Correct Handwashing Education According to WHO Guidelines at MI Muhammadiyah Needs Magelang District

At the beginning of 2020, the world was shocked by the emergence of a new disease outbreak, Covid-19, which was caused by the SARS COV-2 virus. The school environment is one of the places that is vulnerable to the spread of this virus. An effective preventive measure against the spread of Covid-19 is the application of clean and healthy living habits (PHBS) in the school environment, one of which is the habit of washing hands. However, not all residents in the school understand how to wash their hands properly. The purpose of this service activity is to provide education about proper hands washing according to WHO for MI Muhammadiyah Need in Magelang Regency. The material needed for the implementation of the activity is a hand sanitizer liquid made from 70% active alcohol as a hand disinfectant. Implementation of community service activities using demonstration methods and hands-on practice of hands washing according to WHO. Based on this service activity, not all members of the MI Muhammadiyah Need was known the steps for hands washing properly according to WHO. Through this service, school residents are given knowledge and practice the 8 steps of hand washing according to WHO using a handsanitizer. Thus, school residents are expected to be able to apply proper hand washing methods in their daily life and socialize it to other individuals school residents are given knowledge and practice the 8 steps of hand washing according to WHO using a handsanitizer. Thus, school residents are expected to be able to apply proper hand washing methods in their daily life and socialize it to other individuals school residents are given knowledge and practice the 8 steps of hand washing according to WHO using a handsanitizer. Thus, school residents are expected to be able to apply proper hand washing methods in their daily life and socialize it to other individuals

Liver Transplantation – A Case Report

Liver transplantation is a treatment option for patients with End-stage Liver disease for whom all possible modes of surgical and medical treatment have been exhausted. The indications for Liver transplantation can be either acute or chronic liver disease. The absolute contra indications are active alcohol or substance abuse, severe cardiopulmonary or other co morbid conditions that would preclude meaningful recovery after transplant. Patients are listed on the waiting list according to their blood type and Model of End- Stage Liver Disease (MELD) score. The surgical procedure entails the excision of both donor and recipient livers and transplantation of the donor liver into the recipient (Orthotopic Liver Transplantation). This article gives an overview about liver transplantation and its management. A case report is presented and the nursing care has been discussed in detail.

Adherence to Hepatitis C Therapy in a Shelter-Based Education and Treatment Model among Persons Experiencing Homelessness

Background Medication adherence is a common reason for treatment deferment in persons experiencing homelessness. We evaluated adherence to HCV therapy following HCV education in a shelter-based care model. Methods Prospective study conducted at 4 homeless shelters in Minneapolis, MN and San Francisco, CA from 11/2018–1/2021. Sixty-three patients underwent HCV education and treatment. Multivariable modeling evaluated factors associated with (1) medication and (2) overall (composite score of medication, laboratory, and clinic visit) adherence. Results Median age was 56, 73% male, 43% Black, 52% had psychiatric illness, and 81% used illicit drugs and 60% used alcohol in the past year. Following education, 52% were extremely confident in their ability to be adherent to HCV therapy. Medication adherence by patient and provider report was 88% and 48% respectively and 81% achieved HCV cure. Active alcohol use was associated with less confidence in medication adherence (43% vs. 78%, P=0.04). Older age was positively (Coef=0.3) associated with overall adherence to HCV treatment while prior therapy was associated with both medication (OR=0.08) and overall treatment (Coef=-0.87) non-adherence. Conclusions Despite imperfect adherence, SVR rates were still high. Expanding opportunities to treat persons experiencing homelessness in a structured and supportive setting is critical to HCV elimination efforts.

Prevalence and associations of COVID-19 testing in an online sample of transgender and non-binary individuals

BackgroundTesting for COVID-19 and linkage to services is fundamental to successful containment and control of transmission. Yet, knowledge on COVID-19 testing among transgender and non-binary communities remains limited.MethodsBetween October 2020 and November 2020, we examined the prevalence and associations of COVID-19 testing in an online sample of transgender and non-binary people (n=536). Multivariable hierarchical logistic regression analyses examined associations between COVID-19 testing and participants’ sociodemographic, mental health, substance use, gender affirmation, economic changes and healthcare experiences.ResultsPrevalence of COVID-19 testing in this sample was 35.5% (n=190/536). In the final model, transgender and non-binary participants from upper socioeconomic income background and Europe, who reported having active alcohol use disorder, limited access to gender-affirming surgery, had more than 20% reduction in income, and experienced mistreatment in a health facility due to gender identity had significantly increased odds of COVID-19 testing (all p<0.05); those who reported recent tobacco use had significantly lower odds of COVID-19 testing (p=0.007).ConclusionsThese findings highlight structural disparities in COVID-19 testing and reinforce the importance of increasing testing strategies for transgender and non-binary populations.

Black esophagus: a syndrome of acute esophageal necrosis associated with active alcohol drinking

Black esophagus, also known as acute esophageal necrosis (AEN) syndrome, is a rare entity characterized by patchy or diffuse circumferential black pigmentation of the esophageal mucosa from ischemic necrosis. It may present with life-threatening upper gastrointestinal hemorrhage resulting in high mortality in immunocompromised patients. Advanced age with multiple comorbidities compounded with compromised hemodynamic states are poor prognostic factors. Findings on laboratory work-up and radiological imaging are non-specific. After initial resuscitation, endoscopic evaluation and histological examination of esophageal biopsy are diagnostic. Early recognition and aggressive resuscitation are the fundamental principles for the management of AEN and better outcome of the disease. We report a case of a 56-year-old woman with diabetes mellitus, gastro-esophageal reflux disease, and active alcohol binging who presented with hematemesis and acute epigastric pain due to AEN. This case illustrates a rare etiology of AEN due to active alcohol drinking, which may be overlooked. Physician awareness about this etiology is important as early recognition and timely management may improve survival.

Modeling HIV Transmission from Sexually Active Alcohol-Consuming Men in ART Programs to Seronegative Wives

Background: The rollout of antiviral therapy in Low and Middle Income Countries (LMICs) has reduced HIV transmission rates at the potential risk of resistant HIV transmission. We sought to predict the risk of wild type and antiviral resistance transmissions in these settings. Methods: A predictive model utilizing viral load, ART adherence, genital ulcer disease, condom use, and sexual event histories was developed to predict risks of HIV transmission to wives of 233 HIV+ men in 4 antiretroviral treatment centers in Maharashtra, India. Results: ARV Therapy predicted a 5.71-fold reduction in transmissions compared to a model of using condoms alone, with 79.9%, of remaining transmissions resulting in primary ART-resistance. Conclusions: ART programs reduce transmission of HIV to susceptible partners at a substantial increased risk for transmission of resistant virus. Enhanced vigilance in monitoring adherence, use of barrier protections, and viral load may reduce risks of resistant HIV transmissions in LMIC settings.