Background: Patients with end-stage renal disease (ESRD) have a twofold risk of developing heart failure. A number of factors in ESRD patients are related to chronic heart failure (CHF). The intervention of cardiovascular risk factors in the early stages of chronic kidney disease (CKD) can reduce mortality from heart disease and slow the severity of kidney deterioration. This study aims to examine the factors that affect CHF in patients with ESRD. Methods: This study was a cross-sectional analytic observational study of 49 patients with ESRD based on consecutive sampling. The data collected were primary and secondary data on ESRD patients at the Cardiac Polyclinic, Internal Medicine Polyclinic, and the Medical Records Unit Bhayangkara Hospital Denpasar. Results: In this study, it was found that most patients were in the age group ≥40 years (92%) and male gender (63%). From the chi-square test analysis, it was found that the factors affecting CHF in patients with ESRD are hypertension (HT) (p-value < 0.001) with prevalence ratio (PR) 11.19 (1.69-73.92), type 2 diabetes mellitus (T2DM) (p-value = 0.008) with PR 1.72 (1.18-2.51), obesity (p-value < 0.001) with PR 6.67 (2.34-18.92), and smoking (p-value = 0.027) with PR 1.6 (1.02-2.49). Conclusion: It can be concluded that the factors affecting CHF in patients with ESRD are HT, T2DM, obesity, and smoking. The results of this study are expected to be used as an illustration so that in the future, prevention can be made for factors affecting CHF in ESRD patients.

The corona virus infection disease has become a pandemic for almost the last two years that has occurred in all countries including Indonesia. Covid 19 in its development can cause various complications, one of which is the occurrence of neurological disorders in addition to respiratory disorders. One of these neurological complications is stroke. In this case report, we will report a case of a patient who was confirmed positive for Covid 19 with complications of ischemic stroke at the Covid 19 Emergency Hospital Wisma Atlet Kemayoran. A 50-year-old male patient came confirmed positive for Covid 19 to the RSDC Wisma Atlet Kemarayoran. The patient came with a cough since 5 days before going to the ER and was treated using HFNC and was intubated while in the ICU, the patient had decreased consciousness, weakness in the left extremity and seizures. The patient also had a history of hypertension and type II diabetes mellitus. Results Chest X-ray showed bilateral pneumonia and CT scan of the head showed right hemisphere infarction. The pathophysiology of stroke in Covid 19 is due to hyperactivation of inflammatory factors caused by systemic inflammation. In addition, ischemic stroke in Covid 19 patients can occur due to D-dimer and platelet abnormalities. In addition to respiratory disorders, Covid 19 can also cause neurological disorders that can increase morbidity in patients who suffer from it.

A 46-year-old woman with a diagnosis of uterine myoma and anemia who will undergo an elective total abdominal hysterectomy by an obstetrician and gynecologist. The patient has received PRC transfusion, fasted for 8 hours and is hemodynamically stable. Preoperative vital signs showed blood pressure: 130/80 mmHg, pulse: 64 times/minute, respiration: 20 times/minute, and 97% oxygen saturation without supplemental oxygen. Spinal anesthesia technique was performed with the patient lateral decubitus position at L3-4, CSF (+), blood (-), Bupivacaine 0.5% hyperbaric 15 mg and then the patient was positioned back in the supine position. A pin prick test was performed to find that there were no sensory and motor blocks, spinal anesthesia was performed again in a sitting position, at L3-4, CSF (+), blood (-), Bupivacaine 0.5% hyperbaric 15 mg and returned to position. supine. Evaluated by pin prick test and still no sensory and motor block. The block failed and was converted to general anesthesia with ETT. The duration of the operation is 2 hours, during observation in the recovery room the patient can be treated in the room.

Latar belakang: Stunting adalah gangguan pertumbuhan linier yang ditunjukkan dengan nilai Z-score tinggi badan menurut usia (TB/U) kurang dari -2 standar deviasi (SD) berdasarkan standar World Health Organization (WHO). Stunting tetap menjadi salah satu masalah gizi utama di dunia dan mencerminkan efek kumulatif dari malnutrisi kronis selama 1.000 hari pertama kehidupan. Penelitian ini bertujuan mengetahui perbedaan kejadian stunting pada penyakit akut dan kronis pada pasien rawat inap di RSUD Klungkung. Metode: Desain penelitian analitik cross sectional. Pengumpulan data melalui rekam medik anak yang di rawat di RSUD Klungkung periode 1 Januari sampai 31 Desember 2018 dengan metode total sampling yang dipilih berdasarkan kriteria inklusi dan eksklusi yaitu anak usia 0-60 bulan. Data dianalisis univariat dan bivariat menggunakan uji chi square. Hasil: Selama periode penelitian tercatat 404 orang anak dirawat di RSUD Klungkung dengan 356 anak (88,1%) menderita penyakit akut dan 48 anak (11,9%) menderita penyakit kronis. Gambaran status gizi anak berdasarkan BB per TB/PB sebagai berikut: status gizi kurus (<-2SD) sebanyak 45 (11,1%) dan status gizi normal (≥ -2SD) sebanyak 359 (88,9%). Sedangkan gambaran TB/PB per Usia: status gizi pendek (<-2SD) sebanyak 45 (11,1%) dan status gizi normal (≥-2SD) sebanyak 359 (88,9%) anak. Hasil pengolahan data bivariat menunjukkan bahwa tidak terdapat perbedaan bermakna terhadap kejadian stunting pada penyakit akut dan kronis pasien rawat inap di RSUD Klungkung. (p=0,074) OR=2,051 (95% CI 0,919 – 4,577). Kesimpulan: Tidak terdapat perbedaan kejadian stunting pada penyakit akut dan kronis pasien rawat inap di RSUD Klungkung.

Latar belakang: Stunting adalah gangguan pertumbuhan linier yang ditunjukkan dengan nilai Z-score tinggi badan menurut usia (TB/U) kurang dari -2 standar deviasi (SD) berdasarkan standar World Health Organization (WHO). Stunting tetap menjadi salah satu masalah gizi utama di dunia dan mencerminkan efek kumulatif dari malnutrisi kronis selama 1.000 hari pertama kehidupan. Penelitian ini bertujuan mengetahui perbedaan kejadian stunting pada penyakit akut dan kronis pada pasien rawat inap di RSUD Klungkung. Metode: Desain penelitian analitik cross sectional. Pengumpulan data melalui rekam medik anak yang di rawat di RSUD Klungkung periode 1 Januari sampai 31 Desember 2018 dengan metode total sampling yang dipilih berdasarkan kriteria inklusi dan eksklusi yaitu anak usia 0-60 bulan. Data dianalisis univariat dan bivariat menggunakan uji chi square. Hasil: Selama periode penelitian tercatat 404 orang anak dirawat di RSUD Klungkung dengan 356 anak (88,1%) menderita penyakit akut dan 48 anak (11,9%) menderita penyakit kronis. Gambaran status gizi anak berdasarkan BB per TB/PB sebagai berikut: status gizi kurus (<-2SD) sebanyak 45 (11,1%) dan status gizi normal (≥ -2SD) sebanyak 359 (88,9%). Sedangkan gambaran TB/PB per Usia: status gizi pendek (<-2SD) sebanyak 45 (11,1%) dan status gizi normal (≥-2SD) sebanyak 359 (88,9%) anak. Hasil pengolahan data bivariat menunjukkan bahwa tidak terdapat perbedaan bermakna terhadap kejadian stunting pada penyakit akut dan kronis pasien rawat inap di RSUD Klungkung. (p=0,074) OR=2,051 (95% CI 0,919 – 4,577). Kesimpulan: Tidak terdapat perbedaan kejadian stunting pada penyakit akut dan kronis pasien rawat inap di RSUD Klungkung.