Trunk in Stroke

The trunk is the part of the human body that provides basic mechanical stabilization. It provides strength transmission between the upper and lower body regions. Body control is the ability of the body muscles to maintain the upright posture, to adapt to weight transfers, and to maintain selective trunk and limb movements by maintaining the support surface in static and dynamic postural adjustments. Good proximal trunk control provides better distal limb movements, balance, and functional motion. There are many evaluation methods, devices, and scales for trunk function and performance. 3D kinematic, electromyography, hand-held dynamometer, isokinetic dynamometer, trunk accelerometer are some devices that measure trunk function. The motor assessment scale-trunk subscale, the stroke impairment assessment set- trunk control subscale, trunk control test, trunk impairment scale are the most used scales. This chapter explores the effect of strokes on the trunk.

Gambaran Tingkat Kontrol Asma Pada Pasien Asma: Literature Review

Asthma is an inflammation of the respiratory tract characterized by shortness of breath, coughing, and wheezing. A person with asthma will experience a descreace in physical condition, emotional changes, and changes inactivity. Based on previous research, the number of uncontrolled asthma patients in Persahabatan Hospital is still large. Asthma cannot be cured, but it can be observed using the asthma control test (ACT) to keep asthma under control in the long term. The purpose of this literature review was to describe the level of asthma control in asthmatic patients. The data collection technique used a literature review method of six articels sourced from online databeses with electronic searches on Garuda and Pubmed. The searching process used key words : “ tingkatkontrol” and “ pasienasma”. The English articles that were searched used key word : “ level of control” AND “asthma patients”. The research instrument used was the JBI critical appraisal checklist for cross-sectional.The results of a literature review of six articels showed that the describption of the level of asthma control was mostly uncontrolled. From this literature review, the results obtained were 71 (9,8%) controlled, 234 (32,19%) partially controlled, and 422 (58%) uncontrolled.The results of this literature review show that the level of asthma control in asthmatic patients is not controlled.Keywords : level of control, asthma patients AbstrakAsma merupakan gangguan pada saluran pernafasan yang mengalami inflamasi ditandai dengan sesak nafas, batuk dan mengi. Seseorang dengan asma akan mengalami penurunan kondi sifisik, perubahan emosional, dan perubahan aktivitas. Berdasarkan penelitian sebelumnya jumlah pasienasma yang tidak terkontrol di rumah sakit persahabatan masih banyak. Asma tidak dapat disembuhkan, tetapi dapat di observasi menggunakan Asthma Control Test (ACT) untuk mempertahankan asma dalam keadaan terkontrol dalam jangka panjang. Tujuan dari literature review ini adalah untuk mengetahui gambaran tingkat control asma pada pasienasma.Teknik pengumpulan data menggunakan metode literature reviewe nama artikel yang bersumber dari data base online dengan penelusuran elektronik pada Garuda dan Pubmed. Pencarian artikel dengan menggunakan kata kunci : “tingkat kontrol” dan “pasien asma”, sedangkan artikel berbahasa inggris menggunakan kata kunci : “level of control” AND “patients asthma”. Instrumen telaah yang digunakan yaitu dengan menggunakan JBI critical appraisal checklist for cross-sectional. Hasil literature review dari enam artikel didapatkan bahwa gambaran tingkat control asma Sebagian besar tidak terkontrol. Dari literatuyre review ini diperoleh hasil sebanyak 71(9,8%) terkontrol, 234 (32,19%) terkontrol sebagian dan 422 (58%) tidak terkontrol. Hasil penelitian literature review ini menunjukkan bahwa tingkat control asma pada pasien asma adalah tidak terkontrol. Kata kunci: tingkat kontrol, pasien asma

Correlation of Metered Dose Inhaler Use Technique and Asthma Control Level in Asthma Patients at a Hospital in Bandung, West Java, Indonesia.

Background: Asthma is still a major health problem in global population, including Indonesia. Antiasthma drugs available in various dosage forms, including inhaler. However, several problems related to inhalation route were found due to its unique device form and spesific use technique. One of the major problems related to inhalation route is inappropriate use technique of inhaler device, which could lead to treatment failure. Therapy outcome can be measured through Asthma Control Test (ACT). Objectives: This study was aimed to evaluate correlation between metered dose inhaler (MDI) use technique and asthma control level in patients. Material and Methods: A cross-sectional analytic study was conducted in May - June 2021. Thirty patients who met inclusion criteria were enrolled in this study. Patients’ MDI use technique and asthma control level were evaluated using a valid and standardized questionnaire. Statistics analysis was performed to determine the correlation between MDI use technique and asthma control level. Results: This study showed that most of asthmatic patients were women in older age, with mild asthma severity for more than 10 years. The most prevalent medication used was Fenoterol HBr, followed by salbutamol, and salmeterol/fluticasone combination. Inappropriate MDI use was found in 70,0% patients, with major problem found in patients’ breathing technique before and during MDI use. Asthma control test was performed and showed that 90,0% of asthmatic patients involved in this study have an uncontrolled asthma. Statistical analysis using Pearson product-moment correlation test showed a positive correlation between proper use of MDI and asthma control level (r=0.425, p<0.05). Conclusions: Patient who properly use MDI may have a higher score in asthma control test, thus have a better control of asthma. This study emphasized pharmacist role as patient educator in ensuring appropriate inhaler use in order to achieve therapeutic goals.

Stability Indicating and Simultaneous Determination of Saxagliptin, Dapagliflozin and Metformin in Tablet dosage form using RP-HPLC

Aim: To Perform Simultaneous Determination of Saxagliptin, Dapagliflozin and Metformin Tablet dosage form developed in a simple, Accurate, precise manner. Method: Agilent C18 150 x 4.6mm, 5m. Mobile phase containing 0.1% OPA: Acetonitrile taken in the ratio 50:50 was pumped through column at a flow rate of 1.0 ml/min used for the development of chromatogram. Buffer used in this method was 0.1% OPA. Temperature was maintained at 30°C. Optimized wavelength selected was 260nm. Results and Conclusion: Retention time of Saxagliptin, Dapagliflozin and Metformin were found to be 2.253 min, 2.720 min, 3.276 min respectively. % RSD of the Saxagliptin, Dapagliflozin and Metformin were and found to be 0.8, 0.2 and 0.6. % Recovery was obtained as 99.60%, 100.07% and 99.95% for Saxagliptin, Dapagliflozin and Metformin respectively. LOD, LOQ values obtained from regression equations of Saxagliptin, Dapagliflozin and Metformin were 0.06, 0.12, 9.61 and 0.17, 0.36, 29.31 respectively. Regression equation of Saxagliptin is y = 40882x + 889.2, Dapagliflozin is y = 47904x + 3897 and Metformin is y = 4530.x + 35785. Retention times were decreased and that run time was decreased, so the method developed was simple and economical that can be adopted in regular Quality control test in Industries.

Development and validation of new analytical method for the simultaneous estimation of Netupitant and Palonosetron in bulk and pharmaceutical dosage form

A simple, Accurate, precise method was developed for the simultaneous estimation of the Netupitant and Palonosetron in pharmaceutical dosage form. Retention time of Palonosetron and Netupitant were found to be 2.266 min and 2.805 min. %RSD of the Netupitant and Palonosetron were and found to be 0.8 and 1.1 respectively. %Recovery was obtained as 100.08% and 100.15% for Netupitant and Palonosetron respectively. LOD, LOQ values obtained from regression equations of Netupitant and Palonosetron were 1.63, 4.94 and 0.003, 0.010. respectively. Regression equation of Netupitant is y =11553x + 9661.and y = 51072x + 152.0. of Palonosetron. Retention times were decreased and that run time was decreased, so the method developed was simple and economical that can be adopted in regular Quality control test in Industries.

Development and equivalence of new faces for inclusion in the Childhood Asthma Control Test (C-ACT) response scale

Background Accurate symptom monitoring is vital when managing pediatric asthma, providing an opportunity to improve control and relieve associated burden. The CHILDHOOD ASTHMA CONTROL TEST (C-ACT) has been validated for asthma control assessment in children; however, there are concerns that response option images used in the C-ACT are not culturally universal and could be misinterpreted. This cross-sectional, qualitative study developed and evaluated alternative response option images using interviews with children with asthma aged 4–11 years (and their parents/caregivers) in the United States, Spain, Poland, and Argentina. Interviews were conducted in two stages (with expert input) to evaluate the appropriateness, understanding and qualitative equivalence of the alternative images (both on paper and electronically). This included comparing the new images with the original C-ACT response scale, to provide context for equivalence results. Results Alternative response option images included scale A (simple faces), scale B (circles of decreasing size), and scale C (squares of decreasing quantity). In Stage 1, most children logically ranked images using scales A, B and C (66.7%, 79.0% and 70.6%, respectively). However, some children ranked the images in scales B (26.7%) and C (58.3%) in reverse order. Slightly more children could interpret the images within the context of their asthma in scale B (68.4%) than A (55.6%) and C (47.5%). Based on Stage 1 results, experts recommended scales A (with slight modifications) and B be investigated further. In Stage 2, similar proportions of children logically ranked the images used in modified scales A (69.7%) and B (75.7%). However, a majority of children ranked the images in scale B in the reverse order (60.0%). Slightly more children were able to interpret the images in the context of their asthma using scale B (57.6%) than modified scale A (48.5%). Children and parents/caregivers preferred modified scale A over scale B (78.8% and 90.9%, respectively). Compared with the original C-ACT, most children selected the same response option on items using both scales, supporting equivalency. Following review of Stage 2 results, all five experts agreed modified scale A was the optimal response scale. Conclusions This study developed alternative response option images for use in the C-ACT and provides qualitative evidence of the equivalency of these response options to the originals.