bluuebunny/crossref_metadata_2025 huggingface dataset:
The association between biofilm formation ability and antibiotic resistance phenotype in clinical isolates of gram-negative bacteria: a cross-sectional study
Authors: Syaiful Irbasmantini , Widodo Agung Dwi Wahyu , Endraswari Pepy Dwi , Alimsardjono Lindawati , Utomo Budi , Arfijanto Muhammad Vitanata
Published: May 2024

Backgrounds: Antimicrobial-resistant pathogens that form biofilms cause treatment failure, increased mortality, and morbidity. Gram-negative bacteria (GNB) infections have become an emerging issue in antimicrobial resistance. This study analyzes the association between GNB biofilm formation ability and the antibiotic resistance phenotype in GNB clinical isolates.
Methods: From June to August 2022, this cross-sectional study was conducted at Dr. Soetomo General Academic Hospital. Isolates derived from clinical specimens, including blood, urine, and respiratory tract specimens, were identified for antibiotic resistance phenotypes along with a quantitative biofilm formation assay. The antibiotic resistance phenotype was studied in relation to the GNB isolates' ability for biofilm formation.
Results: Of the 271 isolates studied, 95 (35.1%) were non-MDR, 143 (52.8%) were MDR, and 33 (12.2%) were XDR. On the biofilm formation assay, 34 (12.5%) were non-biofilm producers, 237 (87.5%) were biofilm producers, consisting of 101 (37.3%) weak, 131 (48.3%) moderate, and 5 (1.8%) strong biofilm producers. Biofilm formation and antibiotic resistance in Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii were not significantly associated (p > 0.05). However, Escherichia coli isolates resistant to the antibiotics amikacin, imipenem, meropenem, and amoxicillin-clavulanate were found to have a higher predisposition to form biofilms. Klebsiella pneumoniae isolates resistant to gentamycin were also positively associated with biofilm formation.
Conclusions: Gram-negative bacteria's ability to form biofilms is not associated with their antibiotic resistance phenotype; therefore, routine biofilm monitoring is critical for enhancing the quality of treatment strategy for biofilm-associated infection.
Hemostasis in liver surgery: Indonesian Society of Digestive Surgeons (IKABDI) consensus statements
Authors: Lalisang Arnetta Naomi , Nugroho Adianto , Tendean Michael , Irwan  , Situmorang Indah , Uwuratuw Julianus A. , Lesmana Tomy , Prabowo Erik , Handaya Adeodatus Y. , Wibowo Agung A. , Mayasari Maria , Mazni Yarman , Jeffri  , Suprapto Bambang , Fuadi Ahmad F. , Arifin Fransiscus , Rudiman Reno , Lalisang Toar J.M. , Warsinggih
Published: May 2024

Liver resection is a complex operation with bleeding control as one of the most crucial factors. It is essential to determine the amount of bleeding to predict the mortality and morbidity after liver surgery. With technology and scientific development, liver resection can use open or laparoscopic surgical techniques supported by various energy devices and medical management. However, the main goal is to remove the tumor with adequate negative margins and good flow. Indonesian Society of Digestive Surgeons agreed to have an agreement using the Modified Delphi method consisting of twenty digestive surgeons. The consensus was established for hemostasis management choices as surgical and medical strategies in liver surgery. The surgical strategies recommendation include performing anatomical resection in primary hepatic tumor and non-anatomical resection for liver metastases; using of Glissonean Pedicle approach as an inflow control option; doing routine intermittent pringle maneuvers; prohibiting total vascular exclusion; and making a statement that no particular energy device preferred for transecting the liver parenchyma. For medical strategies, consensus recommends limiting the transfusion of PRC or any other blood components, antifibrinolytic's role as hemostatic agents, and using fibrin sealant and matrix coagulant sheets for hemostatic agents in liver surgery. These recommendations reflect current knowledge and can be reviewed if new findings are discovered. Hopefully, this consensus can be a valuable guide for surgeons, especially those practicing in Indonesia, to provide low mortality and morbidity in liver resection.
Association of appetite hormone levels with HbA1c in obese type-2 diabetes mellitus patients
Authors: Limijadi Edward Kurnia Setiawan , Nyoman Suci Widyastiti  , Meita Hendrianingtyas  , Banundari Rachmawati
Published: May 2024

Background: Nesfatin-1 and leptin are hormones that control appetite and affect glycemic control. Nesfatin-1 and leptin levels are affected by body mass index (BMI). Hemoglobin A1c (HbA1c) is an objective parameter to assess long-term glycemic control. This present research aims to know the relationship between levels of nesfatin-1 and leptin with HbA1c values ​​as an indicator of long-term objective glycemic control in patients with T2DM with obesity.
Methods: Cross-sectional study on 54 obese T2DM subjects. Measurement of nesfatin-1 and leptin levels using the enzyme linked immunosorbent assay (ELISA) method. The value of HbA1c was measured by the fluorescent immunoassay (FIA) method. The correlation between nesfatin-1 and leptin with Hb1c was tested using the Spearman correlation analysis test (p <0.05 was considered significant).
Results: The median value of nesfatin-1 levels was 1,824.0 (134.0-5,255.0) pg/mL, the median value of leptin levels was 14.0 (0.4 - 66.4) ng/mL, and the median value of HbA1c was 7.70 (4.9-15.0)%. There is no correlation between nesfatin-1 levels and HbA1c values (p = 0.282 and r = 0.149). There is no correlation between leptin levels and HbA1c values (p value = 0.895 and r = 0.018).
Conclusion: HbA1c levels are not associated with an increased appetite, as evidenced by no association between appetite biomarkers and glycemic control.
Integrated antenatal care services with breastfeeding counseling practices to improve pregnant women's knowledge, skills and readiness for exclusive breastfeeding
Authors: Sudarmi  , Rumintang Baiq Iin , Anggraeni Ni Putu Dian Ayu , Halimatussyaadiah Siti
Published: May 2024

Background: Stunting is the most common form of child malnutrition in millions of children in Indonesia, around 37% and one of the highest proportions of stunting is found in West Nusa Tenggara. Breastfeeding counseling during antenatal care (ANC) can encourage early breastfeeding. Still, counseling is not generally done even though the stage I and stage IV of normal labor, coverage exceeds the target and only one-fifth of the midwives provide complete and correct ANC services for the ten-step component service. The study aims to evaluate model of integrated antenatal care services with breastfeeding counseling practices to increase pregnant women's knowledge, skills and readiness to breastfeed
Methods: Pregnant women from Kuripan Primary health care were selected randomly. This study compared two study groups, namely the intervention and control group of third-trimester pregnant women who were given integrated ANC and breastfeeding counseling compared to conventional ANC. Both groups were assessed for the knowledge, skills, and readiness of exclusive breastfeeding mothers before and after counseling. Chi-square test were used to compare readiness, knowledge, and breastfeeding practice before and after intervention in the study group.
Results: The provision of integrated ANC and breastfeeding counseling in this study show a difference between knowledge before and after treatment with a p-value = 0.002 (p<0.05). There was a difference between the practice of breastfeeding before and after the treatment with p-value = 0.003 (p<0.05) and in the integrated antenatal care breastfeeding counseling treatment group it showed that there was a difference in readiness for exclusive breastfeeding before (p = 0.005) (p<0.05) and after being given treatment with p-value = 0.001 (p<0.05).
Conclusions: Integrated antenatal care and breastfeeding counseling have shown differences in increased knowledge, exclusive breastfeeding practices and readiness for breastfeeding.
Exclusive breast milk by working mothers as a new habit: a literature review
Authors: Dini Setiarsih  , Rizki Amalia  , Rizki Nurmalya Kardina
Published: May 2024

The Indonesian government, WHO and UNICEF recommend exclusive breastfeeding for the first six months of life. Not only for babies, but breastfeeding is also beneficial for mothers, including helping delay pregnancy, accelerating health recovery and providing positive psychological effects. However, one of the obstacles to exclusive breastfeeding is the problem of working mothers. This study aimed to explain exclusive breast milk by working mothers as a new habit. This study is a literature review with the stages of problem formulation, literature search, data extraction, data analysis and interpretation. However, it is proven that many working mothers experience success in exclusive breastfeeding. Good management is one of the keys. The motivation of mothers and families must be built from an early age. With the right education, the knowledge and attitudes of mothers and families on the importance of exclusive breastfeeding can be realized.
Balinese purnajiwa (Kopsia arborea Blume.) extract stimulates male rats' sexual behavior and plasma testosterone level
Authors: I Gede Putu Wirawan  , Sasadara Maria Malida Vernandes , I Made Jawi  , Ida Ayu Putri Darmawati  , I Nyoman Wijaya  , Anak Agung Keswari Krisnandika  , I Gde Nengah Adhilaksman Sunyamurthi  , I Gusti Ngurah Alit Susanta Wirya
Published: May 2024

Introduction: Purnajiwa (Kopsia arborea Blume.) fruit has been traditionally used to improve male sexuality. This study aims to evaluate the potential of K.arborea ethanolic extract to stimulate rats' sexual behavior and testosterone.
Methods: This study used 25 healthy male and 25 female albino rats (Rattus novegicus), aged 15 weeks, and weighed 220-230g. Rats were divided into five groups, with five replications for each group. The phytoconstituent was quantified and analyzed using Gas Chromatography-Mass Spectrometry (GCMS). The sexual behaviors (mount and intromission frequency) and testosterone levels were evaluated in adult male Wistar rats. Three doses of extract (300, 200, and 100 mg/kg BW orally) were compared to sildenafil citrate as standard. Data were statistically analyzed using one-way analysis of variance (ANOVA) and Post Hoc Tukey Honestly Significant Difference (HSD) Test, using IBM SPSS Statistics version 25
Results: Vincadifformine alkaloid was detected as the dominant compound. Treatment of the extract increased all parameters suggestive of dose dependence. Twenty-six days of administration of 300 mg/kg BW of extract produced the highest increase of mount and intromission frequency, higher and similar to sildenafil citrate. Treatment of K.arborea also showed increased testosterone, suggestive of dose dependence.
Conclusion: K.arborea fruit stimulates sexual behavior and plasma testosterone. Nevertheless, further investigation, safety analysis, and mechanism study are required.
Assessment of nutrient intake and antenatal education method for pregnant women in Gianyar, Bali, Indonesia
Authors: Ariyani Ni Wayan , Sri Erawati Ni Luh Putu
Published: May 2024

Introduction: Nutrient intake for pregnant women was associated with the health status of young children from infancy to adolescents.  Antenatal education increases the awareness of nutrient importance for pregnant women. The purpose of this study was to describe the nutritional consumption of pregnant women in terms of the method of antenatal education.
Methods: Cross-sectional study involving 150 pregnant women in Gianyar Regency. They were selected using a cluster random sampling technique. Nutrition consumption data was collected using a 24-hour food recall form. The first interview was conducted on workdays to collect the sociodemographic and obstetric data, the data on the implementation of antenatal education, and 24-hour dietary recall. The second interview was conducted on the weekend, to collect the data on a 24-hour dietary recall.
Results: The results showed that there was no significant difference (p>0.05) in the average consumption of macro and micronutrients for pregnant women in terms of antenatal education methods. The level of consumption of macro and micronutrients was almost all below the nutritional adequacy rate, only protein consumption was in accordance with the nutritional adequacy rate. The results of the analysis of factors related to nutritional consumption showed that there was a significant relationship (p=0.021) between the education factor with calcium consumption. Age, occupation, and gravida factors were not related to the nutritional consumption of pregnant women.
Conclusions: The conclusion of this study was no difference in the nutritional consumption of pregnant women in terms of antenatal education methods. The consumption of macro and micronutrients for pregnant women was almost all below the nutritional adequacy rate
Management of hypocalcemia in a person with hungry bone syndrome post parathyroidectomy due to parathyroid carcinoma: a case report
Authors: Kusumawindani Dananti , Mudjanarko Sony Wibisono , Novida Hermina
Published: May 2024

Introduction: Hungry Bone Syndrome (HBS) refers to a condition in the form of prolonged and severe hypocalcemia accompanied by hypophosphatemia and hypomagnesemia that occurs after parathyroidectomy. The sudden cessation of PTH production leads to increased bone re-mineralization and a rapid shift of calcium from circulation to bone. This case report aims to present our management of hypocalcemia in a person with HBS after he underwent parathyroidectomy surgery due to parathyroid carcinoma.
Case Presentation: Mr. S, 46 years old, had a total thyroidectomy and a total parathyroidectomy on April 30th, 2019, due to parathyroid carcinoma, which the patient previously had. The patient was planned for surgery because of pathological fractures in the patient's hands and feet, which were complications of parathyroid carcinoma. The laboratory examination on the first postoperative day, May 1st, 2019, obtained a total calcium of 8.2 mg/dL. On May 5th, 2019 (day 5), total calcium decreased to 6.1 mg/dL. On May 10th, 2019 (day 10), hypophosphatemia was also found with a value of 2.1 mg/dL and hypomagnesemia of 1.2 mg/dL. When experiencing complaints, the patient's calcium was monitored regularly, low calcium was found, and symptoms of hypocalcemia were also found, so this patient was given drip calcium gluconate 1000 mg every 8 hours in 100 ml normal saline. Calcium checks are carried out every 24 hours; calcium is still low for over 3 days. In addition, he was given calcitriol 2x0.25 mcg titrated up to 2x0.5 mcg, drip 40% MgSO4 in 500 salines in 24 hours, and 4x200 oral phosphate. During the treatment, the patient's calcium reached 8.2 mg/dL with albumin 3.3 g/dL with a calcium ion count of 8.4 mg/dL after 17 days of treatment.
Conclusion: HBS was found due to total parathyroidectomy as the main therapy for parathyroid carcinoma. Close calcium monitoring and early administration of postoperative calcium are needed to avoid complications from hypocalcemia. Avoiding HBS can reduce the number of days in the hospital, thereby saving costs and improving the patient's quality of life.
Relationship between Beighton score, genders, body mass index, and quadriceps angle in East Java Training Athletes
Authors: Sapril Abdul , Subadi Imam , Pawana I Putu Alit , Poerwandari Dewi , Wardani Nurul Kusuma , Melaniani Soenarnatalina
Published: May 2024

Link of Video Abstract: https://youtu.be/BQ3uiW1O8GQ
 
Background: The quadriceps angle (Q-angle) affect the biomechanics of the lower extremities and is important in assessing the knee joint function. Increasing Q-angle can increase the risk of knee injury and also the chance of an athlete withdrawing from training or competition. Ligament laxity, gender, and high body mass index are proposed as risk factors for increasing Q-angle. Only a few research have investigated the correlation between these risk factors and Q-angle in competitive athletes, especially in Indonesia. This study aims to determine the correlation between Beighton score, genders, body mass index and Q-angle in competitive athletes in Indonesia.
Method: This study was a non-reactive study that used medical records from 94 competitive athletes collected to determine the subjects’ characteristics and research variables. The sampling technique was proportional random sampling. Ordinal regression tests were performed to assess the correlation between Q-angle and Beighton Score, Genders, and Body Mass Index in competitive athletes.
Result: There is a significant correlation between Beighton score and Q-angle in the supine position (p=0.000, R=2.829) and standing position (p=0.000, R=2.839), as well as body mass index and Q-angle in the supine position (p=0.003, R=0.23) and standing position (p=0.002, R=0.259), but there is no significant correlation between genders and Q-angle in the supine position (p=0.262, R=0.517) and standing position (p=0.235, R=0.550).
Conclusion: In competitive athletes, there is a strong correlation between Beighton score and Q-angle in both positions, as well as body mass index in both positions; nevertheless, there is no correlation between genders and Q-angle.
High-risk human papillomavirus prevalence among patients with cervical cancer at Moewardi General Hospital in Surakarta, Indonesia
Authors: Brian Wasita  , Suyatmi  , Riza Novierta Pesik  , Ratih Dewi Yudhani  , Nanang Wiyono  , Rachmi Fauziah Rahayu  , Kristanto Yuli Yarso
Published: May 2024

Link of Video Abstract: https://www.youtube.com/watch?v=Ryf_-hvseVc
 
Introduction: In Indonesia, cervical cancer is the second most prevalent type of cancer among the general population. Cervical cancer has the second-highest mortality rate of all cancers. Infection with the Human Papilloma Virus (HPV) is one of the causes that starts the growing phase of cervical cancer. The purpose of this study, therefore, is to determine the prevalence of HPV infection in patients with cervical cancer who were examined at Dr. Moewardi Hospital and lived in the ex-Surakarta Residency.
Methods: Cervical tissue biopsy at the Anatomical Pathology Installation of Dr. Moewardi General Hospital Surakarta which had been diagnosed as cervical cancer was examined by the detection of E6 protein from HPV 16 and HPV 18 using immunohistochemical staining techniques. The data obtained would be analyzed based on the characteristics of the patient's age and the degree of histopathological malignancy with a p-value < 0.05 deemed significant.
Results: Overall, the prevalence of high-risk HPV infection was 77.8% (35/45), with women aged between 41-55 years having the highest prevalence of HPV infection (45.7, 16/35), followed by women aged 56-70 (42.9%), women over 70 (8.6%) and women under 40 (2.9%). The results of statistical tests showed that no significant relationship was found between HPV infection and age (p = 0.428). High-risk HPV infection was most prevalent in the poorly differentiated group (54.3%), followed by the well-differentiated group (34.3%) and the moderately differentiated group (11.4%). The results of statistical tests revealed a significant association between HPV infection and tumor grade (p = 0.027).
Conclusion: To lower patient morbidity and mortality, it is crucial to receive a prophylactic HPV vaccine due to the incidence of HPV 16 and 18 infections in patients with cervical cancer at the Regional Hospital Dr. Moewardi Surakarta, with a prevalence of 77.8%.
Correlation between Superoxide Dismutase (SOD) with Malondialdehyde (MDA) level in blood plasma of seborrheic keratosis
Authors: Yesie Elvira  , Imam Budi Putra  , Nelva K. Jusuf
Published: May 2024

Introduction: Seborrheic keratosis (SK) is a benign tumor of the epidermis, its development is associated with various hypotheses, but none came out as the main culprit. A few study results regarding the oxidative stress strongly associated with skin tumors have been reported. Superoxide dismutase (SOD) is a potent protective enzymatic antioxidant. Malondialdehyde (MDA) is the end product of lipid peroxidation produced by free radicals in the body. Increased levels of MDA usually accompany low levels of antioxidants.
Methods: This study was an observational analytic study with a cross-sectional method involving 42 seborrheic keratosis subjects based on inclusion and exclusion criteria. We recorded the gender, age, family history, and occupation of the subjects. Diagnosis of seborrheic keratosis was made based on history taking and clinical examination—measurement of SOD level by ELISA method and MDA levels by TBARS method. The Spearman correlation test was measured and was considered significant if the p-value was <0.05.
Results: Seborrheic keratosis was more common in females (92.9%), with the most common age group being 40 ̶ 50 years old (57.1%), had a family history of SK (26.2%), and worked in agriculture, forestry, and fisheries (26.2%). The average blood plasma SOD level was 1.68 mmol/L, and the blood plasma MDA level was 181.19 U/L. The correlation coefficient between blood plasma SOD levels and blood plasma MDA levels was -0.393, with a significant value of p=0.01. This study showed that the lower the SOD level, the higher the MDA level in the blood plasma of seborrheic keratosis.
Conclusion: There is a significant correlation between SOD and MDA levels in the blood plasma of seborrheic keratosis subjects.
Do scientists still believe in mindfulness meditation for pain therapy? a bibliometric analysis regarding meditation trends for therapy from 1946 To 2022
Authors: Saleh Arman Yurisaldi , Valentina Rizky
Published: May 2024

Background: Pain medication with meditation has been practiced for a long time. Multiple meta-analyses have shown whether meditation is ineffective for treating pain, but there does not appear to be enough information for researchers to draw firm conclusions. At the same time, the trend of just using meditation as a pain therapy is still apparent in the search results for documents related to this subject.
Method: We collected the Scopus database of meditation as a pain therapy and then performed a quantitative analysis using Biblioshiny and VOSviewer software.
Results: The quantitative analysis's findings show the use of meditation as a pain therapy technique. Researchers continue to trust in the clinical benefits of mindfulness meditation in pain management, despite several studies showing the limited effect of meditation as a pain therapy. Many methods have been utilized to modify mindfulness meditation in recent studies.
Conclusion: Due to mounting clinical evidence supporting its efficacy, researchers are increasingly turning to mindfulness meditation as a kind of pain management.
Medical students’ mental health state during pandemic COVID-19 in Indonesia
Authors: Primatanti Putu Asih , Turana Yuda , Sukarya Wawang S. , Wiyanto Marwito , Duarsa Artha Budi Susila
Published: May 2024

Introduction: The COVID-19 pandemic has not only had an impact on health problems, but also brought many changes in other aspects of human life, including the education sector. Difficulty in adapting with the learning process can affect the mental health, especially medical students who are quite susceptible to depression and anxiety. We aimed to aims to provide an overview of mental health problems in medical students during the COVID-19 pandemic.
Method: The method used was an online cross-sectional survey using student characteristics instruments, the GAD-7 and PHQ-2 questionnaires. Respondents were 7949 medical students from 49 medical faculties in Indonesia from February to May 2021. All data were analyzed by univariate and bivariate statistics to see the relationship between several variables using SPSS version 22.0.
Results: The majority of respondents were women (69.4%) with an average age of 20.9±2.1 years and domiciled in Java (63.4%). The survey was joined by students from all years of education and the most followed by students in the second year (20.3%). Based on the GAD-7 questionnaire, 3471 respondents (43.7%) experienced symptoms of anxiety (mild, moderate, severe) and the most experienced mild anxiety (29.8%), while from the PHQ-2 questionnaire it was found that 1332 respondents (16.8%) experienced symptoms of depression. Analysis of the mean GAD-7 and PHQ-2 on several factors (gender, year of education, education phase, and place of domicile showed a significant relationship (p<0.05), except for the PHQ-2 score which was not significant for place of domicile (p=0.06).
Conclusion: The results of this survey describe the mental health conditions of medical students in Indonesia during the pandemic. This study emphasizes the importance of early detection, support, and mental health services to improve the ability and resilience of medical students in dealing with various changes during the COVID-19 pandemic.
Factors attributed to depressive symptoms in women coping with infertility during the pandemic of COVID-19
Authors: Maidarti Mila , Bailie Emily , Siregar Aprilia , Garinasih Prini Diandara , Silvana Vita , Harzif Achmad Kemal , Pratama Gita , Sumapraja Kanadi , Muharam R , Hestiantoro Andon , Wiweko Budi
Published: May 2024

Link of Video Abstract: https://youtu.be/2L4njgfd3SE
 
Background: The dissemination of coronavirus disease (COVID-19) has led to delayed infertility treatment and fear of contracting the virus which can affect the mental status of women with infertility. This research aimed to investigate whether fear, depression, perceptions, and knowledge related to COVID-19 affected infertility patients in seeking treatment and analyzed factors associated with depression during COVID-19 pandemic.
Method: This is a cross-sectional study utilizing an electronic survey distributed to infertility patients attending fertility services between May and July 2021. The primary outcomes were demographic characteristics, clinical parameters of infertility, depressive symptoms based on the Patient Health Questionnaire-9 (PHQ-9) score, and fear of COVID-19 scale (FCV-1 and FCV-2).
Results: A total of 533 patients were included. The fear of infertility treatment suspension due to COVID-19 was perceived by 34.1% of patients. The mean Patient Health Questionnaire-9 (PHQ-9) score was 4.55 ± 4.248, with mild depression occurring in 33.4% of patients. Low income, delayed treatment, and fear of COVID-19 scale (FCV-1) score together could significantly predict depression status. Despite the pandemic, 94.7% of patients decided to continue the treatment.
Conclusion: The COVID-19 pandemic has given rise to stressors that may aggravate the psychological condition of women with infertility. However, the enthusiasm to continue the treatment remains undisturbed. It is imperative to offer emotional support and address the consequences of COVID-19 infection in women with infertility during the pandemic era.
A patient with large ostium primum atrial septal defect who underwent open heart surgical closure with pericardial patch: a case report
Authors: Rampengan Starry Homenta , Rosmaningtyas Christina Ayu Ariani
Published: May 2024

Introduction: Atrial septal defect (ASD) is one of the most common congenital heart diseases and often diagnosed in adulthood. ASD represents a spectrum of disease with symptoms that vary from asymptomatic to right-sided cardiac volume overload, pulmonary arterial hypertension and atrial arrhythmias depending on the size of the defect, size of the shunt and associated anomalies. We reported a patient with large ostium primum ASD who underwent surgical closure with a pericardial patch.
Case Description: A 18 years old man came with chief complaint of abnormal ECG results of the screening examination of police candidates from Bhayangkara Hospital Manado. The patient had no complaints during admission. The patient could still carry out daily activities without any obstacles. The patient also could do high intensity sport without complaints of shortness of breath, heavy chest, or headaches. .Electrocardiogram (ECG) examination showed sinus rhythm, heart rate 74 beats per minute, left anterior fascicular block (LAFB), complete right bundle branch block (RBBB) and fragmented QRS at inferior leads. Transthoracic and transesophageal echocardiography revealed large ostium primum ASD L-R shunt.  Open heart ASD surgical closure with pericardial patch was done with good results and no residual shunt.
Conclusion: Large ostium primum ASD are associated with significant systemic-to-pulmonary shunts that results in desaturation requiring surgical closure. Large shunt of ASD patients who have a dilated right heart are associated with increased age-related morbidity and mortality. ASD with right heart dilatation should be considered for closure once the diagnosis is established regardless of the patient's age.
Successful treatment of severe subaortic stenosis with left ventricular dysfunction in children
Authors: Karyani Enny , Rahman Mahrus Ahmad , Utamayasa I Ketut Alit , Hidayat Taufiq , Ontoseno Teddy
Published: May 2024

Link of Video Abstract: https://youtu.be/tHcMqNHfLyYBackground: Subaortic stenosis (SAS) is the second most common form of left ventricular outflow obstruction, accounting for 14% of LVOT obstruction in the general population. This obstruction is in the area of the heart under the aortic valve. While only a few cases have been reported in pediatrics, SAS is a gradually progressive disorder rarely seen at birth and infancy. This case study aims to evaluate the successful treatment of severe SAS with left ventricular dysfunction in children
Case Presentation: We present the case of an 8-year-old boy who presented with shortness of breath on exertion and diaphoresis 3 months ago. Transthoracic echocardiography revealed severe aortic stenosis (PG 69.86 mmHg) with discrete tissue in the anterior LVOT and left ventricular systolic function decreased (EF Teich 29.44%), with global hypokinetic. Transesophageal echocardiography (TEE) results in severe subvalvular AS with a fixed subaortic membrane (PG 51.16 mmHg; Stenotic area 0.1 cm2), anterior to the aortic valve 1 cm long. There was mild mitral regurgitation and moderate tricuspid regurgitation. The patient then undergoes successful medical treatment and surgical subaortic membrane resection with tricuspid repair. After one year's operation, the patient remained stable, in good condition and free of symptoms.
Conclusion: Subaortic stenosis is a gradually progressive disorder and could develop into heart failure with significant left ventricular dysfunction. Monitoring is an important aspect, given the nature of disease progression. Successful management of a patient with subaortic stenosis involves a multidisciplinary approach, including an early diagnosis, a comprehensive understanding of cardiac pathophysiology, risk factors of recurrence, optimal medical management and surgical strategy.
The correlation between interleukin-6 (IL-6) level and high sensitivity C-reactive protein (hs-CRP) level in acne vulgaris
Authors: Nauli Agnes , Putra Imam Budi , Jusuf Nelva Karmila
Published: May 2024

Link of Video Abstract: https://youtu.be/nzfZMVQs6Cs
 
Background: Acne vulgaris (AV) is a common inflammation of the pilosebaceous unit. Inflammation is one of the four important factors in the genesis of AV. Interleukin-6 (IL-6) is a powerful major inducer of C-reactive protein (CRP) production and a proinflammatory cytokine. High sensitivity C-reactive protein (hs-CRP) levels can detect very low CRP concentrations. The purpose of this research is to ascertain whether the levels of IL-6 and hs-CRP in AV are related.
Methods: Forty-five subjects over 18 who had AV and 45 subjects who did not have AV served was included in this observational analytic research. IL-6 and hs-CRP levels are measured while the subject is examined, and basic statistics are recorded. Mann-Whitney and Spearman correlation tests were used to evaluate the data.
Results: In this study, AV was more dominant in women, consisting of 30 people (66.7%). The highest age in the study group was aged 18–22 years, comprising 25 people (56%). The mean IL-6 level in the AV group was 63.3 ng/L, and the control group, with an average value of 56.9 ng/L, showed a significant difference (p=0.014). There were substantial differences between the AV and control groups, as evidenced by the average hs-CRP levels of 5.48 ng/mL in the AV group and 4.27 ng/mL in the control group (p<0.001). Between the AV and control groups, there is a significant positive association between IL-6 and hs-CRP levels (r=0.700; p<0.001).
Conclusion: There is a strong correlation between IL-6 and hs-CRP levels in AV.
More is better than less analgesic after total knee replacement in geriatric patient. Is it a myth?
Authors: Hajali Cery Tarise , Irianto Komang Agung , Hernugrahanto Kukuh Dwiputra
Published: May 2024

Purpose: This study aims to assess the effectiveness of mono pharmacy and polypharmacy on the post-TKR outcome, the speed of recovery, time to partial weight-bearing, VAS, and the side effects of single, double, and triple analgesia in elderly TKR patients.
Methods: This observational retrospective comparative study comparing the post-TKR surgical outcome and using mono pharmacy or polypharmacy analgesics was conducted in an Orthopaedic Hospital during 2012-2021. Patients who underwent TKR with a subarachnoid spinal block were diagnosed with osteoarthritis grade IV and treated with single/ unilateral TKR were included in this study. Data would be analyzed using either ANOVA or Kruskal Walis. Treatment of analgesia was given by the anesthesiologist, who determined the types and methods of administration.
Results: A total of 152 patients were included in this study. Most samples were females (N=106, 69.7%) aged 63.75 ± 6.31 years. There was no significant difference between analgetic use on LOS, time to PWB, and VAS on days 1, 3, and 5 (p > 0.05). A significant linear difference was found between nausea and gastric pain incidence with the amount of postoperative analgetic administration (p = 0.01).
Conclusion: The effectiveness of mono pharmacy and polypharmacy is similar regarding the speed of recovery, time to partial weight-bearing, VAS, and side effects of post-TKR patients.
Community behavioral change and attitudes on the health protocol during the Covid-19 vaccination period and level 1 restriction (PPKM)
Authors: Sulistyowati Reny , Khoirunnisa  , Ardiyani Vissia Didin , Syam’ani
Published: May 2024

Link of Video Abstract: https://youtu.be/j5NtdcbvTE4
 
Background: Concern for behavior change in compliance with health protocols during this pandemic continues to increase, especially when the coronavirus disease (COVID-19) vaccination is carried out. During the initial pandemic, the public perceived it as risky to be infected with COVID-19. However, this situation manifests itself in the emergence of a phase where public awareness of wearing masks, maintaining distance, and washing hands is decreasing. This study aimed to understand the impact of implementing the vaccine on the compliance behavior of wearing masks, washing hands, and keeping a distance, as well as attitudes towards behavior complying with health protocols during the COVID-19 vaccination period and the implementation of level 1 restriction on community activities (PPKM).
Method: We used a cross-sectional design, recruiting 110 respondents at the Menteng Primary Health Care Center, Palangka Raya City. Recruited patients were those over 18 years of age. This research instrument is an adaptation of several research questionnaires carried out in Indonesia, and we asked respondents using Indonesian.
Results: Of the 110 respondents, 59.1% were dominated by women, and 61.8% were in the 17-25 age group. A total of 106 respondents (96.4%) revealed that they had received information regarding health protocols. More than 70% obtained information from television (77.3%). Only half of the respondents received the 3rd dose or booster I. Knowledge was not the dominant factor influencing adherence to health protocols, but people's attitudes towards the Covid-19 health protocol. No relationship was found between knowledge and people's behavior toward health protocols.
Conclusion: Most of the respondents (80%) still adhere to health protocols as recommended by the government even though 74.5% of the people have received the 2nd and booster doses of the vaccine.
Impact of ability and willingness to pay for health insurance in Indonesia
Authors: Busyra Anwar , Ibrahim Roszita , Aizuddin Azimatun Noor , Hassan Nor Haty , Irwan Saputra
Published: May 2024

Link of Video Abstract: https://youtu.be/w1aBTIalQSYOne way the community is financially protected from unforeseen health risks is through health insurance. The ability and willingness to pay for health insurance has been linked to improvements in public health, including better access to healthcare services, better public health, and financial protection from health risks, according to earlier research. Since 2014, Indonesia has had a government health insurance scheme under the National Health Insurance (JKN) program with the goal of enhancing community welfare and health access. However, despite the benefits provided by the JKN program, many people are still not registered and have not received benefits from the program. Recent studies have shown that high health insurance costs remain the main obstacle for people with low income to buy health insurance. The aim of this study was to identify the ability and willingness to pay for social insurance premiums in the framework of the National Health Insurance System. Utilizing the terms "impact of ability," "willingness," and "health insurance," the database search includes Google Scholar, ScienceDirect, and PubMed. The last step is to choose the articles that meet the criteria, which include being published between 2011 and 2022 and having the complete text accessible. The criteria for including 13 articles were met.  According to the review's findings, the majority of publications link knowledge, income, how people view health care, and family support to health insurance payment compliance. Additionally, there are barriers and constraints affecting participation in National Health Insurance (NHI), such as registration procedures, benefits received, premiums, and private insurance ownership. There are several factors that affect compliance with health insurance payment, including knowledge, income, perception of health services, and family support.
Phytochemical screening and evaluation of glucose-6-phosphate dehydrogenase activity of fermented honey-garlic in hypothyroidism rats
Authors: Wulandari Devyana Dyah , Wulansari Devyani Diah , Santoso Andreas Putro Ragil , Andini Ary , Nidianti Ersalina , Anggraini Rahayu , Krisnawan Alfian Hendra , Firdaus  , Firdaus Mahestinnisa Mutiara , Azaki Mun’im
Published: May 2024

Introduction: Hypercholesterolemia is an indicator of atherosclerosis in blood vessels and is currently a top priority in overcoming health problems, especially non-communicable diseases in developed and developing countries. Thyroid hormones regulate various metabolic processes in the body including synthesis, mobilization, and lipid degradation. A lack of thyroid hormone in the body or called hypothyroidism will decrease the number of LDL receptors in the liver. This causes an increase in plasma LDL levels which also increases total cholesterol levels. Despite the lack of study, Fermented Honey-Garlic (FHG) is now widely developed for its high antioxidant activity. This study aims to determine the content of bioactive compounds in FHG by qualitative secondary metabolite testing and GC-MS analysis and to evaluate the activity of the enzyme glucose-6-phosphate dehydrogenase (G6PD) in rats with hypothyroidism.
Method: Rats were grouped into 6 groups: positive control group induced by propylthiouracil (PTU) with a dose of 20 mg/day, negative control treated with distilled water, treatment group with a dose of FHG 0.2 g/kg BW (P1), treatment group with a dose of FHG 0.5 g/kg BW (P2), treatment group with a dose of FHG 1 g/kg BW (P3) and standard drug Simvastatin group with the dose 0,18 mg/day/200 g BW.
Results: Results showed that FHG contained flavonoid compounds, alkaloids, tannins, and saponins, and statistical results showed that the significance value for G6PD activity was 0.014 (P<0.05).
Conclusion: Therefore, it can be concluded that FHG administration yields a significant effect on G6PD levels.
A patient with acute fatty liver of pregnancy (AFLP) with acute pancreatitis manifestations
Authors: Nozomi Guntur Megawati Rif'atyyah , Kholili Ulfa
Published: May 2024

Background: Liver disease in pregnancy can be related to the process of pregnancy (liver disease of pregnancy) or not associated with pregnancy (liver disease in pregnancy). Acute fatty liver of pregnancy (AFLP) is a rare but life-threatening cause of jaundice in the third trimester of pregnancy and early postpartum period which in most cases no definitive risk factors are found. In this case report, we report a patient with AFLP with acute pancreatitis manifestations.
Case presentation: A 33-year-old woman referred to the Dr Soetomo General Academic Hospital, Surabaya, Indonesia with diagnosis of day-4 post-section caesarian (SC) accompanied by ileus paralytic, obstructive jaundice hypoalbuminemia hyperbilirubinemia, acalculi cholecystitis, acute kidney injury (AKI) with dd acute on chronic kidney disease (ACKD), suspect pneumonia, and sepsis. Indications for SC were premature rupture of membrane (PROM). The patient initially complained of yellow body and eyes 10 days before delivery with additional complaints including tea-colored urine and brown feces. Chest x-ray results showed infiltrates on the right paracardial suggesting pulmonary inflammation. Abdominal x-rays showed normal result. Abdominal ultrasound results suggested acalculi cholecystitis, however, liver, lien, pancreas, kidney right and left, urinary bladder, uterus, adnexa right and left showed no abnormality. The patient was treated with intravenous fluids, nasogastric insertion for nutrition, analgesics and antibiotics and other symptomatic therapy. The patient was discharged after 20 days of treatment.
Conclusion: This case highlights a potentially fatal complication of AFLP case with acute pancreatitis manifestations and the need of rapid diagnosis and comprehensive management to avoid the complicaton and death.
Trigone point as an alternative location for ventricular shunt insertion
Authors: Bakhtiar Yuriz , Sartika Dewi , Muttaqin Zainal , Arifin Muhammad Thohar , Imawati Sukma , Ningrum Farah Hendara
Published: May 2024

Link of Video Abstract: https://youtu.be/BtHvICeUONYBackground: Hydrocephalus is a condition in which cerebrospinal fluid (CSS) buildup in the ventricles is caused by excessive CSS production or disturbance of CSS circulation or absorption. Insertion of a shunt catheter into the lateral ventricle can be performed at the Kocher, Keen, Dandy, Frazier, Kaufmann, or Tubbs points. This study aims to evaluate the trigone point as an alternative location for ventricular shunt insertion
Methods: This is a retrospective study. We performed a three-dimensional head CT scan reconstruction of hydrocephalus patients; then, we calculated the vertical and horizontal distances perpendicular to each other from the upper edge of the auricle that intersects the trigone point on the right and left sides of the patient. Data were analyzed using SPSS version 26.0 for Windows.
Results: A total of 30 hydrocephalus patients at Kariadi Hospital Semarang from 2021 – 2022 were enrolled in this study. We got the averages of the vertical line is 25.05 mm and the horizontal is 33.00 mm for the right trigone point. In addition, the average vertical line is 25.78 mm and the horizontal line is 34.72 mm for the left trigone point. There was no significant difference between the vertical distance of the right and left trigone points (p=0.578) and the horizontal distance of the right and left trigone points (p=0.185). We found no significant difference between the location of the right and left trigone points.
Conclusion: Trigone point can be an alternative location for ventricular shunt installation.
Effectiveness of relevant interventions with readiness for discharge in transitional care of low birth weight infants: a systematic review
Authors: Resti Utami  , I Dewa Gede Ugrasena  , Ernawati  , Yuni Sufyanti Arief  , Wesiana Heris Santy
Published: May 2024

Introduction: Readiness for the discharge process to caring for low birth weight (LBW) is a top priority in providing quality nursing services in the perinatology room. The process of readiness for discharge is considered successful if the LBW is safe and comfortable during discharge. This study aimed to identify interventions relevant to readiness for discharge to improve transitional care for LBW and to assess the quality of available evidence using a systematic scientific approach.
Methods: Following the PRISMA checklist, a systematic review of randomized controlled trials and quasi-experimental studies was identified in eight electronic databases published from 2015 to 2022. All articles were discovered using the PICO framework and assessed using the Critical Appraisal Skills Program (CASP) tool. All articles were analyzed and synthesized narratively.
Results: A total of 201 titles were identified, and 25 studies met the inclusion criteria involving 3158 parents. Ten studies were RCT studies, and fifteen were quasi-experimental studies. The results of the narrative synthesis carried out on twenty-five articles showed that interventions relevant to readiness for discharge were effective in improving the transition care for LBW, including the transition to parenthood and the transition from hospital to home related to the ability to care for LBW.
Conclusion: This study provides evidence that nurses can modify and effectively carry out interventions relevant to discharge readiness to improve the transition care for LBW. Perinatology nurses must actively involve families in supporting mothers in optimal readiness for discharge.
Exploring waiting time, waste, and resources used for boarding patients in emergency department
Authors: Agus Aan Adriansyah  , Nurul Jannatul Firdausi  , Trisasi Lestari  , Kuncoro Harto Widodo  , Nikmatus Sa’adah
Published: May 2024

Introduction: The demand for health treatment in hospitals has arisen since the Indonesian government launched the National Health Insurance. Admission delay to medical wards (MWs), which makes patients board in the emergency department (ED), disrupts patient flow. This study aims to explore the barriers to boarding patients at the ED by identifying waiting time, waste, and resource adequacy.
Methods: A case study was conducted in the ED of RSUD by Dr. Moewardi. The subject was 45 patients with internal diseases. Collecting data by direct observation using a real-time method is described in value stream mapping. Problem-finding was sharpened by in-depth interviews with health workers and non-health workers in the ED and internal MWs.
Results: Prominent causes of patient flow disruptions depended on service in the ED and inpatient room. Disruptions of patient flow indicated by waiting time amounted to 3 hours, 3 minutes, and 52 seconds. Patients who transferred to the transition room were considered to have gone into MWs, although patients can be treated for more than 3 days due to waiting for bed availability in the inpatient room. Waiting and motion were the most frequent. Inadequate resources both in the ED and inpatient rooms made a wide impact on patient flow, which was worsened by problems with tool layout, fragmented work, and poor utilization of the hospital information management system.
Conclusion: The bottleneck in ED’s and MW's processes contributes to the degeneration of the stacked bed of boarding patients in ED. The improvements must be integrated to address the issues of waiting time, waste, and capacity. Improvements in the flow of boarding patients focus on fixing the documentation of laboratory result problems, arranging patient discharges, and optimizing the use of the hospital information system.