Mobile nursing care plan information system for nursing service in hospitals.

OBJECTIVE: The COVID-19 pandemic has greatly affected the health sector, especially the speed of healthcare services in hospitals, such as nursing care. This is caused by the low ratio between the number of resources available and the number of cases handled, which leads to suboptimal services. One of the solutions to this problem is to implement a digital (mobile) nursing care information system. Therefore, this study aims to produce a digital (mobile) nursing information system model that is suitable for hospitals. SUBJECTS AND METHODS: The research and development (RnD) method used in this study was carried out in three stages, namely, analysis of information system needs, preparation of the model design, and trial of Mobile Nursing Care Plan Information System (MNCPIS). The design was prepared with the Framework for Application of System Technique (FAST). A total of 148 nurses were selected as respondents using a simple random sampling approach. Data were then collected through interviews, focus group discussions, and questionnaires. Furthermore, MNCPIS was assessed with system requirements analysis using the Performance, Information, Economic, Control/Security, Efficiency, and Service (PIECES) framework. RESULTS: The t-test results indicate that MNCPIS was more effective and appropriate compared to the conventional (manual) types. This was indicated by all the variables measured in the MNCPIS component, including assessment, nursing diagnosis and evaluation, planning, and implementation. Based on these findings, the model can be developed as a nursing care information system to improve the quality assurance of services rendered by nurses. CONCLUSIONS: A mobile plan information system can be implemented in the nursing care department in hospitals to ensure satisfaction and quality assurance for the services provided in hospitals.

Self-efficacy, motivation and adolescent's adherence of a health protocol during pandemic COVID-19 in Indonesia.

OBJECTIVE: Compliance with the 5M health protocols of washing hands, wearing masks, keeping a distance of at least one meter, avoiding crowds, and reducing mobility is the best effort to prevent COVID-19. Adolescents are non-compliant in implementing health protocols during the pandemic. Therefore, this study aimed to investigate the level of compliance with the 5M health protocols. It also examines the relationship between self-efficacy, motivation, and compliance with health protocols. MATERIALS AND METHODS: Data analysis was conducted on a cross-sectional survey of 978 adolescents in Surabaya, Indonesia. Multiple logistic regression was performed to analyze the relationship between the three. Furthermore, adolescent self-efficacy was measured using the General Self Efficacy Scale (GSES), while motivation scale and sociodemographic questionnaire were measured to assess the motivation and characteristics of the respondents. RESULTS: Adolescent self-efficacy in compliance with health protocols is around (92.0%) with an average GSES score of 25.52 + 4.64. The analysis showed that adolescents with high self-efficacy and motivation had a high level of adherence (OR 2.804, 95% CI 2.008, 3.915) and high motivation (OR 2.926, 95% CI 2.087, 4.102), compared to those with low self-efficacy and motivation. CONCLUSIONS: The results suggested that initial identification of self-efficacy and motivation should be addressed to ensure compliance with health protocols to prevent the pandemic.

Fibrous histiocytoma of the orbit. A clinicopathologic study of 150 cases.

This is a clinicopathologic study of 150 cases of fibrous histiocytoma of the orbit. The tumors occurred in adults (median age, 43 years). The upper and nasal portions of the orbit were the most common sites of involvement. The most common signs and symptoms were proptosis (60 per cent), mass (46 per cent), and decreased vision (25 per cent). Based on the histopathologic features, the tumors were classified in three groups: benign (94 cases), locally aggressive (39 cases), and malignant (17 cases). The biological behavior correlated well with the duration of symptoms, the size and margins of the mass, and the histologic classification. The rate of recurrence was 31 per cent for the benign tumors, 57 per cent for the locally aggressive tumors, and 64 per cent for the malignant tumors. Follow-up data were obtained for 123 patients, with a mean duration of seven years. The ten-year survival of patients with benign, locally aggressive, and malignant fibrous histiocytoma was 100 per cent, 92 per cent, and 23 per cent, respectively. Nine patients died as a result of the tumor, six from local invasion of adjacent structures and three from metastatic disease. Fibrous histiocytoma is the most common primary mesenchymal orbital tumor of adults. The origin of the neoplasm is probably a primitive mesenchymal cell. Complete surgical excision appears to be the treatment of choice.

Sebaceous carcinomas of the ocular adnexa: A clinicopathologic study of 104 cases, with five-year follow-up data.

One hundred four cases of sebaceous carcinoma that arose from ocular adnexa, with at least five years' follow-up information following diagnosis, were studied to extend the authors' previous observations on various prognostic factors in these tumors. Twenty-three patients died from metastatic disease. Although sebaceous carcinomas elsewhere in the skin are rare, this study establishes that these neoplasms occur much more frequently in the ocular adnexa and have significant morphologic features that identify the more highly lethal carcinomas. The various clinicopathologic features that indicated a bad prognosis were vascular, lymphatic, and orbital invasion; involvement of both upper and lower eyelids; poor differentiation; multicentric origin; duration of symptoms greater than six months; tumor diameter exceeding 10 mm; a highly infiltrative pattern; and pagetoid invasion of the overlying epithelia of the eyelids. In many cases pagetoid change appeared to originate in the underlying sebaceous glands and from there extended to invade the overlying epithelia.

Malignant teratoid medulloepithelioma manifesting as a black epibulbar mass with expulsive hemorrhage.

An 18-year-old woman with malignant teratoid medulloepithelioma had an epibulbar, brown-black mass associated with expulsive hemorrhage and a limboscleral perforation. Histopathologically, a prominent pigmented neuroepithelial component was present and correlated to the black color of the mass. The massive hemorrhage is apparently related to rupture of necrotic and abnormal vascular channels within the angiomatous component of the neoplasm. Other mesenchymal elements included spindle-shaped cells, rhabdomyoblasts, and islands of hyaline cartilage.

Juvenile fibrosarcoma of the orbit and eyelid. A study of five cases.

Five patients had juvenile fibrosarcoma of the orbit and eyelid. At initial surgical intervention, the patients ranged in age from newborn to 8 years (mean, 3 years 9 months). Three patients were male and two were female. Proptosis and/or painless swelling of the eyelid were the most common signs and symptoms. Four tumors grew within a few weeks or months, and all five were poorly circumscribed. They were composed of immature, spindle-shaped fibroblastic cells in a classic herringbone pattern or in interlacing fascicles. Hypercellularity and mitotic activity were present in all lesions. The differential diagnosis included rhabdomyosarcoma, fibromatosis, and fibrous histiocytoma. Electron microscopy confirmed the fibroblastic nature of the tumor cells in three cases. Follow-up ranged from one to 32 years (median, seven years). Two of five tumors recurred locally but none metastasized. Apparently surgical excision is the treatment of choice and the tumor has a favorable prognosis.

Juvenile fibromatosis of the periorbital region and eyelid. A clinicopathologic study of six cases.

Six cases of juvenile fibromatosis of the periorbital region and eyelid were studied. The median age of the patients was 8 years (range, 1 to 11 years). A definite propensity for involvement of the infraorbital region and lower eyelid was observed. THREE TUMORS EXHIBITED A PROMINENT LOBULAR PATTERN AND WERE ADHERENT TO THE PERIOSTEUM. The main entities in the differential diagnosis included leiomyoma, neurofibroma, and well-differentiated fibrosarcoma. Two of six tumors recurred locally but did not metastasize. Electron microscopic studies disclosed that the spindle-shaped tumor cells exhibited features of fibroblasts. It appears that conservative treatment (ie, local excision) is adequate.

Trichilemmoma of eyelid and eyebrow. A clinicopathologic study of 31 cases.

Thirty-one cases of trichilemmoma of the eyelid and eyebrow were studied. All lesions were solitary, small, and asymptomatic. Unlike basal cell carcinoma of the eyelid, trichilemmoma rarely involves the lid margin or the inner canthus. The age range of our patients was from 22 to 88 years old (mean, 56 years). There were 19 men and 12 women. The most frequent clinical diagnoses were verruca vulgaris and cutaneous horn. Typically, the tumor displayed a lobular pattern and was composed mostly of glycogen-rich clear cells. The periphery of the lobules showed palisading of columnar cells and a distinct basement membrane. Histologically, the tumor was frequently misinterpreted as basal cell carcinoma. Review of the literature, including our own series, discloses that the eyelid is the second most common site for trichilemmoma after the nose.

Melkersson-Rosenthal syndrome: new clinicopathologic findings in 4 cases.

OBJECTIVE: To define the clinicopathologic features of eyelid involvement in Melkersson-Rosenthal syndrome (MRS). METHODS: Four patients with eyelid edema consistent with MRS were evaluated clinically, including diagnostic imaging in 2 patients. Eyelid tissue from these patients was examined by light microscopy and immunohistochemistry. Polymerase chain reaction for herpes simplex virus was performed in 1 case. RESULTS: The 3 men and 1 woman ranged in age from 33 to 74 years. All patients had insidious, painless, nonpitting eyelid edema. Three patients had unilateral edema; one had bilateral, asymmetric involvement. Ipsilateral lip edema was present in 1 case. Computed tomography demonstrated periorbital heterogeneous thickening that corresponded to the microscopic finding of scattered granulomas. All 4 patients demonstrated epithelioid granulomas inside and adjacent to dilated lymphatic vessels. Polymerase chain reaction testing was negative for herpes simplex virus. CONCLUSIONS: Isolated eyelid swelling that mimics thyroid-associated ophthalmopathy may occur in MRS. Computed tomography may be useful in the diagnosis. Biopsy should be performed in all cases of unexplained nonpitting eyelid edema. In the eyelid, MRS is characterized histopathologically by a granulomatous lymphangitis, a finding that seems to be unique to this condition.

The clinical spectrum of schwannomas presenting with visual dysfunction: a clinicopathologic study of three cases.

Schwannomas (neurilemomas) are benign tumors that arise from Schwann cells in the peripheral nervous system. The most commonly involved nerves that cause neuro-ophthalmic manifestations are cranial nerves V and VIII. In this series of three women, schwannomas presented as intraconal masses that mimicked a cavernous hemangioma, a superior orbital mass transgressing the superior orbital fissure, and an expansive frontal lobe mass with clinical symptoms and signs of increased intracranial pressure. Although all three complained of visual blurring, none of our patients presented with Vth or VIIIth cranial nerve dysfunction. Histopathologic studies demonstrated well-circumscribed, encapsulated spindle-cell lesions with classic Antoni A and B patterns. Histopathologic examination is essential to confirm the diagnosis of a schwannoma that may be otherwise clinically confusing. Direct optic nerve compression, globe indentation with induced hyperopia, or increased intracranial pressure with optic nerve compromise may be responsible for visual symptoms. A multidisciplinary approach is often required because of the size and location of schwannomas.