bluuebunny/crossref_metadata_2025 huggingface dataset:
A structural model of Mapalus culture, health behavior and coronary artery disease incidence in the Minahasa ethnic community in North Sulawesi Province
Authors: Nelwan Jeini Ester , Sumampouw Oksfriani Jufri , Rumayar Adisti Aldegonda , Maramis Franckie , Pinontoan Odi Roni , Musa Ester , Ticoalu Jansje , Widjajanto Edi
Published: December 2022

Introduction: Coronary artery disease (CAD) is a disease that has caused death across the world, including in Indonesia. CAD is a multifactorial disease. Many studies have been conducted to examine the causes of CAD. Based on previous research, the risk factors questioned are fixed and nonfixed risk factors. Fixed risk factors include age, gender and family history. Nonfixed risk factors include smoking habits, blood cholesterol levels, behavioral types, socioeconomic status and cultural factors, among others. The purpose of this study is to find a structural model of the influence of Mapalus culture and health behavior on the incidence of CAD in the Minahasa ethnic group in North Sulawesi Province.
Method: This research is a case-control research type that uses 220 respondents (110 case and 110 control respondents). The variables studied were Mapalus culture (ethos and principles) and health behavior (smoking habits, knowledge of CAD, healthy behavior and sickness behavior) as independent variables and CAD incidence as the dependent variable. Data analysis used pathway analysis by employing GeSCA software.
Result: The results of this study indicate that Mapalus culture and health behavior influence the occurrence of CAD. The influence of Mapalus culture will be stronger/greater if it interacts with health behavior.
Conclusion: Based on the results of this study, control must be exercised on smoking habits, increasing knowledge about CAD and having a healthy lifestyle.
The effect of Epigallocatechin-3-Gallate (EGCG) combined with low dose sorafenib in apoptosis and Platelet-Derived Growth Factor Receptor (PDGFR) expression in hepatocellular carcinoma rats
Authors: Rosita Emilia , Prasetyo Sigit Adi , Riwanto Ignasius , Atmodjo Wahyuni Lukita
Published: December 2022

Background:  Sorafenib is a targeting therapy in Hepatocellular carcinoma (HCC) that targets Vascular Endothelial Growth Factor Receptors 1 (VEGFR-1), VEGFR-2, and VEGFR-3; Platelet-Derived Growth Factor Receptors β (PDGFR-β); c-Kit proto-oncogenes; FLT-3 genes; RET proto-oncogenes; and Raf-1 genes that have the same function in suppressing tumor cell proliferation, angiogenesis, and promotes tumor cell apoptosis;  but its high cost makes necessary to reduce the dosage by combining with other agents. Epigallocatechin-3-Gallate (EGCG) has great potential in cancer treatment because of its anti-angiogenesis, induced apoptosis, and low cost. This study aimed to examine the effects of combination EGCG with low dose sorafenib compared to standard dose sorafenib in apoptosis and PDGFR expression in HCC rats
 
Methods: Twenty-five male Wistar rats were randomly assigned into 4 groups: sham, control, EGCG+low dose sorafenib, and standard-dose sorafenib. Diethylnitrosamine (DEN) injection to induce HCC was carried out to all Wistar rats except for the sham group. After HCC was developed, the EGCG+low dose sorafenib group and standard-dose sorafenib group received the administration of the drugs for two weeks. PDGFR expression and apoptotic index were assessed in the last 3 groups. Data were analyzed using SPSS version 20 for Windows.
Results: There was a non-significant difference of mean PDGFR expression level between the EGCG+low dose sorafenib group and standard-dose sorafenib group (p>0.05); however, there was a lower significant difference of both groups compared to the control group (p<0.05). There was a non-significant difference of apoptotic index between low dose sorafenib+EGCG group and standard-dose sorafenib group (p>0.05); in addition, there were a higher not significantly different of both groups compared to the control group (p>0.05).
Conclusion: Combining low dose sorafenib with EGCG has a comparable effect with standard-dose sorafenib in reducing PDGFR of HCC, but not for apoptosis.
Analysis of Isocitrate Dehydrogenase (IDH) expression in astrocytoma patients: cases of South Sulawesi, Indonesia
Authors: Sabunga Olivia Desty , Kaelan Cahyono , Miskad Upik Anderiani , Zainuddin Andi Alfian , Sungowati Ni Ketut , Cangara Muhammad Husni
Published: December 2022

Background: Astrocytoma is the most common primary intracerebral tumor in adults and causes high morbidity and mortality. Most patients with astrocytomas, especially diffuse gliomas, have a poor prognosis. Recent genetic and epigenetic studies have shown that mutations in the Isocitrate Dehydrogenase (IDH) gene play an important role in the pathogenesis and prognosis of gliomas, thus facilitating IDH1 mutations in the population to become an important marker, not only to assist in the diagnosis and prognostic factors of these gliomas but also to develop therapeutic targets as currently available. This study aims to see differences in the expression of the IDH in each astrocytoma classification.
Methods: A cross-sectional analytic study was conducted at the Anatomical Pathology Laboratory, Faculty of Medicine, Universitas Hasanuddin, from October 2020 to August 2021. The research sample came from 65 paraffin block preparations for primary brain tumors with the diagnosis of Diffuse Astrocytoma (DA), Anaplastic Astrocytoma (AA) and Glioblastoma (GB). The immunohistochemical staining was performed using the monoclonal antibody IDH1-R132H. The microscopic assessment was carried out using a light microscope. Data were analyzed using SPSS version 20 for Windows.
Results: There was a significant relationship between the expression of IDH1-R132H in each astrocytoma classification (p=0.008). The prevalence of astrocytoma with negative IDH1-R132H expression (IDH-wildtype) is lower by 21 samples (32.3%) compared to astrocytoma with positive IDH1-R132H expression (IDH-mutant), which is 44 samples (67.7%).
Conclusion: There are significant differences in the expression of IDH1-R132H in Diffuse Astrocytoma, Anaplastic Astrocytoma and Glioblastoma, where the proportion of IDH-mutant status is higher than IDH-wildtype and IDH1 mutation status has a significant relationship with tumor grade.
Combination of diabetic Foot Spa and Sauna Bathing Therapy Decreases the Level of Blood Glucose
Authors: Ainiyah Nur , Wardani Erika Martining , Bistara Difran Nobel , Septianingrum Yurike , Fitriasari Andikawati , Firdaus
Published: December 2022

Introduction: There was evidence that diabatic foot spa has a crucial role in regulating blood glucose levels, but the combination of diabetic foot spa and sauna bathing have never been carried out to decrease blood glucose. The aim of this study was to analyze the combination of diabetic foot spa and sauna bathing therapy and its impact on blood glucose levels.
Methods: The data studied were blood glucose levels. This data can be obtained after administering a combination of diabetic foot spa and sauna bathing and afterward. Then this data was analyzed using an independent t test with p value of 0.000 (p <0.005).
Results: : This study showed that 60 respondents, mostly 58.3% were aged 45- 60 years, almost half of the respondents (48.3%) had suffered from DM for <1- 5 years, (70%) women, from the independent t test obtained blood glucose p value= 0.000 (p <0.05).
Conclusion: There was a decrease level of blood glucose after the patients receive the diabetic foot spa and sauna bathing therapy.
The effectiveness of mindfulness based stress reduction and sama vritti pranayama on reducing blood pressure, improving sleep quality and reducing stress levels in the elderly with hypertension
Authors: Noventi Iis , Sholihah Umdatus , Hasina Siti Nur , Wijayanti Lono
Published: December 2022

Introduction: Increasing age has the potential to cause hardening of the arteries. Hypertension is also related to sleep quality and stress levels. Hypertension can be controlled with non-pharmacological therapy using Mindfulness Based Stress Reduction (MBSR) and samavriti pranayama. Samavriti pranayama increases the oxygen supply to the brain, lungs and lowers the heart rate. The purpose of this study was to determine the effectiveness of MBSR and samavriti pranayama for lowering blood pressure, improving sleep quality, and reducing stress levels.
Methods: This study utilized a cross-sectional model. Elders analyzed with hypertension were surveyed for qualification. A add up to of 40 seniors were randomized into the mediation and control bunches. Both bunches gotten schedule care. Eight sessions of MBSR and samavritti pranayama were conducted within the intercession bunch, whereas the control gather gotten no mental intercession. Elders were surveyed with respect to diminished hypertension, uneasiness, and rest quality at two unmistakable stages: some time recently and after the mediation.
Results: There were no significant differences in sociodemographic and clinical parameters between the intercession and control bunches at standard. The mediation program essentially lightened mental and physiological complications in elderly with hypertension. Particularly, the consider uncovered that 8 weeks of the combined MBSR and samavritti pranayama mediation viably decreased lower hypertension and uneasiness scores and made strides the quality of rest in elderly.
Conclusion: The conclusion MBSR combined with samavritti pranayama significantly alleviated clinical symptoms, and could be considered a new, effective psychotherapeutic intervention for Elderly with Hypertension.
Early detection of elevated liver function test in drug-resistant tuberculosis with short term therapy and individual therapy
Authors: Abdul Azis Fahmi Dimas , Nurlaila Hamidah
Published: December 2022

Introduction: Tuberculosis (TB) treatment consists of more than one drug to achieve goal treatment. Hepatotoxicity is a form of side effect that causes the termination of TB treatment or regimen changes due to treatment failure, relapse, and drug resistance. Hepatotoxicity may increase the problem, covering more than 7% of all side effects. DILI is also one of the concerns in the treatment of TB. The objective of this study to assess the role of risk factor in the hepatotoxicity during drug-resistant TB treatment and investigate the time of onset hepatotoxicity during drug-resistant TB treatment.
Methods: The research method was retrospective study. Comprehensive demographic and clinical data, management, and outcome were recorded. Patients who were treated with drug-resistant treatment in Dr. Soetomo General Hospital between January 2018 and January 2020 were enrolled. The statistical method used SPSS ver 16.0. A total sample of 129 patients met the inclusion and exclusion criteria.
Results: Prevalence of hepatotoxic side effects was 54 cases. A total of 2 patients occurred hepatotoxicity in the first 2 weeks, and 52 patients developed hepatotoxicity in the late 2 weeks. There was one risk factor influencing the hepatotoxic side effects of drug-resistant Tuberculosis treatment. The history of alcohol consumption the only one risk factor (OR=3,182; 95% Cl=0,120-9,927.
Conclusion: Hepatotoxicity is a common problem among patients during Antituberculosis Treatment, especially on drug-resistant Tuberculosis in our population. Early detection not only reduces the risk of developing hepatic injury but also prevents mortality.
Diagnostic problems and management of pituitary gigantism leading to ischemic stroke and atrial myxoma in young adult patient: a case report
Authors: Nabilah  , Wibisono Sony , Libriansyah  , Wahyuhadi Joni , Arifianto Muhammad Reza
Published: December 2022

Background: Gigantism is the excessive secretion of growth hormones (GH) during childhood and is mostly caused by benign pituitary adenomas. The signs and symptoms are not specific in early childhood due to growth spurt. An ischemic stroke is rarely present in pituitary adenoma, and here we present a case of ischemic stroke and atrial myxoma associated with pituitary gigantism.
Case Presentation: The patient was an 18-year-old male who complained of continuous growth. In June 2016, the patient suffered from an embolic stroke, and in January 2017 he complained of fatigue and shortness of breath. The echocardiography showed a mass in the left atrium that was removed in March 2017 through open-heart surgery; the pathological histology confirmed a myxoma. The brain magnetic resonance imaging (MRI) showed a pituitary macroadenoma, and the growth hormone (GH) level was 20.6 ng/mL. In October 2019, the patient was referred to Dr. Soetomo Hospital. The height increased from 185 cm in 2017 to 205 cm in 2019. The height was 205cm, weight 85kg, body mass index 20.2 kg/m2, GH level >40 ng/mL, cortisol 11.24 ug/dL, prolactin 1.21 ng/mL, testosterone 425.6 ng/dL, free thyroxine (FT4) 1.03 ng/dL, and insulin-like growth factor 1 (IGF-1) 688 ng/mL. The patient was administered oral cabergoline 0.25 mg twice a week and had endoscopic endonasal transsphenoidal hypophysectomy (EETH). The patient developed postoperative polyuria after surgery which indicated diabetes insipidus, and the patient was administered desmopressin 0.05mg/12 h with fluid restriction. One week later, the morning cortisol level was low, and hydrocortisone therapy was administered and was tap-off. One month-post surgery, the level of morning serum cortisol was 0.86 µg/dL.
Conclusion: This case is extremely rare and we demonstrated that the EETH surgery the stability of GH could be achieved.
Soil worms (Lumbricus rubellus) as feed additives for piglets' growth, blood profile and immunomodulators
Authors: Dharmayudha Anak Agung Gde Oka , Ardana Ida Bagus Komang , Budiasa Ketut , Merdana I Made , Gunawan I Wayan Nico Fajar
Published: December 2022

Background: Before the weaning phase, piglets often experience diarrhea and anemia caused by infection with germs such that after weaning, their growth rate reduces, they become pale and also prone to other illnesses which may lead to death. This study aims to determine the effect of earthworm flour (TCT) on growth, morbidity, mortality, blood profile, and antibody titer as an immunomodulator.
Method: Ninety piglets were used before weaning which was divided into four groups, each consisting of 18 members, namely the group that was not given TCT as a control (P0), the one that was given TCT from the age of 20 to 50 (for 30 days total) days with a concentration of 1% in the feed (P1), the concentration of 1.5% (P2), the concentration of 2% (3) and concentration of 2.5% (4 ). At 14 days old, Hog Cholera vaccination was administered by intramuscular injection, and it was repeated at the age of 28 days. Bodyweight was weighed at the beginning of the study, which was at 21 days old, then repeated at 28, 35, 42, 49 and 60 days after treatment to determine performance. Morbidity and mortality were observed from 21 to 60 days old. At 50 days, blood was collected and stored in a vacuum tube containing an anticoagulant (EDTA) for profile examination. The Hog Cholera antibody titer assessment was performed using the ELISA method.
Result: The TCT concentration of 1.5% in piglet feed significantly increased body weight, decreased morbidity, prevented morbidity, elevated WBC, RBC, Hb, PCV, and neutrophils, reduced eosinophils and lymphocytes but still within a normal range. Therefore, it is judged that the preparation of 1.5% is effective and safe, and the % CP value of hog cholera is positive with a rate of 72.9%, which is significantly higher than the control (66.64%).
Conclusion: Earthworm flour with a concentration of 1.5% in feed is harmless, potent in increasing body weight and is indicated as an immunomodulator.
Profuse haematochezia related to Crohn’s disease: a rare case report
Authors: Paramita Dilly Niza , Widodo Budi , Heriyawati Heriyawati
Published: December 2022

Background: Lower gastrointestinal bleeding (LGIB) can be caused by irritable bowel disease. Haematochezia is one of the LGIB symptoms. Profuse haematochezia is a rare complication in Crohn’s disease.
Case Presentation: We reported a 24-year-old patient with profuse haematochezia with severe anaemia and hypovolemic shock. Anamnesis, physical examination and colonoscopy showed that haematochezia was caused by Crohn’s disease. Colonoscopy was done after the patient was hemodynamically stable with findings of external haemorrhoid and multiple ulcers with varying size (0.5–2 cm) on ascending colon, caecum and terminal ileum. The tissue histopathology of ileocecal junction indicated intestinal epithelia with partially eroded, crypts infiltrated by inflammatory cells, swollen lamina propria with proliferation and dilation of blood vessels indicting the Crohn’s disease. The patient then treated with Crohn’s disease medical therapy including low dose oral steroid, sulfasalazine and antibiotics. Clinical improvement was found on one week follow-up after discharge from hospital.
Conclusion: Profuse haematochezia could be associated with Crohn’s disease and the comprehensive approaches should be taken to manage the Crohn’s disease with such presentation.
Fatality in a pregnant woman with COVID-19 after a cesarean section: A case report
Authors: Parwanto Edy , Digambiro Reza Aditya , Astato Erdiyan , Guyansyah Assangga
Published: December 2022

Background: SARS-CoV-2 can infect anyone, including pregnant women. Pregnant women with COVID-19 experienced fetal hypoxia and reduced amniotic fluid; therefore, a cesarean section was performed. This study aimed to report a case of fatality in pregnant women's G3P1A1 status with COVID-19 after a cesarean section.
Case Report: The patient was a 33-year-old female 36-37 weeks pregnant with G3P1A1 status and infected with SARS-CoV-2. A cesarean section is performed to save the mother and fetus in cases of pregnancy complications. Due to fetal hypoxia and reduced amniotic fluid, a cesarean section was performed, thereby changing the patient status from G3P1A1 to P2A1. The baby survived, healthy and normal after the cesarean section, while the mother underwent COVID-19 treatment. However, the patient still experienced shortness of breath and acute respiratory distress syndrome. Unfortunately, she experienced more symptoms, including hematuria, respiratory failure, acute respiratory distress syndrome, and cardiac arrest on cardiopulmonary resuscitation, before her eventual death.
Conclusion: The pregnant mother G3P1A1, successfully underwent a cesarean section, and the baby is healthy and normal. The pregnant woman's condition worsened during treatment for COVID-19, and she died.
Mitomycin C, curcumin, and fibrin glue inhibit the cell proliferation and expression of TGF-β in human pterygium fibroblast
Authors: Abdurrauf Muhammad , Ramadhan Ferdian , Nurwasis  , Zuhria Ismi , Tambunan Betty Agustina , Notobroto Hari Basuki , Surahman Budi , Komaratih Evelyn
Published: December 2022

Introduction: High recurrence of a fibrotic disease, pterygium, following the surgical procedure is perceived as the primary challenge of its management. As the standard procedure, adjuvant therapy of using mitomycin C could dramatically reduce the recurrence of pterygium but could cause multiple serious complications. Our study aimed to investigate curcumin and fibrin glue as alternative candidates for adjuvant therapy in pterygium surgery.
Methods: Human pterygium fibroblast (HPF) was isolated from the patient and cultured in-vitro. The HPF culture was then exposed with mitomycin C (0.4 mg/mL), curcumin (200 μmol/L), and fibrin glue, respectively, for 48 hours. The outcomes were determined by the proliferation of HPF and the expression of transforming growth factor-beta (TGF-β) which were obtained from 2,5-diphenyl-2H-tetrazolium bromide assay and immunofluorescence staining analysis with TGF-β antibody.
Results: The experiment revealed that mitomycin C, curcumin, and fibrin glue could significantly inhibit the proliferation of HPF (p<0.05) suggesting their antifibrotic effect. Further analysis with immunofluorescence staining showed that mitomycin C, curcumin, and fibrin glue could significantly reduce the level of TGF-β as compared with control group (p<0.05).
Conclusion: Mitomycin C was the most potent adjuvant agent to reduce the recurrence of pterygium, followed by curcumin and fibrin glue. Taken altogether, curcumin and fibrin glue have role as adjuvant therapy to prevent recurrence in pterygium surgery.
Evaluating Low Values of Early Diastolic Velocity (e’) as a Predictor of Major Cardiovascular Events in Patients with Acute Myocardial Infarction
Authors: Vianney Tedjamulia  , Ida Bagus Rangga Wibhuti  , Ida Sri Iswari  , Ketut Badjra Nadha
Published: December 2022

Background: Effective risk stratification is an integral part of acute myocardial infarction (AMI) management. Meanwhile, the stratification system should be performed by using easy instruments or methods, where appropriate management, intervention timing, and prognosis can be determined. A previous study established acute ischemia implicate the diastolic function of the left ventricle. In this situation, echocardiography is an easy-to-use and effective diagnostic tool. Therefore, this study evaluates left ventricular diastolic function using the tissue Doppler imaging (TDI) method to analyze the reduction of early diastolic velocity (e’) as a predictor for numerous cardiovascular events in patients with AMI.
Method: The study design was an observational study with a prospective cohort design. The data for the septal and lateral Early Diastolic Velocities (e’) was acquired using the transthoracic echocardiography procedure on AMI patients. The Hazard Ratio (HR) and survival curve from prognostic factors of major adverse cardiovascular events were also produced.
Results: There were 66 patients diagnosed with AMI. The median was 6.625cm/s, and the cut-off point was to determine the decreasing or abnormal mean e’. Subsequently, this value at RR 2.8 was shown by the multivariate analysis via Cox regression as an independent factor of major adverse cardiovascular events.
Conclusion: Decreased means e’ has been proven as an independent predictor of major adverse cardiovascular events in hospitalized patients with AMI.
Clinical improvement of patients with moderate-to-severe psoriasis treated with methotrexate at Dr. Soetomo General Hospital, Surabaya, Indonesia
Authors: Made Putri Hendaria  , Afif Nurul Hidayati  , Evy Ervianti  , Muhammad Yulianto Listiawan  , Damayanti  , Irmadita Citrashanty  , Sylvia Anggraeni  , Menul Ayu Umborowati  , Budi Utomo  , Cita Rosita Sigit Prakoeswa
Published: December 2022

Background: Psoriasis is a complex, chronic disease with increasing global incidence. Studies on the effectiveness of psoriasis therapy in Indonesia are limited. This study aimed to evaluate the patient’s clinical improvement with moderate-to-severe psoriasis vulgaris using the Psoriasis Area and Severity Index with ≥75% score reduction (PASI75).

Methods: This is a retrospective study involving patients diagnosed with psoriasis vulgaris who visited the Dermatology and Venereology Outpatient Clinic in Dr. Soetomo General Hospital between January 2016 and December 2018. The electronic medical record obtained data on demographic characteristics, the number of visits, psoriasis at initial (PASI) score before and after treatment, type and dose of treatment, and comorbidities. Data were analyzed using SPSS version 23 for Windows.

Results: Overall, 54 patients with psoriasis vulgaris were included. Almost all subjects were adults (≥18 years old) and presented with severe PASI (PASI score > 10) (96.3%). The majority of the subjects (64.8%) successfully achieved PASI75. Most subjects received methotrexate (72.2%); the most frequent dosage was 15 mg/week (61.5%). A significant association was found between methotrexate treatment and a larger improvement in PASI scores (p=0.001).

Conclusion: moderate-to-severe psoriasis therapy in terms of PASI75 achieved a satisfactory success rate of 64.8%, and the improvement of PASI score was significantly better in patients who received methotrexate. Further studies in Indonesia are needed to explore the effectiveness of psoriasis therapy and its factors.
Faculty members’ readiness for interprofessional education
Authors: Eka Ni Gusti Ayu , Manik Marisa Junianti , Houghty Grace Solely , Puspitasari Vivien , Marlina Mona , Suryadinata Neneng
Published: December 2022

Introduction: Healthcare is a complex system that requires collaboration across health professions. However, a plethora of reports has identified poor communication and collaboration within healthcare teams which could lead to patient safety issues. Interprofessional education (IPE) is an educational strategy to promote communication and collaboration between healthcare professionals. Despite knowing the readiness among students, opinions among faculty members regarding the need for IPE at UPH (Universitas Pelita Harapan) have yet to be examined despite the important roles of both students and faculties in developing an IPE curriculum. This study aimed to investigate the readiness among medical and nursing faculty members in establishing an IPE curriculum at UPH.
Methods: This study applied a quantitative study design using the Readiness for Interprofessional Learning Scale (RIPLS) by Parsell and Bligh (1999) which was translated to Indonesian and tested for its validity and reliability. The translated RIPLS questionnaire was administered to a total of 60 participants which consisted of 30 nursing and 30 medical faculty members. Subsequently, both descriptive and Mann-Whitney statistical analyses were conducted.
Results: Findings revealed a statistically significant difference between the IPE scores (RIPLS) of nursing faculties and medical faculties  (U = 652, z = 3.028; p = 0.012, r = 0.390). This demonstrates that the nursing faculty members (Median 4.30) indicated a higher level of readiness or more positive attitude towards IPE compared to the medical faculty members (Median 4.07).
Conclusions: This study highlights that faculty members have a positive attitude or readiness toward IPE, with nursing faculties indicating higher levels of readiness than their counterparts in the medical faculty. Further exploration using a qualitative method is also important to understand the faculty members’ readiness for IPE as well as the commitments of faculty members and leadership on delivering IPE.
Incident analysis of patient safety in hospital: Based on feedback and supervision concept
Authors: Adriansyah Agus Aan , Setianto Budhi , Sa'adah Nikmatus , Lestari Indah , Arindis Pinky Ayu Marsela , Kurniawan Wahyu Eka
Published: December 2022

Introduction: The concept of feedback and supervision is at the core of efforts to reduce hospital patient safety incidents. This study aimed to analyze the effect of feedback and supervision on the occurrence of patient safety incidents in hospitals.
Methods: The population included 18 work units that provide services to patients with samples of the unit head or room head, the person in charge of work shifts and the person in charge of patient safety quality. Data in the form of respondents' perceptions were collected through a questionnaire using Google form and analyzed using cross-tabulation and the Pareto approach with a note that it is influential if a difference of >20% is found between the independent and the dependent variable.
Results: The results showed that most of the feedback in the work unit was lacking (50.0%), and supervision in the work unit was good (55.6%). The number of patient safety incidents at the Surabaya Islamic Hospital was dominated by near-injury incidents (NII) with a green rating. The outpatient unit is the unit with the highest incidence. Feedback and supervision affect the number of patient safety incidents because they have a difference of 22.2% and 52.5%, respectively. This study has shown that hospital patient safety incidents are influenced by feedback and supervision.
Conclusion: This study showed that feedback and supervision influence the incidence of patient safety incidents in hospitals. Therefore, there is a need for training on supervision at the head of the room, providing socialization and education about the importance of patient safety, and increasing the commitment of decision-makers and related stakeholders.
The village fund utilization and its implication for public health improvement in the pandemic era
Authors: Handayani Dwi , Firdausi Nurul Jannatul
Published: December 2022

Introduction: The allocation of village funds to the health sector focused on reducing nutritional problems and involving the village in controlling non-natural disasters caused by COVID-19. The study aimed to analyze the implication of the village fund toward public health performance in the pandemic era.
Methods: Ecological analysis was conducted using secondary data from the East Java Health Profile 2020. The sample was 29 districts of East Java, where all the villages receive village funds. Apart from village fund utilization as the dependent variable, the independent variable consists of nutritional status, active Posyandu, case of COVID-19 and recovery rate of COVID-19. Data were analyzed by univariate and bivariate. The bivariate analysis was performed using the chi-squared test.
Results: Undernourished and wasting were silent health burdens in the pandemic. The pandemic also made the active Posyandu is lower. High attention to Kediri dan Jombang was grouped to vulnerable health areas. Statistically, no correlation between the village fund utilization with public health improvement in the pandemic era
Conclusion: Although there is no statistical correlation, nutrition issues and the impact of using village funds on health must be a concern. An in-depth evaluation needs to be carried out on the use of village funds to get clear implications for public health
Level of student education and knowledge about sinovac vaccine with immunization participation
Authors: Wardani Erika Martining , Riezky Faisal Nugroho  , Bistara Difran Nobel , Fitriasari Andikawati , Wijayanti Lono , Ainiyah Nur , Septianingrum Yurike
Published: December 2022

Introduction: Due to reports of thousands of deaths and cases of illness rising daily, the Covid-19 outbreak has been deemed a worldwide health emergency. Giving vaccinations is one preventive method to stop its spread. Analysis of the association between students' educational attainment and their knowledge of the Sinovac vaccination and their involvement in the Sinovac immunization program was the study's main goal.
Methods: This study uses a cross-sectional methodology to analyze Rank Spearmen. 5400 students made up the study's sample, which was selected using a simple random sampling method. By sending out questionnaires via a Google form, data was collected.
Result: The majority of respondents with undergraduate education are 61.5%. According to the study's findings, the degree of education and immunization rates were significantly correlate, with p value = 0.000 (p-value < 0.05), and knowledge and immunization participation were significantly correlated, with p-value = 0.001 (p-value < 0.05).
Conclusion: The higher the education, the better the way of receiving information so that more information is obtained. Students can get knowledge through social media by exchanging experiences with individuals who have received vaccinations.
Nurses' perception of their readiness using technology information to face Omicron according to the technology acceptance model
Authors: Tukayo Isak Jurun Hans , Sirait Paul , Hardy Syaifoel
Published: December 2022

Background: The emergence of a new variant of Omicron in 132 countries at the beginning of 2022 leaves concerns for nurses. The experience of nurses handling the COVID-19 pandemic makes a question mark on how prepared the profession is to deal with the spreading of the virus. This article attempts to analyze the perceptions of nurses' readiness to use information technology (IT) when facing the new Omicron variant.
Methods: The study used a quantitative approach with a descriptive cross-sectional design supported by the Technology Acceptance Model. This study used a questionnaire to assess respondents' perceptions. A total of 180 eligible respondents were involved in the study. Technology Acceptance Model (TAM) was used to measure the respondents' perception, and SPSS version 26 was used for analytical data.
Results: The results showed that 96% of nurses were vaccinated, 45% never attended COVID-19 training (External Variables), 45.6% ready with information technology facilities (Perceived Ease to Use), 47.2% were mentally/psychologically prepared, 47.2% supported by family, and 37.8% they had public support (Perceived Usefulness). Those 3 components shaped different perceptions (Attitudes) towards using the IT in which 44.4% were ready, 27.2% were in the process, 25.3% were not prepared and 3.1% had no idea (3.1%). As a result (Behavior), out of 180 population, 63.6% of participants were categorized as not ready.
Conclusion: The findings recommend that nurses using IT in dealing with Omicron 100% must be vaccinated and participate in COVID-19 training.
Stress associated with hypertension in middle-age and elderly in Binong, Tangerang
Authors: Pakpahan Martina , Eka Ni Gusti Ayu , Florensa Maria Veronika Ayu
Published: December 2022

Introduction: It is widely recognized that stress cannot be eliminated from one's life and that stress may be associated with the prevalence of hypertension, for which the role of stress as a risk factor is being debated in terms of its correlation with hypertension incidence. This study examined the correlation between the stress of the middle-aged and elderly with hypertension.
Methods: This study applied a cross-sectional study using purposive sampling to recruit the respondents in Binong Tangerang, Indonesia. A modified questionnaire was used to collect the demographic data, stress, and smoking behavior. Blood pressure examinations were also conducted to identify the level of hypertension.
Results: A total of 145 respondents consisted of 79 (54.5%) middle age and 66 (45.5%) elderly were examined. Most of the respondents (82.8%) were female, and half of them were Sundanese (50.3%). Half of the respondents were categorized as pre-hypertension (42.8- 53.1%), where most of the respondents had non-smoking behavior (82%), and half of them were at the level of severe stress (57.2%). There was a significant correlation between respondents’ stress levels and hypertension (p-value < 0.05). 
Conclusion: Stress is related to hypertension in middle age and elderly in the Binong community. Therefore, stress management training is needed to promote the quality of life for middle age and elderly with hypertension at Posbindu in the Binong community.
Nurse students’ satisfaction towards blended learning program
Authors: Sukadarma I Gusti Ngurah Ketut , Suastra I Wayan , Pujawan I Gusti Ngurah , Nitiasih Putu Kerti , Permana I Gede Yoga
Published: December 2022

Purpose: The implementation of online learning during Covid-19 presents challenges especially for nursing education. Nurse students during online learning did not receive enough opportunities to learn clinical skill.  Blended learning becomes an alternative in nursing education during Covid-19 pandemic because it offers both face-to-face and online learning.
Participants and methods: The participants of the current study were nurse students in nursing education university in Bali. 105 nurse students were invited to join blended learning program. After blended learning program, they were asked to fill an online questionnaire. 10 students were also invited to join interview.
Results: The results confirmed that students are satisfied with the interaction (M=3.77, SD=.783), instruction (M=4.04, SD=.794), instructor (M=3.88, SD=.685), and course management (M=4.06, SD=.657) of blended learning implementation. However, in terms of technology the students are neither satisfied nor dissatisfied (M=3.41, SD=.800) with blended learning program.
Conclusion: This study concluded that blended learning could be used as an alternative teaching and learning approach for nursing education especially in Covid-19 pandemic era.
Nursing care and the psychology effects on post-care nurses serving COVID-19 patients in Vera Cruz isolation room, Dili, Timor-Leste
Authors: Soares Domingos , Nursalam  , Carvalho Joaquim Gregorio de , Oqui Maximiano , Barros Ivonia , Silva Valente da
Published: December 2022

Introduction: Coronavirus 2 (SARS-CoV-2) is a syndrome of acute respiration that is serious like corona acid ribonucleic detected, made separation and identification in pneumonia sick patients in Wuhan, China in December 2019 (WHO, 2020). Timor-Leste on May 1, 2020, 24 cumulative cases was confirmed, 16 cases recovered, 12 cases are still being treated, and 12 patients experienced psychological pressure from patients and health professional. This study aimed to determine the knowledge of nurses; nursing service and the psychological influence of nurses after providing care for Covid-19 patients.
Method: Qualitative research with a phenomenological approach has been used in this study, ten nurses who have worked serving Covid-19 patients participated in this study, and data was collected using interview guidelines, voice recorder, deep-interview, data analysis techniques by organizing data, grouping, categorical data, topic and answer formulation, data assessment and writing the results.
Result: The majority of nurses understand and apply Covid-19 prevention, but some are confused the cause. Have not carried out nursing care according to the standards of the International Counsel of Nursing (ICN) and the Timor-Leste Nursing Association, as (assessment, diagnosis, intervention, implementation, and nursing evaluation), reasoned: new job, no format, less manpower, no orientation from senior, emergency time. The majority experienced psychological effects after providing care to the Covid-19 patient.   
Conclusion: This study concluded that nurses understand Covid-19, the nursing care implementation is not yet based on ICN and ETNA standards and after returning home the nurses experienced psychological effects.
Pregnancy care and the relationship between psychological factors and selfcare for pregnant women during the COVID-19 pandemic
Authors: Anggasari Yasi , Laili Uliyatul , Masruroh Nur
Published: December 2022

Introduction: Research on the efforts made to prevent the transmission of COVID-19 in pregnant women with online antenatal care and the telehealth method as well as visits to obstetric polyclinics with improved service strategies have been carried out. However, the strategy of midwifery care by paying attention to the anxiety experienced by pregnant women in carrying out self-care during pregnancy during a pandemic and combined with policies from health workers has not been studied. The strategy applied in a pandemic situation must take into account the socio-demographic conditions of the community. Therefore, the purpose of this study was to explore the factors that influence maternity care and find interventions and strategies to develop prenatal care guidelines. This research has the potential to be applied to the socio-demographic conditions of the middle class.
Methods: The data used in this study were psychological and self-care data for pregnant women during the COVID-19 pandemic, involving 65 respondents at the Endang Widayat Maternity Hospital Sidoarjo from April to June 2021. This study is a mixed method study so the data collection process includes quantitative data. and qualitative data. Quantitative data were collected through questionnaires given to pregnant women, while qualitative data was conducted by conducting in-depth interviews with health workers who carried out pregnancy check-ups.
Results: This study showed that more than half (61.5%) of respondents had moderate self-efficacy and low psychological factors or anxiety. In addition, the bivariate analysis showed that age, education, occupation, parity status, and psychological factors have a significant association with self-efficacy with p-value respectively 0.01, 0.00, 0.03, 0.01, and 0.00. 
Conclusion: The study was conducted to explore the factors that influence pregnancy care and that self-efficacy is related to age, education, occupation, and parity. Self-efficacy also affects the psychological factors of mothers during the Covid 19 pandemic. Pregnancy care during the Covid 19 pandemic is focused on increasing the mother's ability in daily self-care to minimize the spread of Covid 19 to pregnant women.
How face mask usage duration and type affect tear break-up time (TBUT): A survey of health professionals at Sanglah Hospital Denpasar
Authors: William Andy , Sutyawan Wayan Eka , Juliari I Gusti Ayu Made , Widiana I Gde Raka , Rahayu Ni Kompyang , Kusumadjaja I Made Agus
Published: December 2022

Background: As society adapts to the new normal during the Corona Virus Disease 2019 (COVID-19) pandemic, face masks have become one of the health protocols required in the community, especially among health professionals. Wearing a mask regularly for an extended period may lead to dry eye symptoms, which cause discomfort and affect the quality of life. This study aimed to determine the association between the face mask usage duration and type with tear break-up time (TBUT) reduction among health professionals at Sanglah Hospital Denpasar.
Methods: This cross-sectional analytic study was conducted from December 2021 to January 2022. A simple cluster random sampling method was used to obtain 107 health professionals who wore face masks, aged 21-55 years old, and were qualified for both the inclusion and exclusion criteria. The data were collected using a questionnaire and a TBUT test. A chi-square test and multiple logistic regression analysis were performed to determine the association. The p<0.05 was significant.
Results: TBUT reduction was experienced by 30 subjects (29%) after wearing face masks, with an average of about 6±4 seconds. The duration of mask usage ≥6.5 hours per day significantly increased the risk of TBUT reduction by 2.708 times higher than the duration <6.5 hours per day (AOR 2.708; 95% CI 1.099-6.673; p=0.027).  Using a non-N95 mask increased the risk of TBUT reduction by 4.545 times higher than the N95 mask (AOR 4.545, 95%CI 0.556-37.135; p=0.125).
Conclusion: There was an association between face mask usage duration and type with TBUT reduction.
Nutraceuticals of nano-betel (Piper betle L.) leaves: prevent COVID-19 and oral cavity disease
Authors: I Gusti Ayu Ari Agung  , Sri Wahjuni  , Dewa Made Wedagama  , I Wayan Weta  , Anak Agung Wiradewi Lestari
Published: December 2022

Introduction:  Betel leaf is very popular in Asia and known to have a function as traditional medicine. And is often referred to as the "Golden Heart of Nature". This is because the betel leaf has an effect such as antimicrobial, antiviral, radioprotective, antioxidant, antiseptic, bactericidal, anti-inflammatory, antiallergic, wound healing, antiplatelet, antibacterial, antifungal, and immunomodulatory activity. Nutraceutical nano-betel leaf extract contains rich in minerals, vitamins, antioxidants, phenolic compounds, and essential oils. Effectively protects the mouth from pathogens. This research aims to review the nutraceuticals of nano-betel leaf extract to prevent COVID-19 and oral cavity disease.
Methods:  This systematic review study was conducted through six steps: (1) framing the questions (based on theory); (2) Run a search (on Scopus, Google Scholar, EBSCO, ProQuest, and Science Direct publishing articles from 2020 to 2022); (3) Determine the relevant research; (4)  Determine the articles come from diverse backgrounds; (5) Extraction of data from individual studies; (6) Synthesis of results using the narrative method.
Results:  Betel leaf contains nutrients for oral health, immunomodulators, and COVID-19, namely protein, amino acids, vitamins A, B, C, and K, as well as minerals such as Mg, K, Ca, Fe, I, P, Zn, essential oil (eugenol, hydroxylchavicol, allylpyrocatechol, quercetin, etc). Betel leaf nano extract has a significant role as antioxidants, anti-inflammatory, antimicrobial, and antivirus, which act as anti-oral cavity disease and anti-COVID-19. Betel leaf nano extract has a significant role in curing various oral cavity diseases related to COVID-19, including fungal infections, toothache, conjunctivitis, re-current HSV, oral ulcerations, xerostomia or decreased salivary flow, and gingivitis.
Conclusion:  Betel leaf nano extract has a significant role in curing oral cavity disease and COVID-19. It is recommended that research into the oral disease and COVID-19 drugs combined with viable ingredients substances from betel leaf.
Early external neurolysis surgery reduces the pain and improves the functional outcomes and quality of life among traumatic brachial plexus injury patients
Authors: Farhadi Azmi , Arfianti Lydia , Suroto Heri
Published: December 2022

Introduction: Traumatic brachial plexus injury (TBPI) is a debilitating and devastating injury that significantly impacts individuals’ quality of life. This study aimed to evaluate the functional outcomes, pain improvement and quality of life after external neurolysis surgery in TBPI patients.
Methods: A retrospective study was conducted at Dr Soetomo Hospital in Surabaya, Indonesia. Data of TBPI patients who were operated with external neurolysis surgery from 2003 to 2020 were collected. The functional outcome was measured using disabilities of the arm, shoulder, and hand (DASH) score, the pain assessment with pain visual analog score (VAS) and the quality of life with 36-item short-form (SF-36). The outcomes were also compared between those who had the surgery less or more than 6 months after the injury.
Results: A total of 493 TBPI patients were diagnosed between 2003 to 2020. Out of total, 37 patients had external neurolysis surgery, mean age of 31±12.5 years, were included in the analysis. External neurolysis surgery in TBPI patients improved all DASH, VAS and SF-36 scores and these improvements were likely influenced by sex, age, occupation, affected side and the level of the injury. In addition, our data also suggested that the patients who had external neurolysis surgery before 6 months had better outcomes than those after 6 months after the injury in term of DASH, VAS and SF-36 scores.
Conclusion: In TBPI cases, earlier external neurolysis surgery could result in better pain reduction, functional outcome and quality of life outcomes.