Background Adolescents with hypertension are at risk of morbidity and mortality due to cardiovascular problems in later life. Hypertension may be influenced by poor quality of sleep, so early detection of hypertension and ensuring good quality of sleep in adolescence is needed. Objective To assess for a possible association between poor sleep quality and hypertension in adolescents. Methods We conducted a cross-sectional study from January to March 2013 in Mustafawiyah Boarding School, Mandailing Natal, North Sumatera. Subjects' quality of sleep was assessed by the Pittsburgh Sleep Quality Index (PSQI) questionnaire and their systolic and diastolic blood pressures were measured. Quality of sleep was categorized as either good or poor. Blood pressure was categorized as either normotensive or hypertensive. An association between poor sleep quality and hypertension was analyzed by Chi-square test. Results Two hundred forty adolescents participated in this study, of whom 210 (87.5%) subjects were normotensive and 30 (12.5%) subjects were hypertensive. We found higher systolic blood pressure [114.9 (SD 11.7) vs. 109.5 (SD 10.5)] mmHg as well as diastolic blood pressure [74 (SD 9.1) vs. 69.9 (SD 7.5)] mmHg in adolescents with poor sleep quality compared to those with good sleep quality (P=0.001). Conclusion Poor sleep quality is associated with hypertension in adolescents.
Background Children in household contact of adults with smear-positive tuberculosis (TB) are at higher risk of TB infection. Screening of these children is a main strategy for eliminating childhood TB.Objective To determine risk factors of TB among children in household contact with smear-positive adult TB patients.Methods This case-control study was conducted in 5 public health centers at Batu Bara District, North Sumatera. We studied children from birth to 18 year-old living in the same house as adults with smear-positive TB. A tuberculosis scoring system was used to diagnosis TB in the children. Associations between risk factors and the incidence of TB were analyzed using Chi-square, Mann-Whitney U, and logistic regression tests.Results We enrolled 145 children who had household contact with smear-positive adult TB patients. Subjects were allocated to either the case group [TB score >6; 61 subjects (42.0%)] or the control group [TB score <6; 84 subjects (58.0%)]. Bivariate analysis revealed that nutritional status, immunization status, number of people in the house, sleeping in the same bed, and duration of household contact had significant associations with the incidence of TB. By multivariate logistic regression analysis, nutritional status and duration of household contact were significant risk factors for TB, with OR 5.89 and 8.91, respectively.Conclusion Malnutrition and duration of household contact with smear-positive adult TB patients of more than 6 hours per day were risk factors for TB among children.
There is no satisfactory explanation as to why some nephrotic syndrome (NS) patients respond to glucocorticoids and others do not. The aim of this study was to investigate an association between single nucleotide polymorphism of the MIF gene -rs755622 and serum MIF concentrations in NS patients. During a period between November 2011 and September 2012, 120 consecutive children divided into three groups [healthy children, steroid-resistant nephrotic syndrome (SRNS) and steroid-sensitive nephrotic syndrome (SSNS)] were examined. Children were defined as healthy when they had a normal estimated glomerular filtration rate and spot urinary albumin creatinine ratio <150 μg/mg creatinine. SRNS was diagnosed in children who did not respond to the usual doses of steroids within 4 weeks of initiating treatment. SSNS patients were defined as those who had remission after usual doses of steroids. The genotype of -173 G to C polymorphism of the MIF gene was determined using polymerase chain reaction restriction fragment length polymorphism methods. Serum MIF concentration was measured using sandwich enzyme-linked immunosorbent assay. The allele frequency of the C allele was higher in SRNS compared with that of SSNS patients (P=0.025). There was a trend toward an association between genotypes and serum MIF disturbances. In conclusion, this study noted elevated circulating serum MIF levels and higher frequency of the C allele of the MIF gene in SRNS patients. The presence of the C allele implies an increased risk for steroid resistance.
AIM: To evaluate the risk factors of CAUTI in ICU patients at Haji Adam Malik General Hospital and Universitas Sumatera Utara Hospital, Medan, Indonesia. METHODS: This hospital-based observational research was an observational analytic research with a cross-sectional study. This research was conducted at Haji Adam Malik General Hospital Medan, Universitas Sumatera Utara Hospital, and Department of Microbiology Medical Faculty of Medicine Universitas Sumatera Utara, on July to August 2018 until the number of samples was fulfilled. The samples were adults aged ≥18 years, admitted to an ICU between July until August 2018 with an indwelling urinary catheter during their admission, admitted in ICU with different complaints and presentations and developed clinical evidence of infection that did not originate from patient’s original admitting diagnosis, in accordance which corresponded to the inclusion criteria by using consecutive sampling technique were included in the study. Patients who were shifted out of the ICU within 48 h of admission were excluded from the study. These critical patients were referred for monitoring, observation, and management from different departments, e.g., medic, general surgery, neurosurgery, gynaecology/obstetrics, and accident/emergency departments. RESULTS: From this research, it was found that fifty-four patients with catheter were screened for UTI infection. Of those, 24 patients (44.4%) were confirmed to have UTI by urine culture. Pseudomonas aeroginosa (16.7%) and Enterococcus faecalis (12.5%) were the most common pathogens. Patients aged > 50 years old (P < 0.03) and catheter use > 6 days (P < 0.03) were both significantly associated with increased risk of developing UTI. CONCLUSION: There are eleven uropathogens identified in this study: Pseudomonas aeruginosa, Enterococcus faecalis, Escherichia coli, Klebsiella pneumonia, MRSA, Salmonella enteric, Acinetobacter baumanii, Acinetobacter lwoffi, Acinetobacter haemoliticus, Burkholderia cepacia, and Staphylococcus sciur.
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