bluuebunny/crossref_metadata_2025 huggingface dataset:
Los avatares de un cristiano nuevo en la ciudad de Zaragoza (Antioquia) en el siglo XVII
Authors: Navarrete-Peláez María-Cristina
Published: February 2022

el artículo plantea las vicisitudes de un cristiano nuevo portugués radicado en la ciudad de Zaragoza (Antioquia, Colombia), en la primera mitad del siglo XVII, cuyos conocimientos religiosos superaban los de sus contemporáneos. En otras palabras, en este texto se trata de demostrar en qué medida la vida y los conocimientos de Luis Franco Díaz muestran la existencia de discursos disidentes frente a la ortodoxia católica del siglo XVII. Una forma para encontrar la respuesta en esta investigación recae sobre el concepto de hegemonía de Antonio Gramsci y de autores de los estudios subalternos. Asimismo, este artículo aborda metodológicamente la documentación que ofrecen los archivos inquisitoriales de Madrid y Lisboa. Allí se leyó que los conocimientos cristianos de Luis Franco Díaz fueron tergiversados y por eso cayó en manos de la Inquisición de Cartagena de Indias, institución hegemónica aliada a los intereses de la Corona española. No obstante, gracias a la fortuna e influencias de su hermano, ante la Real Audiencia de Santa Fe en el Nuevo Reino, Luis no solo se libró de la sentencia, sino que logró desempeñar cargos públicos en la ciudad minera de Zaragoza. Así pues, este artículo demuestra que las creencias de los cristianos nuevos durante el siglo XVII no fueron homogéneas y que en los reinos de ultramar circulaban discursos alternativos.
Molina Jiménez, I. y Díaz Arias, D. eds. (2021). El héroe de la discordia. Juan Rafael Mora Porras y la cultura costarricense. Editorial de la Universidad de Costa Rica/CIHAC
Authors: Lacaze Catherine
Published: February 2022

Las efemérides posibilitan la confrontación de visiones sobre la historia de los países, ya que constituyen fechas “donde el pasado se hace presente en los rituales públicos, donde los sentimientos son activados y los sentidos interrogados, donde se construyen y se reconstruyen los recuerdos del pasado” (Jelin, 2002, p. 1).
Secondary syphilis with stage III HIV in an adolescent deaf male with a history of sexual relationship with men: a case report
Authors: Mudita Tritya , Puspawati Ni Made Dwi , Sattwika I Gusti Ayu , Wirya Andrew Yoshihiro
Published: February 2022

Introduction: Syphilis is an infection caused by Treponema pallidum of the spirochaete family.Case: A 19-year-old Balinese came with a complaint of red spots on the palms of the hands and feet one month ago. The patient has a hearing disability and is currently enrolled in a special-needs school in Denpasar. VDRL examination with reactive results with titer 1:256 and TPHA reactive with TPHA titer 1:5120. The patient received benzathine penicillin G 2.4 million units intramuscularly. Significant improvement was obtained, and the serological test was decreased.Discussion: Syphilis transmits through sexual contact, vertically from pregnant women to their fetuses, through needle sharing. People with hearing disabilities and adolescents are considered vulnerable as objects of harassment and sexual violence.Conclusion: People with disabilities and adolescents are vulnerable to sexually transmitted diseases. Information on reproductive health and sexually transmitted diseases need to be more readily available for people with disabilities. Secondary syphilis therapy with a single dose of benzathine penicillin is effective from clinical or serological observations.
Case report: a child with type 1 neurofibromatosis and intellectual disability
Authors: Wijaya Elice , Karna Ni Luh Putu Ratih Vibriyanti , Priyadarshini Ida Ayu Uttari
Published: February 2022

Background: Neurofibromatosis is a genetic disorder which manifests as a tumor that surrounds the nerves and several other pathologic presentations.Case: Female, 11 years old, according to history, physical examination and supporting investigation was consistent with the diagnostic criteria of type 1 neurofibromatosis (NF-1). Patient also has intellectual disability. On the patient, a tumor on the foot region that was functionally disabling was found and a surgical treatment was performed.Discussion: Cognitive disorder is the most common neurological complication in individuals with NF-1 and usually present with low intelligence quotient (IQ). There is no specific treatment to prevent the development of NF-1. However, early treatment can minimize and prevent further complication. Treatment for the patient involve multiple clinical discipline.Conclusion: A neurofibromatosis case can be diagnosed clinically alone, however, since there are many other systemic involvements that require multi-disciplinary approach.
Mean pulmonary artery diameter in chest CT scan in the Thai population
Authors: Nirattisaikul Sitang , Sunpech Nuttapat , Hongsakul Keerati
Published: February 2022

Introduction: Pulmonary hypertension has been associated with a significant increase in morbidity and mortality. The pulmonary artery diameter measurement from a CT scan is routinely used to predict possible evidence of pulmonary hypertension. However, no data available as a reference for the normal range, especially in the Thai Population. The primary purpose of this study was to determine the normal diameter of the main pulmonary artery (MPA) and ascending aorta (AAo) and the ratio between MPA and AAo diameter in the Thai population. Methods: Patients who met the inclusion criteria and had a chest CT performed in Songklanagarind hospital between 1 January 2014 and 14 July 2014 were enrolled. Measurement of the MPA diameter at the level of its bifurcation and the AAo from an axial-view contrast-enhanced CT chest (venous phase) image was done. The ratio between the diameter of MPA and AAo was then calculated. Results: 2395 patients were included in this study (male = 1271 patients, female = 1124 patients, aged between 20-96 years; mean = 57 years old). The mean diameter of the MPA was 25.21 mm, and the mean diameter of the AAo was 30.78 mm. The mean MPA/ AAo ratio was 0.83. The sex-specific mean diameters of the MPA were 25.4 mm in men and 25.0 mm in women. The mean diameters of the AAo in men and women were 31 mm and 30 mm, respectively.Conclusion: The mean MPA diameter obtained from chest CT scans in this study was about 25.4 mm in men and 25.0 mm in women. These values are easily obtained from chest CT scans and are highly reproducible. Therefore, it may be used as a reference value for a healthy Thai population.
Single Umbilical Artery (SUA) - prenatal sonography diagnosis and vascular imaging features postnatal cord: a case report
Authors: Sanjaya I Nyoman Hariyasa , Pemayun Cokorda Istri Mirayani , Purwanti Ni Wayan Dewi , Sakuntari Made Diah Vendita , Gianni Ni Putu Nining , Putri Ni Luh Made Diah Mas Cahyani , Pirgantari Ni Komang Anik , Satriani Ni Luh Md Dwi Laxmi , Mintariani Firsta Sesarina , Padmawati Ni Luh Putu Yulia , Putri Anak Agung Wahyu
Published: February 2022

Background: Single umbilical artery (SUA) is a rare presentation in obstetrics practice, yet it comprises most of the umbilical anomaly. Despite its rare occurrence, a proper prenatal diagnosis needs to be established timely in order to prevent morbidity and mortality from commonly coexisting abnormalities. This case report presents a delayed diagnosis of SUA by prenatal sonography diagnosis and vascular imaging features postnatal cord at the third trimester of pregnancy and discusses the proper diagnosis and management of such cases.Case Presentation: We reported a case of a 37 year old pregnant woman who found to have one artery one vein in her umbilical cord on ultrasound. This is very rare case and precise concern for us. Unfortunately we found this case in the third trimester of pregnancy (37w5d), therefore we have slightly to evaluate. Female baby was born by elective C-section. The baby cried immediately, with an Apgar score of 8-9. We didnâ€™t find major abnormalities in the baby. Birth weight 3700 grams. There were not sign of heart diseases and kidneyâ€™s abnormality. Baby was monitoring for one weeks and the baby has good growth and development.Conclusion: This report is expected to increase the awareness of this disease entity as a fundamental basis for developing its screening and management protocols.Â Â Â Â Â Â
Vitamin D Receptor (VDR) Apa1 gene polymorphism increasing the risk of breast cancer women in Bali, Indonesia
Authors: Mahayasa I Putu Gede Fajar , Widiana I Ketut , Adiputra Putu Anda Tusta , Sudarsa I Wayan
Published: February 2022

Background: Breast cancer is the most common cancer diagnosed in women. It basically caused by a progressive accumulation of genetic disorders. Vitamin D and its receptor (VDR) have been shown to have an effect on the carcinogenesis of breast cancer. Several studies have shown VDR Apa1 polymorphisms became the most prevalent polymorphism of other polymorphism variants of breast cancer. There are still lack of studies that review the relationship of VDR gene polymorphisms, especially Apa1 on breast cancer risk among Balinese woman.Method: This study was a case-control design- analytic study to see the relationship between Vitamin D receptor Apa1 gene polymorphism and breast cancer risk in Balinese women. There were 42 venous blood samples from breast cancer women and healthy women in Bali. This study was carried out at the Faculty of Medicine Integrated Biomedical Laboratory. DNA isolation was done for sequencing to determine the sequence of gene bases. Then the data were analyzed using SPSS 16.Results: Univariate analysis showed the characteristics of the subject and research variables. Bivariate analysis showed that the presence of VDR Apa1 polymorphism in Balinese women increased the risk of breast cancer by 5,846-fold higher compared to women without polymorphism (CI95%:1.065- 32.082; P = 0.03). Multivariate analysis confirmed that the VDR Apa1 polymorphism independently influence and increase the risk of breast cancer without being influenced by other variables (95% CI: 1.065-32.082; P = 0.042).Conclusion: In this study has shown VDR Apa1 polymorphism significantly associated and increased the risk of breast cancer in women in Bali.
Functional assessment of operative and non-operative management in major pelvic fracture at Dr. Moewardi Hospital, Surakarta, Indonesia
Authors: Nefihancoro Udi Heru , Muamar Muhamad , Putra Muhammad David Perdana
Published: February 2022

Introduction: Pelvic fractures are responsible for skeletal injuries and soft tissue-related injuries. Pelvic fracture is a disorder of the pelvis bones' structure, including the hip bone, sacrum, and coccyx. The condition will result in stable status if the pelvis can resist weight-bearing loads without the incidence of any displacement. This study aims to determine pelvic fracture outcome, in which operative and non-operative management used the Majeed score to evaluate the functional results.Method: A retrospective case-control study was performed to retrieve data from medical records of patients with pelvic fractures at Dr. Moewardi Hospital Surakarta for the period from January 1st, 2017, until December 31st, 2019. The evaluation of reduction quality was conducted following the scores put forward by Majeed to evaluate the clinical outcomes. Data analyzing used SPSS V.24.0 (IBM Corp). P-value of <0.05 was determined as the statistical significance.Results: In this study, there were 40 samples of pelvic fracture cases; 60% were male, 55% were aged 19 â€“ 40 y.o, motor crash caused 67%, 37.5% were cases of pubic rami fractures. Besides, operative management was 52,5%, while non-operative was 47,5%. Further, operative management's functional outcome was excellent at 66%, good at 19%, fair at 9%, and poor at 8% of the patients. Patients treated with operative management had significantly fewer severe injuries, as rated using the Majeed score than the non-operative group.Conclusion: The results suggest that operative treatment may be a viable option in treating major pelvic fracture as it provides better functional results than non-operative treatment.
Delayed laparotomy and gastric repair in gastric perforation: a case report in the neonatal patient
Authors: Barmadisatrio Barmadisatrio , Mulluzi Ali Sibra
Published: February 2022

Background: The incidence of gastric perforation in neonates is rare but has a high mortality rate of 15-70%. Spontaneous gastric perforation in neonates is estimated to occur in one of 2,900 live births and accounts for approximately 7% of all gastrointestinal perforations in neonates and children.Case: We present a case of gastric perforation complicated by sepsis, anemia, thrombocytopenia, and hypoalbuminemia in a 3-day-old girl. The patient was brought to the emergency room of Dr. Soetomo Hospital Surabaya with blood vomiting complaints from 1 day. On physical examination, it was found that the general condition was weak, with an axillary temperature of 38.2Â° C. The abdomen looked distended from inspection of the abdominal region, with the dilated vein and periumbilical hyperemia. Its percussion revealed the loss of liver dullness. The results of laboratory examinations: Hb 10.7 g/dl, Platelet 14,000/mm3, Albumin 2,6 g/dl. Plain thoracoabdominal X-Ray study showed a pneumoperitoneum. Needle decompression was performed because there were signs of Abdominal Compartment Syndrome (ACS). After five days of optimization in the Intensive Care Unit, a laparotomy exploration and primary repair of gastric perforation were conducted.Conclusion: Gastric perforation in neonates is a rare condition. The management principle for each patient is different depending on the patient's condition. Needle decompression is indicated when ACS is present or the patient's condition is not optimal for surgery. Definitive laparotomy can be done after the patient's condition has been stabilized. Proper selection of treatment can improve the patient's outcome and reduce the risk of morbidity and mortality.
Criteria for palliative care referral in oncology practice: An instrument development
Authors: Witjaksono Maria A , Effendy Christantie , Mulatsih Sri , Dwiprahasto Iwan , Utarini Adi
Published: February 2022

Introduction: Cancer patients experience significant physical symptoms and psychosocial problems during cancer treatment that negatively impact on quality of life which can be intervened by palliative care. However, the referral of cancer patients to palliative care is still low. Therefore, this study aimed to explore the need of palliative care among doctors working in oncology in order to develop an instrument of criteria for palliative care referral in oncology practice.Methods: A mixed method research with a sequential variant exploratory, quantitative dominant design was used. Using phenomenology orientation, the qualitative study exploring the needs of palliative care referral was conducted and data were obtained through in-depth interviews with 32 oncologic care doctors. Identified dimensions, criteria, sub-criteria and indicators were then used to develop the instrument. In the quantitative study, validity of the instrument was tested through expert judgement and Aikenâ€™s V content-validity coefficient was calculated.Results: The study found that palliative referral criteria consisted of 20 indicators, i.e., 15 medical indicators of the aspects related to disease stage, patientâ€™s condition, treatment status, and status of care; and 5 non-medical indicators, included the aspects associated with psychological, social, spiritual, communication and decision making. The validity of the instrument was confirmed through the expert panel, in which the Aikenâ€™s V coefficient of all indicators ranged high from 0.825 to 0.975.Conclusion: The instrument of palliative care referral criteria was developed which consist of 20 indicators and had good validity.
Serum N-Terminal Pro B-Type Natriuretic Peptide is associated with maternal complication in pregnancy with severe preeclampsia
Authors: Hafiz Alini , Dewantiningrum Julian , Kristanto Herman , Pramono M. Besari Adi
Published: February 2022

Background Hypertension is the second most common cause of maternal death in the world. Predicting the occurrence of preeclampsia (PE) complications is needed to optimize management. Brain natriuretic peptide (BNP) is a polypeptide, secreted by cardiac ventricular myocytes. Research linking N-Terminal Pro B-Type Natriuretic Peptide (NT-proBNP) levels with maternal complications has never been conducted in Indonesia. The aim of the study is to evaluate plasma NT-proBNP levels in pregnant women with pre-eclampsia and normotension and to find a relationship between NT-proBNP levels and maternal complications incidence.Methods This cross sectional study was conducted on thirty women with severe preeclampsia with gestational age >20 weeks who attended and underwent labor at Dr. Kariadi Hospital Semarang during study period. Patients with a history of chronic disease, underweight or obese, history of heart disease and consumption of heart drugs were excluded. Serum NT-proBNP was taken prior labor. Correlation between NT-proBNP serum levels and physical characteristics as well as complications was performed using the Mann-Whitney and Spearman correlation test.Results NT-proBNP serum levels were significantly higher in the severe preeclampsia group, especially early-onset compared to the normotensive group (p<0.05). Increased serum NT-proBNP levels are associated with several maternal complications, especially HELLP syndrome, pulmonary edema, retinopathy and renal impairment.Conclusions Increased serum NT-proBNP levels are associated with severe preeclampsia and several maternal complications.
Visual function outcome post intracranial surgery in sellar region brain tumor
Authors: Caesarita Dea Prita , Bakhtiar Yuriz , Prihatningtias Riski
Published: February 2022

Background: The proximity of sellar tumor to the optic nerve and optic chiasm can cause compressive optic neuropathy. Manifestation of optic pathway dysfunction varies from papilledema to optic nerve atrophy and affects visual function. This case report aims to present two patients with sellar region tumor treated with intracranial surgery.Case Presentation: Two cases of sellar region tumor patients had complaints decreased visual function treated with intracranial surgery. Case 1. An 8 years old female, visual acuity pre and post-surgery right eye (RE) 2.2;1.3, left eye (LE) 0.70;0.5. Color vision pre and post-surgery RE 0/38;0/38, LE 0/38;1/38 plate. Contrast sensitivity RE pre and post-surgery canâ€™t be evaluated and left eye 10%;2.5%. The visual field pre and post-surgery was hemianopsia bitemporal. The evaluation had been taken 1-week post-surgery. Â Case 2. A 24 years old female, visual acuity pre and post-surgery RE 1.5;1.0, LE 1.8;1.8. Color vision pre and post-surgery RE 0/38;1/38, LE 0/38;0/38 plate. Contrast sensitivity RE pre-surgery canâ€™t be evaluated and 25% post-surgery and LE pre and post-surgery canâ€™t be assessed. The visual field pre and post-surgery was hemianopsia bitemporal. The evaluation had been taken 1-week post-surgery.Conclusion: All patients with sellar region tumor who underwent intracranial surgery had visual function improvement although progress differed between individuals. It represents a particular challenge for the physicians treating it.
Total occlusion of coronary artery without ST-segment elevation a case series of â€˜de Winterâ€™ electrocardiogram pattern
Authors: Wismiyarso Destrian Ekoputro , Adriana Carina , Mangkoesoebroto Arjatya Pramadita , Christiawan Arman , Sulma Aldila Nila , Effendi Lita Hati Dwi Purnami , Ardhianto Pipin
Published: February 2022

Background: A â€˜STEMI equivalentâ€™ electrocardiogram (ECG) pattern describes an acute thrombotic occlusion of a large coronary artery without ST-segment elevation. This pattern must be recognized and treated with emergent reperfusion therapy. De Winter syndrome is a special ECG pattern reflecting acute occlusion in the proximal segment of LAD (left anterior descending) coronary artery and a primary percutaneous coronary intervention (PCI) should be performed as early as possible.Case illustration: We present two patients admitted to the emergency department with symptoms of chest pain. Their ECGs revealed de-Winter T waves and then coronary angiography was performed. Total occlusion in the proximal segment of the LAD coronary artery was observed in both patients, and stents were implanted to the culprit lesion. Both ECG patients show an up-sloping ST-segment depression (STD, >1 mm) starting from the J-point, with symmetrical, tall and significant T-waves in the precordial leads. This ECG pattern indicates a LAD coronary artery obstruction. The â€˜de Winterâ€™ ECG pattern is not mentioned in the ESC guidelines, but it is essential to recognize this rare ECG pattern as the STEMI equivalent, and it must be treated with prompt revascularization therapy.Conclusion: The â€˜de Winterâ€™ ECG pattern, as other â€˜STEMI equivalentâ€™, must be recognized promptly and treated as soon as possible with emergent reperfusion by percutaneous coronary intervention.
Myasthenia gravis and arrhythmias in COVID-19: a case report
Authors: Tugasworo Dodik , Kurnianto Aditya , Retnaningsih Retnaningsih , Andhitara Yovita , Ardhini Rahmi , Daynuri Daynuri , Budiman Jethro
Published: February 2022

Background: Myasthenia Gravis (MG) is an autoimmune disorder, which autoantibodies against postsynaptic (muscle) nicotinic acetylcholine receptors (nAChR). MG patients have a higher prevalence of cardiac manifestations in the presence of thymoma. It is not known whether Coronavirus disease 2019 (COVID-19) can cause more severe illness in patients with chronic neuromuscular disorders such as MG, which can cause respiratory muscle weakness, or in those who are immunosuppressed. This case report will discuss patient with MG, thymoma, atrial fibrillation, and COVID-19.Case presentation:Â  A 60-year old man came to the hospital with difficulty of swallowing. He had nasal voice and dropping of eyelids. These complaints were happened repeatedly, worsened at night and got better in the next morning. From the neurological examination, it was also obtained Wartenberg test (+), counting test (+), and prostigmine test (+). Atrial fibrillation was found with normal ventricular response and decreased systolic left ventricular function on the electrocardiogram and echocardiography. On the chest MSCT, a lobulated homogeneous solid mass was found in anterior mediastinum which supported the image of thymoma, and there was the imaging of typical viral pneumonia. The patient also had the positive result of COVID-19 PCR test.Conclusion: MG patients have been shown with abnormal manifestations of heart rhythm. This may reflect as a complication of myocarditis or autonomic nervous system dysfunction. COVID-19 infection in MG can be challenging for many reasons. Current guidelines recommend continuing the current standard care treatment of MG during hospitalization.
The effect of cigarette smoke on the histopathological changes of the eustachian tube of Wistar rat
Authors: Dewi Susilowati , Zulfikar Naftali , Dwi Marliyawati , Hermawan Istiadi , Muyassaroh Muyassaroh
Published: February 2022

Background: Inflammation due to irritation of cigarette smoke causes metaplasia of the squamous epithelium of the Eustachian tube. Data on the prevalence and incidence of Eustachian tube dysfunction are still limited. The study aims to determine the effect of exposure to a stratified dose of cigarette smoke on the histopathological changes of the Eustachian tubes of Wistar rats.Method: This study was a true experimental study with post-test only control group design using Wistar rats as the subjects. We included 24 Wistar rats in the study and divided them into four groups. The number of Wistar rats in each group was 6. The control group was not exposed to cigarette smoke. The treatment group 1, 2, and 3 were each exposed to four cigarettes, eight cigarettes, twelve cigarettes per day for thirty days, respectively. We assessed the Eustachian tube histopathological changes using four parameters, namely inflammatory cells, cilia, goblet cells, and epithelium. Finally, we analyzed the data using the Kruskal-Wallis test and the Mann-Whitney test.Result: The Eustachian tube's histopathological changes occurred in inflammatory cells, cilia, goblet cells, and epithelial metaplasia. Group 1 showed grade 1 changes in all parameters assessed. Group 2 showed grade 2 changes in all parameters evaluated. Meanwhile, group 3 showed grade 3 changes in all parameters evaluated compared to other groups (p<0.05). There was a significant difference between the treatment group and the control group (p<0.05).Conclusion: Cigarette smoke with stratified doses affects the histopathological changes of the Eustachian tube.
Fat intake in Javanese breast cancer patients: any difference?
Authors: Christian Christian , Puruhita Niken , Himawan Arientasari , Muis Siti Fatimah , Fasitasari Minidian , Pangarsa Eko Adhi , Panigoro Sonar Soni , Sutandyo Noorwati
Published: February 2022

Background: Breast cancer is the second most prevalent womenâ€™s malignancy in Central Java. The risk of breast cancer incidence drops by 2.5 times for breast cancer if fat consumption is reduced by 50%, although not all types of fat intake increase the risk of breast cancer incidence. Fat consumption in Indonesia increased by 11% in the last 7 years. The study aims to analyze the differences in fat intake between breast cancer subjects and healthy subjects.Methods: This study is a cross-sectional study. We invited 45 outpatients diagnosed with breast cancer in Kariadi Hospital from January to August 2019 as well as 45 healthy subjects who are relatives or friends of the patients who met the inclusion criteria to participate in this study. Various types of fat intake were measured with quantitative food frequency questionnaires. The statistical analysis employed a chi-square test and Mann-Whitney test for non-parametric tests and an independent t-test for parametric data.Results: There was a significant difference in polyunsaturated fatty acid (PUFA) intake between breast cancer patients and healthy subjects (p=0.022). This study found no significant differences in total fat intake (p=0.677), saturated fatty acid (SFA) (p=0.368), monounsaturated fatty acid (MUFA) (p=0.593), omega 3 (p=0.095), omega 6 (p=0.092), and TFA (p=0.669) between breast cancer patients and healthy subjects.Conclusion: There is a significant difference in PUFA intake, but not in the other types of fat between breast cancer patients and healthy subjects. For further study, more precise and objective fat intake measurements may be achieved in studies with animal models.
Spiritual emotional freedom technique (SEFT) improved autonomic nervous activity in primipara
Authors: Hidayat Asri , Emila Ova , Dewi Fatwa Sari Tetra , Sumarni Sumarni
Published: February 2022

Introduction: Anxiety is one of prevalent mental disorders in pregnant women and causes alteration in autonomic nervous system (ANS) function and cardiovascular system adaptation. It could potentially lead to increased risk of maternal complications and morbidity. SEFT had been known to lower anxiety level and autonomic nervous system activity but its application in pregnant women is still debated. Therefore, this study aimed to assess the effectiveness of SEFT in primipara women.Method: a quasi-experimental, non-equivalent control group study was conducted in Bantul District, Yogyakarta, Indonesia involving primipara who fulfilled the research criteria. SEFT was performed at the 9th month of pregnancy and 1 week before the estimated date of delivery. LF/HF ratio was assessed and compared in the two groups as representation of HRV and autonomic nervous activity.Results: 62 primiparous women were enrolled in this study and divided equally to the intervention and control group. This study showed that the LF/HF ratio was already different between the two groups at the beginning of the study. However, while the mean of LF/HF ratio was decreasing in the intervention group, an increasing trend was observed in the control group. Finally, the comparison of the mean difference between the two groups revealed that SEFT significantly lowered the ratio of LF/HF in primipara, thus improving the HRV.Conclusion: SEFT effectively lowered LF/HF ratio in primipara women which might indicate a better balance between sympathetic and parasympathetic nerve responses. However, further study should be conducted to validate the application of SEFT in pregnant women with anxiety.
Visual function recovery post decompression surgery in meningioma: a case report
Authors: Hafizhan Hafizhan , Bakhtiar Yuriz , Prihatningtias Riski
Published: February 2022

Background: Meningiomas represent about 20% of intracranial tumors. Due to these tumors' proximity to the optic nerve, typically progressive unilateral vision loss, over several months to years, is the classic clinical presentation.Case Presentation: A 23 y.o. male presented with a progressive monocular visual loss of the right eye since 4 months. Visual acuity on the right eye was 1/300 and 6/6 on the left eye. Color vision and contrast sensitivity of the left eye was excellent. Fundus examination showed papilledema on right eye and left eye was within normal limit. MRI reveals a strong enhancing mass along the right and left sphenoid wing, measuring approximately 3.9 x 5.5 x 3.3 cm, extending into the parasellar region, compressing optic chiasm and encasing right and left N.III, N.IV and N.V. Patient were diagnosed with compressive optic neuropathy on the right eye due to meningioma. Following the decompression surgery, visual acuity on the right eye improved to 6/24, color vision 25/38 and contrast sensitivity was 5%. The patient was discharged 4 days after surgery and scheduled for routine follow-up at the polyclinic.Conclusion: Vision loss due to the compressive effect of meningioma may be reversible. The severity and the duration of vision loss due to compression may affect the final visual recovery. Early detection and prompt multidisciplinary approach are necessary to obtain a better outcome.
Ergonomic workstation reduces electrical activity of upper trapezius muscles, erector spinae muscles, and musculoskeletal complaints in agel fiber twisting process
Authors: Kurnianingtyas Chandra Dewi , Adiatmika I Putu  Gede , Tirtayasa Ketut , Surata I Wayan
Published: February 2022

Background: Humans' role in small industries as a source of labor is still dominant, mostly manual work. The research was conducted on manual workers in small agel fiber industries in Yogyakarta. Manual work is related to human strength and endurance. Ergonomic problems often arise in manual labor, including neck pain, back pain, and leg pain called musculoskeletal disorders. Non-ergonomic working conditions also increase the electrical activity of muscles. This study aims to reduce electrical muscle activity and musculoskeletal complaints by repairing an ergonomic workstation in the agel fiber twisting process.Methods: This research is an experimental study with 15 female subjects. The electrical activity of muscles is measured when working under conventional conditions (Period 1) and repairing an ergonomic work station (Period 2). The electrical activity of the muscles was measured using surface electromyography. Musculoskeletal complaints were measured before and after intervention with conventional conditions (Period 1) and ergonomic work station repair (Period 2). Musculoskeletal complaints were measured using the Nordic Body Map Questionnaire. The measurement data between the two periods were analyzed by using the paired samples t-test and the Wilcoxon signed-rank test.Results: The results showed a decrease in the upper trapezius muscles' electrical activity by 35.46% and the erector spinae muscles' electrical activity by 22.43%. The average of musculoskeletal complaints decreased by 23.77%, measured after working in period 1 and period 2.Conclusion: Ergonomic work station can reduce the electrical activity of the upper trapezius muscles, electrical activity of the erector spinae muscles, and musculoskeletal complaints in workers twisting the agel fiber rope.
Correlation between nutric score and adequacy of energy and protein intake with duration of mechanical ventilation in the intensive care unit Dr. Kariadi Hospital, Semarang-Indonesia
Authors: Sutrisnawati Ika , Darmono Darmono , Murbawani Etisa Adi , Puruhita Niken , Probosari Enny
Published: February 2022

Background: Malnutrition in the ICU patients increases morbidity, mortality, cost, and mechanical ventilation (MV) duration. Nutric score has been validated as a screening tool in critically ill patients to identify patients at risk of malnutrition. The pathophysiology of malnutrition in critically ill is caused by severity of disease and inflammation resulting in hypercatabolism. Delivering protein-energy intake will reduce hypercatabolism and maintain lean body mass that affects outcome. The study aims to analyze the correlation between nutric score and adequacy of energy and protein intake with MV duration.Methods: This cross sectional study enrolled 65 subjects â‰¥18 years with mechanical ventilation in the ICU of Dr. Kariadi Hospital Semarang during May to July 2020. The nutric score was determined within 24 - 48 hours. Statistical analysis used correlation test.Results: The mean nutric score was 2.3 Â± 1.49, duration of MV was 3.9 Â± 4.44. There was significant correlation between nutric score and duration of MV (r = 0.685; p <0.001). The mean adequacy of energy intake was 1448.7 Â± 235.87 and protein intake was 57.9 Â± 11.94. There was significant negative correlation between adequacy of energy intake and MV duration (r=-0.246; p = 0.048). There was significant negative correlation between protein adequacy intake and MV duration (r=-0.34; p=0.006).Conclusion: Nutric score was correlated with duration of MV in the ICU patients. Adequacy of energy and protein intake had significant correlation with duration of MV.
Hba1c levels correlated to lipoprotein-associated phospholipase A2 and monocyte HDL ratio in type 2 diabetes mellitus
Authors: Kusuma Diah Ayu , Widyastiti Nyoman Suci , Hendrianingtyas Meita
Published: February 2022

Background: In the last few decades, several hypotheses have been proposed to explain the pathogenesis of type 2 diabetes mellitus (T2DM) that links this disease with a systemic chronic inflammatory state. New predictors of lipoprotein-associated phospholipase A2 (Lp-PLA2) and monocyte HDL-c ratio (MHR) has been observed to predict atherosclerosis severity, progression of atherosclerosis and cardiovascular events. The study aims to evaluate correlation between HbA1c with Lp-PLA2 and MHR in patients with T2DM.Methods: Analytic observational research with cross sectional design. HbA1c levels were measured by high-pressure liquid chromatography, Lp-PLA2 values using the ELISA method, and MHR values based on the ratio of absolute monocytes to HDL counted manually.Results: The study was conducted on 42 DMT2 patients aged 34-74 years, mean value HbA1c, Lp-PLA2, and MHR were 8.16Â±2.10, 217.20Â±42.49, 10.55Â±6 11 respectively. Statistical analysis showed a positive correlation between HbA1cÂ  and Lp-PLA2 levels (p=0.046 and r=0.310), and there was a correlation between HbA1c levels and MHR valuesÂ  (p=0.038 and r=0.321).Conclusion: A weak positive correlation between glycemic control (HbA1c) and atherosclerotic markers (Lp-PLA2 and MHR) in DMT2 patients.
Correlation of low vitamin D status with atopic dermatitis severity in children
Authors: Lubis Habibah Hasyim , Nababan Kristo Alberto , Paramita Deryne Anggia
Published: February 2022

Introduction:Â Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disorder. Vitamin D has some roles in immunologic mechanisms. Vitamin D may influence the severity of AD. Previous studies of vitamin D correlation in children with atopic dermatitis have revealed conflicting results. This study determines the correlation between low vitamin D status with the severity of atopic dermatitis in children.Â Methods:Â This is a cross-sectional analytical study with a cross-sectional approach that involved DA subjects aged â‰¤17 years with low vitamin D status. The recording of basics data and examination of subjects included assessing the scoring atopic dermatitis (SCORAD) score and measuring 25-hydroxyvitamin D (25(OH)D) level for all subjects. Statistical analyses were performed using Pearson's correlation coefficients, with P<0.05 was considered statistically significant.Â Result: A total of 30 subjects with AD with the most extensive distribution was in the age group of 11â€“17 years (53.33%), sex proportions were equal both male (50%) and female (50%), all subjects have an atopic family history (100%). The mean vitamin D level was 18,02 Â± 4,56 ng/ ml (deficiency), and the mean SCORAD score was 20,03 Â± 5,80 (mild). There was a significantly strong negative correlation between low serum vitamin D level and severity of AD in children (r = -0.666, p = 0.001).Â Conclusion:Â Lower vitamin D status is inversely associated with the severity of AD in children.Â
The Role of MMP-9 rs 3918242 genetic variant in association between MMP-9 serum level with risk factors of acute ischemic stroke
Authors: Silviana Meyvita , Tugasworo Dodik , Husni Amin
Published: February 2022

Background: Increased serum MMP-9 level is known to be biomarker of atherosclerotic events and risk of cerebrovascular disease. Risk factors for acute ischemic stroke are known to be related to serum MMP-9 level. The genetic variant of MMP-9 rs3918242 is known to have a role in serum MMP-9 level. The aim of the study is to determine the role of MMP-9 rs 3918242 genetic variant in association between MMP-9 serum level with risk factors of acute ischemic stroke.Methods: This was a cross-sectional study with an observational analytic design. 62 subjects of acute ischemic stroke treated at Dr. Kariadi Hospital Semarang from October 2018 to February 2019 were involved in this study. Statistical analysis was assessed by the bivariate test and followed by a logistic regression test.Results: From 62 subjects in this study, 45 (72.6%) had high serum MMP-9 level. The association between serum MMP-9 level with risk factors of acute ischemic stroke was statistically significant in hypertension, diabetes mellitus, dyslipidemia, obesity, and hyperuricemia. There is a positive correlation of serum MMP-9 level with a number of acute ischemic stroke factors. In multivariate analysis, the most influential variables were obesity and hyperuricemia. CC Genetic Variant has a role in the association between serum MMP-9 level with risk factors of acute ischemic stroke, which are hypertension, diabetes mellitus, dyslipidemia, obesity, and hyperuricemia. Meanwhile, CT genetic variants only play a role in the association of serum MMP-9 levels with obesity and hyperuricemia as the risk factors for acute ischemic stroke,Conclusion: CC genetic variants with high serum MMP-9 levels are associated with more acute ischemic stroke risk factors than CT genetic variants with high MMP-9 serum levels. Therefore, CC genetic variants have the potential to pose more risk of acute ischemic stroke.
Analysis implementation of code blue service towards early warning system in Universitas Sumatera Utara Hospital, Medan-Indonesia
Authors: Dandanah Maulidya Ayudika , Aribi Andike , Tanjung Muhammad Sukri , Ikhsan Riyadh
Published: February 2022

Introduction: Since its operation in 2016, the Universitas Sumatera Utara Hospital (USU Hospital) has implemented Medical Services for patients with cardiac arrest conditions by forming a Code Blue team. Based on data in 2018, the number of patients who received the Code Blue emergency was 240 patients. There are still many cardiac arrest events at USU Hospital, it is necessary to evaluate the implementation of the Code Blue services and create an early warning system (EWS) for patients who are potentially in cardiac arrest to prevent high cardiac arrest cases that will economically harm USU Hospital.Method: We analyze the secondary data from the Medical Record, an interview with the code blue team, and an analysis of the resuscitation form that has been completed.Result: The results of the study (n=30) which experienced the most stop breathing and cardiac arrest before the implementation of EWS were chronic diseases with 63.3% (n=19) and after the implementation of EWS there were still chronic diseases with 56.7% (n=17). A paired t-test was conducted with the result that code blue services on the numeric response time parameter was different in response time of 0.266 minutes after the implementation of EWS services (p=0.354). Meanwhile related to the length of time for cardiopulmonary resuscitation(CPR) there is a time difference of 10,767 minutes after the implementation of EWS services, (p=0.000).Conclusion: Interpretation of EWS implementation can affect the time of the CPR performed because the worsening condition of the patient has been monitored before respiratory and cardiac arrest occurred. The conclusion of making an early warning system (EWS) at USU Hospital can be immediately implemented as stated in the guidelines as a form of service in medical and nursing services.
Screening of mental problems and counseling training for primary health care staffs to assess sintren dancer in Pemalang, Central Java, Indonesia
Authors: Wardani Natalia Dewi , Susetya Fajar Pradana , Jusup Innawati , AS Widodo Sarjana , Hadiati Titis , Margawati Ani
Published: February 2022

Introduction: Experiences of trance in Sintren dancer with a history of psychosocial problems, it is possible that comorbidity of mental disorders will appear. One of the Primary Health Care programs is dealing with mental disorders. By providing counseling training to Primary Health Care Staffs, it is hoped that there will be guidance and assistance from the Primary Health Care for the Sintren dancer community.Methods: Screening is carried out to recruit synthetic dancers who have psychological problems and are given counseling. This service involves Primary Health Care Staffs. This service includes networking and treatment and providing counseling to Sintren dancers to deal with the problems they are experiencing.Result: Sintren dancers met the category of mental disorders (dysthymia and PTSD). Primary Health Care Staff had bad experiences in helping people with mental disorders, they are afraid of helping people with mental problems. With counseling training, primary health care staff more confident to help people with mental problems.Conclusion: Sintren dancers have a psychosocial and mental disorder background. Counseling training in Primary Health Care Staff provides understanding of stress management and early detection of mental disorders that often occur in society.
Correlation between thrombocyte, erythrocyte, and ratio thrombocyte leucocyte in patient with cardiovascular disease
Authors: Samsuria Indranila Kustarini , Judiono Judiono , Watuguly Theophilus Wilhelmus
Published: February 2022

Background: Cardiovascular disease (CVD) has caused at least 1.1 million deaths per year globally. Heart and blood vessel disease are silent killer which can cause disability or death if left untreated. Stress on the walls of the blood vessels leads to hypertrophy and hyperplasia of the vascular smooth muscle causing endothelial damage and facilitating atherosclerosis. Endothelial dysfunction indirectly affects platelet (thrombocyte) function which has an important role in the formation of primary blockage. The formation of the primary blockage is influenced by the number and function of the thrombocyte and can be checked by biomarkers of thrombocyte, erythrocytes, and the ratio of thrombocyte -to-leukocytes. The purpose of this study was to analyze the relationship between erythrocytes, thrombocyte, and the ratio of thrombocyte-to- leukocyte (RTL).Materials & Methods: Descriptive analytic design with a cross sectional approach was applied. Sixty CVD patients were examined for thrombocyte, erythrocytes, and ratio thrombocyte-to-leukocyte (RTL) based on routine hematological examinations. Data were tested for normality and checked with Pearson Correlation test. The research was conducted at the Dr. Kariadi Hospital for the period January-April 2020.Results: Based on the statistical analysis test, the Pearson correlation test showed a moderate positive correlation between thrombocyte and RTL (p=<0.001; r=0.569), while the correlation between thrombocyte and erythrocytes were not significantly correlated (p=0.687; r=-0.046) in CVD patients.Conclusion: There is a relationship between thrombocyte, and RTL values in CVD disease, so that thrombocyte biomarkers and RTL are suggested to be biomarkers in the management of CVD.
Maternal and perinatal outcomes with covid-19: lesson learned from the tertiary hospital
Authors: Wiyati Putri Sekar , Adawiyah Rabiah , Dewantiningrum Julian , Pramono Besari Adi
Published: February 2022

Background: The COVID-19 pandemic has led to global health crisis. Most studies have focused on evaluating the effects of COVID-19 on the general population, and there is still insufficient data on its impact on vulnerable populations, such as pregnant women. The study evaluates maternal and perinatal outcomes on pregnant women with COVID-19 in Kariadi as tertiary hospital in Central Java.Methods: We prospectively collected and analyzed data for a cohort of 45 pregnant patients with COVID-19 between March 31st and September 23th 2020 in Kariadi hospital.Results: A total of 45 pregnant women with COVID-19 delivered 46 babies including one twin pregnancy. The symptoms ranged from asymptomatic (54.3%), mild (26.6%), moderate (8.8%), severe (2.2%), and critical (6.6%). Gestational age was 22 to 41 weeks. Cesarean section was the most mode of delivery (86.7 %). Diabetes in pregnancy and HIV were the most common comorbidities found in this study, there were also seven patients came with preeclampsia. There were three maternal mortalities, we reported one maternal death (2.2 %) caused by severe respiratory disease COVID-19 in second trimester. The other two death cases were pregnancy complicated with severe preeclampsia with hyperthyroid and preeclampsia with diabetes in pregnancy.Â  Perinatal outcomes were intrauterine fetal death (8.7%), stillbirth (2.2%), and severe asphyxia (2.2%).Conclusion: Although we obtain mostly maternal and perinatal outcomes in good outcomes, it is urgent to analyze potential high-risk maternal death with COVID 19.