bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis medical therapeutic communication training evaluation at Regional Hospital of Dr. Pirngadi, Medan City
Authors: Lubis Arfah Mardiana , Zulfendri  , Syahri Isyatun Mardhiyah , Rochadi R. Kintoko
Published: January 2025

Introduction: Medical therapeutic communication training is conducted at Dr. Pirngadi Regional Hospital, Medan City in order to allow doctors to improve their skills with regard to therapeutic communication. However, a failure to carry out this training evaluation in an optimal manner means that the hospital management has been unable to get a picture of any weaknesses in the training. This study aimed to analyze the evaluation of training at RSUD Dr. Pirngadi, Medan City.
Methods: This study was a qualitative research carried out at Dr. Pirngadi Regional Hospital, Medan City. Ten respondents were selected by means of the snowball method. Data was analyzed using thematic analysis.
Results: An evaluation of medical therapeutic communication training at a hospital was conducted by looking at the number of training participants in order to meet the needs of hospital accreditation standards, which forms the basis for conducting medical therapeutic communication training in hospitals.
Conclusion: Evaluation of the training conducted was not effective enough to indicate the absorption of the training participants of the material provided. This is because the training needs analysis stopped at organizational analysis and was conducted using a demand-led approach. Therefore, it is recommended that the Hospital Education and Training Sector carry out training needs analysis at the Task analysis stage and use a training-centered Approach. Additionally, complementing the training material with pre-test, post-test, and simulation questions will allow the training evaluation to achieve the second level of the Kirkpatrick Model of training evaluation, namely learning.
An unusual case of primary hepatic neuroendocrine tumor: a case report
Authors: Setyadi Titis Hadiyanti , Amrita Putu Niken Ayu
Published: January 2025

Introduction: Based on the results of medical imaging, primary hepatic neuroendocrine tumors (PHNETs) are an infrequent entity that is challenging to differentiate from other liver tumors. This case was taken to demonstrate the problem of diagnosis and management in a patient diagnosed with PHNET.
Case Presentation: We report an unusual case of a 41-year-old female with PHNET who initially had a chief complaint of an enlarged abdomen accompanied by a hard, solid lump in the upper right region. Complaints have been felt for the last four months and are getting bigger, accompanied by weight loss of more than 10 kg in the last three months. The patient was misdiagnosed with hepatocellular carcinoma based on an abdominal CT scan. Alpha-fetoprotein levels were within the normal limits. No serologic evidence of hepatitis B or C virus infection was found. A liver biopsy was performed with the result of PHNET.
Conclusion: It has been extremely difficult to diagnose this rare tumor, so we emphasize the significance of liver biopsy.
One health approach for taeniasis/cysticercosis control measure in Bali, Indonesia: updated situations, implementations, and challenges
Authors: Sudewi Anak Agung Raka , Swastika Kadek , Sudarmaja I Made , Wulanyani Ni Made Swasti , Dharmawan Nyoman Sadra , Wirawan I Made Ady , Kumbara Anak Agung Ngurah Anom , Pramitasuri Tjokorda Istri , Karang Anak Agung Ayu Suryapraba Indradewi , Ni Made Susilawathi
Published: January 2025

Link of Video Abstract: https://youtu.be/RXotvX4x_ZM
 
Background: Taeniasis/cysticercosis (TC/CC), a group of infectious diseases caused by Taenia solium, is still a burden in Bali, particularly in the Kubu subdistrict. By utilizing Dukuh village as the representative location of TC/CC in the Kubu subdistrict as the continuation of earlier epidemiology studies in the same area, this study provides current situations and state-of-the-art risk factors of TC/CC along with an assessment of post-interventional indicators and their potential challenges in terms of One Health-based TC/CC control in Bali.
Methods: Community-based epidemiological surveys were conducted in the Kubu subdistrict in 2020 as a continuity of previous surveys held in 2011, 2013, 2014, 2015, 2016, and 2019, which have been published.
Results: In absolute counts, 14 out of 474 people were more seropositive than in 2019. Pig seroprevalence in Kubu was 2.92% (8/274) during the 2020 survey. A few related risk variables were investigated. Community-based interventions effectively elevated knowledge and behavior towards TC/CC in the Dukuh village society.
Conclusion: This study has significantly increased public knowledge, behavior, and awareness towards TC/CC as an early step in controlling the disease through the designated One Health framework. Despite some challenges in each stage of implementation, the One Health approach to TC/CC control measures in Bali is a worthwhile contribution to be made.
Correlation between serum interleukin-6 levels and the severity of Enlist ENL Severity Scale (EESS) in Erythema Nodosum Leprosum (ENL) patients
Authors: Nahrisyah  , Lubis Ramona Dumasari , Siregar Remenda
Published: January 2025

Introduction: Leprosy is a chronic infection caused by Mycobacterium leprae (M. Leprae) which no biological examination can yet be appointed as an early marker. This research is aimed to analyze the correlation between serum IL-6 levels and the severity of the ENLIST ENL Severity Scale (EESS) in ENL.
Methods: A cross-sectional study was conducted on all leprosy patients with ENL who sought treatment at the Dermatology and Venereology Polyclinic, North Sumatra University Hospital, dr. Pirngadi General Hospital, and H. Adam Malik General Hospital Medan. ENL patients who were uncooperative, with infectious, autoimmune, malignant diseases, or who were pregnant or breastfeeding were excluded. Data processing was carried out with the help of statistical software with a significance value <0.05.
Results: A total of 40 ENL patients were studied. The mean age of the patients was 33.10±12.23 years, male (70%), high school (75%), and not working (95%). The degree of severity based on mild EESS was more dominant than severe, namely 57.5% vs 42.5%, respectively. The median IL6 level was 64.65±34.06 in ENL patients and was higher in severe compared with mild EESS, namely 105.18±24.14 versus 50.08±16.84, respectively (p=0.103, p=0.167, respectively). There was a very strong and significant positive correlation between serum IL6 levels and EESS (r: 0.813 and p<0.05).
Conclusion: There was a correlation between serum IL6 levels and EESS. Further study is needed in measuring serum IL6 levels to detect early severity of ENL.
The influence of perineural invasion on anal incontinence in postoperative rectal cancer cases by Wexner Score
Authors: Diyansah Firah , Lesmana Tomy , Rahniayu Alphania , Danardono Edwin , Septarendra Denny
Published: January 2025

Introduction: Rectal cancer is the third most common cancer globally. It is often treated with a Low Anterior Resection (LAR) procedure to avoid permanent colostomy. However, LAR can cause Low Anterior Resection Syndrome (LARS), impacting around 80-90% of patients and resulting in issues like anal incontinence. Our study delves into the connection between Perineural Invasion (PNI) and anal incontinence in postoperative rectal cancer cases following LAR, considering the significant impact of PNI on nerve function and the prevalence of anal incontinence in LARS cases. This study aims to explore the relationship between PNI and anal incontinence in postoperative rectal cancer cases following LAR.
Methods: This cross-sectional study examines the correlation between postoperative anal incontinence and PNI in a defined participant group chosen based on specific criteria. The study centers on rectal cancer patients who underwent LAR surgery, including those with and without perineural invasion, drawing data from Dr. Soetomo Surabaya Hospital records spanning January 2020 to December 2022.
Results: Characteristics of subjects, considering age and gender, were analyzed to ensure no differences exist between the negative and positive perineural invasion groups. Statistical analyses show similarities in age distribution (p=0.279) and gender distribution (p=1.000) between these groups. Chi-square analysis reveals a significant relationship between perineural invasion and cell differentiation grading (p=0.035). A significantly lower Wexner score was also found in the PNI negative group than in the PNI positive group (p=0.021).
Conclusion: A significant correlation was found between PNI, cell differentiation grading, and Wexner score. PNI-positive patients are likely to have incontinence compared with PNI-negative patients.
Open hernia repair and risk factors of recurrence at hospitals in Aceh, Indonesia
Authors: Sayuti Muhammad , Akbar Muhammad Khalilul , Simanjuntak Ami Dhania Rovi , Aprilita Rani
Published: January 2025

Link of Video Abstract: https://youtu.be/T7_kPOIgTjo
 
Background: Hernia is a condition involving bulging a whole or part of an organ due to defect on the abdominal wall. Inguinal hernia is one of the most common types of abdominal wall hernia. There are approximately 20 million cases of hernia repair surgery done annually. Hernia repair is deemed successful if there is no recurrence and complications at a relatively affordable cost, and patients can return to daily routine immediately.  The incidence of recurrence is affected by many factors, such as, the knowledge and skills of surgeons, surgical procedures and type of mesh used, mesh fixation techniques, management of lateral and medial hernia sacs, sliding hernia, lipoma in inguinal canal, surgery time, type of anesthesia, post-surgery complications, and factors coming from patients. This study was done to assess the prevalence of inguinal hernia and its recurrence, surgical procedures, and the risk factors related to the recurrence.
Methods: This cohort retrospective study used a total sampling technique in inguinal hernia patients who had received surgery.
Result: There were a total of 1457 patients from 2018 – 2022 from 10 public and private hospitals in North Aceh Regency and Lhokseumawe city. The study found that most hernia patients were male under 60 years of age. The highest risk factors of inguinal hernia were seen in patients with history of vigorous physical activity, chronic cough, and constipation.
Conclusion: Open hernia repair with mesh graft was the most used surgical procedure and most inguinal hernia patients did not have recurrence.
Surgical approach in lumbar spine tuberculosis, which is best? A meta-analysis
Authors: Rahardjo Irsa , Martiana I Ketut , Utomo Budi
Published: January 2025

Link of Video Abstract: https://youtu.be/ZORIuJI9O2I
 
Introduction: Lumbar spine is the area with the maximum spinal load, great shearing force and the stress concentration points with high range of motion. Proper surgical approach in lumbar spinal TB will not only affect the biomechanical outcome but also the surgical outcome. Therefore, this study aims to analyze which of the two most commonly used approach, posterior or combined approach, is best for lumbar spinal TB
Methods: Studies comparing surgical approach of lumbar or lumbosacral spinal tuberculosis by single posterior approach versus combined anterior and posterior approach were identified in a literature search conducted from study inception to February 2023. Visual analog score (VAS), Cobb angle, Lordotic angle, Japanese Orthopedic Association (JOA) score, Erithrocyte Sedimentation Rate (ESR), surgical time, intraoperative bleeding, complication, and time of bone graft fusion was analyzed.
Results: In total, 855 studies were found from the search engines. From screening, 10 studies were finally included for the final quantitative analysis. No difference in VAS (p=0.87) and cobb angle difference (p=0.65) were found from the two studies. Better outcome for combined approach was found in terms of ESR decreasing (p=0.02), and time of bone graft fusion (p=0.09). Meanwhile, better outcome for posterior approach was found on lordotic angle (p=0.02), surgical time (p<0.05), intraoperative bleeding (p<0.05), and complication rate.
Conclusion: This meta-analysis found that posterior approach on one or two level of lumbar spinal TB enables better lordotic correction angle, surgical time, intraoperative bleeding, and complication incidence compared to combined approach.
Entrepreneurial skill level and self-perception of international young family doctors: Before and after basic entrepreneurship training
Authors: Erfen Gustiawan Suwangto
Published: January 2025

Link of Video Abstract: https://youtu.be/xQBeStPkY6g
 
Background: Medical doctors lack entrepreneurship training. Thus, we held training that stimulates international young family doctors (in residency training or under 5 years after residency training) based on modification of standardized modules by International Labor Organization (ILO) in late 2019 until late 2020. This study aimed to measure the character readiness of young family doctors in entrepreneurship, review entrepreneurial traits and tendencies, competency clusters are identified, and get input in this training program.
Methods: This research was qualitative research using a descriptive and cross-sectional approach with voluntary sampling involving 32 young family doctors (members of the Asia Pacific World Organization) from end of 2019 to the end of 2020. We tested entrepreneurial skill level and self-perception before and after training. Data collection used structured and semi-structured questionnaires containing close-ended questions. Further data was analyzed to test significance using t test, paired sample test, and K-means to classify.
Results: Most trainees don’t know about self-serving disclosure, financial relations, and marketing budget in the medical business. There was a significant difference in the pre-test and post-test scores and we got 2 cluster groups with different values regarding entrepreneurial skills and self-perceptions among participants.
Conclusion: self-perception of young family doctors is not ready to become entrepreneurs, so further understanding of entrepreneurial content is needed. There are eight competencies built in this entrepreneurial training. Two competency clusters based on skill level were obtained.
A Comparison of Cornell and Sokolow-Lyon Electrocardiographic Criteria for Detecting Left Ventricular Hypertrophy In Type 2 Diabetes
Authors: Listin Suriyanti , Tandean Pendrik , Aman Andi Makbul , Bakri Syakib , Mapanggara Idar , Zainuddin Andi Alfian
Published: January 2025

Background: Type 2 diabetes mellitus is commonly related to asymptomatic ventricular hypertrophy. While echocardiography is the gold standard, electrocardiography (ECG) is a proper diagnostic method that is both practical and cost-effective. ECG may accurately diagnose left ventricular hypertrophy (LVH) with a sensitivity and specificity similar to echocardiography. However, due to the high cost of managing diabetic patients, there is a need for a simple diagnostic tool to detect early cardiovascular complications. This study aimed to compare the diagnostic performance of Cornell and Sokolow Lyon's criteria for detecting LVH in type 2 DM.
Methods: This research is a cross-sectional analysis including 84 participants. The objective is to evaluate the diagnostic accuracy of Cornell voltage and Sokolow's criteria for detecting left ventricular hypertrophy (LVH). The sensitivities and specificities were calculated by constructing a ROC curve to diagnose LVH.
Results: The Cornell voltage criterion demonstrated superior performance compared to the Sokolow Lyon voltage criteria in the examination of the area under the ROC curve. The Cornell voltage criteria demonstrated an enhanced sensitivity of 66.67%, a specificity of 95.24%, and an AUC of 0.814.
Conclusion: The Cornell criteria had better performance sensitivity than the Sokolow-Lyon criteria for detecting LVH in type 2 DM.
Comparison of five growth factors in the secretomes of hypoxic bone marrow mesenchymal stem cells and hypoxic adipose mesenchymal stem cells
Authors: Putra Zainurrahman Kurnia , Mahyudin Ferdiansyah , Suroto Heri
Published: January 2025

Introduction: The Secretome consists of proteins secreted by human cells, containing various serum proteins and growth factors (GFs) that can aid in tissue repair and regeneration. The two most commonly utilized tissues for producing secretomes are Adipose-Derived Mesenchymal Stem Cells (AdMSCs) and Bone Marrow Mesenchymal Stem Cells (BM-MSCs). Hypoxic conditions are also one of the critical preconditioning factors that enhance the efficacy of the secretome. By analyzing and comparing the growth factor profiles between these two cellular sources, we aim to elucidate their potential therapeutic applications and further our understanding of the underlying mechanisms driving their regenerative abilities.
Methods: A randomized controlled post-test-only group design study was conducted at the Cell and Tissue Bank of Dr. Soetomo Hospital. Secretome was derived from AdMSCs and BM-MSCs cultured under hypoxic conditions (5% O2 level). VEGF, PDGF, IGF-1, TGF-β, and bFGF from each group were analyzed by ELISA and compared.
Results: Each group consisted of 7 samples. PDGF levels were significantly higher in the AdMSCs group (7.99 ± 0.644) compared to the BM-MSC group (7.21 ± 0.46); (p = 0.013; p<0.05). Meanwhile, IGF-1 levels were significantly higher in the BM-MSCs group (16.42 ± 1,878) compared to the AdMSCs group (14.2 ± 0.988); (p = 0.021; p<0.05). There were no significant differences in other growth factors between the two groups, including bFGF (0.57 ± 0.05 vs. 0.61 ± 0.07; p = 0.207), VEGF (1,644.00 ± 123.65 vs. 1,588.26 ± 117.80; p = 0.405), and TGF-β (1,323.29 ± 145.36 vs. 1,264.06 ± 121.60; p = 0.425).
Conclusion: No significant differences in VEGF, TGF- β, and bFGF between the two groups. Therefore, AdMSC can be a better alternative to BM-MSC as it is easier to obtain, readily available, and has higher PDGF content.
Recent update on long COVID syndrome: Immunopathogenesis and clinical consequences
Authors: Soegiarto Gatot , Djajapranata Kenneth Martino
Published: January 2025

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in a global pandemic with millions of confirmed cases. Despite the majority of patients recovered from the acute infection, a subset of individuals experiences persistent symptoms known as long COVID, creating a distinctive clinical entity. Immunopathogenesis emerges as a central player in the intricate web of long-term COVID, involving chronic inflammation, autoantibody formation, and sustained viral presence. The syndrome manifests across diverse organ systems, with neurological, cardiovascular, and musculoskeletal implications. Prolonged lung damage and neurological sequelae significantly contribute to the broad spectrum of symptoms observed, ranging from dyspnea to cognitive impairment. Although the understanding of long COVID continues to evolve, navigating the epidemiology of long COVID remains challenging due to varied definitions and study populations among published studies. In addition, various risk factors, encompassing age, gender, comorbidities, and initial COVID-19 symptomatology, further contribute to the complexity of long COVID. Therefore, this review aims to comprehensively explore long COVID in terms of its definition, epidemiology, recent insights into immunopathogenesis, clinical manifestations, underlying mechanisms, and possible management of long COVID syndrome.
Low tumor-infiltrating lymphocytes (TIL) and high platelet lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and mean platelet volume (MPV) as a risk factor of metastasis in triple-negative breast cancer (TNBC)
Authors: Anggaraditya Putu Bagus , I Gede Budhi Setiawan  , Adiputra Putu Anda Tusta
Published: January 2025

Introduction: Triple Negative Breast Cancer (TNBC) is a subtype of breast cancer that is more aggressive and has a poor prognosis associated with an increased risk of metastasis. Cancer cells are known to trigger an inflammatory process which in turn causes tissue and vascular invasion, leading to changes in the levels of several hematological components. Unfortunately, research regarding various biomarkers in TNBC metastasis is still limited and argumentative. This study aims to determine the role of immune system-derived indices as biomarkers of metastasis in TNBC.
Method: This is a case-control study to examine the relationship between tumor-infiltrating lymphocyte (TIL), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) on metastasis in patients with TNBC subtype breast cancer. This research took place at the Medical Records Installation at RSUP Prof. DR. I.G.N.G Ngoerah Denpasar from August 2021 – April 2022. Research subjects were breast cancer patients with TNBC subtypes with metastases and without metastases who were registered in the Surgical Oncology Division in 2016-2021. All data analysis used SPSS for Windows version 23.0 with the p-value considered significant if p<0.05.
Results: A total of 100 research subjects were divided into metastatic (44 patients) and non-metastatic (56 patients) groups with a mean age of 52.97 ± 12.67 and 51.98 ± 10.86 years, respectively. Bivariate analysis showed a significant relationship between TIL (OR 0.163; IK95% 0.067 – 0.399; p=0.000), NLR (OR 3.644; IK95% 1.585 – 8.375; p=0.002), PLR (OR 9.755; IK95% 3.872 – 24.580; p=0.000), MPV (OR 9.500; 95% CI 6.512 – 58.393; p=0.000) on the incidence of metastasis. Multivariate analysis showed a significant relationship between the NLR and MPV variables (p<0.05).
Conclusion: Patients with metastases had significantly higher NLR and MPV values and significantly increased risk of metastasis in TNBC
Physical activity as hypertension and diabetes mellitus risk factors in the adult population, measured using an adaptation of the Global Physical Activity Questionnaire (GPAQ)
Authors: Setyawan Sigit , Wijayanti Lilik , Supriyana Dwi Surya , Listyaningsih Endang , Riyadi Slamet , Ma’rufah Siti , Haryati Sri , Negara Khesara Sastrin Prasita , Sari Yulia , Dirgahayu Paramasari , Sawartuti Retno
Published: January 2025

Link of Video Abstract: https://youtu.be/O1q96lFA5q0
 
Background: The prevalence of metabolic syndrome (MetS) is disproportionately high in elderly adults as a result of complex, continuing socioeconomic influences. Insulin resistance, abdominal obesity, hypertension, hypertriglyceridemia, high blood sugar, and low HDL-C are all symptoms of mets. This descriptive study described the levels of physical activity, sedentary behavior, and MetS risk variables in the older population.
Methods: Community members were asked to complete the Global Physical Activity Questionnaire (GPAQ) and a survey on self-reported MetS risk factors (n = 120). Data were analyzed using SPSS version 22.0 for Windows.
Results: Chi-square tests were used to analyze the data. With a BMI of 31.4 (8.2) kg/m2, the average (SD) age was 57.8 years (14) old. Across age groups, the intensity of sedentary, work-related, and leisure physical activity (PA) was reported. For those aged 50, 50-60, and 60+, the median (interquartile range) daily sedentary time was 200 (78, 435), 240 (120, 420), and 180 (60, 300), respectively (p = 0.973).
Conclusion: To adopt targeted methods to lower the prevalence of chronic disease in this situation, it is crucial to have a thorough understanding of the types, frequencies, and intensities of the older community. Future community-based initiatives should lower MetS risk factors and enhance quality of life.
Neutrophil – Lymphocyte Ratio (NLR) predicts poor outcome in post-cardiac surgery involving aortic cross-clamping among pediatric patients with Congenital Heart Diseases (CHD): a literature review
Authors: Raharjo Fumansha Cipto , Soebroto Heroe , Utamayasa I Ketut Alit
Published: January 2025

Link of Video Abstract: https://youtu.be/LS9N9Q61Nqg
 
Background: Neutrophil-Lymphocyte Ratio (NLR) has been reported as an independent risk factor of poor outcomes in post-operative patients. Higher NLR is associated with extended Length of Stay (LOS) and nosocomial infections. Aortic Cross Clamping (ACC) is a procedure involved in many open-heart surgeries. Clamping and unclamping the aorta has been shown to cause several changes within the vascular lining, which include promoting inflammatory processes due to vascular remodeling.
Methods: The literature reviewed in our study was gathered from PubMed and Google Scholar. An advanced search was conducted on both Google Scholar and PubMed Builder, with the keywords used being ("Neutrophil-Lymphocyte Ratio") AND "Outcome," AND "Aortic Cross Clamping" AND "congenital heart disease". We also reviewed the articles cited within the literature to broaden the search results.
Results: From all 5 selected articles, it could be concluded that NLR counts are statistically significant with the prognosis or outcome of post-cardiac surgery in pediatric patients with aortic cross-clamping and/or CPB duration. A more than 2-3 ratio shows a significant difference in subjects with longer hospital and ICU stays and nosocomial infections.
Conclusions: The NLR ratio predicts worse outcomes in patients with CHD post-cardiac surgery involving CPB and ACC. A higher NLR ratio is significantly associated with extended LOS in the hospital and ICU, the use of mechanical ventilation, and nosocomial infection.
Allele frequencies and data from 23 STR loci in the Tengger population, Indonesia
Authors: Purwanti Tutik , Ahmad Yudianto  , Ni Wayan Tirtaningsih  , Erfan Kusuma  , Qurrota A'yunil Huda  , Indah Nuraini Masjkur  , Abdul Hadi Furqoni
Published: January 2025

Introduction: Social interactions such as marriage patterns in communities descended from the Tengger ethnic group are hypothesized to affect genetic variations that occur in communities descended from the Tengger ethnic group in the Tengger highland area. DNA identification using Short Tandem Repeat (STR) is a reference for assessing genetic variations that exist in populations. This research aims to determine allele frequencies and genetic variations in the Tengger tribe in East Java, Indonesia.
Method: This observational study used 50 from the Tengger tribe. DNA isolation was done using the Promega kit, PCR was done using 23 autosomal STR loci, and visualization was done using Capillary electrophoresis to obtain allele data from all loci. The data is analyzed and then presented using tables and graphs.
Result: The results show various allele frequencies and the D10S1248 locus on allele 13 has the highest frequency with 0.5300. The percentage of homozygous and heterozygous alleles shows that the CSF1PO locus has a homozygous allele percentage of 42% and the D21S11 and SE33 loci have a heterozygous allele percentage of 94%. The highest Heterozygosity value is found at the SE33 locus with a value of 0.9098 and the highest Homozygosity value is at the CSF1PO locus with a value of 0.3864.
Conclusion: The various allele frequencies and forensic data obtained conclude that the Tengger tribe has unique characteristics.
Profiles of molecular subtypes and clinical responses to anthracycline-based neoadjuvant chemotherapy in locally advanced breast cancer at Dr. Soetomo General Hospital, Surabaya
Authors: Rahman Hadian , Ali Iskandar , Susilo Dwi Hari
Published: January 2025

Link of Video Abstract: https://youtu.be/p3fI1xefgYg
 
Introduction: Breast cancer is a genetically and clinically heterogeneous disease with multiple subtypes. The molecular subtype of breast cancer is one of the significant predictors of chemotherapy response. Until now, anthracycline-based neoadjuvant chemotherapy (NACT) is still one of the recommendations in the management of locally advanced breast cancer (LABC).
Methods: Between January 2017 and December 2021, a descriptive study was performed on 130 LABC patients receiving anthracycline-based NACT at Dr. Soetomo General Hospital Surabaya. Information on demographics, stage, chemotherapy regimen, number of cycles, histology, and immunohistochemistry testing was gathered from the patient's medical record. Human epidermal growth factor receptor 2 (HER2) positive was +3, high Ki-67 ≥ 20%, and 1% were the cut-off values for positive hormone receptors (HR) status for both estrogen receptor (ER) and progesterone receptor (PR).
Results: Out of the 130 patients, we found Luminal A subtype in 11 patients (8.5%), luminal B 83 patients (63.8%), HER2-enriched 14 patients (10.8%), and triple-negative breast cancer (TNBC) 22 patients (16.9%). The clinical response of anthracycline-based NACT in the Luminal A subtype was 81.8%, Luminal B was 71.1%, HER2-enriched was 92.9%, and TNBC was 45.5%.
Conclusion: The Luminal B subtype is the most common molecular subtype in LABC patients at Dr. Soetomo General Hospital Surabaya. In contrast, the HER2-enriched subtype had the highest clinical response to anthracycline-based NACT.
Age and duration of hormonal therapy affect the recurrence of ovarian endometrioma after conservative surgery: a retrospective analytical observational study
Authors: Indrayanti Sofiana , Hendy Hendarto  , Sri Ratna Dwiningsih
Published: January 2025

Introduction: Ovarian endometrioma has a significantly high recurrence rate after surgery. Postoperative hormonal therapy may be useful in preventing recurrence. This study assesses recurrence rates, timing, and risk factors for patients with ovarian endometrioma who had conservative surgery and received hormonal therapy for ≤6 months and >6 months.
Methods: A retrospective study involved 111 endometriosis patients who underwent conservative surgery, divided into two groups based on postoperative hormonal therapy duration (≤6 months and >6 months). Recurrence rates, time to recurrence, and influencing factors were documented.
Results: The cumulative recurrence rate was 35.1% (39 patients) postoperatively in the first 24 months. Patients receiving hormonal therapy for ≤6 months had a 41.6% recurrence rate with a median recurrence at 14 months, while those with therapy for >6 months had a 9.1% recurrence rate with a median recurrence at 24 months. Significant recurrence factors included age at surgery (p = 0.006, OR 0.89, 95% CI 0.83 - 0.97), prior surgery history (p = 0.010, OR 4.94, 95% CI 1.46 - 16.78), therapy duration (p = 0.005, OR 11.04, 95% CI 2.04 - 59.65), and surgical technique (p = 0.001, OR 6.042, 95% CI 2.17 - 16.79). BMI, bilaterality, and cyst size were not statistically significant.
Conclusion: Younger age at surgery and prior surgical history correlate with a higher recurrence rate, and long-term postoperative hormonal therapy (> 6 months) and laparoscopy decrease the recurrence rate.
The differences in quality of life between open thoracotomy and video-assisted thoracoscopic surgery (VATS): a literature review
Authors: Heluth M Hanafie , Winarno Dhihintia Jiwangga Suta , Sembiring Yan Efrata
Published: January 2025

Link of Video Abstract: https://youtu.be/4tAH6YzX6l0 
 
Introduction: Thoracotomy is considered one of the most common surgical procedures related to pain. Patients may consider postoperative complications (such as pain) in the hospital as an acceptable risk, but patients are not ready to accept long-term disability that can affect the patient's daily life.
Methods: This article was conducted by analysis and synthesis from various references. The author uses “video-assisted thoracoscopic surgery-VATS" AND “Open Thoracotomy” AND “Quality of Life" as keywords to explore the literature from PubMed, Google Scholar, ProQuest, and Clinical Key. The related papers published in the last fifteen years were included and non-full-text papers were excluded. These papers were analyzed subsequently to answer the aim of this study.
Results: We obtained a total of four articles that met our review criteria. Up to six journals were extracted from PubMed, Google Scholar, ProQuest, and Clinical Key. According to our review method considerations, many articles excluded by the year of publication criteria are out of date.
Conclusions: Most studies still show VATS's superiority over thoracotomy. There is a difference in the quality-of-life scores of patients after VATS compared to thoracotomy. VATS shows an improvement in quality of life after the procedure. VATS revealed significantly better results in physical function, physical role, bodily pain, and general health than open thoracotomy.
Between policy and practice: a qualitative insights into government-led stunting reduction programs in Lhokseumawe, Aceh, Indonesia
Authors: Ikhsan Maulana , Putri Baluqia Iskandar , Fonna Tischa Rahayu , Matondang Adinda Fahira Dyen , Mailyn Yaiza Aynaya
Published: January 2025

Link of Video Abstract: https://youtu.be/4pqURoFHqe0
 
Background: The 2021 Indonesian Nutrition Status Study (SSGI) found numerous regions have stunting rates above the national average, for instance, in Aceh province, which has been recorded at 33.2%. Numerous strategies have been undertaken to mitigate the prevalence of stunting in Aceh, such as providing additional food, social funds, and iron supplement tablets for adolescent girls in senior high school. However, certain regions, including Lhokseumawe Municipality, have had an upward trend in stunting rates, specifically a 0.7% increase from 2021 to 2022. This number indicates that the efforts made by the local health stakeholders thus far have been insufficient to reduce stunting completely.
Methods: This study qualitatively examines the government-led stunting reduction initiative in Lhokseumawe. The study's principal data collection approach is in-depth interviews with families at risk, field officers, and other health stakeholders about stunting reduction program implementation.
Result: The stunting screening process is insufficient in addressing risk factors, lacks focused strategies, and exhibits uneven data collecting. The supplementary food program lacks specificity in addressing the needs of stunted children and encounters complications. Additionally, financing priorities, overlaps, and socioeconomic factors impede the collaboration between governmental and non-governmental institutions.
Conclusion: This study indicates that the government's stunting reduction program is implemented differently in the field. This study contradicts the typical stunting management approach of referring all stunting cases to pediatricians. Additionally, the stunting reduction program only addresses dietary interventions, not risk factors. Due to ineffective coordination between intra- and extra-government bodies, stunting families receive misdirected support.
The Association Between Types of Admission Selection and Academic Achievement of First-Year Medical Students
Authors: Manuaba Ida Bagus Amertha Putra , I Gusti Ayu Sri Darmayani  , Made Violin Weda Yani  , Putri Ayu Wulandari  , Ni Kadek Yudit Erawati  , I Gede Krisna Arim Sadeva  , Ni Luh Putu Larasati Prabawaning Tyas  , Gede Wirata  , Dwijo Anargha Sindhughosa  , I Gede Putu Supadmanaba
Published: January 2025

Background: Academic achievement is a form to measure students' competency level and academic progress. Admission selection entry routes influence academic achievement. Several factors that can influence student academic achievement come from internal factors, including intelligence, self-concept, motivation, psychological condition, and talent. Besides that, academic achievement is also influenced by external factors, including the academic environment, family support, and social status. This study examined the association between the admission selection entry route and the academic achievement of first-year medical students at the Faculty of Medicine, Udayana University.
Objective: To determine the relationship between the entry selection route and the academic achievement of first-year medical students.
Methods: This research was carried out at the Faculty of Medicine, Udayana University, in May–October 2023, with the subjects being first-year medical students. Data were analyzed using SPSS software. The One-way ANOVA test was conducted to determine the mean difference of GPA with different admission selection entries. The p-value is considered significant if p<0.05.
Results: 239 students with an average age of 19.17±0.39 years were involved. Most subjects are women (64.4%) with an average GPA of 3.57±0.32. Thirty-four (14.2%) had academic achievements, with 12.1% having academic achievements ≤3 and 2.1% having >3. Thirteen percent have academic achievements at the national level, and 1.3% at the international level. There is a significant difference between the average GPA based on the admission selection entry route, which was found to be significant between the SNMPTN and the Independent Selection route (p<0.001) and between the SBMPTN and the Independent Selection route (p<0.001).
Conclusion: There are significant differences in the academic performance of first-year medical students based on the admission selection entry.
Quality of life of adolescent patients undergoing hemodialysis at Dr. Soetomo General Hospital, Surabaya (instrumental case study)
Authors: Rimba Efendi , Konginan Agustina , Mardiana Nunuk , Hendriani Wiwin
Published: January 2025

Background: Chronic Kidney Disease (CKD) is defined as a decrease in kidney function or kidney damage that lasts more than three months, which can affect all stages of age. The end stage of kidney disease is End Stage Renal Disease (ESRD), which requires dialysis or a kidney transplant. The long course of the disease and the long treatment procedures can affect the quality of life of patients. All dimensions of the quality of life of adolescents undergoing hemodialysis, namely physical, functional, psychological and social dimensions are affected during the course of the disease. Hemodialysis, which is a central element for adolescent CKD patients, can affect quality of life, either increasing or even decreasing quality of life. The aim of this research is to qualitatively analyze the quality of life of adolescent patients undergoing hemodialysis at Dr. Sutomo Hospital Surabaya.
Methods: Qualitative with a case study approach. Data collection used interviews (in-depth interviews), observation and documentation and research subjects were determined purposively. Data analysis used Miles and Huberman's interactive model analysis technique.
Results: There were 7 subjects consisting of 4 teenage girls and 3 teenage boys, with an age range of 12-18 years. The four dimensions of quality of life studied, namely physical (short stature), functional (educational barriers), psychological (embarrassment, sadness) and social (peer relationships) are affected by CKD. There are dynamics between dimensions so that not all dimensions worsen in the subject, so that subjects can accept and undergo hemodialysis as a part of their life.
Conclusion: Findings on quality of life dimensions can be used to provide recommendations for adolescent patients to maintain their quality of life while undergoing hemodialysis and to optimize Consultation Liaison Psychiatry to develop more optimal treatment strategies for adolescent patients undergoing hemodialysis.
Role of platelet count, platelet indices, and immature platelet fraction as potential markers for monitoring platelet reactivity in patients with acute coronary syndrome undergoing percutaneous coronary intervention
Authors: Amalia Ikke Nanda , Hernaningsih Yetti , Wardhani Puspa
Published: January 2025

The acute coronary syndrome is an acute manifestation of coronary heart disease, which is caused by a ruptured plaque of the coronary artery, thus forming a thrombus formation and resulting in myocardial infarction. Reperfusion therapy in patients with acute coronary syndrome is needed with the aim of preventing the area myocardium from experiencing necrosis by percutaneous coronary intervention using a stent, but this action may be caused by stent re-stenosis, bleeding, or thrombosis. Treatment with dual antiplatelet therapy in patients with acute coronary syndrome after percutaneous coronary intervention is recommended for used to prevent stent restenosis events or bleeding. A combination of aspirin and P2Y12 inhibitors is commonly used, such as thienopyridine-like clopidogrel and prasugrel as well as non-thienopyridine class drugs to reduce the thrombosis formation. Monitoring DAPT after PCI requires monitoring the reactivity platelet by platelet aggregation test, but this examination is rarely carried out because it needs special tools and a fairly expensive inductor. Another marker that is less noticeable is the platelet marker by complete blood count (CBC), which uses a hematology analyzer such as platelet count, which decreases and indicates bleeding. Index platelets (PDW, P-LCR, MPV, and PCT) reflect that platelet reactivity indicators and immature platelet fraction shows the proportion of thrombopoiesis. This review provides a summary of ACS (Definition, classification, and pathophysiology), PCI (Definition, clinical indication, characteristics of stent and complication of PCI), Combination of dual antiplatelet therapy and Platelet measure for monitoring ACS after PCI (Platelet count, index platelets like PDW, P-LCR, MPV, PCT and immature platelet fraction).
A case report of borderline lepromatous leprosy: a neglected tropical disease that impairs quality of life
Authors: Rusyati Luh Made Mas , Mahariski Pande Agung , Karmila I Gusti Ayu Agung Dwi , Ganeswari Putu Ayu Dewita
Published: January 2025

Background: Leprosy is still a neglected disease, and there might still be undetected cases in endemic countries. A concern for individuals with leprosy is the physical disability due to progressive nerve damage, which can have a psychosocial impact on patients and their families. This case illustrates borderline lepromatous with leprosy defects, which will provide an understanding of the spectrum of the disease still found in Indonesia.
Case: A 32-year-old woman presented with a numb white spot on the right cheek with madarosis, decreased sensation in both feet and thickening of the left great auricular magnus nerve. A slit skin smear examination on both ear lobes found a positive bacterial index (IB) and a grade II leprosy defect characterized by ulcers on the feet. This condition caused the patient to quit her job and be unable to perform her usual activities. The patient was treated with multidrug therapy (MDT), multibacillary (MB), neurotrophic vitamins, empiric antibiotics, and wound care. The treatment showed clinical improvement and quality of life.
Conclusion: The main concern in patients with leprosy is physical disability due to progressive nerve damage and the tendency to become dysfunctional. Early detection of leprosy is essential to prevent leprosy disability and transmission of this infection.
Risk factors correlated with stroke in the population aged over 15 years in semarang: a retrospective study
Authors: Lahdji Aisyah , Pudjonarko Dwi , Shaluhiyah Zahroh
Published: January 2025

Background: Stroke is the primary cause of mortality. Based on data from the World Stroke Organisation (WSO) for 2022, there would be an estimated 12.23 million cases of stroke, with 50% resulting in death. This study aimed to identify the factors that may influence the occurrence of stroke in the population aged ≥15 years in Semarang.
Methods: The study utilized secondary data obtained from hospitals in Semarang. The secondary data comprised medical information obtained from stroke patients. The study employed a retrospective and cross-sectional technique. The study employed frequency distribution analysis and chi-square for data analysis.
Results: 51.1% of stroke patients were female, categorized by sex. 67.7% of stroke patients were aged 55 and above, constituting the majority. Moreover, the predominant risk factor encountered by patients is coronary heart disease, constituting 53.7%. The duration of hospital admissions for stroke patients varied from 1 to 7 days, with the majority (74.7%) falling within this range. The Indonesian National Health Insurance (BPJS Kesehatan) emerged as the predominant source of health financing, accounting for 97% of cases. The duration of the stay is correlated with risk factors, including gender.
Conclusions: According to the study's objectives, all variables that were investigated showed a statistically significant association with the occurrence of stroke. Stroke patients with coronary heart disease have the most prominent risk factors, followed by diabetes mellitus, renal failure, and hypertension. Moreover, a significant correlation was observed between gender and the risk variables experienced by those who had suffered from strokes. Moreover, the risk variables encountered by individuals who have suffered a stroke have a substantial influence on the duration of their hospitalization.
The differences of sP-selectin and platelet lymphocyte ratio between type 2 diabetes mellitus patients with and without coronary heart disease complication
Authors: Rena Ni Made Renny Anggreni , Adnyana I Wayan Losen , Gautama Putu Gizha Satrya , Chrismayana Nyoman Martha
Published: January 2025

Background: In its course, T2DM patients can experience various chronic complications, such as coronary heart disease (CHD). The mechanisms of CHD in T2DM patients are very complex. Still, most of it is associated with forming atherosclerotic plaques and activating the thrombotic process. Platelet to lymphocyte ratio (PLR) and serum soluble P-selectin (sP-selectin) levels are thought to be potential new biomarkers to describe chronic inflammatory conditions and the activation of the thrombotic process that precedes the occurrence of CHD complications in T2DM patients. This study aimed to determine differences in PLR values and serum sP-selectin levels in T2DM patients who did not experience coronary heart disease complications and T2DM patients who underwent coronary heart disease complications. 
Methods: The design of this study was cross-sectional by taking 34 cases of T2DM with CHD and 34 cases of T2DM without CHD. Samples were selected by purposive sampling of T2DM patients treated at the polyclinic or hospitalized at Prof dr IGNG Ngoerah Hospital from July 2022 to October 2022.
Result: The study found that serum sP-selectin levels were significantly higher in T2DM patients with CHD compared with T2DM patients without CHD (21.16 ± 4.96 pg/ml vs. 10.51 ± 1.35 pg/ml, p < 0.001). The PLR value was also significantly higher in patients with T2DM with CHD compared to T2DM without CHD (278.33 ± 93.46 vs. 108.36 ± 2.54, p <0.001).
Conclusion: These studies show that serum sP-selectin levels and PLR values can be used as predictors of chronic inflammation and the activation of the thrombotic process, which underlies the emergence of CHD complications in type 2 DM patients.
Suprapubic abscess due to concealed bladder rupture: A case report
Authors: Sinaga Rendy Muttaqien , Mustafa Akhmad , Siregar Safendra
Published: January 2025

Introduction: Suprapubic abscess is one of the bladder rupture complications. Bladder rupture is one of the most common urogenital injuries that happen because of direct impact on distended bladder, or correlated with pelvic fracture. Most extraperitoneal bladder rupture can be treated conservatively, but in rare instances it may evolve into catastrophic complication, such as urinoma that leads to abscesses.
Case Illustration: We report a 13-year-old female with a history of bladder rupture 3 months ago treated conservatively complaining of lower abdominal lump and pain since 1 week ago before hospitalization and worsening within 3 days. From the physical and radiology examination we suggest the suprapubic abscess.
Conclusion: Although most bladder injuries are well managed non operatively, there is a small chance of delayed bladder healing and make a morbidity for patients.