bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of pandemic restrictions on antenatal complications at a tertiary care center
Authors: Baser Anshu , Kumar S.
Published: March 2021

Background: The ongoing pandemic has drastically affected the heath care sector, especially the tertiary care centers taking the major burden of patients. Apart from COVID-19 positive patients there has also been an increase in Covid 19 negative patients due to other private hospitals being closed. We have conducted an analysis at a tertiary care centre comparing the patient data in 3 months that is from 23rd March 2020 to 22nd June 2020 and the same time period last year 2019. The antenatal and postnatal complications and mode of delivery were analysed.Methods: A total of 1837 cases were compared. Patients were divided into 2 groups case and controls.Control group comprised of 780 patients admitted between 23rd March 2019 to 22nd June 2019. Case group consisted of 1057 patients admitted between 23rd March 2020 to 22nd June 2020. Patient were matched for age, parity, socioeconomic and demographic dataResults: Our results showed that there was no statistically significant increase in antenatal complications despite there being an increase in the total number of patients during the same time period. There was however a significant increase in unregistered cases p<0.0001. There was also a statistically significant increase in the total number of lscs and normal deliveries (p=0.03).Conclusions: Our analysis concludes that despite there being an increase in the total number of cases compared to the previous year there was no statistically significant increase in complications.There was however a significant increase in unregistered cases which may be due to increased referrals from PHCs. The increase in work load perceived by the doctors may possible be due to stress and the added burden of managing COVID-19 positive patients.
Analyzing the short term and long-term complication of hysterectomy: a prospective study
Authors: N. R. Sindhu , Rao Bharathi , Zubair Sabah Mohd.
Published: March 2021

Background: Hysterectomy is the most common surgical procedure done worldwide in women. Although many studies were done regarding short term complications, long term complications are not very well followed up. The objective of the study is to analyze short term and also long-term complications for the different mode of hysterectomy.Methods: It was a time-bound hospital-based prospective study which includes all the women who underwent hysterectomy for benign conditions in the hospital except women with prior psychiatric, bowel, bladder and sexual dysfunctions. All the patients were followed up for one year using a set of questionnaires to study short term and long-term complications.Results: No significant difference in short term post-operative complications concerning the mode of hysterectomy except for UTI was more common in vaginal hysterectomy group and haemorrhage in TAH route. Sexual dysfunction was noted even after 1 year of surgery in all modes of hysterectomy. Mild urinary dysfunction found statistically significant even at 1 year follow up in vaginal hysterectomy mode however there was no bothersome urinary dysfunction persistent after one year.Conclusions: Sexual dysfunction is the most common persistent long-term morbidity following hysterectomy found in the present study.
Clinical profile of women seeking medical termination of pregnancy at a tertiary care institute, South India
Authors: Aggrawal Pratima , Dasari Papa
Published: March 2021

Background: Medical termination of pregnancy (MTP) has largely become a medical procedure rather than surgical and in the recent times and few women approach public health care facility and hence the profile of women has changed and is different in various hospitals. Hence this study was undertaken with the objectives to know the proportion of indications as per MTP act and gestational age in women who opted MTP. The study also aimed to find out the clinic-demographic profile and the method of MTP and contraception adopted along with MTP.Methods: A retrospective cohort over 3 year period (2016-2019). Data was extracted from the medical records of women who were hospitalised for MTP and analysed for the outcome parameters Viz: Women were categorised as per the indication for MTP. In each category of indication, age, socioeconomic status, trimester of MTP, number of living children, methods of MTP and methods of contraception adopted was noted. The results were expressed as proportions and frequencies and the trend over 3 years was expressed as percentage per total number of deliveries per year.Results: There were 640 MTPs over 3 year period and this constituted 1.22% of total deliveries (52,555). Fifty one percent were first trimester MTPs. Thirty eight percent were done for congenital malformations, 32% for socio-economic reasons of family limitation, 17% for saving physical or mental health , 4% for rape victims and 8% for failure of contraception. The mean age was 28 years and the age in humanitarian group was ≤ 20 years. More than 88% belonged to lower socioeconomic class and 37% were third gravidae with 2 living children. Medical methods were used in 90% of terminations and 46% adopted contraception.Conclusions: The most common reason for opting MTP is congenital malformation of fetus. Women who achieved the desired family size and non-practice of contraception was the next common indication for termination of pregnancy and majority of terminations in this group were first trimester. Practice of contraception to avoid unwanted pregnancy and measures to prevent congenital malformations are essential to reduce medical termination of pregnancies.
Outcome of post caesarian pregnancy in a tertiary care hospital in Udaipur, Rajasthan
Authors: Sharma Archana , Jadeja Harshdeep , Malhotra Preeti
Published: March 2021

Background: The prevalence of caesarean section has increased due to a variety of factors such as patient choice and relative safety of the procedure. However in many cases the risk involved in LSCS is still present.Methods: The present study was designed to evaluate the outcome in cases where VBAC or TOLAC were used for the second pregnancy in a previous LSCS case. The study employed a sample of 60 subjects who were equally divided in two groups who were subjected to elective cesarian and TOLAC.Results: The results showed that TOLAC did have a better outcome as compared to repeat cesarian in context of maternal and foetal factors.Conclusions: The practice of TOLAC must be tried as an alternative and can be a viable option for uncomplicated post cesarian deliveries.
A study to evaluate pregnancy with maternal heart disease: a prospective observational study at a tertiary care centre in India
Authors: Goel Khushboo , Tambe Sanjaykumar G.
Published: March 2021

Background: Prevalence of heart disease in pregnancy vary from 0.3-3.5%. Normal pregnancy is associated with physiological cardiovascular changes. These changes may unmask underlying cardiac disease in normal women and increase morbidity and mortality in women with heart disease. Heart disease in pregnancy is an important cause of maternal mortality in India. The aim of this study was to evaluate the maternal and neonatal outcome of pregnancy with heart disease.Methods: A prospective observational study was conducted at Sassoon General Hospital, Pune, India. 75 patients who fulfilled the inclusion criteria were studied. Maternal and neonatal outcome were analyzed.Results: Maternal heart disease was classified into congenital (36%) and acquired (64%). In acquired variety, rheumatic heart disease was most commonly seen. In congenital, ASD was most common. We divided the cases into two groups based on their NYHA status, low risk group had 74.67% patients and high risk group had 25.33% patients. The most common antenatal complication was PROM (41.3%). There was statistically significant association between ICU admission and high-risk group. The most common neonatal complications were IUGR and prematurity. Maternal mortality rate in the study group was 6.6%.Conclusions: The perinatal outcome of heart disease in pregnancy is more dependent on the severity of symptoms rather than the duration and type of heart disease. Multidisciplinary evaluation is necessary. Suboptimal optimization of the heart condition in the antenatal period and delayed referral were the major risk factor for maternal mortality.
Changing trends of maternal mortality with its causes- ten years retrospective study in a peripheral medical college of West Bengal, India
Authors: Dasgupta Anjan , Pal Abirbhab , . Nikita , Dasgupta Debanjana , Ghosh Partha
Published: March 2021

Background: The estimates of maternal mortality can only be used as a rough indicator of maternal health situation in any given country. High maternal mortality reflects not only in inadequacy of health care services for mothers, but also a low standard of living and socio economic status of the community. Objective was to assess the maternal mortality ratio (MMR), its probable causes and changing trends.Methods: The present study conducted at Midnapore Medical College (MMC), West Bengal. Data for analysis were collected from medical college record section and maternal death registrar book after having permission from higher authority of the college during the period from January 2009 to 2018 December. Total sample size for this period was 249. Statistical analysis was done through SPSS software.Results: Ten years data analysis of 249 subjects showed that total live births from January 2009 to December 2018 was 1,39,126 with MMR 178.97%. Hypertensive disorder of pregnancy (40.56%) was the leading direct cause of maternal death followed by hemorrhage (24.49%) and septicemia (10.84%). Heart disease (6.42%) was the major indirect cause of death followed by anemia (3.6%). Maternal death rate found high among primi gravida (59.43%) mothers and within 20 years age group (46.18%).Conclusions: Most maternal deaths are preventable by proper antenatal care, early diagnosis of high risk factors, timely referral to tertiary care centre along with community upliftment especially in rural and tribal based population.
Pelvic abscess in a sexually inactive teenage girl: a case report and review of literature
Authors: Anant Monika , Sinha Kajal
Published: March 2021

Pelvic abscess, a potentially life-threatening collection of infected exudate in pelvic organs, commonly occurrs in sexually active women having pelvic inflammatory disease due to sexually transmitted infections. It is rare to find it in a girl never engaged in sexual activity. The index case was a of pelvic abscess in a 15year virgin girl. She presented with fever abdominal pain and lump. Ultrasonography suggested a complex pelvic mass but on CT imaging pelvic abscess was confirmed. She underwent surgical intervention after failed medical treatment to drain the collection and preservation of internal genital organs. Pelvic abscesses demand prompt diagnosis and management to prevent further complications and long-term poor fertility outcomes specially at young age and should be a differential diagnosis in girls with pain abdomen and fever.
A rare case report of conjoined twins: Thoraco-omphalopagus with anterior abdominal wall defect
Authors: Trivedi Swati , Khokher Santosh , Trivedi Shashank , Rastogi Prasoon
Published: March 2021

Conjoined twins are a rare deviation of monozygotic monoamniotic twins which results from fusion of the two at any part of their body. The prognosis is not good and associated with high mortality. Here we report a case of conjoined twin which was referred to our tertiary care hospital as twin pregnancy with impacted breech in obstructed labour. Taking mothers condition into account, she was taken for emergency caesarean section, performing which we realised that it was a conjoined twin. The baby were still born and conjoined at thorax and abdomen (thoraco-omphalopagus) with anterior abdominal wall defect in one and unrevealed sex in other. Current report emphasizes on making an early diagnosis of conjoined twin pregnancy, so that it can be managed at the earliest according to the gestational age.
A discussion on strategic considerations, effective safety measures and procedural deliberations in otorhinolaryngology practice and surgery during COVID-19: an integrative approach
Authors: Hernot Sharad , Pandey Apoorva Kumar , Kaintura Madhuri , Maithani Tripti , Bhardwaj Aparna , Haq Ajaz Ul , Anjum Fatma , Bisht Akanksha
Published: March 2021

Background: Coronavirus disease of 2019 (COVID-19) has made an imperishable haunting mark worldwide, and has changed in many aspects the way medicine had been practiced till now. This study is intended to highlight the approach that was followed in the department of ear, nose, and throat (ENT) learning from the existing available guidelines to provide safe routine and emergency ENT care to all the patients irrespective of the COVID status. Objectives of the study were to highlight the changes, challenges, triage and safety recommendations associated with patient management during the ongoing pandemic.

Methods: This study conducted between 25th March 2020 to 15th September 2020 constitutes of following points covering various aspects of patient management such as education about personal protective equipment, the 3-station triage system starting from the patient’s entry in the hospital, general working and precautions at the ENT outpatient department (OPD) registration counter, medical consultation with otorhinolaryngologist in OPD or in ER, general precautions in endoscopy room/voice lab, and operation theatre, patient transport, and postoperative care.  

Results: A total of 8930 patients were seen from 25th March 2020 to 15th September 2020. 7885 patients were seen in ENT outpatient department, 561 in emergency room, and 484 patients were seen as referrals sent from other departments. 297 patients were advised admission for various surgical procedures whereas 22 patients were admitted for conservative management.

Conclusions: Through this study, we suggest a paradigm consisting of safety and triage recommendations to be followed while dealing with patients in a way to minimise the cross transmission of virus.
Study of bacteriological profile in chronic suppurative otitis media and their pattern of antibiotic sensitivity
Authors: Shinde Kiran J. , Pathak Netra A. , Katake Namrata J.
Published: March 2021

Background: Chronic suppurative otitis media is a long-standing infection of the middle ear cleft which is characterized by recurrent and persistent ear discharge and persistent non healing perforation of tympanic membrane. It can lead to severe complications if not treated appropriately. Due to emerging antibiotic resistance, it is necessary to understand the antimicrobial pattern and their sensitivity to antibiotics which will help clinicians to select antibiotic which is sensitive to their corresponding microorganism. The aim of the study is to isolate the prevalent microorganism and study their antibiotic sensitivity pattern in patients of chronic suppurative otitis media (CSOM).

 Methods: Total 100 patients were examined, ear swab were collected by sterile ear swab and sent for microscopy and culture sensitivity examination to microbiology department. Results were documented and analyzed.

Results: Pseudomonas aeruginosa was the most common isolate (41%) followed by Staphylococci (28.2%). Gram negative cocci showed high degree of sensitivity to Cotrimoxazole (100%), Amikacin (79%) and Piperacillin - tazobactum (75%). Gram positive cocci showed high degree of sensitivity to Linezolid.

Conclusions: Study of bacteriological profile and their sensitivity pattern helps in empirical therapy and reduces the risk of complications.
Guidelines for oral, pharyngeal and laryngopharyngeal surgery during COVID-19 pandemic
Authors: Husain Parvez , Husain Benazeer , Ahmed Shaheen Khalil
Published: March 2021

The pandemic due to the new respiratory infection known as coronavirus 2019 disease (COVID-19), caused by the SARS-CoV-2 virus, has triggered an unprecedented disruption in the normal activity of ENT, oral, and pharyngeal surgery departments worldwide, delaying routine patient care and elective surgical interventions. ENT, oral, and pharyngeal surgeons are one of the healthcare groups with the highest risk of nosocomial infection because of the close contact that occurs with asymptomatic and symptomatic patients with SARS-CoV-2 infection through the oral cavity and laryngopharynx. The purpose of this document has been to update the available evidence for the safe and effective management and treatment in elective and emergency surgeries, and hospitalization, while minimizing as much as possible the risk of infection for the ENT, oral, and laryngopharyngeal surgeon, health workers and patients. This document aims to clarify the most significant aspects and develop a common protocol for the surgical management of patients with COVID-19 in ENT, oral, and maxillofacial surgery during the acute stage of spread and subsequent control of the pandemic in our country.
Criteria for petroleum potential and forecast of oil and gas prospective zones in the Achimov deposits of the Gydan Peninsula
Authors: Shestakova N. I. , Ershov S. V. , Bardachevskiy V. N.
Published: March 2021

The structure and seismogeological characteristics of the Achimov strata of the Gydan Peninsula are considered. Geological and geophysical criteria for the regional forecast of oil and gas potential, taking into account the clinoform structure of the Berriasian-Lower Aptian deposits, are proposed. Based on the interpretation of drilling data and 2D seismic exploration, predictive maps of the thickness of sand bodies were constructed, depocenters of accumulation of sandy material were mapped. Seismostratigraphic studies, which are based on a comprehensive analysis of the wave pattern of time seismic sections, dynamic and seismic facies analyzes, as well as paleotectonic and paleogeomorphological reconstructions, made it possible to identify the Salmanovskaya and Yuzhno-Gydanskaya oil and gas zones in the Achimov strata of the Gydan Peninsula.
Modeling of the nitrous oxide synthesis in a microchannel reactor: the effect of parameters on the temperature regimes and output
Authors: Ignatov A. S. , Vernikovskaya N. V. , Chumachenko V. A. , Noskov A. S.
Published: March 2021

The study deals with the synthesis of nitrous oxide via selective oxidation of ammonia in a microreactor (MCR), which is a metal disk with cylindrical channels filled with the manganese-bismuth oxide catalyst. The proposed 3D mathematical model of MCR takes into account axial and radial heat and mass transfer, catalytic reactions and related changes of the reaction mixture volume, heat exchange between the disk and channels, and thermal conductivity of the disk. Parameters providing the maximum output of nitrous oxide were determined with allowance for restrictions on the temperature in MCR channels. The highest efficiency of the nitrous oxide synthesis is achieved at a temperature of the outer edge of reactor 370 °С and an inlet concentration of ammonia 20 vol.%. The output per unit catalyst volume in MCR is approximately 1.5 times higher as compared to a tubular reactor; the maximum temperature corresponds to the optimal one, which provides the best selectivity of the process with respect to nitrous oxide.
The effect of treatment with sodium carbonate and hydrogen on the activity and selectivity of polymeric Pd-containing catalysts for hydrogenation of acetylene compounds
Authors: Bertova A. A. , Korshakova A. A. , Bykov A. V. , Sulman M. G. , Nikoshvili L. Zh. , Kiwi-Minsker L.
Published: March 2021

Catalytic hydrogenation of the triple carbon-carbon bond of acetylene compounds is an important industrial process. High selectivity to the olefin compound should be provided in the process. This study considers the effect exerted by sodium carbonate treatment of the palladium catalysts containing super-cross-linked polystyrene (SPS) on their activity and selectivity in the hydrogenation of 2-methyl- 3-butin-2-ol and phenylacetylene. The effect of such treatment was shown to depend on the chosen palladium precursor and the type of polymeric support (non-functionalized SPS or that containing ternary amino groups). At atmospheric pressure of hydrogen and a temperature of 90 °C in a toluene medium, the 1%-Pd/SPS catalysts treated with Na2CO3 provided a 98 % selectivity in the hydrogenation of 2-methyl-3-butin-2-ol (at a 95 % conversion of the substrate), while selectivity in the hydrogenation of phenylacetylene reached 99.5 %.
Critical Thinking among Indonesian Students Studying Public Health in Australia: Autoethnography of Challenges and Strategies to Adapt
Authors: Eka Pertiwi Ratih , Kurniawan Aan , Ariwinanti Desi
Published: March 2021

Critical thinking, as the ability to evaluate, has been a constant challenge for many Indonesians pursuing tertiary education in Australian Universities. As an essential component to the students’ competency set necessary to accomplish their degree, many Indonesian students struggle to sharpen their critical-thinking skills in appraising essays or discussing questions correctly. The struggle might be due to the difficulty in distinguishing critical thinking from other intellectual skills such as understanding, memorising and applying. This article is a reflective writing that explores the challenges faced and strategies applied by Indonesian public health students during their course to improve their critical-thinking skills. Several factors including the collective style-culture, where the students come from a home-education background, and the absence of relevant practices are responsible for their lack of critical-thinking skills. Strategies applied are frequent discussion with native students which helps in breaking the cross-culture barrier, thus increasing their confidence in critical thinking; extensive academic articles reading to familiarise the critical-thinking style; practicing self-questioning various topics and validity of evidence; and being more open to other perspectives.
Keywords: critical thinking, students, public health, autoethnography, reflexivity
The Experience of Adult Clients with Type 2 Diabetes Mellitus at the Cigugur Tengah Public Health Center
Authors: . Budiman , . Nadirawati , Ariansyah Alfi
Published: March 2021

Type 2 diabetes mellitus is a health problem that tends to increase every year and has the most complications among other generative diseases. This study aimed at gaining a deeper understanding of the meaning of type 2 diabetes mellitus treatment for adult clients. The study used a qualitative approach with a phenomenological design. Data were collected through in-depth interviews, and field notes were analysed by applying the Collaizi technique. In total, five individuals were included in the study. The study included seven themes: risk factors for type 2 diabetes; changes experienced by the patients of type 2 diabetes; efforts made by the patients to overcome diabetes; behaviour towards diet and treatment, support from the family; expectations of the patients; and complications faced by the patient. For this reason, the authorities, especially nurses at the Cigugur Tengah Public Health Center, should continue to monitor and counsel DM patients so that the complications due to DM can be resolved as early as possible.
Keywords: experience, adult, type 2 DM
Development of Educational Media For Type II Diabetes Mellitus Patients in the Work Area of Kedundung Health Center, Mojokerto City
Authors: . Supriyadi , Katmawanti Septa , Arviolika Yunita , Aflah Samah Dea
Published: March 2021

Diabetes is one of the big four non-communicable diseases. According to the Mojokerto City Health Office, the incidence reached 3,365 in 2019 with the highest recorded at the Kedundung Health Center with 822 patients. Although the Ministry of Health has introduced dietary programmes for tackling the incidence of diabetes, a survey of the dietary rules of diabetes patients at the Kedundung Health Center revealed that it is only limited to consultation with nutritionists. Thus, it is necessary to develop a health-education media product in the form of a booklet explaining a more practical diet for diabetes mellitus patients. This study comprised of 10 stages adopted from the Sugiyono’s development model using a qualitative and quantitative descriptive analysis. The booklet produced b this study is titled “How to Diet Diabetes?” and contains information on understanding diabetes diet, the purpose, the calories needed, eating schedule, type of food, diet composition, dietary restrictions, and various menus. An assessment of the final product showed that 91.6% of the media experts considered it “very worthy” and 75% of the members providing the material included in the booklet considered it “eligible with minor revision.” Similarly, 92.7% of a small test group and 88.7% of a large test group classified it as “very worthy.” However, further work is needed to evaluate the effectiveness and impact of the booklet. Expansion of the subject is expected so that the booklet could reach more targets.
Keywords: booklet, diabetes mellitus Diet, educational media
Community Behaviour in Efforts to Prevent Covid-19 Transmission in The City of Padang
Authors: Wirna Putri Novia , Pristi Rahmah Septia
Published: March 2021

During the Covid-19 pandemic, people are asked to stay at home to break the chain of disease transmission. The purpose of this study was to see an overview of the people’s attitude towards Covid-19 prevention measures in the city of Padang. This descriptive analytic study was carried out in 2020 in the city of Padang. The study included 401 individuals who responded to the google form questionnaire. Data analysis includes univariate analysis. The results showed that community behaviour in efforts to preventing the transmission of Covid-19 was categorized as bad by 48.6% and good by 51.4%. Some community behaviours that are still poor include the habit of shaking hands with other people by 50.9%, being in a crowd when out of the house by 41.6%, and participating in joint activities by 62.6%. The most important strategy at this time for the people is to wash hands and use hand sanitizer every time they interact with others and reduce the interactions with people outside home. For the government, tightening quarantine rules for areas that are still in the red zone of Covid-19 transmission is important.
Keywords: Covid-19, community behaviours, prevention
The Relationship between Complementary Food After Exclusive Breastfeeding, Immunization and Family Income with Stunting in Kedungrejo, Malang Regency
Authors: Agie Permata Diash , Radita Alma Lucky , Yunus Moch
Published: March 2021

Stunting in Malang Regency has shown an increasing trend in the last three years: 22.9% in 2016, 28.3% in 2017 and 31.7% in 2018. Kedungrejo is one of Pakis Public Health Centre (PHC) working area which has an increasing prevalence of stunting. It was 38.2% in 2017, 53.1% in February 2018 and 81.8% in August 2018. This study aims to determine the factors related to stunting, which include complementary food after exclusive breastfeeding, immunization and family income. This case–control study included 30 two-to-five-year-old children diagnosed with stunting as the case group and 60 children in the same age group as the cases but not diagnosed with stunting and with no history of infectious diseases as the control group. Data were collected through interviews and documentation of the Mother and Child Book (Buku KIA) and analysed by Chi square test. The results showed that the majority of respondents were children aged 24–35 months (40%), male (62%), received complementary food after exclusive breastfeeding (54%), had complete immunization status (61%) and had low family income 63%. A bivariate analysis was used to show complementary feeding p = 0.017, OR= 2.98, immunization p = 0.032, OR= 2.88 and parents’ income p = 0.063, OR = 2.51.
Keywords: stunting, complementary food after exclusive breastfeeding, immunization, family income
Comparison of Documentation Quality using Electronic Nutrition Care Process (NUCAPRO) and Manual System
Authors: Paramita Farah , Hartriyanti Yayuk , . Susestyowati , Lazuardi Luftan
Published: March 2021

Hospital nutritional care requires a timely, accurate and complete information delivery to the patients. Some barriers found in the documentation process include incomplete documentation and errors in calculating patient’s nutritional needs. We developed NUCAPRO (NCP Electronic), a computer-based system, to document the nutritional care process and help dietitians in calculating a patient’s nutritional needs. This computer system was compared with a manual system to find out which of the two provided more accurate and complete documentation. This pre-experimental study used a pre–post-test design. Eight dietitians were recruited from the Internal Medicine Department Hospital in Malang to perform the documentation of the nutritional care of 40 diabetes mellitus patients. The documentation was performed using a manual system and NUCAPRO. The completeness and accuracy of documentation were compared between the two systems. Statistical analysis was done using McNemar. The results showed no difference in terms of completeness and accuracy of documentation between the two systems (p < 0.05). However, the error in calculation using NCP Electronic was found to be lower than the manual system. We suggest developing an alert feature for the system so that the process is more efficient.
Keywords: dietetics, documentation, medical informatic application, completeness, accurate, error
Relationship of Chronic Energy Deficiency, Birthweight and Exclusive Breastfeeding with Stunting in Kedungrejo Village, Pakis District, Malang
Authors: Endah Tri Maulina Esthi , Radita Alma Lucky , Nurrochmah Siti
Published: March 2021

n 2018, the average prevalence of stunting in Indonesia ranked sixth in the Asian region, at 36.4%. In the Java region, East Java ranked first with a stunting proportion of 32.81%. Malang is a district that has continued to experience an increase in the proportion of short nutritional status over the past three years: 22.9% in 2016, 28.3% in 2017 and 31.7% in 2018. Factors that affect stunting include income, education, economic status, number of family members, knowledge, exclusive breastfeeding, sanitation, clean water, health services, nutritional status of pregnant women, infections and birthweight. The purpose of this study was to determine the relationship of maternal nutritional status, birthweight and exclusive breastfeeding with the rate of stunting in Kedungrejo Village, Pakis District, Malang. This analytical observational study used a case–control design. The sample size of the case and control groups were 31 and 62 toddlers, respectively, selected using a purposive sampling technique. Data were analysed by Chi-square test. No significant relationship was seen between the maternal nutritional status and the rate of stunting (X2 value 0.151 < X 2 table 3.841), and the birthweight and the rate of stunting (X2 value 0.427 < X 2 table 3.841), however, there was a significant relationship between exclusive breastfeeding and the rate of stunting (X2 value 10.747 > X 2 table 3.841).
Keywords: the birthweight of babies, exclusive breastfeeding, mother’s nutritional status, stunting
Juridical Assessment of Food Safety in Packaged Processed Food Product
Authors: Bagus Pambudi Dwi , Ekawati Rany
Published: March 2021

Food safety is one of WHO’s primary concerns during a pandemic. The current Covid-19 pandemic requires us to boost our immune system by eating a healthy and balanced diet. Food consumed by the masses must be free of chemical and biological substances that can be harmful for the body. Nowadays, food products have developed to be more innovative, such as packaged processed food products that can be stored for a long time, generally using Food Additives. The safety of packaged processed food products must be guaranteed by the manufacturers in order to guarantee consumer protection. To ensure this, the government has established the Consumer Protection Law; the Government Regulation on Food Safety, Quality and Nutrition; and the Food and Drug Administration Division. Through the BPOM, the government supervises food products circulating in the community. The supervision carried out by BPOM are preventive and repressive. One form of supervision carried out by BPOM is granting distribution permits for packaged processed food products before they are distributed to the public.
Keywords: packaged processed food products, BPOM
Sleep Disturbance and General Health Status in Patients with Chronic Conditions
Authors: Dwi Tama Tika , Astutik Erni
Published: March 2021

Patients with chronic conditions often report sleep disturbance that affects their daily activities and health status. Information about the association between sleep disturbance and general health status in patients suffering from chronic conditions is limited, especially in relation to the developing countries of Asia. This study was conducted to estimate the prevalence of sleep disturbance and its relationship with the general health status of patients with chronic conditions in Indonesia. This cross-sectional study included 9,807 patients with chronic conditions who had participated in the Indonesian Family Life Survey (IFLS) wave 5. While sleep disturbance was measured by using the PROMIS sleep disturbance 4a short-form v1.0, general health status was assessed from self-rated health. Multivariable logistic regression was performed to assess the association between sleep disturbance and general health status. The study found that 75.7% of the patients with chronic conditions experienced sleep disturbance. In addition, the odds of being unhealthy among patients with sleep disturbance was 18% higher than those who did not experience sleep disturbance after being controlled by other covariates (p-value = 0.002; AOR 1.18; 95% CI 1.06–1.30). Sleep disturbance was associated with a poor general health status in patients with chronic conditions. Therefore, early detection of sleep disturbance and immediate intervention may lead to better health outcomes in patients with chronic conditions.
Keywords: sleep disturbance, health status, chronic conditions, Indonesia
JKN and Maternal Mortality Phenomenon at the Banyuwangi Referral Hospital, Indonesia
Authors: Al Farizi Sofia , Katmawanti Septa , Nuari Harmawan Bagus
Published: March 2021

Maternal mortality is a persisting problem in Indonesia. JKN can realize universal health coverage so that the service quality and its utilization can be improved. Maternal mortality in the referral hospital of Banyuwangi was stagnant during the JKN implementation. This study was a comparative analysis of the maternal mortality characteristics before and during the implementation of JKN in Banyuwangi. The study used mixed methods with sequential explanatory design. The study began with a quantitative method and was confirmed in depth by qualitative research. The study was conducted at four secondary hospitals, joined by BPJS Kesehatan. In the quantitative research, the characteristics analysed were the incidence of maternal death, cause of death, time of death, and period of death. Results showed that the proportion of maternal mortality increased after the JKN implementation [from 0.19% to 0.25%] PR = 1.31. Also, patients who died of uterine rupture and pre-eclampsia increased during the JKN implementation – from 15.39% to 18.75%, PR = 1.22 and from 7.69% to 25%, PR = 3.25, respectively. Death time < 48 hr and puerperal death also increased during the JKN implementation – from 61.5 % to 68.75%, PR 1.12 and 46.15% to 53.34%, PR = 1.15, respectively. The tiered referral and non-massive early detection affected the increase in maternal mortality. Many factors contributed to the increase in the proportion of maternal mortality characteristics at the Banyuwangi referral hospital. However, several policies of JKN need to be improved to be more effective in reducing maternal mortality.
Keywords: maternal mortality, health insurance, delay in referral, early detection
The Relationship between Age, Parity and Husband's Support and the Selection of Long-term Contraception Method (MKJP) By Woman of Childbearing Age
Authors: Windi Kusuma Elsa , Eko Wardani Hartati , Hapsari Anindya
Published: March 2021

The high birth rate of Indonesia has become a significant problem and requires special attention. As an effort to tackle the rapid population growth, the government has formulated a number of development and family planning programs. For instance, the National Family Planning programmes, which is mainly directed towards the use of the Long-term Contraception Method (MKJP); however, the actual usage rate of the programme is still low. This research aimed to examine the relationship between age, parity and husband’s support, and the MKJP selection by women of childbearing age in the working area of Dinoyo Public Health Centre, Malang City. This study was an analytical research with a cross-sectional design. The samples in this research were chosen through the purposive sampling method, with a total sample of 45 women. Data were collected through interviews and questionnaires. Data analysis was carried out using the Chi-Square test, with a significance level of < 0.05. The results showed that there was no significant relationship between the age and the selection of MKJP (sig. 0.461), between the parity and the selection of MKJP (sig. 0.522), and between the husband’s support and the selection of MKJP (sig. 0.460). Therefore, we conclude that there is no significant relationship between the age, parity and husband’s support, and the selection of MKJP by women of childbearing age in the working area of Dinoyo Public Health Centre.
Keywords: age, parity, husband’s support, long-term contraception methods
Factors Influencing Pregnant Women's Participation in Prenatal Classes in Magetan Regency, Indonesia
Authors: Uzza Rofiatul , Adi Sapto , Puspita Ratih Suci
Published: March 2021

Prenatal classes in Indonesia are government’s effort to improve the knowledge and skills of pregnant women. Several factors influence the participation of pregnant women in these classes. This research aimed to identify the factors that correlate with pregnant women’s participation in prenatal classes in several rural villages of Magetan Regency, Indonesia. This observational analytical research was performed quantitatively using a cross-sectional design. Seventy-eight pregnant women meeting the research criteria were included in this study. Data were collected through a questionnaire that has been tested through validity and reliability tests. A binary logistic regression was employed to conduct a statistical analysis. Results showed that supports from family (OR 32.40, p-value < 0.01, 95% CI 4.55–230.64) and from health workers (OR 22.53, p-value < 0.001, 95% CI 3.96–128.19) were significantly associated with the respondent’s participation in prenatal classes after controlling the potential confounding factors such as knowledge, attitudes and information availability.
Keywords: maternal health, health promotion program, pregnancy, infant health
Relationship between Physical Environment and Smoking Behaviour with Accute Respiratory Infection in Class-I Correctional Institutions in Lowokwaru, Malang
Authors: Laily Trisnaningdyah Devia , . Supriyadi , Al-Irsyad Muhammad
Published: March 2021

Many prisoners experience Accute Respiratory Infection (ARI), and as many as 5,000 new cases are reported every year. This is generally caused by the prisoners’ inadequate physical environment and smoking behaviour. This observational analytical study was conducted using a cross-sectional design over a duration of two months, from December 2019 to January 2020. The independent variables in this study included occupancy density, ventilation, temperature, humidity, lighting and prisoners’ smoking behaviour on a nominal scale, while the dependent variable included the incidence of ARI with a nominal scale. A total of 96 prisoners who were positive for ARI and visited the Class-1 Prison Clinic of Lowokwaru, Malang were selected using the sampling estimation method. While a univariate analysis was used to explain the characteristics of each variable in the study, a bivariate analysis was done to determine the relationship between the independent and dependent variables using the contingency coefficient test. The results of the study indicated that there was a significant relationship between the occupancy density, ventilation, temperature, humidity and lighting, and the incidence of ARI, but no significant relationship was noted between the prisoners’ smoking behaviour and the incidence of ARI in Class-1 prisons of Lowokwaru, Malang.
Keywords: physical environment, smoking behaviour, ARI
Analysis of Human Resources Performance Evaluation Instrument at X Health Centre in Malang
Authors: Nur Putri Pratiwi Indah , Tristanti Puspitasari Sendhi , . Roesdiyanto
Published: March 2021

X Health Centre is one of the health centres located in the Sukun sub-district of Malang, with a working area covering four villages. As a healthcare facility, X Health Centre is expected to continuously improve the quality of its services and performance. However, over a period of three years, from 2016 to 2018, the performance and the level of community satisfaction of X Health Centre has downgraded. The overall performance of the health centre depends on the total value of its employee performance. The employee performance can be determined by evaluating individual performance using performance evaluation instruments. Thus, the purpose of this study was to analyse the instrument for evaluating the performance of the employees of X Health Centre in Malang. This qualitative descriptive study used a case study design and a cross-sectional approach. The samples in this study were selected through purposive sampling techniques. Based on the results of the study, it was observed that the instrument for evaluating the performance of the employees of X Health Centre does not meet the requirements stated in the Government Regulation of the Republic of Indonesia Number 30 of 2019 about the Performance Evaluation of Civil Servants.
Keywords: health centre, employee performance evaluation, employee performance evaluation instruments
Impact of Effective Communication on the Quality of Excellent Service and Patient Satisfaction in the Outpatient Department
Authors: Ratna Sari Dwi , Kartikasari Dhian , Herya Ulfah Nurnaningsih
Published: March 2021

Effective communication is crucial to support nurses in providing excellent service, including a caring attitude towards patients to help facilitate their needs and to realize patient satisfaction. The purpose of this literature review was to describe the impact of effective communication on the improvement of the quality of excellent service and patient satisfaction in outpatient departments. This review was conducted by searching published articles on Google with selected keywords including “effective communication,” “excellent service” and “patient satisfaction.” The search was limited to publications between 2009 and 2019. The result of the study showed that effective communication can significantly impact the improvement of excellent service quality, thereby increasing patient satisfaction with the health care they receive. The study recommends a collaboration between the HR and the Head of Nursing to conduct effective communication training. Nurses are expected to be able to improve their effective communication skills with patients, and further studies are needed to dig deeper into the impact of effective communication on improving the quality of excellent service and patient satisfaction.
Keywords: effective communication, excellent service patient satisfaction
Body Ignorance and Toughness Culture: Injury Issues among Elite Indonesian Athletes
Authors: Rahayuni Kurniati
Published: March 2021

Elite sport is a demanding career and injuries are common among elite athletes. However, empirical attempts to understand it in the Indonesian context through a sport psychology perspective has been rare. In this qualitative research about Indonesian elite athlete psychological demands, 37 elite athletes and 9 sport practitioners were interviewed through semi-structured interview and photographic elicitation interview (PEI) and data were analysed using a reflexive thematic analysis. The results showed that athletes realised that their elite athletic career is ephemeral and will come to retirement; during that short time, they moved along in a continuum of caring and exploiting their body. Two distinct sub-themes about injury built from the analysis were: (i) Exploiting the body versus caring the body, which reflects the dynamic stance of athletes in treating their body and its influential factors. (ii) The social environment around athletes that promotes ignorance versus support, which describes the cultural and social nuances of injury. Implications and invitations for future research through a multidisciplinary approach of health and sport sciences is also discussed.
Keywords: injury, elite athlete, Indonesia
Factors Related to the Quality of Life of Patients with Coronary Heart Disease at Saiful Anwar General Hospital, Malang
Authors: Imanuna Mazidah , Eko Wardani Hartati , Dwi Tama Tika
Published: March 2021

Most coronary heart disease (CHD) patients experience a decrease in quality of life that can worsen the prognosis. To the best of our knowledge, no previous study has identified the quality of life of CHD patients in Saiful Anwar General Hospital and its predictors. Hence, this study was conducted to determine the factors related to the quality of life of patients with CHD at Saiful Anwar General Hospital. A cross-sectional study was conducted by selecting 90 patients diagnosed with CHD in 2019 purposively. The instruments used in this study were the DASS-21, SF-36 and social support. Data were analysed using univariate and bivariate with binary logistic regression. The study found that the quality of life of patients with CHD has an average value of 63.29. As many as 88.9% of CHD patients were categorized as having a good quality of life. There was no relationship between the independent variables and the quality of life. Further research needs to be done on potential variables related to the risk factors of the CHD patients’ quality of life, which can subsequently be used as a guideline for optimizing and improving the patients’ quality of life.
Keywords: coronary heart disease, risk factors, quality of life
Occupational Accident Analysis in CV. Purnama Workshop Using HAZOP (Hazard and Operability) Method
Authors: Kuswanda Alfanny , . Solichin , Novita Deniati Ema
Published: March 2021

CV. Purnama’s workshop is a welding workshop with appropriate technology. The workshop covers an area of 600 m2 , with a total of seven workers. The workshop manufactures a cracker-making machine, a cutting machine, a dough mixer, etc. A preliminary study on the manufacturing process of the workshop conducted in 2014 reported a work accident in which the workers’ feet were exposed to iron. Also, in 2019, workers fell into a boiler-machine pulley, which hit the head of one of the workers. Thus, this study aims to determine the risks and hazards involved in the work process at the Purnama workshop. This study used a qualitative research method and collected data through observation in each machine-building process and interviews with all workshop employees and workshop owners. The results of this study highlighted that the process of making a chopping machine had six hazards, while that of a dough mixer had five. The levels of hazards in the processes of making a chopping machine and a dough mixer were “high” at 58% and 56%, respectively. It is concluded that since a higher level of danger was found in each machine-building process in the workshop, risk control is necessary to avoid work accidents or occupational diseases. The workshop owners and workers are recommended to apply K3 in the workplace.
Keywords: HAZOP, risk assessment, work accidents