Decubitus ulcer or pressure sore is a serious morbidity in elderly patients. The incidence of pressure sores in geriatric patients is 11%. Population at 70-75 of their aged had a two-fold risk higher for suffering decubitus ulcers compared with 55-69 years of aged people. The highest incidence is in group of 80-84 years old peole. Studies has found 95% of cases are preventable. Prevention efforts have already proven to be more effective and cost effective than treatment. Prevention efforts include mobilization, skin care, fulfillment of fluids and adequate nutrition, the use of tools / aids for body movement, environmental regulation of health care and education. Treatment of decubitus ulcers by administering topical material, systemic drugs or surgery should be done as early as possible. Keyword: decubitus ulcer, geriatric patients, prevention, treatment
The COVID-19 pandemic has brought a devastating impact on the world. Medical students who belong to psychologically vulnerable groups also share more burdens due to the medical education academic demands, curriculum transition to virtually-delivered format, and the risk of being infected by the disease during clinical settings. This study aims to identify the anxiety level of undergraduate and clerkship medical students to create proper and effective strategies to build good mental status among medical students during the COVID-19 pandemic. It is a cross-sectional study. The survey was conducted using an online questionnaire to assess respondents’ identity, demographic data, family history, perceptions about online/offline learning, and the researchers used the Taylor Manifest Anxiety Scale (TMAS) test to measure the anxiety level of the subjects. The subjects of this study were 164 medical students, divided into two groups, 94 final year undergraduate students and 70 final year clerkship students who were still doing their clinical rotations at the hospital. The findings of this study informed that the average anxiety level was 18.3 for undergraduate students and 19.6 for clerkship students. The TMAS score was higher among clerkship students than undergraduate students. However, the statistical analysis showed no difference (p=0.306) in TMAS scores between clerkship and undergraduate students. A close approach and continuous observation are needed because the higher the TMAS score indicates the higher the anxiety level.
Tempuyung (Sonchus arvensis) consisted of � avonoid were effect as obstruct xantine oksidase enzyme, antioxidant captur superoxsidase radical. The � avonoid total in leave of tempuyung is 0,1044%, in its root have 0,5% � avonoid and the more is apigenin-7-O-glikosida (3,4,5). This research aim to know effect of infusa root of tempuyung (Sonchus arvensis) to lower the uric acid level at blood serum and infusa root of Tempuyung (Sonchus arvensis) to lower the uric acid level at mouse blood serum compared to allopurinol.This research is laboratory experimental method. The object were 25 Wistar male mice 2-3 months old, 150-200 gr divided into 5 groups. Negative Control group given potassium oxonate by intraperitoneal, Positive Control group given potassium oxonate by intraperitoneal, added by allopurinol 18mg/kgBB, Infusa Concentrated Group 1 given potassium oxonate by intraperitoneal added by infusa root of tempuyung 1,25g/kgBB, Infusa Concentrated Group 2 given potassium oxonate by intraperitoneal added by infusa root of tempuyung 2,5g/kgBB, Infusa Concentrated Group 3 given potassium oxonate by intraperitoneal added by infuse root of tempuyung 5g/kgBB. Executed until one day, where measurement of uric acid of mouse blood serum done before and after treatment. Measurement of uric acid level is done by using spectrophotometer. Obtained to be data to be analysed with Kolgomorov-Smirnov test, One-Way ANOVA and continued with LSD (Least Signi� cant Difference) test with 95% con� dence interval (CI). Result of statistical test of research shoe that infusa root of Tempuyung (Sonchus arvensis) dose 1,25g/kgBB, 2,5g/ kgBB, 5g/kgBB have effect to lower the uric acid level at mouse blood serum. Infusa root of Tempuyung (Sonchus arvensis) concentrated 5g/kgBB proportional wih dose allopurinol 18mg/kgBB to lower the uric acid level at mouse blood serum.
Hypertension is a chronic condition which is often found worldwide and becomes a major risk factor for cardiovascular disease. Initial antihypertensive therapy with Angiotensin Receptor Blocker can be used for patients who have intolerance to Angiotensin-Converting Enzyme Inhibitors, such as telmisartan. Telmisartan can be taken as monotherapy or in combination with other antihypertensive drugs. This study was designed to review the current update on the efficacy of telmisartan in patients with hypertension as single-dose or doubledose monotherapy or in combination therapy. Methods: We searched the PubMed, ScienceDirect, and Hindawi databases for terms related to telmisartan efficacy as single-dose or double-dose monotherapy, in combination with amlodipine or hydrochlorothiazide, and as therapy for hypertension with diabetes or for dyslipidemia patients with blood pressure and TGs or LDL cholesterol or post-meal blood sugar or fasting insulin or fasting plasma glucose. The articles matching the restriction criteria were then passed the PRISMA flowchart. The quality of the articles was tested using the GRADE method. Results: The article searches found 1033 journals, 12 articles were eligible for systematic review with high-grade result, 1 article with moderate-grade result, and 1 article with low-grade result based on the GRADE method. The review of articles on telmisartan single-dose monotherapy showed significantly reduced blood pressure (±5.61/5.15 mmHg) and 21.8 ± 5.592/16.00 ± 5.965 mmHg when used as double-dose therapy. The combination of telmisartan with amlodipine showed a highly significant effect to reduce blood pressure (−15.3 ± 11.2/−8.0 ± 8.6 mmHg) after 8 weeks, and with hydrochlorothiazide it was −31.1−18.1 mmHg in 8 weeks. For hypertension patients with diabetes, telmisartan has significantly reduced blood pressure (−24.9/−19.5 mmHg), post-meal blood sugar (−36.9 mg/dL) after 12 weeks, and FPG (−1.06 mg/dL) as well as fasting insulin (−0.818 μU/mL). Telmisartan has good tolerability for treatment with anti-cholesterol drugs. Conclusion: Telmisartan is favorable and effective for the treatment of patients with hypertension as single-dose and double-dose monotherapy, in combination with amlodipine or hydrochlorothiazide, and therapy for hypertension with diabetes or dyslipidemia patients.
ABSTRACT Pomegranate (Punica granatum L) is widely used for health. Pomegranate peel is part of the pomegranate fruit which is often discarded and has not been widely used. Pomegranate peel is thought to contain antioxidants. One of the examinations for antioxidants is the 1,1 dipheyl-2-picrylhydrazyl (DPPH) method, by calculating the IC50 value, where the smaller the IC50 value means that the stronger of antioxidant potential. The purpose of this study was to compare the antioxidant activity of the ethanol extract, ethyl acetate fraction, and the active isolate from pomegranate peel. The antioxidant potency was tested using the DPPH, using the UV-Vis spectrophotometer, at 515 nm wavelength. Isolation of isolates was carried out by column chromatography shepadex and TLC with toluene as mobile phase; ethyl acetate : formic acid : methanol, with a ratio of 3:3:0.8:0.2. The purity of the isolate was detected by HPLC, with water-methanol as the mobile phase. The research results showed that 96% ethanol extract, ethyl acetate fraction and active isolate from pomegranate peel have potential as antioxidants with IC50 4.52 ± 0.00, 2.71 ± 0.01, and 0.979 x 10-5 ± 0.00 µg/mL, respectively, the positive control was vitamin C, had an IC50 3.66 ± 0.02 µg/mL. The conclusion of this study is that pomegranate peel isolate has the strongest antioxidant potential, compared to 96% ethanol extract and the ethyl acetate fraction of pomegranate peel, and even vitamin C. ABSTRAK Delima (Punica granatum L) banyak dimanfaatkan untuk kesehatan. Kulit delima merupakan bagian dari delima yang sering kali dibuang dan belum banyak dimanfaatkan. Kulit delima diduga memiliki kandungan antioksidan. Salah satu pemeriksaan antioksidan adalah dengan metode 1,1 dipheyl-2-picrylhydrazyl (DPPH), dengan menghitung nilai IC50, dimana semakin kecil nilai IC50 dapat diartikan bahwa semakin kuat potensi antioksidannya. Tujuan dari penelitian ini adalah untuk membandingkan aktivitas antioksidan dari ektrak etanol, fraksi etil asetat, dan isolat aktif kulit delima. Potensi antioksidan diuji dengan metode DPPH, dengan menggunakan spektrofotometer UV-Vis, pada panjang gelombang 515 nm. Isolasi isolat dilakukan dengan kromatografi kolom shepadex dan KLT dengan fase gerak toluene: etil asetat: asam format: metanol, dengan perbandingan 3:3:0.8:0.2. Kemurnian isolat di deteksi dengan HPLC, dengan fase gerak air-metanol. Hasil peneiltian menunjukan bahwa ekstrak etanol 96%, fraksi etil asetat dan isolat aktif dari kulit delima memiliki potensi sebagai antioksidan, dengan nilai IC50 masing-masing sebesar 4,52 ± 0,00; 2,71 ± 0,01; dan 0,979 x 10-5 ± 0,00 µg/ mL, sebagai kontrol positif vitamin C memiliki nilai IC50 3,66 ± 0,02 µg/ mL. Kesimpulan penelitian ini adalah bahwa isolat kulit delima memiliki potensi antioksidan terkuat, dibandingkan ekstrak etanol 96% dan fraksi etil asetat kulit delima, bahkan juga vitamin C.
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