bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of diabetic foot ulcers: dermatology perspective
Authors: Daryago Adi Agung Anantawijaya , Fitriani Fitriani , Kartowigno Soenarto , Aryani Inda Astri , Yahya Yulia Farida , Diba Sarah , Stephanie Aurelia
Published: February 2022

Diabetes mellitus (DM) is a chronic and complex disease that affects various parts of the body. It can lead to multiple systemic complications and also cutaneous manifestation. Diabetic foot ulcer (DFU) is one of the most devastating complications of DM in dermatology. The main etiology is an increase in plasma glucose, risk factors, or comorbidities due to DM itself. Neglected DFU can lead to further complications, including high amputation and mortality rates; thus, the healing of ulcers is the main objective of the treatment. Management is divided into the standard of care and adjuvant therapies. This study aims to optimize DFU management, so it can provide proper treatment and prevent complications.
Decision to Delivery Interval in Emergency Cesarean Section at Two Academic Hospitals in Yogyakarta and Central Java, Indonesia
Authors: Prawitasari Shinta , Widyandana Doni , Hakimi Mohammad , Utarini Adi
Published: February 2022

Background: The international guideline suggests that the ideal DDI is 30 minutes for grade 1 and grade 2 CS, but they are still hardly achieved. Therefore, the main purpose of this study was to determine the DDI for grade 1 and 2 CS, and its determinants in two academic hospitals.Methods: A prospective cohort study was conducted using pregnant women who underwent grade 1 and 2 emergency CS. Data regarding demographic characteristics of the subjects were extracted from the medical record, while DDI and its components were measured by direct observation. Odds ratio was used to determine the association between DDI and its determinants.Results: The median DDI for grade 1 and 2 CS in the main academic hospital were 112.5 minutes and 181 minutes respectively, longer than their duration in the affiliated hospital with 80 minutes for grade 1 CS and 104 minutes for grade 2 CS. The significant determinants for a 75-minute DDI in the main academic hospital were grade of CS (OR: 0.12; 95%CI: 0.01-1.05; p: 0.047), indication of CS (OR: 0.77; 95%CI: 0.6-0.89; p: 0.014), and anesthesiologist response time (OR: 9.18; 95%CI: 2.21-38.13; p: 0.001), while in the affiliated academic hospital, operating room waiting time was the only significant determinants (OR: 6.18; 95%CI: 2.07-18.48; p: 0.001).Conclusions: DDI for emergency CS still exceeded the standard in academic hospitals with different determinants causing the delay. Strengthening interprofessional collaboration should be implemented systematically.Â Â
The change of cell biometric and its nucleus on cervical-squamous-epithelial-cell with GA genotype of Fas-promoter-670 gene, high-risk human papillomavirus and Candida species infection: a case report
Authors: Parwanto Edy , Wratsangka Raditya , Guyansyah Assangga , Anggraeni Kirana , Digambiro Reza Aditya , Tjahyadi David , Arkeman Hanslavina , Widyatama Haryo Ganeca , Edy Hosea Jaya , Edy Yosua Jaya
Published: February 2022

Background: Cervical samples of patients with human papillomavirus (HPV) infections show positive results in HPV DNA testing. HPV infection can alter cervical squamous epithelial cells (CSECs) to be abnormal. Epigenetically, CSECs that change to be abnormal are affected by Fas-promoter-670 gene polymorphism. High-risk HPV (hr-HPV) patients can be infected by other microbes, for example, Candida species (Candida sp.). The present study's purpose was to show CSEC biometrics based on epigenetics of the Fas-promoter-670 gene polymorphism in Indonesian women with hr-HPV and Candida sp. infection. Biometric quantification was performed based on the following analysis of CSECs.Case report: Indonesian hr-HPV women at the age of 28 years, with Candida sp. infection, underwent a Pap smear examination on April 21st, 2016, using the ThinPrep method, and a blood test was also performed using the cubital vein. Blood and ThinPrep samples were examined for the Fas-promoter-670 gene polymorphism. Epigenetically, the subjects had the GA genotype of the Fas-promoter-670 gene in the blood and ThinPrep samples. Patients with Candida sp. infection in the early stages were characterized by the appearance of polymorphonuclear leukocytes (PMN), whereas those in advanced stages presented without PMN on the hyphae. CSEC biometric measurements were performed quantitatively using mononuclear CSECs (mn-CSECs) and binucleated CSECs (bn-CSECs).Conclusion: Biometric measurements of the CSECs were performed quantitatively and assessed the length, width, area and perimeter of the cell and its nuclei. Cell length, cell width, nucleus area, nucleus perimeter and nucleus length index were significantly different between the mn-CSECs, the 1st nucleus of bn-CSECs and 2nd nucleus of bn-CSECs (P<0.05).
Acute kidney injury in patient with djenkolism: a case report
Authors: Kandarini Yenny , Sridana Made Edwin , Mahadita Gede Wira
Published: February 2022

Background: Djenkolic poisoning or djenkolism is one of the causes of acute kidney failure common in Southeast Asia. Djenkol bean or jering (Archidendron pauciflorum) is one of the foods commonly found in Southeast Asia. These seed plants are usually processed by boiling or frying, but often they are also consumed raw. Djenkolism sometimes occurs, albeit infrequently after ingesting djenkol beans. The clinical presentation of djenkolism is varied but generally presents as a spasmodic loin to groin pain and acute kidney injury (AKI), with evidence of urinary obstruction.Case description: We report a previously healthy 40-year-old male developed AKI after consuming a large amount of uncooked djenkol beans, which was resolved with rehydration with normal saline and conservative therapy.Conclusion: We highlight the importance of healthcare practitioners, especially in the Southeast Asian region to consider this rare cause of acute kidney injury to provide early diagnosis and prompt treatments.
Effect of preoperative inspiratory muscle training on right ventricular systolic function in patients after heart valve replacement surgery
Authors: Satoto Hari Hendriarti , Paramitha Aditya , Barata Sri Hastuti , Sugiri Sugiri , Suhartono Suhartono , Wahyudati Sri , Sofia Sefri Noventi
Published: February 2022

Background: The reduction of right ventricular function after heart valve surgery was associated with mortality and morbidity after cardiac surgery, prolonged ICU length of stay, and higher hospital cost. Inspiratory muscle training can be considered for improving right ventricular systolic function by optimizing afterload dan cardiac contractility. The study aims to determine the effect of inspiratory muscle training on right ventricular systolic function in patients after heart valve surgery.Methods: Patients undergoing heart valve surgery were randomized into a conventional preoperative rehabilitation group and conventional preoperative rehabilitation added high-intensity inspiratory muscle training at least 14 days before surgery. Echocardiography examination was performed before rehabilitation and after cardiac surgery.Results: There were 24 subjects consist of 12 control group and 12 intervention group. By using independent t-test or Mann Whitney test, we found significant differences on right ventricular function between intervention and control group, by using RV free wall strain (17.7 + 3.0% and 14.4 + 4.0%; p=0.033), RV FAC (43.2 + 4.9% and 35.1 + 8.8%; p=0.006), and TAPSE (12.7 + 3.4 mm and 9.9 + 2.7 mm; p=0.039). ICU length of stay in the intervention group was significantly shorter than the control group (3.2 + 0.8 and 4.2 + 1.3 days; p=0.044).Conclusion: Patients underwent conventional preoperative rehabilitation added inspiratory muscle training had better right ventricular systolic function than patients in control group.
Primary infertility of male and female factors, polycystic ovary syndrome and oligoasthenoteratozoospermia dominate the infertile population in agricultural and industrial areas in Karawang Regency, West Java Province, Indonesia
Authors: Guyansyah Assangga , Wratsangka Raditya , Dhanardono Denny , Ghazali Muhammad Farid , Edy Hosea Jaya , Widyatama Haryo Ganeca , Kusumaningrum Dietha , Tjahyadi David , Parwanto Edy
Published: February 2022

Introduction: Indonesia is a country with a large agricultural and industry, known to utilize various types of pesticides, as well as several other industries with uncontrolled pollution levels distributed across the nation. Besides, numerous studies have stated the adverse effects of chemicals substances used in daily life and industrial waste on the health of living things, including humans. This study aimed to determine the infertility characteristic in the agricultural and industrial areas in Karawang Regency, West Java Province, Indonesia.Methods: The study was conducted retrospectively on medical records. Therefore, this study determined the infertility characteristics based on sperm analysis, the etiology of the causes of infertility in female, and the diagnosis of infertility. Data collection was obtained from patients' medical records in the Infertile Poly of Mitra Bunda Amanda Hospital Karawang, Karawang Regency, West Java Province, Indonesia.Â Result: The results showed infertility was most prevalent in males aged 30-40 years (55.79%) and females below 30 years (61.05%). Furthermore, the male and female's most prevalent educational qualification (33.68% and 36.84%, respectively) was discovered to be high school diploma. In terms of occupation, most male (56.84%) were laborers, while the female was mostly housewives (36.84%). Meanwhile, oligoasthenoteratozoospermia was the most analyzed sperm type (33.68%), and polycystic ovary syndrome was the most common etiology of infertility in females (26.32%). The most prevalent diagnosis was primary infertility factors, male and female (45.26%).Conclusion: Primary infertility of male and female factors, polycystic ovary syndrome and oligoasthenoteratozoospermia dominate the infertile population in agricultural and industrial areas in Karawang Regency, West Java Province, Indonesia.
Meningoencephalitis due to SARS-CoV-2 and tuberculosis co-infection: a case report from Indonesia
Authors: Retnaningsih Retnaningsih , Purwaamijaya Bima , Tugasworo Dodik , Andhitara Yovita , Ardhini Rahmi , Kurnianto Aditya , Afany Nur , Bunyamin Jacob , Utami Fatiha Sri , Sogata Ida Ayu , Hairuzaman Hairuzaman
Published: February 2022

Introduction: The novel coronavirus which firstly detected in December 2019 in Wuhan, China, has been known to cause neurological dysfunction either by directly or indirectly infecting the brain.Case: We are reporting a case of meningoencephalitis due to co-infection of M. tuberculosis and SARS-CoV-2 in a hospital in Indonesia. A 26-year-old gentleman working as a courier in a Sars-Cov-2 red zone without adequate protection complained frequent headaches since a month to admission. M. tuberculosis was detected on very low level by GenXpert® and rapid test for SARS-CoV-2 was nonreactive. Repeated GenXpert® showed detected M. tuberculosis with undetected rifampicin resistance. Subsequent CSF SARS-CoV-2 PCR was positive although the oropharyngeal swab was negative.Conclusion: The report of pulmonary co-infection of TB and SARS-COV-2 has been published, however, to our best knowledge there has been no report of neurological co-infection to date. We are reporting the report of CNS co-infection from our country.
Quran memorization and early childhood development: a case-control with neuroscience approach
Authors: Hanafi Muchtar , Jumiatmoko Jumiatmoko , Muhammad Faizal , Wiyono Nanang , Ardyanto Tonang Dwi
Published: February 2022

Background: Early childhood is the crucial period in forming children's learning modalities. Various innovations are carried out to optimize early childhood development. Studies on the early childhood development in the tahfidz program school in Indonesia are still few and limited. This study investigates the relationship between Quran memorization and early childhood development in six aspects: religious and moral values, physical-motoric, social-emotional, cognitive, linguistic, and art.Method: A total of 316 kindergarten children between the age of 60 to 84 months were involved in the study. The study consists of Group A (n = 155) with memorization of 0 up to 20 chapters, and Group B (n = 161) with minimum memorization was 21 up to 37 chapters. Data of Quran memorization and development aspects were obtained from the classroom teachers. The development aspects indicators including developed very well, developed as expected, starting to develop, and undeveloped. It was then converted and processed in the form of a rating scale. The analysis was carried out using the Mann-Whitney test. Group A showed better development outcomes in the mean ranks of each aspect than Group B.Result: Group A's early childhood development achievements were better than Group B. The childhood development comparison aspects between the two study groups showed religious and moral values (p=0.001), physical-motoric (p=0.001), social-emotional (p=0.001), cognitive (p=0.002), linguistic (p=0.045), and art (p=0.001). Meanwhile, there was no significant difference in comparing cognitive and linguistic aspects between boys and girls in each group (p>0.05).Conclusion: The study implication was focused on brain workload management strategies based on the neuroscience approach. Appropriate learning support and strategy are required for children with more Quran memorization to prevent disproportionate childhood development.
Peripheral nerve injury and its regeneration processes: a biomolecular point of view
Authors: Sumarwoto Tito - , Poetera Cakradenta Yudha , Abimanyu Dimitri
Published: February 2022

Peripheral nerve regeneration occurs spontaneously after injury due to the permissive environment and activation of the intrinsic growth capacity of neurons. Injuries can be divided into three categories: neurapraxia, axonotmesis and neurotmesis. Wallerian degeneration occurs due to axonotmesis and neurotmesis, affecting the axon distal to the site of damage. After this phase is complete, the damaged neurons try to rebuild the damaged fibers with axonal budding. Axonal growth can occur efficiently, which is influenced by signaling molecules and the integrity of the connective tissue tunnel. It can allow axons to grow back in the right direction and innervate the innervation of the target tissue.
Role of angiotensin-converting enzyme inhibitors on changes in troponin levels in breast cancer with anthracycline chemotherapy
Authors: Rizka Adi , Purwanto Heru , Budianto M. Bachtiar , Rohman Mohammad Saifur
Published: February 2022

Introduction: Breast cancer is the most common type of cancer among women throughout the world. The anthracycline is widely used in the treatments of this cancer. Although it is very effective, its usage is limited due to side effects, such as heart failure. Angiotensin-converting enzyme inhibitors (ACEi) have been reported to delay the process of left ventricular (LV) dysfunction in several clinical trials. This study assesses the role of ACEi in the alteration of troponin levels in breast cancer patients treated in anthracycline chemotherapy.Methods: This research was a clinical trial Quasi-experimental design that has a control group, whereas the treatment group is purposively determined. The treatment group received with anthracycline chemotherapy plus ACEi, and the ACEi were given before chemotherapy until to 3rd cycle of chemotherapy. Initial troponin levels of the patients were measured pre- and post-treatment, whereas the sample size was determined by calculating via the equation from 15 people each group.Results: The administering of ACEi could prevent increasing troponin levels by an average of 0.1133 ng/dl from 0.120 ± 0.077 ng/dl to 0.233 ± 0.219 ng/dl, with a p-value = 0.014. Delta Troponin's in Mann-Whitney test value has a p-value of 0.021, so it can be concluded that there is a significant difference between control and treatment group in Delta Troponin, in which the value of control has fewer number than the control treatment.Conclusion: The treatment group that received the ACEi intervention could prevent an increase of troponin levels after chemotherapy. Overall, it can be concluded that the consumption ACEi can inhibit the rise of Troponin.
Description of depression in people with epilepsy in Aceh
Authors: Lestari Nova Dian , Sary Nirwana Lazuardi , Ummah Arina Khairu , Zulkarnain Zulkarnain , Astini Nur
Published: February 2022

Background: Depression is the most common comorbid in people with epilepsy (PWE). Detection of depression in PWE is not a routine examination at a neurology clinic because it takes a long time. The education of Acehnese people regarding epilepsy is still limited, leading to discrimination and stigma in society. It is not easy to carry out examinations, and the diagnosis is often overlooked. The objective of this study was to screen and to describe the characteristics of depression in PWE in Aceh.Method: This study was a descriptive observational study with the total respondents involved 41 PWEs. Detection of depression in PWE was conducted using the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), a valid, reliable, shorter and more straightforward instrument test. The sample was determinate using the probability sampling method with a simple random sampling technique.Results: Our results found that 39% of respondents experienced depression, with the most NDDI-E scores ranged between 11-15, with a percentage of 41.5%. Out of total, 57.1% of the depression occurred in women and those who aged between 18-25 years old were more frequent to experience depression. Depression was more frequent among those who had no formal education (66.7%).Conclusion: Depression in PWE in Aceh tends to occur in women, those with no education and those who worked as labor or farmer.
Unexpected leiomyosarcoma after total abdominal hysterectomy with indication uterine myoma in nullipara: a case report
Authors: Yeni Cut Meurah , Maharani Cut Rika , Supriadi Herman
Published: February 2022

Introduction: Uterine sarcomas are rare tumors, with 3-7% incidence. Abnormal uterine bleeding, abdominal or pelvic masses, and pain are the most common symptoms in the patient. Non-specific clinical symptoms or preoperative diagnostic techniques to differentiate uterine myoma and uterine sarcoma lead to the general diagnosis after surgery. The incidence of uterine sarcoma established from the literature was 0.09% -0.49% in women undergoing benign hysterectomy or myomectomy. The difficulty of diagnosing preoperative leiomyosarcoma is a challenge in itself. This case report aims to provide knowledge information with characteristics of a sonographic image with a non-hypervascularity encapsulated image and intraoperative findings with a regular smooth uterine surface, which is thought to be a uterine myoma is different from the anatomical pathology results, which indicate a leiomyosarcoma malignancy.Case description: Miss A, 47 years old with complaints of an enlarged stomach for two years, felt abdominal pain and complained about prolonged menstruation for four years. The patient was unmarried and had no previous history of surgery. Intraoperatively, there was posterior corpus adhesion with ascending colon and adhesion was performed. Large, fragile blood vessels appeared. Then it was decided to do a total abdominal hysterectomy—intraoperative hemorrhage 1200 cc. The results of the anatomic pathology showed a leiomyosarcoma. Furthermore, the patient was consulted to the oncology subdivision for a bilateral Salpingo-Oophorectomy procedure followed by chemotherapy. MRI, 3D Doppler sonography were required to increase the preoperative diagnosis of uterine sarcoma.Conclusion: Our case reported that a patient was diagnosed with uterine myoma and stage II hypertension. The patient showed common signs and symptoms. There was posterior corpus adhesion with ascending colon, and adhesion was performed. Theoretically, pelvic sonography is a first-line imaging study. MRI can be used to help differentiate uterine sarcomas from uterine myomas.
Comparison of brain-derived neurotrophic factor (BDNF) serum level in inflammatory and non-inflammatory acne vulgaris
Authors: Marpaung Sweet Caroline , Jusuf Nelva Karmila , Putra Imam Budi
Published: February 2022

Background: Acne vulgaris is a chronic and self-limiting inflammation disorder of the pilosebaceous unit, generally manifested in adolescents with polymorphic lesions, such as comedones, papules, nodules, and cyst. Brain-derived neurotrophic factor (BDNF) is a member of neurotrophins that can be downregulated because of stress. It is suspected that a lower BDNF level is induced inflammatory process, although its relationship with acne vulgaris has not been widely studied. This study compared BDNF serum levels in the inflammatory and non-inflammatory type of acne vulgaris.Methods: This is analytical observational research with a cross-sectional design that involved 31 acne vulgaris patients with inflammatory lesions and 31 acne vulgaris patients with non-inflammatory lesions. Each subject was interviewed and going through dermatology examinations, followed by blood sampling to assessed their BDNF serum levels through the ELISA test. The collected data were analyzed statistically using an independent T-test. P<0.05 was significant.Result: The mean BDNF serum levels in acne vulgaris patients were 32,53±6,32 ng/ml. In subjects with inflammatory-type lesions, the mean BDNF level is 27,55±3,31 ng/ml. While, in the non-inflammatory type lesions group, the mean BDNF is 37,51±4,37 ng/ml. The BDNF serum level is significantly lower in inflammatory-type subjects than in non-inflammatory type (p < 0,001).Conclusion: There was a significant difference in serum BDNF levels between the inflammatory and non-inflammatory type acne groups.
One Health concept and role of animal reservoir in avian influenza: a literature review
Authors: Wedari Ni Luh Putu Harta , Sukrama I Dewa Made , Budayanti Ni Nyoman Sri , Sindhughosa Dwijo Anargha , Prabawa I Putu Yuda , Manuaba Ida Bagus Amertha Putra
Published: February 2022

One Health concept is composed of a collaborative strategy approach in conducting program implementations, policies, legislative aspects, and research studies that involve active participation from various sectors to achieve global public health goals better. It represents a collaborative implementation between clinical, veterinary and government to overcome a specific illness. In Avian influenza, clinical networks should monitor risk factors and clinical signs of severe avian influenza to be controlled or eliminated effectively and quickly. Also, active laboratory surveillance should be conducted, rather than just passive one. Veterinary surveillance possesses high importance in controlling transmission and eliminating avian influenza disease. Well coordination, collaboration, cooperation concerning animal and human surveillance, and disease management involving various health professionals in every sector should be implemented and expanded simultaneously.
Reliability study of radiology interpretation in osteosarcoma
Authors: Martadiani Elysanti Dwi , Asih Made Widhi , Winarti Ni Wayan , Zulfariska Nony , Maria Dessy , Asih Krista Putri
Published: February 2022

Introduction: Radiography interpretation of osteosarcoma is almost similar with the benign and other malignant bone tumors. The radiologists’ ability to accurately diagnose osteosarcoma will determine the therapy and diagnostic consistency. Currently, there is lack of evidence on radiography interpretation reliability of osteosarcoma performed by radiologists. This study aimed to evaluate the interobserver and intraobserver radiologists’ compatibility to confirm the diagnosis of osteosarcoma and explore the interpretation variability of radiological description.Methods: This was an interobserver and intraobserver reliability study for osteosarcoma radiograph interpretation. The osteosarcoma radiographs, which have been histopathologically diagnosed, were evaluated retrospectively by two observers and twice by one observer in a different timeline. The components of osteosarcoma identified through the radiographs are bone destruction and its pattern, zone of transition, type of periosteal reaction, type of matrix calcification, skip metastasis, and soft tissue mass. The data analyzed with reliability testing through agreement analysis and Kappa value.Results: After evaluation of 30 radiographs of osteosarcoma, substantial reliability score for periosteal reaction (Kappa 0.79) to almost perfect for bone destruction, types of bone destruction, transitional zone, types of periosteal reaction, calcification matrix, and presence of soft tissue mass (Kappa 0.84-1) were found. There is a strong level of agreement (96.7%) found for skip metastasis. Intraobserver reliability also showed substantial value for the presence of soft tissue mass (Kappa 0.78) and almost perfect for other characteristics of osteosarcoma (0.84-0.93).Conclusion: Intraobserver and interobserver reliability of osteosarcoma radiograph interpretation was substantial and almost perfect.
The relationship between skin color and keloid
Authors: Oei Felicia , Putra Imam Budi , Jusuf Nelva Karmila
Published: February 2022

Introduction: Keloid is a fibroproliferative tumor with excessive growth caused by an abnormality in the wound healing process. Several factors are contributing to the development of keloid, such as genetics, local and systemic factors. Keloid can happen in any skin color, but more common in darker skin colors related to melanocytes, melanin, or ?-MSH. Color bar tool is an objective and economical tool used to determine each skin color. This study aimed to evaluate the relationship between skin color and keloid.Methods: This is an analytic observational study with a cross-sectional method that includes 44 keloid subjects and 44 controls according to inclusion and exclusion criteria. Sex, age, education, job, family history were documented. Diagnosis of keloid was made by history taking and clinical examination. The skin color is measured with the color bar tool. Kruskal Wallis test was used to determine the relationship between skin color and keloid. The result was significant, with a p-value <0.05.Results: Keloids were found primarily in females (58.8%), 18-25 years old age group (40.9%), and unemployed (40.9%). The majority of the subjects have high education (47.7%) and no family history of keloid (63.6%). The most common location was the sternum (18.9%), followed by the abdominal (15.0%). This study found that the most documented skin color was color bar 2 (54.5%), followed by color bar 3 (29.5%). We found that there was a significant relationship between skin color and keloid (p=0.026).Conclusion: There was a relationship between skin color and keloid.
Ethyl p-methoxycinnamate isolated from Kaempferia galanga L. rhizome reduces airway remodeling in asthmatic rat models
Authors: Andarini Ismiranti , Salimo Harsono , Purwanto Bambang , Rahardjo Setyo Sri , Wasita Brian , Widyaningsih Vitri
Published: February 2022

Background: Asthma causes changes in the airway structure called airway remodeling due to chronic inflammatory reactions. Transforming Growth Factor-? (TGF-?) is one of the inflammatory mediators which has a significant role in the remodeling and inflammatory process. One of the medicinal plants known to have anti-inflammatory potential is Kaempferia galanga L. This study aims to analyze the effect of ethyl p-methoxycinnamate isolated from Kaempferia galanga L. rhizome on the expression of TGF-? and fibrosis in the bronchial mucosa of asthmatic rat models.Methods: We conducted an experimental laboratory study using the posttest only control group design. Thirty-six Wistar male white rats were allocated into six groups, NC (negative control), PC (positive control), T1 (treatment group), T2 (treatment group), T3 (treatment group), and T4 (treatment group) receiving 1% ovalbumin in alum (OVA); 1% OVA as well as 1 mg/kg steroid; 1% OVA, 1 mg/kg steroid, and 200 mg/kg ethyl p-methoxycinnamate isolated from Kaempferia galanga L. rhizome (KG-EPMC); 1% OVA, 1 mg/kg steroid, and 400 mg/kg KG-EPMC; 1% OVA and 200 mg/kg KG-EPMC; and 1% OVA as well as 400 mg/kg KG-EPMC, respectively. Data were analyzed with SPSS version 22.0 for Windows.Results: The expressions of TGF-? and fibrosis were significantly lower in positive control as well as treatment groups than those of the negative control group (only receiving OVA) (p<0.05). There were no significant differences between positive control and treatment groups regarding TGF-? level and fibrosis (p>0.005).Conclusion: Ethyl p-methoxycinnamate isolated from Kaempferia galanga L. rhizome exhibits antiasthma effect by reducing the expression of TGF-? and fibrosis in the bronchial mucosa of an asthmatic rat model. Hence, it can be a potential therapy for asthma.
Root cause analysis of maternal deaths at Dr. Soetomo General Academic Hospital Surabaya, Indonesia in 2019
Authors: Desetyaputra Dimas Ryan , Prasetyo Budi , Damayanti Hanifa Erlin
Published: February 2022

Introduction: Maternal mortality in Indonesia especially in dr. Soetomo General Hospital is still very high, and the biggest problem is obstetric complications. It is possible that the mother who has obstetric complications is safe and recovered or died. This study aimed to identify the root cause of maternal death at Dr. Soetomo General Academic Hospital in 2019.Methods: This is a descriptive retrospective study with the Root Cause Analysis method to analyze total of 87 maternal deaths at Dr. Soetomo General Academic Hospital in 2019.Results: There were 87 cases of maternal death at Dr. Soetomo General Academic Hospital in 2019. Direct maternal death was the leading cause of maternal death, contributing 59 cases (67.8%). From 59 cases, 31 cases (35.6%) direct maternal deaths were caused by preeclampsia/eclampsia. Contributing factors that influence maternal mortality are including organizational management, medical personnel, equipment, materials, & ward, environmental, and family barriers factors. Organizational management factors, the most common factor that causes maternal death is a poor information sharing system at the referring hospital, as many as 17 cases (27.4%). Medical personnel factors, maternal death was mostly caused by lack of knowledge and skills during antenatal care, as many as 42 cases (44.2%). Equipment, materials,  and ward factors, the most common cause was the unavailability of the ward, contributing 5 cases (55.6%). Family barrier factors, most maternal deaths were caused by the families that did not understand about the emergency condition of the patient, as many as 52 cases (67.5%).Conclusion: The maternal deaths at Dr. Soetomo General Academic Hospital in 2019 were mostly caused by the family barrier factor which did not understand about patient’s emergency condition, followed by the medical personnel factor which was lack of knowledge and skills during antenatal care.
Nursing 'new normal' education: an investigation of barriers and strategies of curriculum planning to meet national standards
Authors: Jainurakhma Janes , Imron Ali , Ulfatin Nurul , Arifin Imron , Zaenal Zaenal , Sekarini Sekarini
Published: February 2022

Introduction: The COVID-19 pandemic has a major effect on nursing education in Indonesia, it needs for adaptation of the curriculum to achieve competent nursing graduates meet national and international standards. The aim of this study is to explore the barriers and strategies of nursing education of private institutions, in curriculum planning in the new normal era during the COVID-19 pandemic.Methods: This qualitative study was conducted in five nursing study programs in East Java. Data collection was carried out by in-depth interviews, observations, documentation studies of 25 participants, with the criteria of lecturers being actively involved in curriculum planning based on Indonesian national standards. The data used purposive sampling and snowball sampling. The data validity is carried out with four criteria: credibility, dependability, confirmability, and transferability. Data analysis was carried out using the model approach of Miles, Huberman & Saldana. Data records from interviews, observations and documentation then carried out data selection, reducing, focusing on data findings (data condensation). Results: The study found five themes: (1) barriers from human resources, (2) barriers during the curriculum planning process, (3) barriers for Nursing Study Program lecturers in obtaining information sources related to Indonesian Qualification framework-based curriculum planning, (4) strengthen the pro-active leadership of study programs; (5) foster dynamic communication between curriculum teams.Conclusion: The results showed, in pandemic crisis COVID-19, the need for a curriculum planning workshop with clear technical guidelines in producing an effective, efficient, adaptable nursing curriculum, the effective one of planning has high potential in producing high quality nursing graduates.
Teaching method to increase critical thinking in health profession student: a literature review
Authors: Musharyanti Lisa , Yusup Rian Maulana , Priyatnanto Hendra
Published: February 2022

Nursing students should have some competencies to be professional nurses, like creativity, the ability to think critically, and have good communication and collaboration skills. We change the traditional learning approach to a student-centered approach to improve critical thinking skills. Some studies implement the SCL methods and we need to know the role of SCL learning strategies in improving critical thinking skills. This literature review aims to analyze the role of the student-centered learning application in improving critical thinking skills in health profession students. The design used literature review with the articles reviewed is the result of original research selected based on inclusion and exclusion criteria using a database with electronic searches on Pubmed, Science Direct, Proquest, Sage Journal, and Google Scholar, published in 2016 - 2021 which contains teaching methods that can increase the health profession student’s critical thinking skills. Search strategies with keywords and terms used in English are health profession student, student center learning, and critical thinking. The various learning methods used to improve the critical thinking of health profession students were case-based learning method, simulation learning method, cooperative learning method, problem-based learning method, team-based learning method, self-directed learning method, experiential learning method, and debate and role-play learning methods. All teaching methods are influential in increasing critical thinking in health profession students.
Subchronic toxicity of piperine in piper nigrum on the histology of the kidney, liver, and lungs of mice (Mus musculus L.)
Authors: Makiyah Sri Nabawiyati Nurul , Tasminatun Sri , Arsito Puguh Novi , Fauziah Khairina Nurul , Nugrahanti Dieny Rizka , Putriani Annisa
Published: February 2022

Introduction: Piperine is a compound that has many health benefits, but piperin has toxic effects that endanger the human body. The purpose of this study was to determine the toxic dose of subchronic piperine administration using histology of the liver, kidneys, and lungs of mice (Mus musculus L).Method: This is a quasi-experimental research with posttest only control group design.  Thirty male BALB/c mice were divided into five groups. Piperine was administered orally to the mice. The normal control group and four treatment groups at dosage of 17.5, 35, 70, and 140 mg/kg body weight for 21 days. At the day-22, the liver, kidneys, and lungs were removed and prepared using the HE staining technique. Scores of liver, kidney, and lung damage are recorded. The data was analyzed using one-way ANOVA with the post hoc Tukey test.Result: The liver histological damage score after administration of piperine doses of 35, 70, and 140 mg/kg significantly different from the control group. The kidney and lung damage scores after 140 mg/kg administration showed significant differences from the control group. The conclusion is piperine at dosage of 35, 70, and 140 mg/kg was toxic to the liver, and piperine at doses of 140 mg/kg was toxic to the kidney and lung histology of BALB/c mice.Conclusion: Piperine should not be used at doses of 35 mg/kg body weight or larger.
Dominant factors which affecting the quality of life of hypertension patients in rural and sub-urban area in Yogyakarta
Authors: Relawati Ambar , Kurniawan Movit
Published: February 2022

Background: Hypertension is a condition where the systolic blood pressure result is 140 mmHg, and the diastolic blood pressure result is 90 mmHg. Uncontrolled blood pressure is one of the etiologies of the emergence of complications that will reduce the quality of life. It is necessary to measure the quality of life and to know the factors that affect the quality of life of people with hypertension as a benchmark to improve the welfare of life. This study aims to analyze the dominant factors affecting the quality of life of hypertension sufferers in rural and sub-urban areas in Yogyakarta.Method: This type of research is non-experimental with quantitative methods and correlational descriptive design. The approach used is cross sectional. Respondents in this study amounted to 85 respondents using the purposive sampling technique. This research was conducted in February-March 2021. The data analysis used was the frequency test and logistic regression test.Result: The dominant factor influencing the quality of life of hypertension sufferers in rural and sub-urban areas in Yogyakarta is medication adherence (OR=0.164).Conclusion: The dominant factor influencing the quality of life of hypertension sufferers in rural and sub-urban areas in Yogyakarta is medication adherence.
Persistence of anti-Salmonella O9 IgM as measured by Tubex® TF may contribute to the over-diagnosis of typhoid fever in endemic areas
Authors: Pranata I Wayan Adi , Diana Aly , Heryanto Marco R , Lukman Nurhayati , Kosasih Herman , Djauhari Hofiya , Butarbutar Deni PR , Widjaja Susana , Alisjahbana Bachti
Published: February 2022

Background: Diagnosing typhoid fever definitively, using bone-marrow, blood or feces culture is either invasive, time-consuming, expensive, or complicated. Hence, clinicians often use clinical presentations and/or rapid diagnostic methods to examine the indirect evidence of Salmonella typhi infections. This study describes the proportion of typhoid fever, challenges of diagnosing typhoid fever, and the kinetics of anti-Salmonella O9 IgM.
Methods: During a prospective dengue study in Bandung, Indonesia, 1,431 febrile occurrences were observed among 2,978 adult volunteers over a four-year period. As typhoid fever is endemic and represents a major cause of febrile illness in this study area, acute- and convalescent-phase sera from 964 subjects that had been excluded for dengue and chikungunya infections, were tested with Tubex® TF. To observe the kinetics of anti-Salmonella O9 IgM, we tested sequential sera up to 260 days post-illness from 3 subjects.  
Results: Based on Tubex® TF, 71 of 964 (7.4%) subjects had anti-Salmonella O9 IgM (score≥4) in their convalescent sera. Anti-Salmonella O9 IgM scores in convalescent sera increased compared to the acute sera in 36 subjects, indicating probable acute typhoid fever. The convalescent scores decreased/remained the same as acute sera in the other 35 subjects, which more likely indicating previous S. typhi infections. Using serially collected sera, it was determined that anti-Salmonella O9 IgM could be detected for a long period after illness.
Conclusion: Tubex® TF test should be conducted using paired acute- and convalescent-phase sera to reduce the chance of false positive result that may due to long-lasting anti-Salmonella O9 IgM.
The association of prostatic inflammation grade with prostate volume and Prostate-Specific Antigen (PSA) value in Benign Prostate Hyperplasia (BPH) patients at Wahidin Sudirohusodo Hospital, Makassar
Authors: Saleh Adriandy , Sahrir Syakri , Palinrungi Muhammad Asykar Ansharullah , Kholis Khoirul , Bakri Syarif , Miskad Upik Anderiani , Seweng Arifin
Published: February 2022

Background: Prostate inflammation is commonly found in patients with benign prostate hyperplasia. On the histopathological examination, infiltration of the prostate gland's inflammatory cells was visible in chronic inflammation of the prostate. This study aims to determine prostate inflammation's association based on the histological examination with prostate volume and prostate-specific antigen (PSA) levels in benign prostate hyperplasia (BPH) patients.Methods: A cross-sectional study was enrolled among 50 subjects with benign prostate enlargement observed at Wahidin Sudirohusodo hospital and its affiliate Hospitals in Indonesia from April to September 2018. The patients' data, including age, prostate volume, PSA level, and histopathology, were collected. Statistical tests using Chi-square were performed (considered significant if P <0.05). Data were analyzed using SPSS version 17 for Windows.Results: Among 50 subjects, the age ranged from 51 to 85 years, with an average of 68.2 Â± 8.9 years, while the prostate volume average remained at 64.2 Â± 31.4 mm3.Â  The average of the prostate-specific antigen (PSA) grade was 21.0 Â± 30.2 ng/ml. The statistical analysis showed the association of age with the degree of inflammation (P = 0.25), the relationship of the prostate volume of the degree of inflammation (P = 0.46) and the value of PSA (P = 0.74). Among the 50 subjects examined, 100% were inflamed. The highest grade of inflammation was a moderate degree by 19 cases (38%). There is no significant relationship between the degree of inflammation with prostate volume and PSA's value (p>0.05). Besides, there is no significant association between the degree of prostate inflammation with prostate volume and the value PSA levels (p>0.05).Conclusion: On the histopathological examination, inflammation was found in all research subjects with BPH, in which the highest degree of inflammation was at a moderate level.
Grading of lymphocyte infiltrating tumor can be used as a prognosis factor compared to T Pathology and N Pathology on recurrency of colon cancer
Authors: Saraswati Putu Ayu , Budipramana Vicky Sumarki , Rahniayu Alphania
Published: February 2022

Background: 30-50% of colon cancer patients will experience recurrence and then die. Several factors that can be used as a prognosis for recurrence are tumor staging, number of lymph nodes resected, high pT, and grading of TILs as an immune response that is useful for suppressing tumor growth. This study aimed to determine whether the TILs grading can be used as a prognostic factor for recurrence than pT and pN.Methods: This study used a descriptive retrospective study with all colon cancer patients who had hemicolectomy R0 right and left and patients who had received chemotherapy folfox who experienced recurrence at Dr. Soetomo Surabaya. Data were analyzed using SPSS version 25.0 for Windows.Results: It was found that 33 people (32.4%) experienced a recurrence of less than 2 years and 69 people (67.9%) experienced a recurrence of 2-5 years. Low-grade TILs were 37 people (32.4%), and high TILs were 65 (63.7%). Patients with low-grade TILs at most 21 people (56.7%) will experience a recurrence of less than 2 years, while patients with high-grade TILs at most 53 people (81.5%) will experience a recurrence in years 2 - 5. pT4 has a recurrence of less than 2 years as many as 6 people (46.2%), less than pT4 with a recurrence of 2-5 years, namely 7 people (58.3%) while pT3 who experienced a recurrence of less than 2 years, the number was higher than pT4, namely 22 people (32.8%). pN0 will experience the highest recurrence in years 2-5 as many as 37 people (80.4%), while pN2 will experience the highest recurrence in less than 2 years as many as 14 people (66.6%). Grading TILs were significant (p = 0.018) in determining the prognosis than pT (p = 0.204) and pN (p = 0.083) in the first 2 years.Conclusion: Grading of TILs can be a prognostic factor for colon cancer recurrence in only the first 2 years.
Factors influencing the response to neoadjuvant chemotherapy in stage III triple-negative breast cancer patients
Authors: Angga Sudewa Anak Agung Bagus , Manuaba Ida Bagus Tjakra Wibawa , Adiputra Putu Anda Tusta
Published: February 2022

Introduction: Breast cancer is a significant burden to women’s health worldwide, mainly due to the diagnostic tendency at the advanced stages, metastasis, and chemoresistance. Therefore, this study aimed to determine the relationship between age, histological grading, menopausal status, Ki-67, and the percentage of tumor-infiltrating lymphocyte (TIL) to the neoadjuvant chemotherapy response in stage III TNBC patients.Methods: This study was a case-control analytic observational study. Samples were obtained using a consecutive sampling method. All patients’ and clinicopathological characteristics were extracted from medical records, including the chemotherapeutic response.Results: This study found no association between age and menopausal status to chemoresistance. Meanwhile, tumor grade, Ki-67, and TIL were significantly associated with chemotherapeutic resistance. Finally, multivariate analysis showed that only Ki-67 was independently associated with chemoresistance with R 14.4 (CI: 1.80-115.73) and a p-value = 0.012.Conclusion: High Ki-67 was independently associated with increased chemoresistance to neoadjuvant chemotherapy in stage III triple-negative breast cancer patients.
Near point of convergence amongst school aged children with refractive errors in Bali
Authors: Aryawan I Ketut , Handayani Ariesanti Tri , Triningrat Anak Agung Mas Putrawati , Manuaba Ida Bagus Putra
Published: February 2022

Background: Near Point of Convergence (NPC) is a nearest point where the image still properly fused and the patient do not experience double vision. However, there is still no study that evaluate the normative value of NPC in Indonesia. Therefore, the purpose of this study was to evaluate NPC break and recovery amongst school aged children with refractive error in Badung Regency, Bali.Methods: A cross-sectional study was conducted from July to September 2018. Data were collected prospectively from the examinations of school aged children in four elementary schools. Categorical data were described in frequency and percentage. The others were described in median. Kruskal Wallis test was used to statistically analyzed the data.Results: A total of 149 children were included in this study, which consisted of 56.4% women and 43.6% men. Most of the students were at 7years old age group (25.5%), while only minority who in the 12-years old age group (2%). Median NPC Break is 3,5 cm and 3,70 cm in male and female, respectively (p = 0,77).  The median NPC break and recovery was greater in the 9 to 12 years old group compared to the other groups (p = 0.007 and p =0.00, respectively). Finally, hypermetropia had a greater NPC break and recovery than another groups (p = 0.05).  Conclusion: There were significant differences between NPC break and recovery value according to the age group and underlying refractive error.