bluuebunny/crossref_metadata_2025 huggingface dataset:
LBW incidence based on socio-economic, Hb level and compliance of pregnant women taking Fe supplements
Authors: Amareta Dahlia Indah , Palestin Cindy Nur , Lestari Alinea Dwi
Published: December 2022

Introduction: Lob birth weight (LBW) is a condition of fetal growth failure characterized by birth weight of fewer than 2,500 grams. LBW is influenced by several factors, including socio-economic, perinatal nutrition, infectious diseases, maternal hemoglobin levels, and pregnant women's compliance with taking iron tablets. This study aimed to examine the association between each risk factor toward the incidence of LBW.
Methods: This study with a case-control design used a retrospective approach. From a population of 450 mothers with 0-10 months old babies, 35 LBW incidences were found, and 35 normal-weight babies were selected randomly. Questionnaires were used to identify pregnant women's socio-economic status and compliance with consuming Fe supplements. At the same time, the data for Hb levels and identification of LBW incidences were taken from the MCH (maternal child health) handbook. Statistical analysis used SPSS 16 with Somers'd correlation test.
Results: The results showed that the correlation between education (p<0.001), socio-economic (income) (p=0.002), Hb level (p<0.001), and the compliance of pregnant women taking Fe supplements (p<0.001) were correlated with the incidence of LBW. It is necessary to optimize the consumption of iron tablets through assistance during pregnancy.
Conclusion: Based on the results of the study that has been conducted, it can be concluded that there is a correlation between socio-economic (education and income), Hb levels, and compliance of pregnant women taking Fe supplements with the incidence of LBW.
Psychological and coping strategies of the red zone community: a cross-sectional study of COVID-19 pandemic in rural area in Indonesia
Authors: Laili Nurul , Mariani Mariani , Suhartini Titik , Handayani Erna
Published: December 2022

Introduction: People who live in red zone communities are at high risk of COVID-19 transmission. This condition can elicit various societal reactions, both physically and psychologically. This psychological response will urge them to search for alternative solutions. The fundamental purpose of this study was to determine the psychological state and coping mechanism, especially for people living in the rural red zone.
Methods: A cross-sectional study was conducted on 12.423 persons living in a rural area of East Java province. According to Krejcie and Morgan's table, the sample size was 372 participants. The questionnaires were circulated through social media applications and a Google form. Two experts examined the validity of the content. In early June 2021, data collection began. The data were analyzed using descriptive statistics, Pearson correlation, and Kruskal-Wallis tests.
Results: The population suffers from three categories of ailments, the most common of which are anxiety and stress. The community employs both emotion-focused and problem-focused coping mechanisms. Seeking emotional and instrumental social support, turning to religion, acceptance, mental and behavioral divergence, active coping activities, focusing and releasing emotions, denial, and bodily symptoms are examples of coping mechanisms. The findings also show a significant relationship between several demographic variables, precisely age and coping strategies. People who live in the rural red zone have varied psychological reactions, such as anxiety and stress. The community's coping mechanisms tend to revolve around releasing emotions and denial.
Conclusions: The increasing prevalence of COVID-19 contributes to the onset of psychological health problems in some people living in the red zone. When psychological health difficulties occur, they urge an individual to develop coping mechanisms for coping with the current condition.
Application of failure mode effect analysis on hazard identification and risk control
Authors: Ratriwardhani Ratna Ayu , Sunaryo Merry , Hutapea Octavianus , Rhomadhoni Muslikha Nourma
Published: December 2022

Introduction: PT. X is a chemical industry with high hazards, especially those related to hazardous and toxic materials; the company also uses equipment and machines with fire or explosion hazards. Component's failure to operate is a major problem in PT. X. The specific objective of this study was to evaluate hazards and control the risks to prevent accidents and protect company assets, especially for employee safety.
Methods: The data collected is Process Flow Diagram (PFD), Material Safety Data Sheet (MSDS), and component failure data. The risk assessment for the components of Sodium Silicate Production is carried out by multiplying the occurrence measurement scale and severity measurement scale. The risk value for the unacceptable risk category is between 12 and 25, where the risk must be controlled first.
Results: This study found that the highest risk value is dissolver tank leaks, the production pump not working, and the ball valve stuck. An example of structural mitigation in the dissolver tank is to carry out routine maintenance once a month to know the material's condition and to immediately make repairs if there are signs of tank damage to prevent leakage in the tank.
Conclusions: This research proves that some hazards have not been evaluated and controlled, so there are still some failures in the production process of Sodium Silicate.
Vesico-Peritoneal Fistula As A Rare Cause Of Peritonitis In Guillain-Barre Syndrome: A Case Report
Authors: Nugroho Eriawan Agung , Waridiarto Dimas Susilo , Daniswara Nanda , Addin Sofyan Rais , Wibisono Dimas Sindhu , Santosa Ardy
Published: December 2022

Introduction: Guillain-Barre syndrome is the most common and most severe acute paralytic neuropathy with any clinical features. Some patients present with the neurogenic bladder in which bladder dysfunction happens, resulting in urinary retention. The delayed diagnosis often leads to some complications, including bladder perforation. Vesico-peritoneal is lined by epithelial cells that communicate between the peritoneal cavity and the urinary bladder. In this location, can occur a fistula called vesico-peritoneal fistula. This type of fistula leads to peritonitis with high morbidity and mortality.
Case description: A 22- year- old female was admitted to a neurologist with lower extremities paralysis. The surgery department then consulted the patient for suspicion of generalized peritonitis. The patient had a history of taking medication for Guillain-Barre syndrome and complaint of abdominal pain, bloating, nausea, hematemesis, and hematuria. The abdominal radiograph showed pneumoperitoneum. The patient received antibiotics and underwent exploratory laparotomy. Exploratory laparotomy revealed vesico-peritoneal fistula. In this case, the defect was achieved by dissection of the fistulous tract and the primary closure of the bladder. Postoperative follow-up indicated no sign of complication.
Conclusion: Fistulation between the bladder and peritoneal in GBS could cost high morbidity and mortality. Dissection of the fistulous tract and primary closure of the bladder could overcome this condition without any concerning complications.
Risk-taking behavior and biopsychosocial theory for predicting risky sexual behavior of adolescents in Islamic Boarding Schools
Authors: Andayani Sri Astutik , Maria Maramis Margarita , Sulistiawati  , I’tishom Reny
Published: December 2022

Background: Risky sexual behavior in adolescents occurs in several cities in Indonesia, including in students in Islamic boarding schools. The phenomenon of risky sexual behavior is found in adolescents in Islamic boarding schools. This study aimed to analyze the factors that influence risky sexual behavior on a biopsychosocial basis.
Method: This study used a cross-sectional observational analytical design, explaining the relationship between variables through hypothesis testing. The samples of this study were adolescents from Islamic Boarding Schools in Probolinggo. A total of 346 adolescents were selected by multistage random sampling. Data were analyzed by Structural Equation Modeling-Partial Least Square (SEM-PLS) test.
Results: The results showed that the independent variables contributed 43.8% to risky sexual behavior, and the model had a good fit. There is a significant relationship between biological maturation, self-perceptions, perception of social and spiritual, and perceptions of sexual on risky sexual behavior.
Conclusion: The results of this study revealed that the model of risky sexual behavior viewed from risk-taking behavior and biopsychosocial theory could be used as a theoretical basis for carrying out activities related to health-promotive and preventive actions for adolescents, which focus on individual, family and peer group factors.
Exploring academic procrastination among nursing students during pandemic COVID-19
Authors: Budury Syiddatul , Setiawan Arif Helmi , Masruroh Nur , Nero Francis Don L
Published: December 2022

Introduction: An instrument that is frequently used to gauge academic procrastination is the Procrastination Assessment Scale for Students (PASS). During covid-19 pandemic the chance to get more into procrastination mode is higher because while students is studying at home they have something distracted their mind such as watching movie, using social media and the others things. The objective of this study was to evaluate the constructs of validity and reliability of the procrastination assessment scale for nursing students during the pandemic COVID-19 are examined.
Method: It is a cross sectional study where distributed to 416 nursing students and the data taken by stratified sampling. The scale consists of two part, part one is area of procrastination had 18 items and second part is reason for procrastination had 26 items. The data was analyzed with Stata.
Results: The reliability of first part was 0.6615 and the second part was 0.9136. The model was acceptable where root mean squared error of approximation (RMSEA) = 0.108, standardized root mean square residual (SMRS) = 0.063, comparative fit index 0.957, CI 90%.
Conclusion: Based on the investigation, the dimensions and indicators that make up the academic procrastination construct are credible and valid ways to assess it among Indonesian nursing students.
Anticipating suicide act of patient with borderline personality disorder and history of severe depression
Authors: Faisal Ferren Oktavena , Algristian Hafida , Azizah Nur
Published: December 2022

Introduction: Suicide as a complication of depression is often caused by two main feelings, helplessness and hopelessness. Patients with borderline personality disorder (BPD) experience these two emotional conditions for a long time in their lifetime, which makes them self-harm quite often. They need another person as a “holding environment”, including their caregiver or doctor. This case study aims to assess how influential the role of medical personnel and pharmacotherapy is on the management of suicide in patients with BPD with a history of major depression.
Case Description: Depression has multifaceted symptoms, including feeling sad, confused thoughts, hopelessness, reduced concentration, loss of interest in doing things, reduced self-esteem and self-confidence, decreased appetite, difficulty breathing, sleeping, contemplating suicide, and eventually attempting suicide. This patient's dynamics illustrate that suicide is often the last peak of her depressive state, however impulsive she may be with her BPD. The patient experiences a preoccupation with helplessness, that she no longer deserves to live and is no longer able to face the problems she faces. Her meeting with her doctor made her feel recognized that her feelings were valid, and not try to deny what she was feeling. The patient received treatment with fluoxetine 20mg tab and felt that the medicine she was taking was not a "punishment" for her illness, but a way of healing. The patient felt that from the beginning of treatment until now, she admitted that she had never thought about committing suicide again.
Conclusion: The combination of pharmacotherapy with psychotherapy is more effective in anticipating this risk of suicide, and preventing relapse or recurrence of depression, compared to pharmacotherapy or psychotherapy alone.
The effect of ginger compress on reducing back pain on the third trimester pregnant women
Authors: Abidah Siska Nurul , Anggraini Fritria Dwi
Published: December 2022

Introduction: Ginger is one of the herbal plants that has been known for a long time. However, most people did not know further about the benefits of ginger for pregnant women. Therefore, this study aimed to analyze the ginger effect to compress the lower back in third-trimester pregnant women.
Methods: The data were used in this study obtained from the intensity of pain felt by pregnant women in the third trimester. This study involved 10 respondents who were collected by purposive sampling technique. The analysis used in this study was to determine the difference in the level of the back before the ginger compress and after the ginger compress in the third trimester of pregnant women using the Wilcoxon test.
Results: This study shows that the significant value of ρ=0.005<0.05, from these results, it was shown that there is an effect of ginger compresses on reducing back pain in third-trimester pregnant women.
Conclusion: This study was conducted to analyze the effect of ginger compress on the lower back in third-trimester pregnant women. Furthermore, this study proves that ginger compress can significantly reduce back pain in the third-trimester pregnant women
The management of acute pancreatitis among children on chronic ambulatory peritoneal dialysis during COVID-19 pandemic crisis in Indonesia: report of two cases
Authors: Agustina Wulandari  , Risky Vitria Prasetyo  , Muhammad Riza Kurniawan  , Ninik Asmaningsih Soemyarso  , Mohammad Sjaifullah Noer
Published: December 2022

Background: Children on dialysis seem to be at greater risk for COVID-19. Acute pancreatitis (AP) is an infrequent but severe complication of chronic peritoneal dialysis (PD). It contributes to morbidity and mortality rates of up to 25%. Patients with PD are exposed to a series of factors associated with AP risk. This report aimed to describe rare and interesting cases of acute pancreatitis in children with CAPD following PD-related peritonitis with a favorable response to conservative treatment.
Case report: We present two cases admitted to our emergency room (ER) with severe abdominal pain preceded by PD-related peritonitis. Poor adherence, lack of monitoring, and healthcare service restriction during the COVID-19 pandemic predisposed these patients to PD-related complications. Patients were diagnosed as AP based on the revised Atlanta criteria. Both met the criteria as they had abdominal pain, a threefold increase of pancreatic enzymes, and evidence of pancreatitis through ultrasonography (USG) investigation. Both patients presented a rapid resolution of AP after receiving conservative treatment, including fasting, total parenteral nutrition (TPN), prophylactic antibiotics, and analgesics. None of them experienced invasive intervention due to AP.
Conclusion: Diagnosing AP in children with CAPD may be challenging since the symptoms mimic other abdominal problems. Our cases are likely to be associated with PD-related peritonitis. This report may prove conservative treatment as a recommendation for managing AP in children with CAPD. The rapid development of innovative clinical management strategies in response to the COVID-19 pandemic is crucial to improving children's health care quality with CAPD.
Perioperative management of patient with late rheumatoid arthritis and post-bone tuberculosis with genu contracture undergoing tenotomy
Authors: Rahma Asri Insanur , Awalia
Published: December 2022

Background: Rheumatoid arthritis (RA) is an autoimmune and inflammatory disease that potentially attacks all parts of the human body. Despite the use of disease-modifying anti-rheumatic drugs (DMARDs), the rate of total knee arthroplasty (TKA) remains high. Critical complications such as infection, dislocation, and readmission following TKA are also reportedly high and therefore, appropriate management during perioperative period is critical. We reported the perioperative management of a patient with late RA and genu contracture underwent tenotomy.
Case Presentation: A 22-year-old male was referred to Dr. Soetomo General Hospital with a chief complaint of pain in the right and left groin. He also complained of immobilization and stiffness in both knees. He had been diagnosed with bone tuberculosis in 2014 and underwent a total knee replacement of both knees in 2015 due to stiffness and inability to walk. Radiography examination indicated erosion and loss of joint spaces in the joints of the hip, fingers, and toes. Laboratory investigation showed positive anti-mutated citrullinated vimentin (anti-MCV), confirming RA. The patient underwent tenotomy surgery and was treated with methylprednisolone 4 mg peroral daily, chloroquine 250 mg peroral daily, and natrium diclofenac peroral to reduce pain. Tenotomy was performed. Considering the disease activity, conventional DMARDs (chloroquine 250 mg peroral and low dose steroid, methylprednisolone 1x4mg peroral) were prescribed.
Conclusion: The case highlights the complexity of perioperative management of late RA and genu contracture underwent tenotomy that required multiple disciplines. Therefore, interdisciplinary collaborative team is critical to be able to achieve optimal results of the patient.
Baby delivery development by one phase in active primigravidal mothers through Al Qur'an murrotal method
Authors: Romdhani Retno Hastri Risqi , Suhartini Titik
Published: December 2022

Introduction: The opening-stages of the cervix during baby-delivery-process is a physiological condition. In any case, if the interaction is excessively long, whenever left unchecked, it can influence the mother's condition as weariness, dread, stress, and stress that can expand agony and influence the conveyance cycle. The reason for this investigation was to break down the impact of murottal or reading Al-Qur'an treatment on the advancement of the main phase of work in the dynamic period of primigravida mothers.
Methods: The research is utilized pre-experimental with a pre-posttest design. The participants in this study was 102 primigravida mothers who emanated to the VK Maternity who met the inclusion conditions with the sampling technique utilizing the accidental sampling method. Data collection comprises coding, editing, and tabulating, then the data is scrutinized by computer using the paired t-test with P-Value = 0.05.
Results: The results exposed that the average cervical dilatation before murottal therapy was 5.46, the average after murottal therapy was 8.95. Paired t-test showed that there was an effect after murottal therapy. There is an increment in the amassing of cervical dilatation after murottal Al-Qur'an treatment. The examination presumes that there is an impact of murottal Al-Qur'an treatment on the advancement of the main phase of work in the dynamic period of primigravida mothers.
Conclusion: The use of murottal Al-Qur'an treatment to primigravida mothers is extremely huge in aiding smooth the advancement of baby-delivery as far as the cervical opening. With the goal that the baby-delivery-process is simpler for the mother to live.
The potential of carrot extract as a sunscreen to prevent apoptosis in white mice (Mus musculus) fibroblast cell cultures exposed to UVB light
Authors: Bagus Komang Satriyasa  , I Gusti Ayu Widianti  , I.B.G. Fajar Manuaba
Published: December 2022

Introduction: UVB rays are one of the main external factors that play a role in the aging process. Apoptosis of fibroblasts affects skin aging, and the decline in fibroblasts is also caused by the reduced number and ability of growth factors and other hormones. Sunscreen has been used for a long time to protect the skin from the harmful effects of solar radiation, especially UVB rays. Antioxidant activity such as β-carotene and vitamin E from carrots can counteract free radicals and oxidative stress caused by UV radiation. This study aims to test whether in vitro administration of carrot extract can be used as a sunscreen to prevent apoptosis in mouse fibroblast cell cultures exposed to UVB light.

Method: This research is a laboratory experimental study, using a Randomized Post-test Only Control Group Design. The research sample was fibroblast cell culture derived from the back skin of white mice (Mus Musculus) isolated with Collagenase 1 (primary culture). Observation of fibroblast apoptosis using propidium iodide staining. Data were analyzed using Shapiro-Wilk test, Levene's test, One Way Anova and continued with LSD test. The confidence level in this study is 95%.

Result: There was a significant difference between the control group and the carrot extract treatment group, but no significant difference was found between the SPF15 group and the carrot group (p>0.01).

Conclusion: Carrot extract can provide a protective effect on the skin (fibroblasts) and prevent apoptosis.
Mature teratoma with somatic-type solid malignancy in the mediastinum: A case report of rare and poor prognosis tumour
Authors: Dewi I Gusti Ayu Sri Mahendra
Published: December 2022

Background: Germ cell tumor with somatic-type solid malignancy is a germ cell tumor accompanied by a non-germ cell, the somatic-type malignant component in the form of sarcomas or carcinomas. These germ cell tumors are rare, accounting for only about 2% of all germ cell tumors in men. About 25-30% of these tumors occur in the mediastinum. These tumors are often located in the anterior mediastinum and occur in adult males with a peak incidence between 20-40 years.
Case description: A 19-year-old female patient came with chief complaints of chest pain and shortness of breath about three months ago. Chest CT scan images showed a right lung reactive pneumonia with suspicious atelectasis at the second and third segments of the right lung. The image also showed a tumor mass with heterogeneous density at the mediastinum. Then thoracotomy surgery and tumor resection were performed. Macroscopically, there was a multicystic tumor mass measuring 14.0x11.0x6.5 cm, partly solid with 7.0x5.0x5.0 cm. Microscopic examination of the tumor mass showed three components of the germ layer, namely ectodermal, mesodermal and endodermal. No immature component appears. The tumor also contains neoplastic epithelial cells that form a solid, cribriform, acinic and papillary structure in the extracellular mucinous pool.
Conclusion: Based on the clinical finding, radiologic, and routine histopathological examination, this case was concluded as mature teratoma with somatic-type solid malignancy in the form of mucinous adenocarcinoma.
Giant Deep Aggressive Angiomyxoma of The Vulva: A Rare Case Report
Authors: Claudio Udjaja , Very Great Eka Putra , Faiza Rizky Aryani Septarina
Published: December 2022

Background: Deep Aggressive Angiomyxoma (DAA) is a rare benign tumor with about 250 cases reported worldwide. It was first reported in 1983. This tumor is commonly found in women of reproductive age, with the highest incidence in the 3rd and 4th decades of life. DAA is most often found in the pelvic, genital, inguinal region, or perineum.
Case Report: Nulligravida woman 52 years old, with enlargement of the vulva that had felt since ± 20 years ago. A mass was found on local examination of the right vulva with a size of ±50x40x10cm, which was supple, mobile, and with no pain. Enlarged inguinal lymphadenopathy was also observed. MRI showed a well-defined lesion at the right vulvar region (which visualized the size of ± AP 14.95 x LL 31.80 x CC 15. 3 cm) with the signal intensity hypointense on T1WI, hyperintense on T2WI and FatSat, restricted on DWI, with no enhancement was seen. A wide excision was conducted, and post-excision measurements showed a right vulvar mass size was 50x42x10cm, with 14.8kg in weight.
Conclusion: DAA is a rare benign tumor that can disturb patients. The nature of the tumor should be evaluated carefully using radiological and pathological approaches. A wide excision can remove the tumor completely, but control and follow-up are mandatory to evaluate the completeness of the procedure and monitor for any relapse.
Trends of ischemic stroke admission during two years of COVID-19 pandemic: A retrospective cross-sectional study at a tertiary hospital in Indonesia
Authors: Sari Pipit Mei , Agniana Atika Mira , Ardhi Mohammad Saiful
Published: December 2022

Introduction: There is no much information on how admission rates of non-coronavirus disease 2019 (COVID-19) diseases altered after two years of COVID-19 pandemic. The aim of this study was to determine the pattern of ischemic stroke admission rates within the two years of the COVID-19 pandemic in Indonesia.
Method: A cross-sectional retrospective study investigated the admissions data of ischemic stroke was conducted at a tertiary hospital in Indonesia between January 2019 and December 2021. Ischemic stroke patients aged over 18 years old were identified using the ICD-10 I63 code. The data was accumulated every month and analyzed descriptively. We also analyzed the admissions data of ischemic stroke patients with COVID-19 and in-hospital mortality was calculated.
Results: There were 2,710 ischemic stroke patients treated between 2019 and 2021 of which the number decreased from 1535 patients in 2019 to 730 in 2020 and only 445 cases in 2021. During 2019-2021, a total of 777 patients (28.67%) died during hospitalization; the most was in 2021 (33.3%). There is a consistent downward trend in ischemic stroke admissions during the COVID-19 pandemic with the monthly average admissions decreased 52.4% in 2020 compared to 2019 and 38.9% in 2021. Despite that, the mortality rate of ischemic stroke patients in the hospital increased from 26.5% in 2019 to 30.4% in 2020, and 33.3% in 2021. The number of ischemic stroke patients coinfected with COVID-19 was 3.5% (26/730) in 2020 and 8.1% (36/445) in 2021. Of all 62 ischemic stroke cases with COVID-19 in 2020-2021, 36 died yielded 58.1% in-hospital mortality rate.
Conclusion: The decreased admissions and the increased mortality rate of ischemic stroke patients in particular those coinfected with COVID-19 during the first two years of pandemic should draw government attention to the necessity of improving stroke managements in Indonesia.
The Differential Effectiveness of Calcium Hydroxide (Ca(OH)2) Combination with Chlorhexidine Digluconate (CHX) 2% and Clindamycin Hydrochloride 5% Against Enterococcus faecalis (in vitro)
Authors: Erma Sofiani  , Novita Kartika Sari
Published: December 2022

Background: The main factor causing failure of root canal treatment is re-infection of the bacterium Enterococcus faecalis, so it is necessary to give the right intracanal medicament. Calcium hydroxide (Ca(OH)2) is an intracanal medicament often used in endodontic treatment. To increase the effectiveness of calcium hydroxide, a mixing agent is needed. Mixing agents such as Chlorhexidine digluconate (CHX) 2% (aqueous) and Clindamycin hydrochloride 5% (viscous). The viscous mixing agent can penetrate well into the dentinal tubules, and the antibiotic can fight various root canal endodontic pathogens and dentinal tubules without causing discoloration. This study aims to determine the differential effectiveness of calcium hydroxide combination of chlorhexidine digluconate 2% and Clindamycin hydrochloride 5% as an intracanal medicament against Enterococcus faecalis (in vitro).
Methods: The design was in vitro experimental laboratories that tested the value of turbidity (Optical Density) using a spectrophotometer before and after being treated. Data were analyzed by the Kruskal-Wallis test and then Mann-Whitney U Test.
Results: The positive control group had the largest negative Optical Density (OD) difference, followed by a calcium hydroxide combination of Chlorhexidine digluconate 2%, and the third sequence was a calcium hydroxide combination of Clindamycin hydrochloride 5%. A negative OD difference indicates a decrease in the number of bacterial cells.
Conclusion: There are differences in the effectiveness of the antibacterial of intracanal medicament calcium hydroxide combination of Chlorhexidine digluconate 2% and calcium hydroxide combination of Clindamycin hydrochloride 5%.
The effect of kefir polysaccharide extract on the expression of matrix metalloproteinase 9 (MMP-9) and integrin activation of HeLa cervical carcinoma culture cell
Authors: Yahya Irwanto  , Eddy Mustofa  , Teguh Wiyono  , Dodi Tri Oktafianto  , Arif Rahman Nurdianto  , Robby Rinaldi Widodo
Published: December 2022

Background: Cervical cancer is the leading cause of cancer in the world, especially in developing countries. Kefir is a goat's milk product that contains a lot of nutrients and bioactive complex which are involved in the synthesis of the anticancer, and have anticarcinogenic and antimutagenic effect. Integrins are involved in various biological processes associated with cancer development, such as migration, invasion, differentiation and proliferation. MMP-9 can also degrade ECM through proteolytic action, affecting cell-cell interactions in ECM. This research aimed to see the effect of kefir on MMP-9 and integrins activation. Thus, it is expected that kefir can be used as an additional supplement in patients with cervical cancer.

Methods: This research study was conducted in an experimental laboratory in vitro using HeLa cells as the object of research. Data were analyzed using the SPSS program to determine the most effective dose of kefir and a regression test to determine the effect between integrins and MMP-9.

Results: The mean value of MMP-9 and integrin at a dose of 180 µg/ml was 165.1 ± 5.8 and 378.5 ± 12.6 respectively. This result had a significant value of p = 0.0000 for both MMP-9 and integrin-b. In the regression test, the value of p = 0.05 was obtained while the coefficient value was positive (0.565).

Conclusion: The higher the expression of MMP-9, the activation of the integrin-b would increase. Kefir extract dosage of 180 µg/ml significantly reduced MMP-9 and Integrin-b expression. MMP-9 affects improving Integrin-b
Factors associated with the length of hospital stay post an open appendectomy
Authors: Sayuti Muhammad , Anna Millizia  , Muthmainnah  , Muhammad Syahriza
Published: December 2022

Introduction: An appendectomy is the surgical removal of the inflamed vermiform appendix organ system. Patients who have had an appendectomy will be treated in hospital inpatient rooms for varying lengths of time, which is affected by several factors. This study aims to analyze the factors associated with the length of hospital stay post an appendectomy in Arun Lhokseumawe hospital, Aceh between 2019 and 2020. The factors analyzed are age, gender, type of appendicitis, duration of surgery, and comorbidity.
Method: A retrospective study with an analytical descriptive cross-sectional study design. The sampling technique used was purposive sampling with a total of 251 samples. All data analysis used SPSS 26.
Results: The characteristics of patients were as follow: age 17 – 25 years old (25.15), female (58.2%), acute appendicitis (57.8%), and no comorbidity (66.1%). The statistical analysis by Chi-square α =0.05 provides the factors associated with the length of hospital stay after an appendectomy, such as gender (p = 0.000), type of appendicitis (p = 0.000), and comorbidity (p = 0.000). Whereas age (p = 0.059) and the duration of surgery (p = 0.052) were not related to the length of hospital stay after an appendectomy.
Conclusion: There were significant relationships between the following factors, such as age, type of appendicitis, comorbidity, and the length of hospital stay after an appendectomy procedure in Arun Lhokseumawe hospital, Aceh.
Synovial fluid evaluation in COVID-19 patients
Authors: Jainal Arifin  , Jainal Arifin  , Muhammad Nasrum Massi  , Yosua Adi Nugroho  , Mirza Ariandi  , Yosia Handoko
Published: December 2022

Background: COVID-19 can provide symptoms outside the respiratory tract and musculoskeletal symptoms. Some viruses can indeed cause arthritis, and the genetic material of these viruses can be found in a joint fluid using PCR assays. With this study, we will conduct an examination using PCR on the joint fluid of COVID-19 patients who have musculoskeletal symptoms, especially arthralgia, during the infection.

Methods: This cross-sectional study with a descriptive explanation of synovial fluid in COVID-19 patients was performed from April 1st to July 30th, 2021, with patient data collection conducted centrally at Wahidin Sudirohusodo Hospital Makassar Synovial fluid was taken from the knee using the sterile procedure in a patient that met the inclusion criteria, such as hospitalized patients who had positive PCR swab results in the nasopharynx for less than 2 weeks and had arthralgia symptoms on April – July 2021. Other musculoskeletal symptoms (e.g., myalgia and fatigue) were noted. About 2 ml sample of synovial fluid was tested using a PCR kit (M BioCov) in the laboratory. The sample shows a positive result when there is an amplification of RDNP with a CT value below 40.

Results: 189 patients with 21 participated, 14 subjects were male, and 7 subjects were female. Age range 18 - 72 years with arthralgia, myalgia, and fatigue symptoms. Only 2 patients had arthralgia, 13 patients had myalgia and arthralgia, 1 patient had fatigue and arthralgia, and 5 patients had all of the symptoms (arthralgia, myalgia, and fatigue). Only 1 patient had direct contact with the COVID-19 patient. PCR test for synovial fluid in all patients showed negative for COVID-19.

Conclusion: COVID-19 infection can be manifest in the musculoskeletal system. Detection of COVID-19 virus using a specimen from knee synovial fluid in a patient with musculoskeletal symptoms (arthralgia, myalgia, fatigue) was negative.
Drop foot and adult onset tethered cord syndrome caused by filum terminal ependymoma: A case report
Authors: Wardhana Dewa Putu Wisnu , Permana Made Agung Yudistira , Awyono Steven , Maliawan Rani Paramitha Iswari , Novita  , Rosyidi Rohadi Muhammad
Published: December 2022

Introduction: Filum terminal is a fibrous tissue to stabilize the position of the spinal cord, located in both intradural and extradural sections anchored caudally to the coccyx. Tumors located at the filum terminal are a rare case. Filum terminal does not have any spinal cord component, but tumours in that area can directly cause a significant neurological disorder. 
Case Presentation: Presenting 43 years old man with chief complaints of drop left foot and tethered cord syndromes. MR Image revealed 9,4x10mm intradural extramedullary mass at L1 with L1-L5 disc desiccation. The patient was untethered by laminectomy and underwent total mass excision. The sample was analyzed pathologically, and the results matched myxopapillary ependymoma. Pain sensation and sensory disturbance immediately improved after surgery. The urinary disorder also gradually improved. The patient was discharged without any urinary problems. After six months of follow-up, painless, mild left lower drop foot and mild gait disturbance was found without residual urinary and other neurological disorder.
Conclusion: Filum terminal ependymomas need to be considered for differential diagnoses in patients with drop foot and adult-onset tethered cord syndromes.
Association between metabolic syndrome and knee osteoarthritis
Authors: Savitri Ardyarini Dyah , Veterini Lysa , Widyaswari Meidyta Sinantryana , Abdillah Diaz Syafrie
Published: December 2022

Introduction: The inflammatory process underlies either osteoarthritis (OA) or metabolic syndrome. Systemic inflammation that occurs in the metabolic syndrome will result in the production of inflammatory cytokines and activation of macrophages and chondrocytes. This can affect the entire body including joints and the surrounding tissues, causing OA. Type 2 Diabetes Mellitus (DMT2) and hypertension are the first and second most common metabolic syndrome components found in OA patients. This study aimed to determine the relationship between metabolic syndrome and knee OA in DMT2 patients with hypertension.
Methods: By using an analytic observational method and cross-sectional design, this study involved the medical records of patients with DMT2. The sample consisted of 50 medical records selected by using the purposive sampling technique and fulfilling the inclusion and exclusion criteria.
Results: This study involved 25 medical records of patients with and without knee (genu) OA. The characteristics of the sample were as follows: 1 medical record of patient aged 36-45 years, 18 medical records of patients aged 46-55 years, 16 medical records of patients aged 56-65 years, 15 medical records of patients aged > 65 years, 21 medical records of male patients, 29 medical records of female patients, 27 medical records with metabolic syndrome, and 23 medical records without metabolic syndrome. The association between metabolic syndrome and knee (genu) OA was analyzed by using the Chi-Square Test using the SPSS application, where the results showed a significance value of p < 0.05 (p = 0.001).
Conclusion: This study shows that there is a significant association between metabolic syndrome and knee (genu) OA.
Antioxidant activity of Tinospora crispa extracted with different ethanol solvents
Authors: Puspitasari Renny Novi , Sri Agus Sudjarwo  , Pranoto Agung , Basori Achmad
Published: December 2022

Introduction: Tinospora crispa (T. crispa) is an herbaceous plant that commonly grows wild in tropical regions of South East Asian countries such as Indonesia, Malaysia, and Thailand. In Indonesia, this plant is well known to be used as a traditional medicine to treat gout, diabetes, hypertension, rheumatic, fever, and appetite stimulant. Researches worldwide indicate that T. crispa poses several pharmacological properties. One of those is the antioxidant activity, acting as a free radical scavenger. The objective of this study was to determine the antioxidative properties of T. crispa and to compare the different ethanol solvents used for extraction.
Methods: The amount of 300 g T. crispa powder was extracted using 70%, 80%, and 96% ethanol. The spectrophotometry method is used to assess the total flavonoid and polyphenol contents as well athe s DPPH assay.
Results: The 80% ethanol had the highest flavonoid content 0.090% ± [0.453%], while 96% ethanol indicated the lowest 0.038% ± [3.090%]. In the case of phenolic content, 96% ethanol showed the highest result 0.521 ± [11.341%]. However, this value was relatively comparable with the other solvents. The highest DPPH activity was shown by 80% ethanol 6.46 mg ± [3.04 mg].
Conclusion: Despite low in the concentration, flavonoid and polyphenol content was successfully determined from T. crispa by using different ethanol solvents. Based on the result of antioxidants concentration and activity, 80% ethanol is the most ideal solvent to be used for extraction of T. crispa.
Successful management of Congenital Diaphragmatic Hernia (CDH) in an 8-day-old infant with moderate persistent pulmonary hypertension, moderate muscular Ventricular Septal Defect (VSD), and small Patent Ductus Arteriosus (PDA)
Authors: Wardana Oktavian Prasetia , Utomo Martono Tri , Etika Risa , Handayani Kartika Darma , Hariastawa I Gusti Bagus Adria , Fitriati Mariza
Published: December 2022

Background: Congenital diaphragmatic hernia (CDH) is a rare, complex and severe abnormality in an infant. Globally, neonatal mortality as a consequence of congenital anomalies is increasing and is therefore outlined as an emerging priority to be addressed by the UN Sustainable Development Goals (SDGs) in the post-2015 child health agenda. Although numerous cases are discovered prenatally or in the early postnatal period, 5-25% of CDH are detected in delayed onset after birth. The aim of this article was to discuss the case of CDH with moderate persistent pulmonary hypertension, moderate muscular ventricular septal defect, and small patent ductus arteriosus.
Case Presentation: A-8 days old, 3,060 g, a full-term male infant was referred to our tertiary hospital with transient tachypnea of the newborn and a suspected case of congenital heart disease. The defect was repaired after stabilization of the cardiac output and gas exchange. During recovery after surgery, the patient was placed on high-frequency oscillation after surgery and was given potent inotropic support. The patient made an uneventful postoperative recovery.
Conclusion: The management of CDH patients should be multidisciplinary. More clinical studies were required to elaborate on a suitable management protocol for the CDH
Successful conservative treatment for Ogden type-IV tibial tubercle avulsion fracture with transverse fibular fracture in 15 years old boy in remote area: a case report
Authors: Michael Sutandio
Published: December 2022

Background: Tibial tubercle avulsion fracture is very rare. Its incidence has been reported to account for only 3% of all proximal tibia fractures and less than 1% of all growth plate injuries. This fracture occurs when the quadriceps are forcefully contracted against resistance, such as during jumping, or when rapid knee flexion occurs with contracted quadriceps, such as during landing. Most authors recommended surgical options in type IV tibial tubercle avulsion; however, we reported successful conservative treatment in this case report.
Case report: A 15-year-old male athlete with no significant past medical history presented via emergency medical services after a ground-level fall while playing basketball which landed with his left foot in a pivot position. He felt immediate pain and swelling about the left knee, all sensation was intact, as were pedal pulses, and neurovascularly remained intact. The patient did not want to go for medical evacuation to do surgery and consent to be managed with conservative treatment with close follow-up.
Conclusion: The results and prognosis of these fractures are excellent, despite the fracture pattern or treatment used, as long as an anatomical reduction is obtained
The correlation between the usage of kami pekarasa card (cards of pregnant mother for posyandu's members and villages authority holders) and the visit coverage of k4 pregnant mother during COVID-19 pandemic event
Authors: Iis Hanifah  , Tutik Hidayati  , Riska Faraswati
Published: December 2022

Introduction: Covid-19 Pandemic event in Indonesia is still spreading, with one of the worst outbreaks occurring in Probolinggo, East Java. Pregnant mother is at a high risk of getting covid-19 pandemic, thus prenatal checkups at Public Health Center or independent practice midwives are limited during the pandemic. The purpose of this study is to investigate the correlation between the usage of the kami pekarasa card (cards of pregnant mother for posyandu's members and villages authority holders) and the coverage of the visit of k4 pregnant mother during the covid-19 pandemic event.
Methods: Correlational analytic research design was adopted in this study. This study used a 32-person sample. Data was collected by cadres using health protocols and analyzed using the chi-square test.
Results: The data revealed a p-value=0.018 and r=0.05, indicating that there is a correlation between the usage of kami pekarasa card and visit coverage of k4 pregnant mother during covid-19 pandemic.
Conclusion: Based on the result there was a significant between the usage of kami pekarasa card and the visit coverage of k4 pregnant mother during covid-19 pandemic event.
Comparison between mini-Percutaneous Nephrolithotomy (PCNL) and standard PCNL in pediatric patients: a systematic review and meta-analysis
Authors: Aulia Kindy , Atmoko Widi , Birowo Ponco , Rasyid Nur
Published: December 2022

Background: We conducted a systematic review and meta-analysis to determine the efficacy and safety of mini-Percutaneous Nephrolithotomy (PCNL) compared to standard PCNL in children with nephrolithiasis. Clinical trials and observational studies comparing standard PCNL and mini-PCNL in pediatric patients were identified from electronic databases in November 2021.
Method: Studies were extracted for author, year, location, design, subjects’ age, sample size, objective, primary endpoint, level of evidence, and results (stone-free rates and complications). Results were subjected to qualitative analysis using the synthesis method. Adequate results were extracted and analyzed quantitatively using the fixed-effect model on homogenous data or the random-effect model on heterogeneous data for meta-analysis. Outcome variables are shown as odds ratios (ORs) with 95% confidence intervals (CIs). All statistical analyses were performed with Review Manager version 5.4.
Result: We reported that stone-free rate and residual stone vary between two studies with contrary results. However, our quantitative analysis showed an insignificant difference between both groups of stone-free rate (OR 0.75; 95% CI 0.22-2.54) and residual stone (OR 1.27; 95% CI 0.55-2.91). Complications rates were insignificantly different between mini-PCNL group and PCNL group in two studies in Clavien 1 (OR 0.65; 95% CI 0.27-1.54) and Clavien 2 grade (OR 0.48; 95% CI 0.19-1.22). In addition, pooled analysis of both complication grades was also insignificant in the difference between groups (OR 0.56; 95% CI 0.30-1.06).
Conclusion: The efficacy and safety of mini PCNL were neither superior nor inferior compared to standard PCNL in managing nephrolithiasis in pediatric patients. Moreover, mini PCNL was considered better regarding post-operative pain and tract infection; thus, mini PCNL could be considered a treatment option for pediatric patients with nephrolithiasis.
The effectiveness of topical hyaluronic acid on decreasing Interleukin-6 and acceleration of wound healing (Push Score) in Wagner II-III diabetic foot ulcer in Dr. Soetomo Hospital Surabaya
Authors: Gulo Christian Ibezaro Harazaki , Puruhito  , Novida Hermina
Published: December 2022

Background: A diabetic foot ulcer is a complication that often occurs in patients with diabetes mellitus. The healing process of a chronic wound is more complicated and requires more complex treatment. There is an increase in IL-1, IL6, and TNF-α pro-inflammatory cytokines in a chronic wound. Hyaluronic acid (HA) is a component that has been used for a long time and is known to help the wound healing process. This study was at a time to determine the effectiveness of hyaluronic acid on the reduction of interleukin-6 in accelerating the healing of Wagner II-III diabetic foot ulcers.
Methods: This study is an experimental, randomized study of pre and post-test design on diabetic foot ulcer patients with the Wagner II-III classification who were controlled at the thoracic, cardiac, and vascular surgery polyclinic at Dr. Soetomo Hospital Surabaya. Data were analyzed using SPSS version 20 for Windows.
Result: About 39 samples are willing to participate in the study, divided into 20 samples in the treatment group and 19 in the control group. The mean concentrations of IL-6 in the treatment group before and after the intervention were 280.70±155.50 ng/ml and 126.60±145.60 ng/ml. There was a significant decrease in IL-6 levels (p<0.05) before and after the intervention. The mean concentrations of IL-6 in the control group pre and post were 315.20±127.40 ng/ml and 136.30±134.60 (p<0.05). The decrease in the control and treatment groups was no statistically significant difference (p>0.05). There was no significant difference in the PUSH Score (p>0.05) in the two groups before intervention/treatment. The decrease of wound area in the control and treatment groups were -4.80 ((-0.40)-(-24.50)) and -4.8 ((-0.70)-(-30.90)) (p>0.05).
Conclusion: Topical hyaluronic acid and wound care using 0.9% NaCl reduced interleukin-6 levels, PUSH scores, and wound area in Wagner II-III diabetic foot ulcers.