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Renal, the main characteristic of COVID-19 infection. Acute kidney injury (AKI) has been documented in 20-50% of the hospitalized COVID-19 patients. Renal involvement among COVID-19 patients might be multifactorial. COVID-19 Patients with AKI significantly had higher mortality than patients without AKI. This case series reported severe COVID-19 with respiratory failure and AKI during admission to the hospital. All patients were admitted to the intensive care unit (ICU) and obtained the standard therapeutic protocols according to the COVID-19 severities. The first patient developed AKI in the three days of admission, while the second and third patients had AKI from the first day of admission. The patients had similar complications, including type 1 or 2 respiratory failures, secondary infection with sepsis, hyperpotassemia, and metabolic acidosis. The first and second patients underwent hemodialysis as indicated on these patients. However, the evaluation of their renal functions did not improve after that. The third patient did not receive the hemodialysis therapy and only obtained supportive treatment with adequate fluid therapy. The third patient was getting better on the 16th day of admission. In addition, the renal function test was getting normal after the 16th day of admission. The patient was discharged on the 19th day of admission in stable condition. Early recognition of renal involvement in COVID-19 infection, preventive measures, renal function monitoring, and therapeutic intervention were essential to reduce the morbidity and mortality of COVID-19 patients. Hospitalized patients should be monitored closely for their renal function to prevent renal function deterioration in the future.

Background: Low back pain (LBP) is one of major health problems experienced by 80-85% of patients in their lifetime. Spondyloarthritis (SpA) has become one of the leading causes of chronic LBP but is often undiagnosed. General practitioners (GP) have an essential role in the early diagnosis of SpA. Aim: To explore the knowledge of GP about SpA from clinical diagnosis and early management and elaborate on each GP’s clinical perspective and practice performance. Methods: A qualitative study that involved 12 GP. All was consented to participate in an in-depth interview with the experts by online meeting with 15-20 minutes duration. Analysis was focused on the definition, classification, clinical manifestation, diagnosis, and early management of SpA in primary care. Results: All GP were interviewed (12 GP, 9 men, and 3 women; mean age 29.42) with average years in clinical practice was 3.8 years. All GP could describe the definition of SpA. Only a few subjects are aware of the subtype of SpA. Most of the GP could mention chronic back pain as the main SpA symptom, some GP mentioned extra-articular manifestation, but incomplete. All GP understood the current treatment in clinical practice. Conclusion: GP is aware of SpA, but not all could completely mention the type and clinical entities. In addition, a limited resource for investigation makes a diagnosis of SpA difficult. Current early treatment has been acceptable in clinical practice. A comprehensive understanding of diagnosis and effective early treatment may reduce delayed diagnosis and improve patients' quality of life.

Background: Peritoneal dialysis (PD) is one of the modalities of renal replacement therapy (RRT) in end-stage renal disease (ESRD). One of the complications that are often found in the use of PD is peritonitis. Presence of the culture from the peritoneal fluid was known to be associated with the incidence of peritonitis relapse among ESRD patients with PD. Aim: Comparing the incidence of relapse in patients with continuous ambulatory peritoneal dialysis (CAPD) with culture-negative and culture-positive in RSUD Dr. Saiful Anwar Malang. Methods: This study measured the incidence of relapse after administration of CAPD peritonitis therapy. Descriptive data are presented in percentages, and numerical data is presented in Mean ± SD. The analysis test was carried out using the Mann-Whitney with p

Implementing the Regional Revenue and Expenditure Budget (APBD) policy and at the same time reducing income disparity is a tangible manifestation and success of local governments to keep poverty level low. This study focuses on the analyzing short-term and long-term effects of variables government expenditure realization and income disparity toward poverty in Aceh Province, Indonesia during 2010-2019 period using Auto Regressive Distributed Lag (ARDL) approach. It is found that both independent variables have no significant effect on short term but have significant effect on long term. Government expenditure realization is found significant at error level 1% while income disparity is found significant at error level 5% toward poverty in long term. Also both government expenditure realization and income disparity is found to have positive effect toward poverty in long term. Based on these findings it is hoped the policy maker will able to formulate a strategic plan to reduce poverty rate in Aceh Province, Indonesia.

Objective This study aimed to observe the association between the presence of hypertension with Covid-19 vaccine effectiveness among healthcare workers who received CoronaVac vaccination. Methods We conducted a prospective cohort study in Saiful Anwar General Hospital, Malang, Indonesia on 155 healthcare workers aged 18–59 years old who already received twice of the CoronaVac (Sinovac Life Science, Beijing, China) injection with 14-day intervals. Hypertension was diagnosed according to the 2020 International Society of Hypertension. Subjects were monitored for six months. The primary outcome was the rate of Covid-19 diagnosed by the pharyngeal swab for the real-time reverse transcription-polymerase chain reaction (RT-PCR) examination. The secondary endpoints were: (1) severity of Covid-19 among infected participants; (2) rate of hospitalizations; and (3) anti-SRBD antibody levels measured by ECLIA. Results Among 155 participants, 18.7% of them were diagnosed with hypertension, and 31.0% had the desirable BP target according to the current guidelines. Subjects with hypertension, especially those with uncontrolled blood pressure, had a higher incidence of Covid-19 infection than subjects without hypertension. Subjects with symptomatic Covid-19 and hospitalized because of Covid-19 were higher in participants with hypertension. The anti-SRBD antibody levels were lower in the second month after CoronaVac vaccination in hypertensive subjects. In contrast, comparable anti-SRBD levels were seen from both groups at sixth months after vaccination. Conclusion Hypertension was associated with lower vaccine effectiveness in healthcare workers. Subjects with hypertension had a higher risk of being infected with Covid-19 despite getting a complete dose of vaccination and lower antibody production.

Abstract Flipped classroom (FC) approaches have gotten substantial attention in the last decade because they have a potential to stimulate student engagement as well as active and collaborative learning. The FC is generally defined as a strategy that flips the traditional education setting, i.e., the information transmission component of a traditional face-to-face lecture is moved out of class time. The FC relies on technology and is therefore suitable for online or blended learning, which were predominant forms of learning during the COVID-19 pandemic (March 2020–July 2021). In this paper we present a systematic literature review (SLR) of studies that covered online FC approaches in higher education during the pandemic. We analyzed 205 publications in total and 18 in detail. Our research questions were related to the main findings about the success of implementation of online FC and recommendations for future research. The findings indicated that those who had used FC approaches in face-to-face or blended learning environments more successfully continued to use them in online environments than those who had not used it before. The SLR opened possible questions for future research, such as the effectiveness of the FC for different courses and contexts, the cognitive and emotional aspects of student engagement, and students’ data protection. It pointed to the need to examine different aspects of online delivery of the FC more comprehensively, and with more research rigor.

Introduction: Déjà vu is a feeling of familiarity experienced when one undergoes certain events when in reality it is unknown. Déjà vu in epilepsy has shown to occur frequently, last somewhat longer and associated with fatigue, hyperactivity, exhaustion, headaches, blackouts or fear. Aims & Objectives: To determine any difference in déjà vu and its parameters among epileptic and normal healthy individuals. Place and duration of study: The study was conducted at Central Park Medical College Lahore, Pakistan December 2019 to March 2020. Material & Methods: A cross-sectional study was conducted to determine the frequency of the phenomenon of déjà vu between epileptics and non-epileptics. The assessment was done by IDEA questionnaires comprising of 23 items assessing quantitative and qualitative aspects of déjà vu with some additional demographic questions such as age, gender, parental consanguinity, drugs, cause of epilepsy, and fitness status. Data was analyzed using SPSS version 23, p value

Objective:To evaluate mid to long term effects of adding deltoid ligament repair (DLR) to syndesmotic screw fixation (SSF) in the treatment of distal fibula fractures -in terms of functional and radiographic results and quality of life.Method:Seventy-eight patients who underwent SSF or SSF+DLR with the diagnosis of distal fibula fracture in the Maltepe University Hospital, Department of Orthopedics and Traumatology were included in the study retrospectively.Results:71.8% of the cases were male. The mean age was 39.24±11.95 years. The radiographic and functional results and quality of life were better in the SSF+DLR group compared to the SSF group. Additionally, the operation time was longer in the SSF+DLR group.Conclusion:Performing DLR in appropriate cases of distal fibula fracture may contribute to better clinical outcomes in the mid to long term.

Ascites is defined as the accumulation of intra-peritoneal fluid that can be caused by several diseases. We described a 47-year-old female presenting with low serum-ascites albumin gradient (SAAG) and a markedly high level of serum globulin. Serum protein electrophoresis revealed an M spike in the gamma region. Other laboratory results showed a marked increase in aspartate aminotransferase and alanine aminotransferase and predominantly conjugated hyperbilirubinemia without a sign of dilatation of bile ducts from abdominal ultrasonography examination. Furthermore, the follow-up showed a positive result for the anti-nuclear antibody test. The patient was assessed with autoimmune hepatitis, and the cause of ascites was suggested from portal hypertension although the level of SAAG was low. The ascites condition got improved after salt restriction, diuretics treatment, and abdominal paracentesis. However, the patient passed away because of the intracranial hemorrhage as a result of prolonged INR and APTT due to liver failure.

Background and objectives: The inappropriate use of antibiotics in hospitals can potentially lead to the development and spread of antibiotic resistance, increased mortality, and high economic burden. The objective of the study was to assess current patterns of antibiotic use in leading hospitals of Pakistan. Moreover, the information collected can support in policy-making and hospital interventions aiming to improve antibiotic prescription and use. Methodology and materials: A point prevalence survey was carried out with data abstracted principally from patient medical records from 14 tertiary care hospitals. Data were collected through the standardized online tool KOBO application for smart phones and laptops. For data analysis, SPSS Software was used. The association of risk factors with antimicrobial use was calculated using inferential statistics. Results: Among the surveyed patients, the prevalence of antibiotic use was 75% on average in the selected hospitals. The most common classes of antibiotics prescribed were third-generation cephalosporin (38.5%). Furthermore, 59% of the patients were prescribed one while 32% of the patients were prescribed two antibiotics. Whereas the most common indication for antibiotic use was surgical prophylaxis (33%). There is no antimicrobial guideline or policy for 61.9% of antimicrobials in the respected hospitals. Conclusions: It was observed in the survey that there is an urgent need to review the excessive use of empiric antimicrobials and surgical prophylaxis. Programs should be initiated to address this issue, which includes developing antibiotic guidelines and formularies especially for empiric use as well as implementing antimicrobial stewardship activities.

Introduction: Coronavirus disease 2019 (COVID-19) is a highly infectious viral disease with high morbidity and mortality. Successful control of COVID-19 requires an approach of safety and cautious behavior of the general public as well as healthcare workers which can be attained by enhancing awareness based on scientific evidence. Aims & Objectives: To assess the knowledge, attitude, and practice (KAP) of Covid-19 safety precautions in people with a medical and allied health background and compare them with non-medical people from the local population. Place and duration of study: Study was conducted at Central Park Medical College from July 2020 to September 2020. Material & Methods: A total of 976 people participated in the study and were segregated into two groups; Group 1 (People having medical background; n=388) and Group 2 (People having non-medical background; n=588) to compare KAP scores between Group 1 and Group 2 by using validated scales on Google forms. Data were presented as percentages and frequencies. Independent sample t-test was used to analyze statistical differences. Results: Higher knowledge scores were observed for group 1 as compared to group 2 (9.92 + 2.27 v/s 9.16 +2.53; p= 0.001). Better knowledge, good attitude and safe practice trends were observed in group 1 (medical background) as compared to group 2 (non-medical background). Conclusion: Individuals with a medical background are more knowledgeable and exhibit a cautious attitude and better safety practices regarding COVID-19 as compared to the general population. There is a need to educate the general population about safety measures for COVID-19 including social distancing, usage of masks, self-isolation, avoidance of gatherings and others.

Objective: Porcine-derived small intestine submucosa (SIS) extracellular matrix (ECM) surgical patches claim to have greater regenerative properties compared with dermal extracellular matrices. We hypothesized that using SIS-ECM in a bioengineered composite tracheal graft would allow better incorporation into the native tissue. Methods: Two types of size-matched polycaprolactone support scaffolds were designed: rigid and flexible. The SIS-ECM was wrapped around the polycaprolactone supports lining the inside and outside of the graft. The grafts were implanted in 4 Yorkshire pigs, replacing an ∼2 cm segment of native trachea. Airway patency was evaluated with computed tomography scans and explanted grafts were examined grossly and histologically. Results: All animals survived through the immediate postoperative period. Generally, extraluminal examination showed a smooth transition between native and graft without significant volumetric loss. Animals that received the flexible design survived ∼10 days longer than those that received the rigid design; however, severe perianastomotic intraluminal granulation tissue was observed. The rigid design had less significant intraluminal granulation tissue development at the distal anastomosis, but partial dehiscence had occurred at the proximal anastomosis interrupting graft incorporation. Conclusions: The generally good extraluminal graft incorporation in our composite tracheal graft highlights some increased regenerative capabilities of SIS-ECM. However, the presence of intraluminal granulation tissue indicates that its use as an off-the-shelf, unaltered substrate in an airway graft is still not ideal. Further research must be conducted to determine whether a modification of the substrate is possible to enhance luminal airway incorporation and to exert control over the mechanisms responsible for granulation tissue development.

Low back pain (LBP) is a common problem encountered by physicians. It is a considerable cause of morbidity and socioeconomic loss and is one of the most expensive musculoskeletal disorders. Conventional treatments include bed rest, analgesics, therapeutic exercises, lumbar or caudal epidural corticosteroids, and surgery. Several new biological therapies are being investigated for use in LBP and one of these is platelet-rich plasma (PRP). In this article, we summarize the current literature published on PRP concerning its composition, classification, and application in LBP. We believe our review will prove useful to clinicians and academics alike, interested in new developing therapies for LBP.

Objective: To describe the prevalence of antiphospholipid antibodies in coronavirus disease-19 (COVID-19) and to find potential associations between antiphospholipid antibody positivity and clinical outcomes. Methods: From September to November 2020, clinical and laboratory data were collected from 50 COVID-19 patients hospitalized at Saiful Anwar General Hospital in Malang, Indonesia. Antiphospholipid antibodies were measured by finding IgM anti-β2 glycoprotein, lupus anticoagulant, and IgM/IgG anticardiolipin. Clinical characteristics, thrombotic events, ICU admission, and mortality during hospitalization were recorded. Disease severity was defined by the Guidelines for the Prevention and Control of COVID-19, Indonesia. Results: Among 50 patients, 5 patients (10.0%) were positive for antiphospholipid antibodies: 4 patients (80.0%) had IgM anti-β2 glycoprotein and 1 patient had IgG anti-cardiolipin (20.0%) and IgM anti-cardiolipin (20.0%), none of lupus anticoagulant was detected. Antiphospholipid antibodies were associated with anosmia (OR 8.1; 95% CI 1.1-57.9; P=0.018), nausea and vomiting (OR 12.4; 95% CI 1.2-122.6; P=0.010), diarrhea (OR 9.8; 95% CI 1.3-70.9; P=0.010), cardiovascular disease (OR 1.4; 95% CI 1.0-1.9; P=0.001), chronic kidney disease (OR 12.0; 95% CI 1.6-90.1; P=0.05), acute coronary syndrome (OR 29.3; 95% CI 2.0-423.7; P=0.001), moderate (OR 0.11; 95% CI 0.01-1.10; P=0.031) and severe (OR 18.5; 95% CI 1.8-188.4; P=0.002) disease severity, and in-hospital mortality (OR 8.1; 95% CI 1.1-57.9; P=0.018). However, there is no correlation between the presence of antiphospholipid antibody and ICU admission. Conclusions: In summary, the prevalence of antiphospholipid antibodies in COVID-19 patients is low, mainly against IgM anticardiolipin, and is associated with an acute coronary syndrome, gastrointestinal manifestations, moderate and severe disease severity, and increased risk of mortality.

ABSTRACT Introduction To compare two different intraoperative fluoroscopy techniques used for closed reduction and percutaneous pinning (CRPP) in pediatric patients with supracondylar humerus fractures (SHF). Materials and Methods Thirty-six patients who underwent SHF surgery from May 2011 to June 2019 were included in the study. During surgery, the classical fluoroscopy method (CFM) was used in 21 patients and the new fluoroscopy method (NFM) was used in the remaining 15 patients. Results The mean age was 5.14±1.13 years in the NFM group and 5.38±1.36 years in the CFM group. Mean operative time was 38.14±5.92 minutes in the CFM group and 21.54±3.48 minutes in the NFM group (p=0.001), while mean fluoroscopy times were 25.65±3.91 seconds and 39.84±7.50 seconds in the NFM and CFM groups, respectively (p=0.001). The NFM and CFM groups demonstrated similar functional capacity as measured by the Mayo Elbow Score (p=0.168). Direct radiographs obtained to measure Baumann’s angle also showed that the two groups had similar results (p=0.848). Conclusions The NFM is a reliable and successful technique as it leads to shorter operative and fluoroscopy times, as well as providing improvement in functional scores and radiological outcomes in short-term follow-up. Level of Evidence III, Therapeutic Studies-Investigating the Results Level of Treatment.

Pertanian di Indonesia umumnya masih dilakukan secara sangat sederhana dengan mengandalkan tenaga manusia dan hewan. Jorong Koto Gadang merupakan daerah yang berpotensi untuk bercocok tanam holtikultura seperti tomat, cabe, kol, dan sayur-sayuran lainnya. Lahan yang tersedia lebih kurang seluas 20 ha, tetapi tergarap semua oleh masyarakat. ini disebabkan petani masih menggunakan peralatan manual (cangkul) untuk mengolah lahan yang ada. Selain itu pekerjaan mencangkul yang relatif lama akan dapat menyebabkan resiko cedera pada beberapa bagian anggota tubuh (Musculoskeletal Disorders/MSDs). Dirasakan sangat perlu memanfaatkan teknologi yang telah untuk memudahkan pekerjaan petani dan mengurangi resiko cedera tersebut. Berdasarkan asesmen awal dengan REBA diperoleh skor awal 10 artinya resiko levelnya sangat tinggi dan tindakan perbaikan perlu saat ini juga. Teknologi yang dapat digunakan adalah menggunakan cultivator. Pemilihan cultivator ini diperoleh dari diskusi dengan anggota Kube dengan melihat kondisi lahan dan fungsinya. Selanjutnya dilakukan asesmen kembali dengan REBA dan memperlihatkan hasil lebih baik dengan skor 7 yang artinya masih perlu perbaikan. Perbaikan dapat dilakukan dengan memodifikasi alat dan jenis material alat tersebut. Kata Kunci: Ergonomi, Holtikultura, KUBE, Musculoskeletal disorders ABSTRACT Agriculture in Indonesia is generally still done very simply by relying on human and animal labor. Jorong Koto Gadang is an area that has the potential to grow horticulture such as tomatoes, chilies, cabbage, and other vegetables. The available land area is approximately 20 hectares, but it is cultivated by the community. this is due to farmers still using manual equipment (hoes) to cultivate existing land. In addition, relatively long hoeing work can cause the risk of injury to some parts of the body (Musculoskeletal Disorders / MSDs). It is felt that it is necessary to utilize technology that has made it easier for farmers to work and reduce the risk of injury. Based on the initial assessment with REBA an initial score of 10 means that the level of risk is very high and corrective action is necessary at this time. The technology that can be used is to use a cultivator. The selection of cultivators was obtained from discussions with Kube members by looking at the condition of the land and its functions. Furthermore, the assessment was carried out again with REBA and showed better results with a score of 7 which means it still needs improvement. Improvements can be made by modifying the tool and the type of material the tool is. Keywords: Ergonomic, Holticultura, KUBE, Musculoskeletal disorders

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'Background:' On 1 March, 2018, 15 students of a religious boarding school presented to a tertiary care hospital in Islamabad with complaints of nausea, vomiting, abdominal pain and diarrhea. A team of FELTP fellows were tasked to investigate the suspected outbreak to confirm diagnosis, determine magnitude, evaluate possible risk factors, identify the source and implement control measures. 'Methods:' A retrospective cohort study was conducted from 25 February to 5 March, 2018. Medical records were reviewed at the hospital. All the students and staff of the boarding school were interviewed using a structured questionnaire. A case was defined as any student of the religious school reported with nausea, abdominal discomfort and one of the following symptoms of vomiting, diarrhea, and chills on 1 March, 2018. Information on demographics, history of food intake and clinical features was collected. Suspected food items and drinking water samples were sent to the National Institute of Health for microbiological analysis. Frequencies and attack rates were calculated and risk ratios computed at 95% confidence interval at the margin of error P

Objective: To ascertain glycemic control and sleep quality in patients with Type 2 Diabetes Mellitus and compare them with age-matched non-diabetic control subjects. Methodology: In this cross-sectional study, plasma glycated hemoglobin (HbA1c) levels and sleep patterns in diabetic subjects were compared with non-diabetic control subjects. Ethical approval was granted by the institutional ethical review board of Central Park Medical College vide number CPMC/IRB/1728. After taking written informed consent, a total of fifty participants between the ages of 40-60 years were recruited by convenience sampling from the medical outpatient clinic at Central Park Teaching Hospital in 2018. Based on the fasting blood glucose levels, participants were categorized as Group I (diabetic subjects) and Group II (non-diabetic control subjects). Sleep quality was assessed using two validated scales, namely Insomnia Severity Index (ISI) and Epworth Sleepiness Scale (ESS). HbA1c levels were evaluated using standardized blood assays. Independent samples t-test was employed to determine mean differences between the two groups. A p-value of ? 0.05 was considered significant. Results: Mean age of the study participants (n=50) was 49.28±2.34 years. The diabetic subjects had significantly higher HbA1c levels (10.15±2.50 vs. 6.26±1.04; p-value 0.001) and ISI scores (12.64±7.91 vs. 4.68±4.88; p-value 0.000) as compared to non-diabetic control subjects, indicating poorer glycemic control and greater degree of insomnia. Conclusion: Poorly controlled diabetes mellitus as reflected by higher HbA1c levels is associated with increased insomnia.

The ongoing COVID-19 pandemic is caused by SARs-CoV-2. The virus is transmitted from person to person through droplet infections i.e. when infected person is in close contact with another person. In January 2020, first report of detection of SARS-CoV-2 in faeces, has made it clear that human wastewater might contain this virus. This may illustrate the probability of environmentally facilitated transmission, mainly the sewage, however, environmental conditions that could facilitate faecal oral transmission is not yet clear. We used existing Pakistan polio environment surveillance network to investigate presence of SARs-CoV-2 using three commercially available kits and E-Gene detection published assay for surety and confirmatory of positivity. A Two-phase separation method is used for sample clarification and concentration. An additional high-speed centrifugation (14000Xg for 30 min) step was introduced, prior RNA extraction, to increase viral RNA yield resulting a decrease in Cq value. A total of 78 wastewater samples collected from 38 districts across Pakistan, 74 wastewater samples from existing polio environment surveillance sites, 3 from drains of COVID-19 infected areas and 1 from COVID 19 quarantine center drainage, were tested for presence of SARs-CoV-2. 21 wastewater samples (27%) from 13 districts turned to be positive on RT-qPCR. SARs-COV-2 RNA positive samples from areas with COVID 19 patients and quarantine center strengthen the findings and use of wastewater surveillance in future. Furthermore, sequence data of partial ORF 1a generated from COVID 19 patient quarantine center drainage sample also reinforce our findings that SARs-CoV-2 can be detected in wastewater. This study finding indicates that SARs-CoV-2 detection through wastewater surveillance has an epidemiologic potential that can be used as supplementary system to monitor viral tracking and circulation in cities with lower COVID-19 testing capacity or heavily populated areas where door-to-door tracing may not be possible. However, attention is needed on virus concentration and detection assay to increase the sensitivity. Development of highly sensitive assay will be an indicator for virus monitoring and to provide early warning signs.

Bioethanol might be one of the most potent solutions to overcome the demand for liquid transportation fuel. The demand for ethanol has been continually increasing on account of the growth of user industries and use of ethanol as a fuel. However, the production and availability of ethanol has largely lagged behind. The major problem with bioethanol production is the availability of raw material. Lignocellulosic biomass is the most promising feedstock considering its abundant availability and low cost. Ethanol production is much more challenging and difficult when lignocellulosic material is to be used as raw material. Unlike the starch-based materials, pretreatment and hydrolysis of lignocellulosic material produce a mixture of pentose and hexoses along with other inhibiting compounds, causing many problems in the fermentation process. Bioconversion of lignocellulosic biomass to ethanol requires three major unit operations including pretreatment, hydrolysis, and fermentation, which is comprehensively summarize in this review.

Penghematan pemakaian energi menjadi, karena cadangan energi makin berkurang. Ada dua cara yang dilakukan untuk menghematkan pemakaian energi, dalam hal ini energi listrik yaitu, mengurangi waktu pemakaian dam memperkecil daya listrik peralatan yang terpakai. Penelitian ini merancang sistem kendali pemakaian energi listrik pada ruang kuliah. Monitoring dilakukan dengan sensor arus, sensor untuk mengetahui apakah AC, infokus dan lampu hidup ketika ruang kuliah tidak digunakan. Hasil pembacaan sensor disampaikan melalui Xbee dan Arduoino. Ruang kelas dibuat dalam sebuah proyotype dengan beban listrik sebuah lampu. Pengontrolan dapat dilakukan melalui komputer untuk menghidupkan atau mematikan peralatan dalam ruangan kuliah. Dari hasil pengujian ada dua hal yang mempengaruhi penerimaan sinyal pada receiver, yaitu jarak dan kebebasan terhadap transmiter. Dari hasil pengukuran semakin jauh jarak antara transmiter dan receiver maka waktu delay makin besar. Pada jarak 5 m waktu delay hanya 5 detik, untuk jarak 30 m waktu delaynya adalah 60 detik dan pada jarak 50 m waktu delaynya menjadi 121 detik. Sedangkan jika ada penghalang antara transmiter dengan receiver waktu delay pada jarak 10 m adalah 10 detik, jarak 30 m menjadi 90 detik dan ketika jaraknya 50 m waktu delay adalah 191 detik. Didapatkan hasil semakin jauh jarak antara transmitter dan receiver maka semakin lama waktu pengiriman. Hal ini dapat dipengaruhi oleh adanya pantulan dan loss data oleh udara.