bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perbandingan efektivitas teknik modifikasi dan konvensional pada operasi open pyelolithotomy batu staghorn
Authors: Sucipta I Gede Hendra , Oka Anak Agung Gde , Widiana I Gede Raka 
Published: April 2020

Background: Open pyelolithotomy for staghorn stone patient management has a high stone-free rate. The disadvantages of open pyelolithotomy include aesthetics and postoperative complications, so a breakthrough to reduce these complications is needed, which can be achieved by doing modified open pyelolithotomy.Objective: To compare the modified and conventional open pyelolithotomy techniques according to the duration of operation, the volume of surgical bleeding, pain, and post-operative drop in hemoglobin (Hb).Method: A quasi-experimental study with twenty-two samples of staghorn stone patients was collected from October 2016 to October 2017. Parametric tests were used as data were normally distributed and homogeneous. The independent t-test was used to compare each measured parameter according to the type of operation. Analysis of covariance (ANCOVA) was used to control the variables of age, gender, and body mass index (BMI).Result: The modified technique had a shorter operating duration than the conventional method (p < .05). The volume of surgical bleeding in the modified technique was lower compared to the conventional technique (p < .05). Pain scores in the modified technique were lower than the conventional technique (p <Â .05). The drop in Hb levels in the modified technique was lower than the conventional technique (p < .05). Analysis using ANCOVA found that the type of operation has a direct effect on the duration of operation, volume of surgical bleeding, and post-operative pain.Conclusion: The modified open pyelolithotomy technique was more effective than the conventional open pyelolithotomy technique based on the duration of operation, the volume of surgical bleeding, and post-operative pain scale. In this study, it was found that the drop in Hb levels was not directly affected by the type of surgery.
Perbedaan stress kerja pada perawat di ruang unit gawat darurat dengan perawat di ruang rawat inap Rumah Sakit â€œSâ€ di Kota Denpasar tahun 2017
Authors: Putri Mahastuti Putu Dharma , Muliarta I Made , Adiputra Luh Made Indah Sri Handari 
Published: April 2020

Introduction: Job stress can be interpreted as a demand or stressor that can cause a complaint or stress caused by work. This study was conducted to know the difference of job stress that happened at Emergency Room and inpatient ward at Sanglah Hospital Denpasar. Method: This study used cross sectional analytic design and the data was analyze from the job stress questionnaire that was validated. Questionnaires were given to nurses that working in the emergency room and inpatient ward at Sanglah Hospital Denpasar. The samples size is 116 subjects. Result: The result is 7 nurses at the emergency room (12.1%) and 29 inpatients (50%) had mild stress, 33 ER nurses (56.9%) and 25 inpatients (43.1%) experienced moderate stress meanwhile, at 18 ER nurses (31%) and 4 inpatients (6.9%) had severe stress. Based on statistical test to find out the difference of work stress using Mann-Whitney test, the result of Mann-Whitney U value is 841.0 and p value is 0.000. So it can be concluded that p valueÂ <0.05. Conclusion: Thus, there is a significant difference in the level of work stress between nurses who served in the emergency room with inpatient care.
Impact of depression on the academic performance of international students in Udayana University
Authors: James Jacintha , Sawitri AA. Sagung , Ariastuti Luh Putu , Aryani Putu 
Published: April 2020

Background: Depression is a mental disorder that affects an individualâ€™s mood and emotion. Depression is very common among the students. In this study, the impact of depression, especially on the academic performance of students who are abroad, studies along with the risk factors of depression.Aim: The study aims to know the relationship between depression and the academic performances of international students studying abroad. Â Method: In this analytic study, a cross sectional method was being used. This method is being used to analyze the relationship between the factors that influence the academic performance and also to investigate the relationship between depression and academic performance of the students.Result: As for the residence factor, the student who was lived alone performed better in academic. For the method of study factor, the student who conducts independent learning performs well in academic whereas for the factor back to Malaysia in a year, the students who go back to Malaysia less than or twice a year performs better in their academic. As for the family support factor, students who have good family support obtain good results in academic performance, but for factor family financial support, students with inadequate financial support obtain good results in their academic.
Proporsi depresi pada penderita diabetes melitus tipe 2 di RSUP Sanglah Denpasar
Authors: Krisnawan Gede Aditya Ersa , Aryani Putu , Sari Komang Ayu Kartika 
Published: April 2020

Introduction: Over 285 millions of people in 2010 in the world live with diabetes mellitus type 2 (DMT2). In Indonesia based on Riskesdas 2013, 2.45 millions of people live with DMT2 or around 1.5% of Indonesiaâ€™s total population. One of the disease causded by DMT2 is depression. 30% people with DMT2 has also experience depression. Depression in Indonesia based on Riskesdas 2013 has 19 millions of people suffering from it or 11.6% of Indonesiaâ€™s total population.Method: This research was a descriptive study with cross-sectional approach. The subjects was 51 patients diagnosed with diabetes melitus type 2 and did the follow-up in Diabetic Centre of RSUP Sanglah from October-November 2017.Data for this research was acquired Â from interview using Zung Self Depression Scale (ZSDS).Result: The results showed 78.9% sample which experience depression higher in women (80.0%), the unemployeed subject (88.6%), medium educational degree (86.2%), duration of illness >5 years (87.5%), the usage of insulin (81.0%), and patient with complication history (78.8%).Conclusion: Higher depression was found in patients with DMT2 with female gender, not working, disease duration> 5 years, history of insulin use, and had a history of complications. The proportion of depression in DMT2 patient was high, thus further research on relation between depression and DMT2 is necessary to conduct
Hubungan antara TIL (Tumor Infiltrating Lymphocyte) dan MAI (Mitotic Activity Index) dengan kejadian metastase kelenjar getah bening (KGB) aksila pada operable breast cancer di RSUP Sanglah, Denpasar.
Authors: Santhi I Gede Aditya Krishna , Christian I Nengah Wiadnyana Steven , Widiana I Gede Raka 
Published: April 2020

Latar belakang: Kanker payudara merupakan penyakit yang menduduki urutan ketiga di Eropa dan United State sebagai jenis kanker yang menyebabkan kematian. Studi dua dekade terakhir mengungkapkan bahwa Tumor microenvironment (TME)juga merupakan penentu penting perilaku tumor.Tumor padat umumnya terdiri dari berbagai sel kekebalan tubuh, termasuk limfosit T dan B, sel NK, makrofag, dan neutrofil. Imunitas adaptif dan imunosupresi selalu menunjukkan tingkat ekspresi yang berbeda pada tumor, dan banyak gen kekebalan terkait dengan inflamasi. Interaksi antara sel imunitas menentukan induksi atau penghambatan perkembangan tumor, angiogenesis, dan metastasis. Sistem imunitas mempengaruhi surveillance pada pasien kanker. Proliferasi telah dikenali sebagai â€œhallmarkâ€ dari kanker dan merupakan faktor prognostik kanker. Evaluasi dari derajat proliferasi sel dalam jaringan tumor digunakan untuk menilai progresifitas tumor. Penilaian indeks mitosis telah digunakan sebagai â€œgold standardâ€ dalam menilai agresivitas tumor. Maka dari itu, tujuan penelitian ini adalah untuk mengetahui hubungan respon imun pada tumor dalam hal ini sel Lymphocyte dan aktifitas pembelahan sel tumor dengan kejadian penyebaran kanker ke KGB aksila pada operable breast cancer di RSUP Sanglah Denpasar.Â Metoda:Lima puluh tiga sampel pasien kanker payudara post MRM (Modified Radical Mastectomy) yang berobat di RSUP Sanglah yang mempunyai catatan medis (data klinis, histopatologis), sampel dipilih secara eligible sampling pada rekam medis pasien di Bagian/ SMF Bedah Onkologi Fakultas Kedokteran Universitas Udayana RSUP Sanglah dari tahun 2016 sampai dengan 2018. Penelitian ini merupakan â€œCross Sectional Analitik" hubungan antara TIL dan MAI dengan kejadian metastase KGB aksila pada pasien operable breast cancer Â Â Â Â secara univariant, bivariat dan multivariant dengan menggunakan perangkat lunak SPSS 20 for windows.Â Hasil: menunjukkan analisa dengan uji Chi-square didapatkan pasien dengan low TIL (P= 0,627), intermediate TIL (P= 0,339) dan pasien dengan MAIÂ â‰¥ 25 /10 lp (P= 0,531), MAI 13-24 /10 lp (P= 0,531) tidak dijumpai adanya hubungan bermakna dengan kejadian metastase KGB aksila karena tidak signifikan secara statistika. Â Simpulan:tidak dijumpai adanya hubungan bermakna, low dan intermediate TIL memiliki kecenderungan metastase KGB aksila pada Operable Breast Cancer lebih tinggi, dan dijumpai pula adanya kecenderungan makin tinggi MAI, semakin tinggi resiko metastase KGB aksila pada operable breast cancer di RSUP Sanglah Denpasar.Hubungan antara TIL (Tumor Infiltrating Lymphocyte) dan MAI (Mitotic Activity Index) dengan kejadian metastase kelenjar getah bening (KGB) aksila pada operable breast cancer di RSUP Sanglah, Denpasar.
The prevalence of panic disorder among English Class students at Medical Faculty, Universitas Udayana, Bali, Indonesia in 2018
Authors: Ramachandran Thevarani , Wardani Ida Ayu Kusuma , Setyawati Lely 
Published: April 2020

Background: Panic disorder is diagnosed in people who experience spontaneous, seemingly out-of-the-blue panic attacks and are very preoccupied with the fear of a recurring attack. Panic disorder usually begins in adulthood (after age 20) and can interfere a lot with daily life, causing people to miss work, go to many doctor visits, and avoid situations where they fear they might experience a panic attack. This study aims to determine the prevalence of panic disorder among English Class students at Medical Faculty, Universitas Udayana, Bali, Indonesia in 2018Methods: An observational cross-sectional study was conducted among 89 medical students from English Class at the Faculty of Medicine, Universitas Udayana in 2018 using total sampling techniques. A self-administered questionnaire was carried out to determine the prevalence of panic disorder by several valid and reliable questions. Data were analysed using SPSS version 20 for Windows and presented in frequency and percentage.Results: Â Most of the respondents were 20 years old (57.3%). There are only 12.0% of English class Semester 7 students are free from panic disorder, 51.0% suffers from mild panic disorder, and 37.0% suffers from moderate panic disorder. Around 64% of female respondents have panic disorder while 34% in male respondents. Female respondents are tended to get more panic attacks than male respondents in a ratio of 2:1.Conclusion: Female medical students tend to have a higher risk of panic disorder compared with males. The majority age of students suffering from panic attacks is from 20 to 23 years old.
Management of denture foreign body in esophagus with cervical esophagotomy: case report
Authors: Mahendra Kadek Yudi Fajar , Yasa Ketut Putu 
Published: April 2020

Introduction: Impaction of dentures in the esophagus is a distressing experience for a patient and can lead to serious consequences, such as esophageal perforation. Patients with an impacted denture often present with a history of accidental swallowing, frequently during trauma, seizures, or sleep or in association with some degree of psychological dysfunction. The common signs and symptoms of an impacted denture are odynophagia, dysphagia, or simply pain and tenderness in the neck or chest.The preferred method of removal of esophageal foreign bodies is extraction with the flexible endoscope. Surgical removal is rarely indicated except in the event of perforation or other foreign body complications.In situations where this appears potentially hazardous, such as with impacted denture, open surgical extraction by cervical oesophagotomy is promptly performed is a safe option.Cases Report: The successful removal of impacted denture in the esophagus in a patient is reported, with a review of the literature. A women23-year-oldÂ complained of dysphagia after swallowing his denture. Following unsuccessful attempts at removal via a rigid esophagoscope, open surgery was performed. Without further delay, the impacted denture was removed by cervical oesophagotomy, and the patient recovered uneventfully.Conclusion: The successful removal of impacted denture by cervical oesophagotomy in the esophagus in a patient is reported. We conclude that cervical esophagotomy is a safe method for removing foreign bodies impacted in the cervical esophagus when they cannot be removed endoscopically.
A Novel Hypothetical Method to increase the Dimensions of the Coronary Arteries when Required
Authors: Arokiaraj Mark Christopher 
Published: April 2020

Background: The purpose was to develop a novel hypothetical method to increase the size of coronary arteries.Methods: During long-term observation an increase in coronary size has been seen in three unexpected scenarios. Changes in coronary artery sizes were observed in patients with mitral stenosis (n=69) by angiogram prior to percutaneous balloon mitral valvuloplasty or valve replacement surgery for severe mitral stenosis. The coronaries of patients with patent ductus arteriosus who underwent surgical closure in the past (n=14) were examined by echocardiogram. Patients with renal failure on long-term dialysis through peripheral arterio-venous fistula without left ventricular hypertrophy (n=17) were studied by echocardiography. Normal age, weight and sex matched coronary sizes served as controls in the study. All these observations were made over a period of 12 years.Results: The sizes of coronaries in patients with mitral stenosis, patients who underwent closure for patent ductus arteriosus, and in patients on hemodialysis through arteriovenous fistulas were higher than normal controls (p<0.05, for all). A hypothetical model to increase the coronary sizes could be developed based on the analysis of the differential equations of Poiseuille’s. A method is proposed of creating a peripheral arterio-venous fistula, which could be closed later electively by a percutaneous method/surgery. The closure time needs to be determined by experimental studies. The other methods could be a continuous exercise program or by the use of beta-blockers.Conclusion: A novel hypothetical method of peripheral arteriovenous fistula formation is decsribed which could potentially increase the size of the coronaries, which could be closed later.
Monitoring of adverse drug reactions in psychiatry outpatient department of a tertiary care hospital in Central India
Authors: Mahakalkar Sunil , Tiple Prashant , Mohod Bhagyashri , Dhargave Nikhil 
Published: April 2020

Background: Adverse drug reactions (ADRs) are prevalent in patients taking psychotropic medications and can occur even at the normal doses used in the management of acute and maintenance phases of psychiatric disorders. Pharmacovigilance have cardinal role in alerting the healthcare providers from the possible ADRs and thus protecting the patients who are using psychotropic medications. To Monitor and estimate the incidence and nature of ADRs in psychiatry OPD of tertiary care hospital in central India and assess the causality, preventability and severity of documented ADRs.Methods: A prospective observational study was conducted in psychiatry out-patient department (OPD). Patients diagnosed with any psychiatric disorder and receiving psychotropic medications was included in the study. The recorded data were filled in the ADR form obtained from pharmacovigilance program of India (PvPI). Causality assessment was done using Naranjo scale and severity was assessed using Hartwig scale and preventability assessment using modified Schumock and Thornton’s scale.Results: The incidence rate of ADR was found to be 15.8%. A total of 61 ADRs were documented. Weight gain 14 (18.1%) followed by nausea 11 (14.2%) was the most commonly reported ADR. Atypical antipsychotics were the most common class of psychotropic drugs implicated in ADRs. Clonazepam 21 (27.2%) followed by amitriptyline 20 (25.9%) were associated with a maximum number of ADRs. Majority of the suspected ADRs were probable in nature (40.9%) followed by possible type (31%).Conclusions: Study revealed a moderate incidence of ADRs in patients attending the psychiatry OPD. Majority of the ADRs reported during the study were mild in nature and definitely preventable type.
Identification of separation phenomenon during brain death determination of potential organ donor and analysis of relative factors
Authors: Xu Guixing , Yu Ping , Xu Ping , Zheng Donghua 
Published: April 2020

Background: With analyzing the incongruent phenomenon of electrical active and cerebral blood flow in brain death determination and screening the related factors, offer correct explanations and countermeasure to ensure the successful implementation of donation after brain death.Methods: Relevant clinical data of potential brain death organ donors were prospectively collected between June 2018 and May 2019. The related parameters of neurological examination, laboratory examination and neuroimaging examination during the period of brain death determination were dynamically recorded. Separation phenomenon was used as grouping factors to screen the factors related to separation phenomena through univariate and multivariate analysis.Results: According to the inclusion criteria, 127 patients were included in the study. Among 22 patients (17.3%) with incongruent phenomenon, 17 (77.3%) had electrical silence earlier than cerebral blood flow arrest, and 9 (22.7%) had cerebral blood flow arrest earlier than electrical silence. Univariate and multivariate analysis showed that age <14 years (OR=6.25, 95%CI 1.21-32.22, p=0.028), SBP≥140 mmHg (OR=7.43, 95%CI 1.62-33.99, p=0.010), primary brainstem injury (OR=15.89, 95%CI 3.04-82.93, p=0.006), spontaneous respiratory arrest time ≤72 hours (OR=11.96, 95%CI 1.59-89.78, p=0.009) and decompression craniotomy(unilateral or bilateral) (OR=16.28, 95%CI 2.25-117.73, p=0.001) were associated with separation phenomenon..Conclusions: Separation phenomenon is a common during the confirmation test of brain death determination in China, and should be correctly recognized. To adopt corresponding measures according to risk factors is useful for successful implementation of donation after brain death.
Potential gain in life expectancy by gender after elimination of a specific cause of death in urban India
Authors: Gulati Bal Kishan , Sahu Damodar , Kumar Anil , Rao M. V. Vardhana 
Published: April 2020

Background: Life expectancy is a statistical measure to depict average life span a person is expected to live at a given age under given age-specific mortality rates. Cause-elimination life table measures potential gain in life expectancy after elimination of a specific disease. The present study aims to estimate potential gain in life expectancy by gender in urban India after complete and partial elimination of ten leading causes of deaths using secondary data of medical certification of cause of death (MCCD) for the year 2015.Methods: Life table method was used for estimating potential gain after eliminating diseases to the tune of 25%, 50%, 75% and 100%.Results: Maximum gain in life expectancy at birth estimated from complete elimination of diseases of the circulatory system (11.1 years in males versus 13.1 years in females); followed by certain infectious and parasitic diseases (2.2 versus 2.1 years); diseases of the respiratory system (2.2 versus 2.1); injury, poisoning and certain other consequences of external causes (1.1 versus 0.7); neoplasms (0.9 versus 1.0); endocrine, nutritional and metabolic diseases (0.8 versus 0.9); diseases of the digestive system (0.8 versus 0.4); diseases of the genitourinary system (0.6 versus 0.6); diseases of the nervous system (0.4 versus 0.4); and diseases of blood & blood forming organs and certain disorders involving the immune mechanism (0.2 versus 0.3 years).Conclusions: Elimination of the circulatory diseases resulted into maximum gain in life expectancy. These findings may have implications in setting up health goals, allocating resources and launching tailor-made health programmes.
Introduction of newer vaccines in national immunization programme in India: a challenge
Authors: Verma Ramesh , Chayal Vinod , Kalhan Meenakshi , Dhaka Rohit , Chawla Suraj , Bhalla Kapil 
Published: April 2020

Immunization significantly reduces the incidence of communicable diseases in children and improves the quality of life of children. Many developing countries including India, is lagging behind in sufficient coverage of routine immunization among children. Currently, India manufactures about 43% of the global vaccines. Newer vaccine research can be promoted only when there is conducive environment, funding and subsequent chances of vaccine being introduced in the universal immunization programme (UIP). Government of India has a National Vaccine Policy which was developed after the recommendations made by National Technical Advisory Group on Immunization.This policy addresses the issues to streamline the process on new and underutilized vaccine and also suggests to strengthen the institutional framework, processes, evidence base and framework required for decision making for strengthening of UIP in India. Government of India laid some standard guidelines and few criteria for the introduction of new vaccine in UIP. While planning to introduce a newer vaccine, cost effectiveness of the vaccination program should be kept in mind.
Comparison between simultaneous versus staged bilateral total knee arthroplasty: a prospective, randomized, controlled study
Authors: Sharma Rajesh Kumar , Meena R. P. 
Published: April 2020

<p class="abstract"><strong>Background:</strong> Bilateral total knee arthroplasty (TKA) is a common procedure nowadays. Although, staging of surgery is a subject of debate. We conducted a study to compare safety and functional outcomes of simultaneous and staged bilateral TKA.</p><p class="abstract"><strong>Methods:</strong> Our study includes total 70 patients of symptomatic severe bilateral osteoarthritis, underwent simultaneous or staged bilateral TKA during 2015 to 2019. 35 patients were randomly allotted for each procedure. The postoperative evaluations were done according to Knee Society Score at one, three, six and 12 months and yearly thereafter for 2 years following a simultaneous bilateral TKA (group A) and the second procedure in the staged bilateral TKA (group B). In the staged group, the patients were followed at monthly intervals until the second procedure. The categorical variables were statistically significant when p value &lt;0.05.<strong></strong></p><p class="abstract"><strong>Results:</strong> As compared to staged procedure (group B), estimated blood loss was significantly less in simultaneous TKA (group A). Although, blood transfusion rate was significantly high in group A. The length of hospital stay was significantly shorter in group A. Overall complication rate (inpatient and/or 90 days readmission) was not significantly higher in group A. Knee infection rate was significantly lower in simultaneous TKA group. There was no revision of surgery and no mortality in any of our study group within 2 years of follow-up.</p><p class="abstract"><strong>Conclusions:</strong> Simultaneous bilateral TKA is safe and cost-effective procedure with acceptable complication rates for bilateral symptomatic end stage knee osteoarthritis.</p>