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.

Akkermansia muciniphila is a promising gut microbiota for the treatment of type 2 diabetes mellitus (T2DM). A. muciniphila stimulates intestinal wall integrity, is an anti-inflammatory agent, and reduces endoplasmic reticulum stress, lipogenesis and gluconeogenesis. These properties make A. muciniphila a potential treatment option for T2DM by reducing insulin resistance and increasing insulin sensitivity and glucose tolerance in different tissues. This article explores the possible role of A. muciniphila in T2DM management, along with the various methods known to modulate A. muciniphila .

Background: The COVID-19 pandemic affects various aspects of everyone's life. One of the impacts of the pandemic is psychological disorders, such as decreased sleep quality and anxiety. Until now, there has been no research to assess the relationship between these two conditions in university students during the pandemic era. Therefore, this study aims to evaluate the relationship between decreased sleep quality and anxiety disorders in Indonesia’s university students during the COVID-19 pandemic.Methods: The cross-sectional study was conducted from September to October 2021 on 376 university students, both domiciled in Bali and outside Bali. Data were collected using a questionnaire consisting of participant demographic data, sleep quality assessment using the Pittsburg Sleep Quality Index (PSQI), and measurement of anxiety levels using the Zung Self-Rating Anxiety Scale (SAS). Bivariate analysis was performed using the Pearson correlation test.Result: 294 of the 376 participants had high PSQI scores (>5) and experienced sleep disturbances. Meanwhile, 44 participants reported experiencing anxiety disorders, with detail of 41 participants having SAS scores in the low category and 3 participants having SAS scores in the moderate category. The relationship between the PSQI and SAS variables showed a correlation coefficient of 0.619 and was statistically significant.Conclusion : Decreased sleep quality is positively correlated with anxiety disorders experienced by university students during the COVID-19 pandemic. The author suggests research with larger parameters and population size to get more accurate results.

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.

Background Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that has a great diversity of clinical presentations and occurs mostly in young women. However, late-onset SLE does exist and seldom presents with an atypical case, including pericardial effusion (PE). Case presentation A 64 years old Asian woman presented with weakness all over the body and slight breathlessness for the past 2 days before the hospital admission. Her initial vital signs are 80/50 mmHg for blood pressure and a respiration rate of 24 breaths/min. Rhonchi were heard on the left lung and pitting edema on both legs. No evidence of any skin rash. Laboratory examination displayed anemia, hematocrit decrement, and azotemia. A 12-lead ECG demonstrated left-axis deviation with low voltage (Fig. 1). Chest X-ray showed left massive pleural effusion (Fig. 2). Transthoracic echocardiography revealed biatrial enlargement, normal EF 60%, diastolic dysfunction grade II, and thickening of the pericardium with mild circumferential PE corresponding with effusive-constrictive pericarditis (Fig. 3). The patient also brought CT angiography and cardiac MRI result, which confirmed pericarditis with PE. Treatment was initiated in ICU with fluid resuscitation of normal saline. The patient’s routine oral treatments, including furosemide, ramipril, colchicine, and bisoprolol, were carried on. An autoimmune workup was performed by a cardiologist and demonstrated an elevation in antinuclear antibody/ANA (IF) of 1:100, which finally unveiled a diagnosis of SLE. Pericardial effusion is one critical condition to consider, despite it being an uncommon presentation in late-onset SLE. Mild pericarditis in an SLE case can be treated with corticosteroid administration. Colchicine also has been found to reduce the risk of pericarditis recurrence. However, an atypical presentation from this case led to a slightly delayed treatment that escalated the morbidity and mortality risk. The patient had a sudden cardiac arrest and passed away 3 days after being treated. Conclusions Atypical presentation during late-onset SLE, mainly in the form of pericardial effusion even constrictive pericarditis, should be taken into a consideration since they are a scarce feature in SLE patients. Swift recognition and prompt treatment are important for the optimal outcome.