Coronavirus disease 2019 (COVID-19) is an infectious disease that was later declared a pandemic. During a pandemic, excessive workloads cause an increase in physical symptoms, such as tension-type headaches, in medical personnel. Tension-type headache (TTH) is associated with decreased sleep quality which will lead to excessive daytime sleepiness (EDS) and fatigue syndrome. This study aims to determine the relationship between TTH and sleep quality, EDS, and fatigue syndrome in medical personnel during the pandemic. This study is a cross-sectional study conducted on health workers at Sebelas Maret University Hospital, Surakarta, Indonesia in March–August 2020. The relationship between TTH and three other variables was analyzed using the Spearman correlation test. Multiple logistic regression analysis was used to calculate the odds ratio (OR) of headache associated with the covariate. The Kruskal-Wallis test was used to compare sleep quality, EDS, and fatigue syndrome in the TTH, non-TTH headache, and control groups. There were 120 respondents (mean age 30.93±12.48) in this study. The Spearman correlation test found a weak positive correlation between TTH and the three dependent variables. OR sleep quality, EDS, and fatigue syndrome with the incidence of TTH respectively 2.33 (95% CI=1.18–5.11, p<0.001); 2.52 (CI 95%=1.17–4.79, p=0.001), and 4.46 (95% CI=2.71–7.69, p<0.001). The Kruskal-Wallis test showed that the TTH group had poorer sleep quality and more frequent EDS and fatigue syndrome. There is a significant relationship between TTH and sleep quality, EDS, and fatigue syndrome in medical personnel during the pandemic. HUBUNGAN NYERI KEPALA TIPE TEGANG DENGAN KUALITAS TIDUR, RASA KANTUK BERLEBIHAN DI SIANG HARI, DAN SINDROM KELELAHAN PADA TENAGA MEDIS SELAMA COVID-19Coronavirus disease 2019 (COVID-19) merupakan penyakit menular yang kemudian dinyatakan sebagai pandemi. Selama pandemi, beban kerja yang berlebihan menyebabkan peningkatan gejala fisik, seperti nyeri kepala tipe tegang (tension-type headache) pada tenaga medis. Tension-type headache (TTH) dikaitkan dengan penurunan kualitas tidur yang akan menyebabkan rasa kantuk berlebihan di siang hari (excessive daytime sleepiness, EDS) dan sindrom kelelahan. Penelitian ini bertujuan mengetahui hubungan TTH dengan kualitas tidur, EDS, dan sindrom kelelahan pada tenaga medis selama pandemi. Penelitian ini merupakan studi potong lintang yang dilakukan pada petugas kesehatan di RS Universitas Sebelas Maret, Surakarta, Indonesia pada Maret–Agustus 2020. Hubungan antara TTH dan tiga variabel lainnya dianalisis menggunakan uji korelasi Spearman. Analisis regresi logistik ganda digunakan untuk menghitung odds ratio (OR) nyeri kepala yang terkait dengan kovariat. Uji Kruskal-Wallis digunakan untuk membandingkan kualitas tidur, EDS, dan sindrom kelelahan pada kelompok TTH, nyeri kepala non-TTH, dan kontrol. Terdapat 120 responden (rerata usia 30,93±12,48). Uji korelasi Spearman menemukan korelasi positif lemah antara TTH dan tiga variabel terikat. OR kualitas tidur, EDS, dan sindrom kelelahan dengan kejadian TTH secara berurutan 2,33 (IK 95%=1,18–5,11; p<0,001); 2,52 (IK95 %=1,17–4,79; p=0,001); dan 4,46 (IK 95%=2,71–7,69; p<0,001). Uji Kruskal-Wallis menunjukkan bahwa kelompok TTH memiliki kualitas tidur yang lebih buruk dan lebih sering mengalami EDS, serta sindrom kelelahan. Terdapat hubungan yang signifikan TTH dengan kualitas tidur, EDS, dan sindrom kelelahan pada tenaga medis selama pandemi.

During the COVID-19 pandemic, nation-wide social restriction policy is implemented to prevent virus spread. Medical students are relying on gadget and internet-based services for online learning. Prolonged use of gadget is related to various medical condition. This study aims to determine correlation between duration of gadget use and their relationship to neck pain, neck disability, and sleep quality among medical student<em>. </em>This was a cross-sectional study conducted using Numeric Pain Rating Scale (NRS), Oswestry Disability Index (ODI), and Pittsburgh Sleep Quality Index (PSQI) in online form. Sample was selected with simple random sampling from the population of medical student of Universitas Sebelas Maret, entrance year of 2017-2020. <em>Results: </em>A total of 271 students were included in this study. Statistically significant correlation between duration of gadget uses and neck pain (p=0,014); neck disability (0.471,p=0.042); and sleep quality (0.571,p=0.023). Duration of gadget use increased the incidence of neck pain by 3.028 times (95% CI 2.272-4.327,p=0.037); incidence of neck disability by 2.144 times (95% CI 1.174-3.461,p=0.015); and decreased sleep quality by 2.384 times (95% CI 1.107-3.661,p=0.007). Duration of gadget use increased the incidence of neck pain, neck disability, and decreased sleep quality of medical student. Awareness of the importance of proper ergonomics while using gadget for medical education during COVID-19 pandemic should be raised among students, lecturers, and healthcare professional.

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Background: Diabetes mellitus (DM) is among the diseases with high morbidity and mortality. The pathogenesis of DM involves pancreatic β-cell damage or insulin sensitivity disorder that result in hyperglycemia. Tapak liman (Elephantopus scaber L) is known to have high flavonoid content. Flavonoids are antioxidants that play a role in reducing pancreatic β-cell damage or damage to other tissues, which potentially reduce blood glucose levels. Objective: To determine the hypoglycemic effects of tapak liman using the DM rat models. Methods: Twenty-eight Wistar albino rats (Rattus novergicus) were divided into four groups: the normal control group (KKn), not induced by streptozotocin-nicotinamide (STZ-NA) intraperitoneal; negative control group (KK-), induced by STZ-NA; treatment group 1 (KP1), induced by STZ-NA and 150 mg/kg body weight of tapak liman plant extract; and the treatment group 2 (KP2), induced by STZ-NA and 300 mg/kg body weight of tapak liman. Blood glucose levels were measured on the 7th day after STZ-NA induction and the 28th day after the administration of tapak liman plant extract. The results were analyzed for statistical significance. Results: There was a significant decrease in blood glucose levels in KP1 and KP2 (p≤ 0.05). The decrease in blood glucose in KP1 had not reached normal levels compared to KP2. Conclusion: Administration of tapak liman plant extract at a dose of 300 mg/kg body weight in DM rat models reduced blood glucose levels to normal. Latar Belakang: Diabetes melitus (DM) merupakan salah satu penyakit dengan morbiditas dan mortalitas yang cukup tinggi. Patogenesis DM ditandai dengan kerusakan sel β pankreas atau gangguan sensivitas insulin yang menyebabkan naiknya kadar glukosa darah. Tanaman herbal tapak liman (Elephantopus scaber L) diketahui mempunyai kandungan flavonoid yang cukup tinggi. Flavonoid berfungsi sebagai antioksidan untuk mengurangi kerusakan sel β pankreas ataupun jaringan lainnya sehingga berpotensi menurunkan kadar glukosa darah. Tujuan: Penelitian ini bertujuan untuk untuk mengetahui apakah pemberian ekstrak tanaman tapak liman dapat menurunkan kadar glukosa darah puasa tikus putih model DM. Metode: Sampel sebanyak 28 ekor tikus putih (Rattus novergicus) dibagi menjadi 4 kelompok yaitu kelompok kontrol normal (KKn) yang tidak diinduksi streptozotosin-nikotinamid (STZ-NA) intraperitoneal; kelompok kontrol negatif (KK-) yang diinduksi STZ-NA; kelompok perlakuan 1 (KP1) diinduksi STZ-NA dan

Case Report: A 50-year-old man was referred to Dr. Moewardi General Hospital with history of right chest pain that radiate to the right back and hand for 2 months. His complaint did not improve with medication and physical therapy. On physical examination we observed multiple nodules on the right axilla, scapula, and colli region. Neurological examination revealed right sided partial ptosis, anisocoria, ipsilateral weakness, and ipsilateral allodynia, and anhidrosis T1 dermatome. CT-scan showed a right lung mass in the superior lobe of the apical segment. The diagnosis of Horner syndrome is then established caused by multiple lymphadenopathies. His symptoms then relieved after lymphadenectomy. Conclusion: Horner syndrome, characterized by ipsilateral pupillary anisocoria, ptosis and anhidrosis, is one of the complications of Pancoast tumor invasion to the sympathetic nervous system in the C8, T1, and T2 nerve territory.