bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics of the rectosigmoid index in pediatric patients with definitive Hirschsprung’s disease in radiology installation of Sanglah General Hospital, Denpasar from January 2018 to December 2019
Authors: Anandasari Pande Putu Yuli , Margiani Ni Nyoman
Published: May 2024

Background: Hirschsprung's disease is a developmental disorder of the enteric nervous system of the distal intestines. Colon in-loop examination is used as a spearhead in the diagnosis of Hirschsprung's disease, and according to previous studies, it was found that the presence of transitional zone and rectosigmoid index of less than 1 were correlated with positive pathology results in 79%-87% of cases. The purpose of this study was to provide an overview of the rectosigmoid index of patients suspected of having Hirchsprung's disease as illustrated by a colon in-loop examination.
Methods: The research method is cross-sectional descriptive from January 2018 to December 2019 at Prof. Dr. dr. I. G. N. G. Ngoerah Hospital Denpasar. Data collected from colon in-loop examination in patients suspected of having Hirschsprung's disease included gender, age, RSI, and pathology results in patients who underwent biopsy. Data were analyzed using SPSS version 20 for Windows.
Results: The results found from 49 samples were that Hirschsprung was dominant in males (63.27%). Patients aged less than 1 month were the most common, with a percentage of 44.9%. The second most common was at the age of 1 to 12 months at 30.6%, while the incidence rate with the least number was at the age of more than 12 months, namely 24.5%. RSI data found that of the patients suspected of having Hirschsprung's disease, 40 samples, or 81.6%, had an RSI < 1, and it was found that of the 40 samples with RSI < 1, 82.9% confirmed Hirschsprung's with an aganglionic pathology result. In contrast, in patients with aganglionic PA, the proportion of patients with RSI < 1 was more than 80%.
Conclusion: The data obtained in this study are in accordance with those described in previous studies and support the role of RSI in strengthening the diagnosis of Hirschsprung's disease.
Critical priority Multidrug-Resistant Organisms (MDROs) secondary infection among COVID-19 patients: hidden threat during a pandemic? A retrospective study
Authors: Syaiful Irbasmantini , Mertaniasih Ni Made , Alimsardjono Lindawati , Endraswari Pepy Dwi , Utariani Arie , Utomo Budi
Published: May 2024

Background: The global Coronavirus Disease 2019 (COVID-19) pandemic is superimposed on the ongoing Multidrug-Resistant Organisms (MDROs) pandemic. Bacterial co-infection, particularly those caused by MDROs, is one of the risk factors linked to higher morbidity and mortality rates in COVID-19 patients. This study aims to compare critical priority MDROs profile causing bacteremia in COVID-19 and non-COVID-19 patients during a pandemic.
Methods: A hospital-based retrospective cross-sectional study was conducted at Dr. Soetomo General Academic Hospital from April 2020 to December 2021. This study used a consecutive sampling technique, which included and analyzed all identified microorganism isolates from blood specimens that met the inclusion criteria. The Mann-Whitney test was used to compare MDRO profiles between COVID-19 and non-COVID-19 patients, which is significant if p < 0.05.
Results: The total proportion of critical priority MDRO isolates in COVID-19 patients was 90/390 (23.08%), while in non-COVID-19 patients were 377/1446 (26.07%) isolates (p=0.228). Carbapenem-resistant Acinetobacter baumannii (CRAB) had a higher proportion of events in COVID-19 patients (12.05% vs. 7.05%, p < 0.001). In contrast, extended-spectrum β-lactamases (ESBL)-producing Klebsiella pneumoniae (ESBL-KP) had a higher proportion of events in non-COVID patients (7.54% vs. 2.82%, p < 0.001). Acinetobacter baumannii exhibited a high level of resistance, with 149/223 (66.82%) of the isolates being CRAB, with the COVID-19 group accounting for 47/59 (79.66%) and the non-COVID-19 group accounting for 102/164 (62.19%; z = 2.438; p = 0.015).
Conclusion: The high proportion and resistance rate of critical priority MDROs, CRAB particularly, among COVID-19 patients, highlights the importance of effective AMR control practices and prevention strategies during the pandemic.
The effectiveness of incentive spirometry exercise on pulmonary function in COVID-19 survivors: a randomized controlled trial study
Authors: Kusumawardani Rosa Indah , Tinduh Damayanti , Andriati  , Poerwandari Dewi , Marhana Isnin Anang , Melaniani Soenarnatalina
Published: May 2024

Background: COVID-19 survivors often result in persistent symptoms, even months after being discharged, that lead to decreased lung function. Incentive spirometry is commonly used in pulmonary rehabilitation as it encourages the patient to take slow and deep inspiration through visual feedback. This study aimed to analyze the effects of incentive spirometry exercise on pulmonary function in COVID-19 survivors.
Method: Twenty COVID-19 survivors aged 18-59 were enrolled in the study and divided randomly into two groups; ten survivors in the experimental group that received incentive spirometry exercise and ten survivors in the control group that received diaphragmatic breathing exercise. Both exercises were performed five times daily, with ten repetitions each for four weeks. Peak expiratory flow (PEF) was measured by a peak flow meter before and after the treatment in both groups. The data were analyzed statistically.
Result: There was a significant increase in pulmonary function in the experimental group (p=0.001) and control group (p=0.001). However, the two groups had no significant difference in pulmonary function (p=0.198). The incentive spirometry exercise shows a more significant effect on pulmonary function rather than diaphragmatic breathing.
Conclusion: Incentive spirometry exercise could be an alternative therapy to improve the pulmonary function of COVID-19 survivors.
Development of nursing learning program for COVID-19 patients with e-learning method for nursing department students Poltekkes Ministry of Health Jayapura Papua
Authors: Maryorita Blestina , Maay Jems Kifen Roget
Published: May 2024

Introduction: In the COVID-19 pandemic, educational institutions must align learning programs with advances in information technology and conditions of COVID-19. Knowledge about COVID-19 nursing care is also very much needed, especially for students majoring in Nursing.One of the media suitable for current conditions is e-learning, which can have a positive effect because students can study independently anytime and anywhere. The-learning method has more independence. Some experts believe that in learning, learner autonomy and self-determination are important. This research method uses the ADDIE Model. This study aims to investigate the problems and needs of the learning program in nursing care COVID-19 and to respond to the Nursing care learning program for COVID-19 disease.
Method: The research was conducted at the nursing department of Jayapura Health Polytechnic. Data collection techniques using questionnaires and observation sheets. The data were analyzed using quantitative descriptive, namely changing the quantitative data from the results of product validation and testing into qualitative data based on the criteria for the validity and feasibility of the product. The ADDIE model stages consist of five steps: analysis, design, development or production, implementation and evaluation. 
Result: The results showed that 78.2% of COVID-19 nursing care learning was inadequate, and 82% indicated the need for COVID-19 nursing care learning. The expert team's assessment of program development is averaging 81.6% with valid criteria. The results of product trials in the small group obtained an average result of 81.11% with very good criteria. While the results of product trials in the large group were 81.26% with very good criteria.
Conclusion: The results of the COVID-19 nursing care learning program using e-learning were developed through the stages of analysis, design, development, trial and evaluation. It is necessary to test the product to produce an up-to-date program. The development of COVID-19 nursing care learning programs using e-learning makes it easier to understand and be able to achieve the competencies expected in the COVID-19 pandemic situation.
Cardiac myxoma misdiagnose as infective endocarditis in a patient with acute limb ischemia and cardioembolic cerebral stroke: a case report
Authors: Zulfa Putri Oktaviani , Habibie Yopie Afriandi
Published: May 2024

Introduction: Fever, systemic embolism, and intra-cardiac masses are all symptoms of Infective Endocarditis (IE) and Cardiac Myxoma (CM)1. As a result, despite proper imaging studies, these diseases are frequently misdiagnosed one for the other.2
Case description: A 23-years-old female patient was admitted to emergency department of Zainoel Abidin General Hospital with acute onset right lower extremity pain for the last few hours and presented roth spots of the retina. The next day after admission, she presented fever. The patient denied having chronic disease, drug abuse, and thrombotic history. Tooth decay were found. Transthoracic Echocardiography (TTE) were obtained due to concern of infective endocarditis. Head CT-scan revealed cardioembolic cerebral stroke. TTE showed ejection fraction 56%, severe mitral regurgitation, and a mobile mass size 3.1x2.4 cm in mitral valve, attached to anterior mitral leaflet. The patient underwent thrombectomy, stroke therapy, dental tooth decay treatment, and lower limb rehabilitation at that moment, before having Mitral Valve Replacement (MVR) surgery. Six months afterward MVR surgery was done, rather than vegetation, we found a 50cc cardiac myxoma in anterior mitral valve leaflet. A 27mm bioprosthetic valve was installed. The patient was recovered quickly and she was able to discharge from hospital in the next 7 days after procedure without any further issue.
Conclusion: In order to effectively manage the patients, it is crucial to distinguish between IE and cardiac myxoma. The mainstay of treatment for cardiac myxoma cases is surgery, which has an excellent prognosis. To evaluate for recurrence, long-term follow-up is frequently required.
The Efficacy of Blood Flow Restriction Training for Grip Strength and Disability in Lateral Epicondylitis
Authors: Kinandana Gede Parta , Anak Ayu Nyoman Trisna Narta Dewi  , I Made Niko Winaya  , Ni Komang Ayu Juni Antari  , Ari Wibawa  , I Putu Gde Surya Adhitya
Published: May 2024

Background: Lateral epicondylitis is a work-related musculoskeletal disorder caused by inflammation of the extensor carpi radialis longus and brevis muscles tendons with symptoms of pain in the lateral side of the elbow and decreased range of motion that causes forearm muscle weakness and disability. This study aimed to compare the effectiveness of blood flow restriction (BFR) training with resistance exercise (RE) in increasing grip strength and forearm disability in lateral epicondylitis patients.
Methods: This study used the randomized controlled trial design that involved 28 subjects who were divided into intervention and control groups. All subjects received the treatment 3 times per week for 4 weeks, including the standard ultrasound therapy and electro-muscular stimulation interventions for 20 mins with additional treatment of the low-load BFR training for the intervention group and the high-intensity RE for the control group. This study measured grip muscle strength using a handgrip dynamometer, and functional ability was measured using a patient-rated tennis elbow evaluation questionnaire (PrTEEQ) before and after the treatment session. The statistical analyses of paired t-tests and independent t-tests were used in this study.
Results: This study found significant differences between pretest and posttest scores in the measurements of forearm muscle strength (change= 20.0~49.0%, p-values <0.001) and PrTEEQ (change= 64.5~70.5%, p-value <0.001) in the intervention and control groups. In addition, the independent t-tests resulted in significant differences in the score changes of forearm muscle strength and PrTEEQ measurement between these groups with p-values <0.001.
Conclusion: This study described that BFR training had better effects on grip strength and functional ability than RE in people with lateral epicondylitis.
Knowledge, attitude, and skills of partograph utilization among health workers: a systematic review
Authors: Alfun Dhiya An  , Emilia Ova
Published: May 2024

Partograph is a simple tool that World Health Organization (WHO) has recommended utilizing during labor monitoring. The ability of health workers in the obstetric unit to interpret clinical data from partograph to detect abnormal labor monitoring is influenced by their knowledge, attitude, and skills. We undertook a systematic review to determine the knowledge, attitude, and skill of partograph among health workers in the obstetric unit. We use the standard of PRISMA guidelines. Different online databases were used for this review: PubMed, ScienceDirect, Scopus, and Google Scholar. We found 16 of 1.957 articles from the selection process which meet the eligibility criteria. Overall, the partograph utilization was low due to a lack of knowledge, poor attitude, and poor skills of health workers. This influences how health workers interpret clinical data from partograph to detect abnormal labor progress. Therefore, on-the-job training and supportive supervision are needed to improve the knowledge, attitude, and skills of health workers in the obstetric unit.
Skin graft as a modality reconstruction of post-burn contractures during pandemic area: case series
Authors: Elfiah Ulfa , David Sontani Perdanakusuma  , Iswinarno Dososaputra  , I Nyoman Riasa  , Lumintang Loelita Marcelia , Naufal Muhammad Fahmi
Published: May 2024

Background: The Covid-19 pandemic causes the postponement of elective surgery. At the same time, patients with post-burn contractures require immediate operation due to impaired function that can lead to depression and disruption of daily life. Operations on contracture patients during a pandemic must be carried out using the principles of accuracy, speed, and safety. The skin graft is one of the most appropriate treatments modalities for releasing contractures. This case study aims to evaluate the skin graft as a modality reconstruction of post-burn contractures during pandemic area.
Case Presentation:  We present three cases of post-burn contractures who underwent contracture release and skin graft surgery with a hospital stay of 3-5 days. Surgical results showed that graft take reached 90%-100% in all patients, and 100% epithelialization occurred at donor sites between 2-4 weeks postoperatively. There were no post-operative complications.
Conclusion: The skin graft is an effective and suitable technique for treating post-burn contractures in the pandemic era.
Prevalence of multidrug-resistant Escherichia coli isolated from Jember hospital food handler in Indonesia
Authors: Suswati Enny , Supangat  , Indreswari Laksmi , Nur U’alifa Farhatina , Nabila Faiza , Inas Gama Putri Hertian
Published: May 2024

Introduction: Foodborne illness is a significant global public health issue. Improper food handling and personal cleanliness can result in a few ailments. Over 400 food-related infections have been found by the CDC, of which food handlers cause 20%. Escherichia coli is often found in hospital food handler hand and nasal swabs. This study aimed to ascertain the prevalence of  E. coli and the antibiotic susceptibility profile of food handlers working in hospitals in Jember City, Indonesia.
Method: A cross-sectional investigation uses a total sampling method held between October and November 2022. Inclusion criteria are asymptomatic food handlers that have not taken antibiotics for the last three months and have already given informed consent. Exclusion criteria are food handlers who’s sick or with incomplete questionnaires. We performed hand and nasal swabs and continued with bacteria identification, culture, and antibiotic sensitivity tests.
Result: Ten food workers (14.71%) and fourteen (20.59%) of the 68 who underwent hand and nasal swab culture screenings for E. coli were positive. All E. coli hand swab isolates were susceptible to levofloxacin and azithromycin antibiotics. Still, of the 10 E. coli hand swab isolates, 90% were resistant to the antibiotics; penicillin, Cefotaxime, and ceftriaxone, while 70% were resistant to erythromycin. For E. coli isolates originating from nasal swabs, 85.71% were resistant to Cefotaxime, 71.43% to Penicillin and Cefepime, and 57.14% were resistant to Ceftriaxone and Erythromycin. E. coli  Multiple Antibiotic Resistance (MAR) index for hand and nasal swab specimens is 0.18 – 0.82. Most of the hand swab specimens (90%) are Multidrug Resistant (MDR), while nasal swab specimen shows 78.57% Multidrug Resistant (MDR).
Conclusion: The predominance of multidrug-resistant E. coli among hospital food handlers makes it imperative to implement infection control measures, including better biosecurity, to ensure that they do not enter the food supply and limit alternatives to inpatient therapy.
Prediction of hypertension risk as an occupational health disease in palm oil factory workers at Gandapura District, Bireuen Regency, Aceh, Indonesia
Authors: Yuziani  , Rizka Sofia  , Harvina Sawitri
Published: May 2024

Introduction: Hypertension is a condition where the pressure in the blood vessels increases continuously. Stress, a risk factor for hypertension, can be caused by a person's workload exceeding the normal time limit. A job that exceeds the normal time limit can trigger work fatigue so that can affect aspects of mental, physical and work time. There is a relationship between mass index (BMI), waist circumference and waist-to-height ratio measurements with blood pressure in working men and women. Workers in palm oil mills are at risk of developing hypertension because of their daily work activities. The prevalence of hypertension in palm oil factory workers is 18.4%, caused by the risk factors of smoking, obesity and waist circumference ratio. The research will be carried out at the palm oil factory, Bireuen Regency. Sampling was carried out by means of simple random sampling on selected subjects using a cross-sectional design. The end result of this study is a formula for predicting the risk of hypertension in palm oil factory workers. The study aims to make predictions of risk factors for hypertension as an occupational health disease in palm oil factory workers.
Patients and methods: Workers in palm oil mills are at risk of developing hypertension because of their daily work activities. The research will be carried out at the palm oil factory in Bireuen Regency, Aceh, Indonesia. Sampling was carried out by means of simple random sampling on selected subjects using a cross-sectional design.
Results: There is a relationship between BMI, waist circumference and waist-to-height ratio measurements with blood pressure in working men and women. Workers in palm oil mills are at risk of developing hypertension because of their daily work activities.
Conclusion: Most of the oil palm workers were male, had a university education, were married, the amount of income was according to the minimum wage and below the minimum wage, they did not smoke, were physically active, and all workers were not stressed. . Based on the risk of hypertension, the average age of the respondents was 34.4 years, blood pressure was above normal, Body Mass Index was in the overweight category and waist circumference was above normal limits.
Exercise improving balance function in the older adult with locomotive syndrome stage 1: a randomized clinical trial
Authors: Nayasista Ajeng Hayu , Rwahita Satyawati Dharmanta  , Yudith Dian Prawitri  , Sri Mardjiati Mei Wulan  , Yukio Mikami  , Soenarnatalina Melaniani
Published: May 2024

Introduction: Fall risk is generally increased in older adults. The aging process is linked to several balance issues and gait abnormalities in the elderly. A multicomponent exercise program for older persons that combines locomotor training and cardiovascular exercise may help the aged population's balance and strength. This study aims to investigate the effects of aerobic exercise and locomotor training on the elderly's capacity to balance.
Methods: This study is a randomized clinical trial with a pre-test and post-test group design. 24 older adults were divided into an intervention group (locomotor training combined with aerobic exercise) and a control group (aerobic exercise only). They underwent locomotor training 3 times a week for 8 weeks under supervision and aerobic exercise 7 times a week 40-70% HR maximal. The pairwise comparisons within-group evaluations, and between-group evaluations used independent- and paired-sample t-tests.
Results: One Leg Stance (OLS) and Timed Up and Go (TUG) test intra-group and inter-group differences were significantly higher (p< 0.05).
Conclusion: The combination of locomotor exercise and aerobic exercise improves static and dynamic balance in older adults with locomotive syndrome stage 1.
Association between immunoscore with lymphovascular invasion and clinical staging in colorectal cancer
Authors: Fachruddin Raden Achmad Hussein , Jeo Wifanto Saditya
Published: May 2024

Background: Despite the immunoscore benefit function as a prognostic tool in colorectal cancer, no study reports its reason. This study tried to identify the relationship between the immunoscore and the incidence of lymphovascular invasion and clinical stage in colorectal cancer patients as a mechanism for immunoscore to predict the outcome of colorectal cancer.
Methods: This is correlational with a cross-sectional study that analyzed medical record data and laboratory results. Immunoscore was collected from an independent private laboratory, and other data (gender, age, diagnosis, tumor location, lymphovascular invasion) were from medical records from the Private Hospital colorectal cancers registry. Data collection was carried out from October to December 2022. We performed data analysis with the Chi-Square statistical test with a significant p-value<0.05.
Results: The results showed that the majority of subjects had tumor locations in the rectosigmoid (25%) and advanced stages (65%) with lymphovascular invasion findings (80%). Chi-Square statistical test shows the result of p = 0.025 and p = 0.64, respectively, lymphovascular invasion and clinical staging.
Conclusion: This study shows that the immunoscore has a dependent relationship with the incidence of lymphovascular invasion and an independent relationship with the clinical stage of TNM in colorectal cancer patients. The application and use of immunoscore are beneficial for clinicians to give suggestions and understanding to patients about their choice of therapy also outcome for the patient.
The effect of added Transcutaneous Vagus Nerve Stimulation (tVNS) on quality of life in patients with chronic low back pain: a randomized controlled trial study
Authors: Halim Muhammad Jasman Erwin , Subadi Imam , Pawana I Putu Alit , Arfianti Lydia , Satyawati Rwahita , Melaniani Soenarnatalina
Published: May 2024

Background: Low back pain can significantly reduce a patient's quality of life if it is not treated properly. The SF-36 questionnaire assesses the patient's quality of life with chronic low back pain. Transcutaneous vagus nerve stimulation (tVNS) is one of the treatment options for chronic pain. This study aims to determine how adding tVNS to exercise treatment affects the quality of life of individuals with chronic low back pain.
Method: 22 subjects in total joined the study consecutively. They were randomly assigned to the intervention group or the control group. Eleven patients receiving exercise therapy without the addition of tVNS made up the control group, and 11 patients receiving exercise therapy and tVNS made up the intervention group. The SF-36 questionnaire was utilized to assess participants' quality of life before and after two weeks of therapy. Throughout the study, safety and adverse events were monitored.
Results: Both the control and intervention groups showed a positive effect on improving the SF-36 score. The improvement of the SF-36 score on the pain aspect differed significantly in the intervention group (p = 0.011). Adding tVNS to exercise therapy produces a better clinical response in improving the quality of life, especially in pain.
Conclusion: tVNS should be considered as an additional therapy to increase patients' quality of life with chronic low back pain.
A systematic review and meta-analysis of the impact of obesity on postoperative outcomes for patients undergoing laparoscopic cholecystectomy
Authors: Natalia Maria Christina  , Wijaya Jeremiah Hilkiah
Published: May 2024

Introduction: Laparoscopic cholecystectomy may reduce post-operative complications in the majority of patients, but it remains a challenge for obesity patients. We aimed to examine the postoperative outcome in obese patients undergoing laparoscopic cholecystectomy.
Method: Each author conducted a search form PubMed, EuropePMC, and Sciencedirect databases from on 30 November 2022. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses we conducted this study. All types of studies, laparoscopy cholecystectomy in obese patients, English papers, older than 18 years old were included in these studies. Abstract only articles, no fully published English papers were excluded from this study.
Results: Nine publications including 7138 patients from 1999 to 2022 were identified. Compared with normal weight patients, adult obese patient had higher conversion rates (P=0.002), blood loss (P=0.009), intraoperative complication (P=0.08), postoperative complication (P=0.04), mortality (P=0.45), longer need of surgical time (P<0.00001). No significance difference in length of stay were found (P=0.98).
Conclusion: This study found that laparoscopic cholecystectomy for obese patients has a higher conversion rates, the need of longer surgical time, and blood loss compared to normal weight individual. Intraoperative, postoperative complication, and mortality were found but not statically significance. Further prospective studies are required to maximize outcome.
Efficacy of tadalafil and l-arginine combination therapy compared with tadalafil-only for the treatment of erectile dysfunction: A systematic review and meta-analysis
Authors: Wibisono Donny Austine , Hidayatullah Furqan , Rizaldi Fikri , Djojodimedjo Tarmono
Published: May 2024

Introduction: Phosphodiesterase type 5 inhibitors (PDE5-I) has known to be the treatment for erectile dysfunction (ED), whereas tadalafil is a PDE5-I that has a rapid onset of action with a long duration of action and is not affected by dietary intake. L-arginine is a supplement that can improve erectile function by increasing the endogenous amino acids required for ideal nitric oxide (NO) synthesis and production. The combination of tadalafil and L-arginine can improve erectile function and testosterone levels. Thus, we conducted a meta-analysis to determine the efficacy and safety of the tadalafil and L-arginine combination therapy compared to tadalafil monotherapy for ED.
Methods: This meta-analysis study is consistent with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A total of four included studies were found by performing a systematic search thoroughly on Embase, MEDLINE, and Scopus databases. This study’s protocol is registered on PROSPERO (CRD42022343590).
Result: The study analysis revealed that the The International Index of Erectile Dysfunction 5 (IIEF-5) scores in the tadalafil and L-arginine combination therapy significantly increased the IIEF-5 scores (p < 0.00001; MD 1.64; 95% CI: 1.13-2.15) compared to tadalafil monotherapy. Testosterone levels were also observed to increase in the tadalafil and L-arginine combination therapy group (p < 0.00001; MD 3.05; 95% CI: 2.05-4.04).
Conclusion: A significant increase in IIEF-5 score and testosterone level is observed in patients with ED who received combination therapy of tadalafil and L-arginine compared to tadalafil monotherapy.
A tuberculosis spondylitis patient with paraplegic manifestations
Authors: Akzatama Nugra , Rahmawati Lita Diah
Published: May 2024

Background: Mycobacterium tuberculosis is the primary causative agent of tuberculous spondylitis (TB spondylitis), a chronic granulomatous inflammatory disease of the spine. Patients with TB spondylitis may have spinal lesions in up to 50% of cases, and 10-45% may also have neurological deficits. We reported a case of severe paraplegia manifesting TB spondylitis in a young adult patient.
Case Presentation: A 28-year-old female Javanese Muslim was admitted to Dr. Soetomo General Academic Hospital in Surabaya, Indonesia with back pain, inability to move, and feeling stiff in both legs. During previous therapy, the patient was thought to have spondyloarthropathy. X-ray examination demonstrated T9 to T10 retrolisthesis and T10 corpus lipping. Thoracolumbosacral MRI with contrast revealed that the patient had TB spondylitis. A debridement and hemilaminectomy of T7-8 for fusion with bone segments at T7-8 were performed on the patient. The patient was treated with oral antituberculosis drugs for 10 months and could walk perfectly 8.5 months after the initial treatment.
Conclusion: This case demonstrates the complexities of diagnosing TB spondylitis, which necessitates the use of multiple disciplines. Because the clinical manifestations of TB spondylitis differ, various methods, including thoracolumbosacral X-ray and MRI with contrast, are required to confirm the disease. As a result, an interdisciplinary collaborative team is required to achieve optimal patient outcomes and to prevent long-term sequalae.
Factors affecting patient safety culture in the nursing section of a type C private hospital in Surakarta using structural equation modeling
Authors: Herdiman Lobes , Susy Susmartini  , Dewani Asmara Sekartaji Pangau  , I Gusti Ngurah Priambadi
Published: May 2024

Introduction: Patient safety culture is a high-quality health service that must be owned by all hospital staff, specifically for type C private hospitals. Therefore, this research selected seven factors influencing patient safety culture and made operational definitions based on references from preliminary research. The indicators used refer to Patient Safety Management Activities (PSMA) based on the International Patient Safety Goals (IPSG) principles regulated by the Minister of Health Regulation 11 of 2017. This research aims to identify hospital elements related to implementing a patient safety culture. It includes individuals, working conditions, work environment, management, awareness related to safety, safety culture, and PSMA.
Methods: Data were collected from 215 respondents through independent questionnaires distributed online to two type C private hospitals in Surakarta City, where 160 nurses work in in-patient rooms and 55 nurses in the Emergency Room (ER). Data collected were analyzed using structural equation modeling (SEM), such as SmartPLS 3.0, to determine the relationship between seven factors: individual, working conditions, work environment, management, safety awareness, culture, and PSMA.
Result: SEM test results in Factors affecting PSMA on the SEM test with a p-significant value of 0.05. A significant direct positive effect on PSMA is the factor of safety culture and work environment. Meanwhile, the indirect significant positive influence on PSMA comprises individual conditions, management, and safety-related awareness factors through safety culture factors. The process of not having a significant direct effect on PSMA is working conditions and safety-related awareness factors.
Conclusion: The involvement of all parties with active roles in every healthcare system is expected to increase a safety culture which can then influence the increase in PSMA.
p16 expression in uterine cervical lesions and its role as diagnostic markers and clinical management
Authors: I Gusti Ayu Sri Mahendra Dewi  , Ni Putu Sriwidyani
Published: May 2024

Background: Cervical cancer is one of the world's third most common gynecologic malignant tumors, especially in developing countries. This cancer is the most common cause of cancer-related death. High-risk human papillomavirus (HPV) is the main cause. p16 is a biological marker that can be used as a surrogate marker to increase diagnostic agreement for high-risk HPV infection. This study proved the differences in p16 expression in various age groups in low-grade cervical intraepithelial neoplasm (CIN), high-grade CIN, and squamous cell carcinoma (SCC).
Methods: The research design was a cross-sectional analytic observational study, with a total sample of 40, taken from biopsy and surgery specimen patients diagnosed with CIN and SCC whose tissues were examined at the Anatomical Pathology Laboratory Faculty of Medicine Universitas Udayana/ Prof. dr. I G.N.G. Ngoerah General Hospital Denpasar. Histopathological diagnosis and determination of the type of cervical lesion were performed by Hematoxylin and Eosin (H&E) staining. p16 expression was evaluated by immunohistochemistry. The results were analyzed using the chi-square test to prove differences in p16 expression in various age groups and the Kruskal-Wallis Test followed by the Mann-Whitney Test to prove differences in p16 expression in low-grade CIN, high-grade CIN and SCC, with a significance level of p < 0.05.
Results: The mean age of low-grade CIN was younger than high-grade CIN, which was 45.5±8.44 compared to 46.1±9.11. The mean age of low-grade and high-grade CIN is also younger than the mean age of SCC, which is 50.9±10.80. There was no significant difference in the expression of p16 in low grade CIN (p=0.34), high-grade CIN (p=0.45) and SCC (p=0.28) in various age groups. The expression of p16 was found significantly differ in all groups (p=0.011). Low-grade CIN significantly differed from high grade CIN (p=0.012) and SCC (p=0.008). However, we found same p16 expression in high-grade CIN and SCC (p = 0.866).
Conclusion: p16 can be used as a screening method for diagnostic markers of high-risk HPV infection and a reference for planning therapy.
Effects of modified hybrid resistance training on concentric quadriceps femoris peak torque and eccentric hamstring peak torque in untrained healthy subjects
Authors: Priyantono Wirawan Indra , Tinduh Damayanti , Prawitri Yudith Dian , Pawana I Putu Alit , Melaniani Soenarnatalina
Published: May 2024

Background: Leg muscular strength may decline as a result of decreased mechanical stress on the muscles brought on by the COVID-19 pandemic's physical inactivity. The hybrid training method uses the force generated by an electrically stimulated antagonist muscle to resist a voluntarily contracting agonist muscle. Due to the lack of external resistance or stability equipment, this exercise may be a good option for strengthening workouts during a pandemic. Modifications were made using conventional stimulation tools because the hybrid training system was difficult to replicate. The study's objective was to analyze the effect of modified hybrid resistance training on concentric quadriceps femoris peak torque (QCON) and eccentric hamstring peak torque (HECC).
Methods: The study was conducted at the Medical Rehabilitation Installation of Dr. Soetomo General Academic Hospital Surabaya. The subjects were 30 untrained healthy men aged 18-40 years divided into the treatment group, which received modified hybrid resistance training and the control group, which received Russian protocol neuromuscular electrical stimulation 3 times per week for 4 weeks. Due to COVID-19 infection, four participants couldn’t continue in intervention. Statistical tests were carried out on subjects that were able to complete the study (treatment: 13, control:13).
Results: There were increases in 60o/sec QCON (p-value 0.005) and 120o/sec QCON (p-value 0.001) in the non-dominant leg in the treatment group. There were increases in 60o/sec QCON (p-value 0.043), 120o/sec QCON (p-value 0.014), and 120o/sec HECC (p-value 0.043) in the non-dominant leg in the control group. There is a significant difference in non-dominant 120o/sec ΔQCON between the two groups (p-value 0.036).
Conclusion: There was a more significant increase in QCON in the modified hybrid training exercises group compared to the Russian stimulation group in untrained healthy subjects.
The effect of Curcuma longa extract on fibroblast count and collagen density in intestinal anastomosis: an experimental study on New Zealand rabbits
Authors: Budiman Sarwendah Pratiwi , Hariastawa I Gusti Bagus Adria , Matulatan Fendy
Published: May 2024

Background: Anastomotic leakage was the most feared complication after intestinal surgery because it could bring morbidity and mortality. Curcuma longa (turmeric) has been known for its effect on wound healing by increasing fibroblast count and collagen density. Nevertheless, its effect on intestine anastomosis has not yet been proven. This study was an experimental study on New Zealand rabbits to analyze the effect of Curcuma longa extract on fibroblast count and collagen density in intestinal anastomosis.
Methods: This study was a randomized control trial experimental study on a New Zealand white rabbit. The rabbits were divided into 2 groups randomly, the control group and the treatment group, which were given Curcuma longa extract for 4 days after laparotomy intestinal resection and anastomosis. Fibroblast count and collagen density of the anastomotic area were evaluated on the 5th day after the surgery.
Results: 36 New Zealand white rabbits underwent laparotomy intestinal resection and anastomosis, then randomly divided into 2 groups. On the 5th day, the subjects were evaluated. The analysis results showed that the control group had a lower mean count of fibroblasts (9.89) than the treatment group (27.11), with the Mann-Whitney analysis showing significant differences (p-value 0.000). The lowest score for collagen density in the control group was +2, with the highest being +3. While on the treatment group, the lowest score was +3, and the highest was +4. The mean value was lower in the control group (10.61) rather than in the treatment group (26.39), with the Mann-Whitney analysis showing significant differences (p-value 0.000).
Conclusion: Curcuma longa extract had an effect on intestinal anastomosis by increasing fibroblast count and collagen density.
Case report: diagnostic approach to malignancy ascites patient who misdiagnosed with abdominal tuberculosis
Authors: Widiana Sang Ketut , Widodo Budi , Purbayu Herry , Sugihartono Titong , Nusi Iswan A.
Published: May 2024

Introduction: Ascites is an accumulation of free fluid with an abnormal amount in the peritoneal cavity. The causes of ascites are hepatic cirrhosis, malignant ascites, and mixed ascites, which can be caused by tuberculosis infection. Malignant ascites is a pathological condition caused by primary abdominal and extra-abdominal malignancies. This study aims to report malignant ascites that was misdiagnosed with abdominal tuberculosis.
Case Presentation: Forty-one years old man came with an enlarged stomach, pain in the abdomen, fever, and decreased appetite accompanied by >20 kg weight loss with a change in bowel habits in the last 3 months. At first, the patient was diagnosed with abdominal tuberculosis and took a tuberculosis drug regimen for almost 2 months. However, the patient did not feel any improvement in the symptoms he was experiencing. The patient then went to Soetomo General Hospital and underwent several examinations. In colonoscopy examination, we found a mass in the transverse colon that almost covered the lumen with hard consistency and was not easy to bleed. Pushing outside the recto-sigmoid lumen causes narrowing of the lumen, and from CT scan showed a solid mass in the pelvic cavity; visible lesions penetrate the serosa to form a picture of "fat stranding," attached to the rectum posteriorly and bluntly to the anterior; multiple nodules in the left mesentery with peritumoral lymphadenopathy can be a feature of malignant soft tissue mass. Ascites accompanied by multiple nodular peritoneal thickening and thickening of the omentum that forms an omental cake can represent peritoneal carcinomatosis. The results of the open biopsy obtained histopathological results in the adverse colon suggesting adenocarcinoma, signet ring cell carcinoma. All the examination results led to the diagnosis of colorectal cancer.
Conclusion: A 41 years old man, who was misdiagnosed with abdominal tuberculosis and had been taking the drug for tuberculosis for 2 months, has no improvement in his symptoms. Then he went to Soetomo General Hospital and underwent several examinations, which led to the diagnosis of colorectal cancer. This instance demonstrates that some doctors still struggle to diagnose colorectal cancer, even if patient outcomes improve with earlier treatment.
Research gap and trend in neurological therapy related to nanotechnology based on bibliometric analysis
Authors: Saleh Arman Yurisaldi , Valentina Riezky
Published: May 2024

Link of Video Abstract: https://youtu.be/3n_K49-K4jM
 
Introduction: The development of nanotechnology science is so fast that there has been a lot of progress in terms of therapeutic research related to diseases in Neurology. To our knowledge, there have been no bibliometric studies in this field, so this study is needed to see research gaps that world researchers can do to accelerate and multiply nanotechnology that can be applied in patient therapy in clinics and collaborate with existing researchers in this field. This research aims to look for gaps in research fields that have not been widely studied in the field of nanotechnology related to neurological diagnosis and therapy and know research trends.
Method: Documents were collected from the Scopus site from 2002 to 2022, totaling 245 documents, which were then analyzed quantitatively with Biblioshiny and Vosviewer software. Furthermore, a qualitative analysis was also carried out.
Results:  Gathered information on document trends, citation counts, authors, producing nations, affiliations, research topics, and research networks. Three developing domains (niches) are three developing domains (niches) that present research opportunities for researchers worldwide. The United States seems to be the industry leader in document production.
Conclusion: The politics of a nation's financing policies heavily influence the advancement of research in the field of nanotechnology connected to the diagnosis and treatment of neurological illnesses. In order to expedite and replicate applications in the therapeutic use of nanotechnology, establishing new international research networks is required. Research gaps might be found through this research.
Predictors of neonatal mortality with congenital heart disease
Authors: Pradnya Paramita Made Indah , Gunawijaya Eka , Yantie Ni Putu Veny Kartika , Kardana Made
Published: May 2024

Link of Video Abstract : https://youtu.be/Vi3785NsB1A
 
Introduction: Congenital heart disease (CHD) is the leading cause of birth defect-associated infant illness and death. In developing countries, the mortality related to CHD increased by up to 25%, but the data about predictors of mortality are limited. The purpose of this study was to investigate the predictors of mortality in neonates with CHD.
Methods: We conducted a case-control study of neonatal mortality with CHD from January 2018 to October 2022. Data were collected from the neonatal registry in Prof Ngoerah Hospital, Bali. Characteristics and clinical risk of mortality were analyzed. Chi-square and logistic regression analysis was carried out to determine the potential predictor of mortality. 
Results: A total of 288 neonatal with CHD were analyzed. Neonatal morbidities such as extremely low birth weight (ELBW) were found in 7.6%, asphyxia in 50.7%, multiple congenital anomalies (MCA) in 13.2%, pulmonary hypertension (PH) in 13.5%, sepsis in 66.3%, and severe form of CHD in 50.7%. Patent ductus arteriosus (PDA) was the most acyanotic CHD (35%). Mortality resulting from CHD was 27%. ELBW, severe and moderate asphyxia, MCA, PH, sepsis, and severe form of CHD were significant mortality predictors (p<0.05) with (OR; 95%CI) were (6.21; 1.24-31.12), (4.13; 1.93-8.81), (3.20;1.69-6.08), (2.70; 1.17-6.24), (2.54;1.10-5.84), (2.33; 1.28-4.22), (2.00; 1.15-3.49) respectively.
Conclusion: ELBW, severe and moderate asphyxia, MCA, PH, sepsis, and severe forms of CHD are predictors of neonatal mortality with CHD.
Management of critical patient infected with extended spectrum beta-lactamase (ESBL) producing Escherichia Coli
Authors: Suyata Maya Permatasari , Arif Syafri Kamsul , Tanra A Husni , Muchtar Faisal
Published: May 2024

Introduction : Antibiotics has been widely used in medical practices nowadays. Antibiotics usage is often massively performed and sometimes not as indicated. Un-judicious and overuse of antibiotics that is not correlated with clinical pathways could result in antimicrobial resistance. Extended Spectrum Beta-Lactamase (ESBL) is an enzyme that has a capability of hydrolysing and deactivate Penicillin group antibiotics, 1st, 2nd, 3rd generation cephalosporin, as well as Monobactam antibiotics, further will cause resistance to those antibiotics. These matters will make it difficult to choose antibiotics. This article will discuss patients with Escherichia coli infection with ESBL in septic shock and its management.
Case Presentation: Thirty five years old female with BMI 22 Kg/m2 was admitted to ICU with septic shock caused by infected sacral pressure sore. She has a history of traffic accidents and was mechanical ventilated 6 months ago. We performed septic shock management according to the Surviving Sepsis Campaign recommendation along with other supportive management. Macro (temperature, heart rate, mean arterial blood pressure) and micro haemodynamic (lactate, pCO2 gap, central venous pressure, vena cava inferior diameter) changed on day 3. We change the antibiotic according to the culture result. Escherichia Coli was found in blood culture with ESBL. The antibiotics were Amikacin combined with Tigecycline. Improvement was seen on the fifth day, then stopped the vasopressor, on day six weaned the mechanical ventilation.
Conclusion: Resuscitation and rapid source control of infection focus, combined with appropriate antibiotic choice become the key principle in managing patients with septic shock caused by Escherichia coli with ESBL.
Correlation between age, the clinical status of patients, operator characteristics, and surgical landmarks with the incidence of tracheotomy complications
Authors: Anindito Evan , Yusuf Muhtarum , Ahadiah Titiek H
Published: May 2024

Link of Video Abstract: https://www.youtube.com/watch?v=YTXRefXDzlU
 
Background: Tracheotomy is a surgical procedure often performed in the field of ear, nose, throat-head, and neck surgery. This study aims to analyze the risk factors for tracheotomy complications based on age, clinical status, operator characteristics and surgical landmarks.
Methods: This study was analytically observational with a case-control design using secondary data. The study was conducted at Dr. Soetomo Hospital Surabaya. Patients who had a tracheotomy for the period January 1, 2015 to December 31, 2019 and met the research criteria were included as samples.
Results: This study obtained 174 patients with 136 men and 38 women. Analysis of the correlation between age and the incidence of tracheotomy complications obtained p=0.008 (p<0.05). The correlation between clinical status of patients with complications of tracheotomy was found to be significant (p=0.001). The correlation between operator characteristics and tracheotomy complications was significant (p=0.000) and the correlation between surgical landmarks and tracheotomy complications was significant (p= 0.000).
Conclusion: The correlation between age, the patient's clinical status, operator characteristics and surgical landmarks with the incidence of tracheotomy complications from 174 patients who underwent tracheotomy surgery at Dr. Soetomo Hospital Surabaya showed that these factors mutually influence the postoperative complications of tracheotomy.