Latar Belakang: Mahasiswa dihadapkan dengan berbagai kegiatan akademik dan non akademik hingga terkadang menyita waktu tidur, sementara waktu tidur yang cukup dibutuhkan untuk menjaga kestabilan emosi.
Tujuan: mengetahui hubungan antara kualitas tidur dengan masalah emosional (tingkat depresi, cemas, dan stres) mahasiswa pre-klinik Program Studi Pendidikan Dokter, Fakultas Kedokteran, Universitas Udayana.
Metode Penelitian: Studi cross-sectional dilakukan pada mahasiswa kedokteran pre-klinik di Fakultas Kedokteran Universitas Udayana. Responden melengkapi kuesioner data demografik, Pittsburgh Sleep Quality Index (PSQI), dan kuesioner Depression, Anxiety, and Stress Disorder Scale (DASS).
Hasil: Sebanyak 132 responden terlibat dalam studi ini dengan jenis kelamin laki-laki sebanyak 37,1% dan berjenis kelamin perempuan sebanyak 62,9%, dengan rentang usia 18-22 tahun. Indeks kualitas tidur secara umum memiliki korelasi positif dengan tingkat depresi (r=0,32; p<0,001), tingkat cemas (r=0,26; p=0,002), dan tingkat stres (r=0,36; p<0,001) mahasiswa.
Simpulan: Kualitas tidur secara umum berhubungan signifikan dengan tingkat depresi, cemas, dan stres mahasiswa kedokteran pre-klinik di Universitas Udayana, Bali. Penting bagi pihak institusi maupun badan kemahasiswaan guna menekankan program yang mendukung kualitas tidur dan kesehatan psikis mahasiswa.
Background
Hypertonic saline and mannitol are hyperosmolar agents frequently used to lower ICP and relax the brain during surgeries. Several methods have been used to achieve a good and relaxed brain, such as hyperventilation, cerebrospinal fluid drainage, head position correction, and administration of hyperosmolar agents. Comparing equiosmolar doses between hypertonic saline and mannitol in patients undergoing elective craniotomies is important to further notice the differences in several outcomes. This study aims to compare the outcome of hypertonic saline versus mannitol on brain relaxation in patients undergoing elective craniotomy.
Results
10 articles from 2007 to 2021 were included. Hypertonic saline is associated with better brain relaxation (OR = 1.84, 95% CI 1.31–2.59; P = 0.001) but significantly increase blood natrium level, both serum and arterial (MD = 3.03, 95% CI 1.70–4.36; P = < 0.001 and MD = 7.14, 95% CI 0.04–14.24; P = < 0.001, respectively). Mannitol was associated with increased fluid input and urine output (SMD = − 0.56, 95% CI − 0.98 to − 0.15; P = < 0.001 and SMD = − 0.96, 95% CI − 1.42 to − 0.50; P = < 0.001, respectively). Serum osmolality and hemodynamic parameters difference was insignificant.
Conclusions
Hypertonic saline is associated with significantly better brain relaxation score and increased blood sodium level without increase in urine. This may prove to be clinically significant in patients with electrolyte imbalance.
Background
Guillain–Barre syndrome (GBS) is a complication that occurs in patients with Coronavirus Disease (COVID-19) infection. The spectrum of symptoms varies from mild to severe symptoms, even death. The study aimed to compare the clinical manifestations in GBS patients with and without COVID-19 comorbidity.
Results
A systematic review and meta-analysis of cohort and cross-sectional studies was conducted comparing the characteristics and course of GBS disease in the COVID-19 positive and COVID-19 negative groups. Four articles were selected with a total sample of 61 COVID-19 positive and 110 COVID-19 negative GBS patients. Based on clinical manifestations, COVID-19 infection increased the likelihood of tetraparesis (OR: 2.54; 95% CI 1.12–5.74; p = 0.03) and the presence of facial nerve involvement (OR: 2.34; 95% CI 1.00–5.47; p = 0.05). Demyelinating type GBS or AIDP was more common in the COVID-19 positive group (OR: 2.32; 95% CI 1.16–4.61; p = 0.02). COVID-19 in GBS significantly increased the need for intensive care (OR: 3.32; 95% CI 1.48–7.46; p = 0.004) and the use of mechanical ventilation (OR: 2.42; 95% CI 1.00–5.86; p = 0.05).
Conclusions
GBS following COVID-19 infection showed more severe variations in clinical characteristics compared to the group of GBS patients without COVID-19. Early detection of GBS, especially the typical manifestations post COVID-19 infection, is very important to carry out intensive monitoring and early management before the patient's condition worsens.
The management of certain health disorder can be done through a combination of conventional methods, namely with medicine, as well as traditional in a holistic (comprehensive) manner. The same also can be done for people with chronic obstructive pulmonary disease (COPD). Breath training technique and self-relaxation can be used as a complement, in addition to the consumption of drugs. Yoga pranayama combined with music therapy is a new rehabilitation therapy combination that can be implemented. This study was a narrative literature review composed by original articles and reviews written in English, aims to determine the potential of a combination of yoga pranayama and music therapy as a holistic rehabilitation therapy in patients with COPD. That therapy combination has been proven capable by some literatures in reducing dyspnea, increasing lung capacity and oxygen saturation, improving fitness and minimizing anxiety level, however, there were not any studies that ensure the potency of this therapy combination in COPD patients, therefore further research should be addressed.
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