Background: Solid waste from coffee depulping process threatens the organism in environment as it produces organic pollutants. Evidence suggested that coffee by-product could valorize owing to its potential as antioxidant sources. The aim of this systematic review was to evaluate antioxidant activity of coffee by-products obtained from different coffee variants (arabica and robusta) and processing methods. Methods: The systematic review was conducted as of May 29, 2021 for records published within the last ten years (2011–2021) using seven databases: Embase, Medline, BMJ, Web of Science, Science Direct, Cochrane, and PubMed. Data on type of specimen, processing methods, and antioxidant activities were collected based on PRISMA guidelines. Results: Our data suggested that aqueous extract was found to be the most common processing method used to obtain the antioxidant from various coffee by-products, followed by methanol and ethanol extract. A variety of antioxidant properties ranging from strong to low activity was found depending on the variety, type of coffee by-products (cascara, pulp, husk, silverskin, and parchment), and processing technique. Fermentation employing proper bacteria was found effective in improving the yield of bioactive compounds resulting in higher antioxidant capacity. Applications in feedstuffs, foods, beverages, and topical formulation are among the potential utilization of coffee by-products. Conclusion: Coffee by-products contain bioactive compounds possessing antioxidant properties which could be used as additives in foods, beverages, and cosmetics. In particular, their benefits in skin care products require further investigation.

Introduction: The cause of serious problems in patients with chronic kidney disease on hemodialysis is due to uncontrolled fluid intake problems. Factors affect the restriction of patient's fluid intake include internal factors such as age, education, level duration of hemodialysis therapy and external factors such as closest people relationships. Method:  Analytical descriptive method with total sampling; 57 patients at Dr. H. Soewondo Kendal Hospital. The instrument used Fluid Management Instrument from António Filipe (2015). Result: fluid restriction mostly in bad category were 55 respondents (96,5%) and salt reduction in bad category 47 respondent (82,5%). Discussion: It is advisable to the hospital to require education and evaluation for the patient about structured fluid management by health personnel so that people with chronic kidney disease (CKD) on hemodialysis in accordance with the expected results more leverage.

The purpose of this community service is to increase sales turnover and expand the thread filter technology technique. The method of implementing the service activities in this program aims to improve the welfare of the people who work as salt farmers who previously processed salt using traditional techniques. Therefore, this service activity desires to develop and apply the latest technology, namely Thread Filter and/or Geomembrane (plastic), to provide solutions to salt farmers in developing their business in an easier and more modern way which increases the quantity and quality of the salt produced. Besides, through this service salt farmers are also trained on how to process salt into nanoparticles, as a good product for skin care. Thus, the salt production process will be easier and faster and the benefits obtained by salt farmers will be higher. In this service activity, it will focus on traditional salt farmers to be able to switch and apply the technology of thread filter (TUF) or Geomembrane (plastic) as a process of making salt easily and competently for the community. The results showed that using Thread Filter Technology (TUF) was able to produce results of four to five tons after using geomembrane. Previously without using TUF farmers from the village were only able to produce three tons of salt. The prospect of salt farm business is profitable when applied the techniques of TUF or geomembrane. Finally, the salt farmers can earn income significantly.

Toxic epidermal necrosis (TEN) is rare and can be life-threatening for patients. Appropriate management of TEN patients could give optimal results and prevent complications. One treatment modality for TEN is plasmapheresis, which is rarely available in most cases with severe TEN. Here we reported a successful treatment of severe TEN with plasmapheresis. A 40-year-old woman under tuberculosis therapy complained of shortness of breath that began four days prior to hospital admission and worsened ever since. The patient's skin was peeling with red spots and rashes all over the body for a week. During the examination, the patient was compos mentis, and the SCORTEN score was 2 with 12.1% risk of mortality rate. Dermatological examination of the face, trunk and extremities found extensive erosions, loose bullae filled with clear fluid, brown crusts, and generalized distribution with more than 30% epidermolysis. The patient was diagnosed with toxic epidermal necrolysis caused by antituberculosis therapy. We treated the patient by discontinuing the suspected drugs and administering the corticosteroids, but no improvement was observed. The patient underwent two cycle plasmaphereses with 5% albumin, resulting in 1.2 liter of plasma exchange. Re-epithelialization was observed after three days, and the patient was discharged on day 8. This case-report highlights the important role of plasmapheresis in treating the TEN patients. However, a study with larger sample sizes is warranted to validate the efficacy of plasmapheresis in TEN.

Approximately half of the coffee will become by-product in coffee processing. This by-product needs a special focus because of its content can be pollutant for nature. One of the coffee by product that underutilized is cascara, composed by pulp and husk. The major by-product of dry process is husk whereas pulp is the major by-product from wet process. Nowadays, there are various ways to utilize coffee by-product. Previous studies have shown that coffee has a potent antioxidant activity which can be a solution in dermatology problem. This research aims to identify the antioxidant component of coffee arabica husk and pulp of Gayo, Aceh Tengah, Aceh using GC-MS method. One of the compounds that identified in both coffee husk and pulp is caffeine. Caffeine is a potential natural antioxidant and it also has anticellulite effect to skin. The other compounds found in coffee husk and pulp also have benefit in dermatology. We conclude that coffee arabica husk and pulp can be a potential natural source to eradicate dermatologic problem.

This study aims to see whether there is an effect of ozone therapy on the wound healing phase of diabetic ulcers in patients with diabetes mellitus at Al Huda Woundcare Clinic Lhokseumawe City in 2016. This research is quassy experiment with samples in this study amounted to 20 patients diabetes mellitus at Al Huda Woundcare Clinic Lhokseumawe City. This research was conducted from 04 until 18 October 2016. Sampling by total sampling method. The analysis used paired t-test (dependent). The result of this research is the age of patient of diabetes mellitus patient at Al Huda Woundcare Clinic of Lhokseumawe city most of the aged between 56-65 years as many as 12 respondents (60,0%) and gender of patient of diabetes mellitus mostly female are 11 respondent (55,0%). The result of paired t test is obtained p-value 0.000 <α = 0,05. This shows that there is influence of ozone therapy to phase wound healing diabetic ulcer in patient of diabetes mellitus at Al Huda Woundcare Clinic of Lhokseumawe City 2016. The results of this study can provide benefits for the community, especially reponden that as an input that ozone therapy can serve as a new treatment alternative in addressing the problems of diabetic wounds with modern wound care so convincing to the public that diabetic wounds can be cured.

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Diagnosis of Kawasaki disease (KD) requires presence of persistent pyrexia for ≥5days in absence of an infectious cause [1, 2]. Younger infants with KD often present with atypical or incomplete disease and are at increased risk of complications [3]. Certain overlapping features of KD with sepsis may cause diagnostic delay. One such feature is chest X-ray (CXR) abnormality in KD that is not frequently reported.Case report: 13 week old boy was admitted to a regional hospital in Victoria with <24 hour history of high temperature, poor feeding, irritability, diarrhoea, conjunctivitis with mucous discharge and generalised fine macular rash. Initial assessment revealed an alert yet irritable infant with dry mucous membranes, delayed central capillary refill time, high grade pyrexia, cool peripheries with normal breathing and heart sounds.Respiratory swabs, cerebro-spinal fluid, urine, blood and stool cultures and virology returned normal. Initial fluid bolus (20ml/kg) and IV antibiotics were administered on admission.Initial Hb and Albumin were low; CRP, ESR, WBC, Neutrophil and Platelet counts were raised and remained so in first 5 days of illness. CXR was suggestive of abnormal air space density in both perihilar regions in the right upper zone.Polymorphic rash was observed on day 4. Mild non-pitting oedema of hands and feet was noticed on day 5 and treatment with intravenous immunoglobulin infusion and aspirin were commenced. Irritability and pyrexia settled within hours of the infusion.2D ECHO on day 8 was reported normal. Desquamation of fingers and toes was evident on 2 week review.Discussion: Peri-bronchovascular haze has been described as a frequent CXR finding due to pulmonary vessel intimal thickening during acute phase of KD [4]. We suggest that CXR finding in a febrile infant without chest signs may support an early diagnosis of KD in absence of microbiological evidence of infection. Background: Generalized morphea with linear scleroderma is a rare disorder that usually occurs in childhood and can affect any area of the body surface.