure was 18.64 cm (range from 7–25 cm). There is no mortality associated with TERPT procedure. Hirsch sprung associated enterocolitis (HAEC) occurred in 43 subjects (54.5%). Statistical analysis showed the significant relation between age at surgery and HAEC (p= 0.000) and no significant relationship between gender (p=0.425) and bowel resection length (p=0.780) with HAEC.Conclusions: Transanal endorectal pull-through procedure has been shown as an effective minimally invasive treatment in resolving obstructive symptoms in ultra–short segment of HD patients. The number of HAEC incidence among HD patients underwent TERPT significantly increased with older age of children.
Introduction: Appendicitis is the inflammation of appendix vermiformis and is designated a national health priority issue by the Ministry of Health. Obstruction of the appendicitis lumen is the main etiology of acute appendicitis, and one of the risk factors is eating habits. This study aimed to determine how eating habits are at risk of causing appendicitis in children. Eating habits that were becoming the focus of this study are fiber intake, water consumption, and fast food. Methods: This research is a literature study with the scoping review method, compiled based on PRISMA-ScR. Results: The results obtained are four works of literature stating that low fiber intake and inadequate water consumption in children have a relationship with acute appendicitis, and one piece of literature states that there is no correlation. However, the consumption of fast food has no direct relationship to the occurrence of appendicitis. Conclusion: In this review, a low-fiber diet was significantly correlated with an increased incidence of appendicitis in children.
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