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Introduction: Patients with coronary heart disease (CHD) may experience various physical, psychological or spiritual issues. A holistic mind-body spiritual nursing care (MBS) model is needed to help patients' cope with the issues. This study aimed to develop an MBS nursing care model for CHD patients. Method: The study employed a crossectional design with 110 CHD patients participated in the study. Respondents were asked to fill out questionnaires to gather the required data. Criteria for respondent selection were Moslem, aged 40-75 year, medical diagnosis of CHD, and haemodynamically stable. The independent variables were focal, contextual and residual stimuli, while the dependent variables were coping and spirituality. Data were analyzed using partial least square. Results: The results show that the mind-body-spiritual nursing care formed focal stimuli. Spirituality is formed by focal, contextual, residual stimuli and coping style. Nursing care significantly affects spirituality, shown by T-statistics of 6.795. Spirituality can be explained by patience, endeavour toward wellness, and offer the results only to God by 72%, while the rest is explained by other factors. Conclusion: MBS nursing care model has a strong relationship with spirituality. This model needs to be applied in a further research to see its effectiveness in improving spirituality and expression of cardiovascular risk inflammatory markers.

Introduction: Flow phase with high cardiac output and increased metabolic conditions. When metabolic conditions are not stable there will be a long duration of complications until death. One of the benefits of Nutrition Risk Screening (NRS-2002) is reliable inpatient care for critical patients. While the Malnutrition Universal Screening Tool (MUST) shows speed in the classification of nutritional disorders. Methods: This study used the observational design method. The sampling technique in this study used Consecutive sampling in accordance with the criteria consisting of 31 respondents. This was to determine the specificity and sensitivity values of NRS 2002 and MUST using contingency table analysis and for the Area Under Curve (AUC) using Receiver Operating Characteristic (ROC) curve analysis. Results: The sensitivity values in MUST was predicted for metabolic conditions which was higher than when using NRS 2002, but the specificity and value of AUC (Area Under Curve) was higher using NRS 2002 than using MUST when it came to predicting metabolic conditions. Conclusions: There were differences in effectiveness between use of Nutritional Risk Screening (NRS-2002) with the Malnutrition Universal Screening Tool (MUST) in relation to changes in metabolic conditions of trauma patients. NRS-2002 is more effective than MUST. NRS 2002 has the ability to identify patients more precisely who are likely to have a negative outcome.

Introduction: Type 2 Diabetes Mellitus (DM) is a chronic disease that requires long-term treatment. Supportive educative model facilitates self care agency improvement through self regulation and self effi cacy. This study was aimed the impact of supportive educative model on the improvement of self care regulation and self effi cacy on an increased of self care agency as well as HbA1c. Method: The research method used was quasy experimental with pre-post control group design. This study was conducted with a sample size of 76 patients with Diabetes Mellitus type 2 who were selected through consecutive sampling, they were divided into treatment group of 38 subjects and control of group 38 subjects. Data were collected by questionnaire and HbA1c test. Analysis of the data used paired t-test, independent t test and Partial Least Square (PLS). Result: Result showed that Supportive Educative Model affect on self regulation on dietary control and diet, physical exercise, medication, blood sugar control and foot care (p =

Introduction: Acute complications are common in patients with Diabetes Mellitus (DM). To improve the behavior prevention of complications and control blood sugar levels, patients need to be equipped with knowledge about the disease process to built a positive attitude and good behavior. The aim of this study was to analyze the effect of patient empowerment based on experiential learning behavior on the prevention of complications and blood sugar levels. Methods: This study used a quasi-experimental design with pre-post test approach using control groups. Samples were 46 diabetic patients who take control in poly RS Mardi Waluyo Blitar taken by consecutive sampling. Data were collected using a questionnaire and checklist recall. Data were analyzed using paired t test, wilcoxon signed rank test and mann whitney. Results: The patient empowerment-based experiential learning have a significant impact on the behavior of prevention of complications. Discussion: Methods of experiential learning can be applied to improve the self-care of patients, especially those who have experienced an acute complications, so the patient is easier to implement behavioral prevention of complications and control blood sugar levels. Keywords: patient empowerment, experiential learning, behavioral prevention, blood glucose

Latar Belakang: Kejadian stunting mempengaruhi kualitas sumber daya manusia suatu negara sehingga penting untuk dicegah dan ditanggulangi. Kasus stunting di Kecamatan Kalinyamatan Jepara meningkat dari 12,4% di tahun 2021 menjadi 18,9% di tahun 2022 dan menjadi 19,05% pada tahun 2023. Tujuan: Menganalisis determinan kejadian stunting pada anak bawah dua tahun di Kecamatan Kalinyamatan Kabupaten Jepara. Methods: Penelitian dengan studi kasus kontrol ini dilakukan pada 77 anak stunting dan 77 anak normal. Pemilihan subyek dilakukan di posyandu dengan pengunjung anak bawah dua (baduta) tahun terbanyak di semua 12 desa di Kecamatan Kalinyamatan Kabupaten Jepara yang memenuhi kriteria inklusi dan eksklusi. Penelitian ini dilaksanakan bulan Maret sampai April 2024. Pengumpulan data primer dengan wawancara menggunakan kuesioner terstruktur, keragaman makanan dengan food recall 2x24 jam dan data sekunder memakai buku Kesehatan Ibu dan Anak (KIA). Data dianalisis dengan uji chi square dan regresi logistik. Hasil: Tidak ada perbedaan proporsi jenis kelamin dan usia baduta, jumlah paritas dan usia ibu, serta status bekerja ayah antara anak stunting dan normal. Determinan kejadian stunting adalah riwayat anemia selama hamil (OR:2,75; 95% CI:1,31 – 5,78; p:0,007), ibu bekerja (OR: 2,81; 95% CI: 1,24-6,37; p:0,014), berat badan lahir rendah (OR: 3,98; 95% CI: 1,54-10,27; p:0,004), keragaman pangan yang kurang (OR: 3,71; 95% CI: 1,63-8,44; p:0,002), dan imunisasi yang tidak lengkap (OR: 4,02; 95% CI: 1,66-9,74; p:0,002). Kesimpulan: Faktor maternal (anemia selama hamil, ibu bekerja dan Berat Badan Lahir Rendah (BBLR)), keragaman pangan yang kurang, dan imunisasi dasar tidak lengkap merupakan determinan kejadian stunting pada baduta di Kecamatan Kalinyamatan Kabupaten Jepara.

Literacy is a set of individual abilities and skills in reading, writing, speaking, calculating, and solving problems at a certain level of expertise. According to the World Economic Forum, there are six literacy skills that must be mastered by students, parents, and all citizens of the community, namely reading and writing, numeracy literacy, financial literacy, scientific literacy, cultural and civic literacy, and information and communication technology or digital literacy. However, this ability is not only in the form of general literacy, but also literacy in various scientific fields such as financial literacy, health literacy, social literacy, and scientific literacy as well as the influence between other fields of science. Therefore, a survey on the influence of literacy in various fields of science is needed. Based on the survey results that have been conducted, it can be concluded that UNAIR students in semester 2 of the 2021 batch already have an understanding of literacy skills and the important role of reading in literacy skills. However, the literacy skills of second semester students at Universitas Airlangga are still lacking because 62% of respondents still carry out literacy activities only depending on their reading, and 86% of respondents still have difficulty understanding the information they read. [ABSTRACT FROM AUTHOR]

Background: Enterococcus faecalis commonly infects root canals by forming a biofilm. Extracts from neem leaves (Azadirachta indica A. Juss) have been shown to have antibacterial properties, indicating their potential in preventing or treating biofilm formation caused by bacteria. Purpose: This study aims to investigate the phytochemical compounds present in neem leaves (Azadirachta indica A. Juss) and establish the concentration of ethanol-based neem leaf extract that can effectively inhibit the in vitro growth of Enterococcus faecalis biofilm. Methods: This study employed the maceration technique for extraction, gas chromatography mass spectroscopy for the analysis of plant chemicals, and a microtiter plate assay for measuring biofilm formation with treatment concentrations of 6.25%, 12.5%, 25%, 50%, and 75%, with a positive control of 0.2% chlorhexidine. Results: A phytochemical analysis revealed that the ethanol extract of neem leaves contained 22 different metabolites, mainly terpenoids and fatty acids. The extract demonstrated antibiofilm activity only at a concentration of 12.5% with an average biofilm inhibition of 36.85%. However, lower concentrations of 6.25%, 25%, 50%, and 75% had the opposite effect, promoting biofilm formation in Enterococcus faecalis. Conclusion: Phytochemical metabolite contained in the ethanolic extracts of neem leaves might contribute a promising agent in treating a biofilm-mediated root canal infection of Enterococcus faecalis.

Introduction: Previous studies found that young children, children, pregnant women, and farmers are at risk of pesticide exposure. Organophosphate pesticides are detected in children’s urine, but other types of pesticides, their toxicity classification, and their toxicity level have not been identified. Hence, this study aims to identify types and toxicity levels of pesticides that are possible causes of health problems in an agricultural area. Methods: The population of the study were 1,017 households in two villages of an agricultural area of Brebes Regency, Indonesia. The data were collected from 166 participants using a cross-sectional design involving questionnaires to identify the characteristics of the respondents and observations to identify the pesticide, pesticide packaging, and pesticide residue in their houses. The toxicity levels of the pesticides were identified based on the pesticide toxicity classification recommended by the World Health Organization (WHO). Potential health problems due to pesticides were subsequently identified based on literature reviews. Results and Discussion: According to the results, organophosphate, carbamate, and pyrethroid pesticides were found in 30.7% of the respondents’ houses. The toxicity levels of the pesticides ranged from highly hazardous (Ib) to unlikely presenting acute hazard (U). The potential health problems due to pesticides varied from poisoning symptoms to genetic disorders and polymorphisms. Conclusion: There were three types of pesticides with toxicity levels ranging from highly hazardous to unlikely presenting acute hazard in the agricultural area in Brebes Regency

Introduction: Presently, the global consumption of pesticides including insecticides, herbicides, and fungicides to protect crops is increasing. Pesticides' role as Endocrine-Disrupting Chemicals (EDCs) has gained great concern in the field of thyroid hormones. Therefore, this systematic review aimed to determine the link of pesticide exposure with thyroid hormone levels among male agricultural workers and pesticide applicators. Discussion: It was discovered that the majority of reviewed articles have similar results concerning the effects of pesticide exposure on the serum levels of thyroid hormones among either farmworkers or pesticide applicators. Commonly, insecticides, herbicides, and fungicides are known as one of the EDCs. The results showed the elevation of TSH and T4 serum levels mostly occurred among groups exposed to insecticide application only rather than those exposed to various pesticide types. Moreover, the hormonal change differed based on each class of pesticide. Conclusion: This review suggests that some types of pesticides extensively used in agriculture might be involved in the increase and decrease in thyroid hormone levels among exposed individuals. Further studies should assess specific types of pesticides and the adverse health effects which involve confounding factors to yield robust analysis.

Introduction: Gestational Hypertension (GH) and Pre-eclampsia (PE) are the leading causes of maternal death. Exposure to lead from the environment, especially agricultural activities, may cause pregnant women to suffer from GH and PE. GH/ PE may occur through oxidative stress mechanisms and progressive endothelial damage. Brebes District is one of the areas with the highest Maternal Mortality Rate (MMR) in Central Java where the occurrence of GH/PE was a lot. This study aimed to analyze the differences in Blood Lead Levels (BLL) in pregnant women with GH/PE and normal pregnant women in Brebes District. Methods: This study used a cross-sectional design. By selecting and applying inclusion criteria, 18 subjects were selected for the GH/PE group (case group), and 46 subjects were selected for the normotension group (control group). Measurement of BLL was carried out using the Atomic-Absorption Spectrometry (AAS). Some of the statistical methods used were independent t-test, Mann-Whitney test, Chi-square test, multivariate logistic regression test, and Rank-Spearman correlation test. The risk estimate was calculated from the Odds-Ratio (OR) and 95% Confidence Interval (CI). Results and Discussion: The median value and range of the BLL in the case and control groups were 40.20 g/dL (15.50-89.20) and 32.75 g/dL (3.60-42.80), respectively (p = 0.011). Pregnant women with the BLL of ≥ 35.15 g/dL had eight times the risk of experiencing GH/PE (Adj-OR = 8.1; 95% CI = 1.7-39.0). Exposure to lead will increase the production of Reactive Oxygen Species (ROS), resulting in oxidative stress and endothelial dysfunction in addition to increasing the blood pressure. Conclusion: The BLL in pregnant women with GH/PE is higher than women with normal pregnancy, and the BLL in the high category is a risk factor for GH/PE.

Background: Type 2 diabetes mellitus is a chronic disease that is still a global health problem. Uncontrolled diabetes mellitus (DM) can result in poor glycemic status, with factors that affect patients including long-term DM and medication compliance. Purpose: This study aimed to determine the risk factors of long-term DM and non-compliance with medication on the poor glycemic control status of patients with type 2 DM. Methods: This type of research used observational analysis with a case–control design. Samples were taken from patients with type 2 DM, with 40 cases and 40 controls. The criteria for sample inclusion were that the patients had a glycosylated hemoglobin level check, were willing to be research respondents, and could communicate well. The exclusion criterion was patients experiencing a drastic decline in health status during the study. The sampling technique used was consecutive sampling. This research was conducted at the Panti Wilasa Citarum Hospital in Semarang City from July to September 2019. The relationship and the risk of long-term DM and adherence to taking medication with glycemic status were tested using the chi-square test. Results: This study showed that a duration of DM >5 years (p = 0.01; Odss Ratio (OR) = 3.46; 95% confidence interval [CI] = 1.37 < OR < 8.69) and non-compliance with taking medication (p = 0.02; OR = 3.15; 95% CI = 1.25 < OR < 7.93) are risk factors for poor glycemic status. Conclusion: Duration of DM >5 years and non-compliance with taking medication are risk factors for poor glycemic status in patients with type 2 DM.

Introduction: Affirmation - tapping interventions have been shown to reduce pain complaints in post-operative patients completing conventional treatment. This is thought to be due to serotonin performance but clinical studies have not been conducted. The aim was to compare the mean perception of the pain reported by post-operative patients given affirmation- tapping treatment with another treatment as a complementary nursing intervention. This was to see if the performance of the serotonin serum level is different from in other treatments. Methods: We used a randomized post-test only control group design carried out in parallel in post-caesarean section patients. The sample totaled 40 patients divided into four groups (10 in affirmation, 10 in tapping, 10 in affirmation-tapping and 10 in the control). They were obtained through simple random sampling. The instruments included affirmation-tapping guidelines, Elisa kits and the McGill - Melzack Pain Questionnaire short-form (MPQsf). The independent variable was the intervention of affirmation-tapping and the dependent variables were pain perception and serotonin level. The data was analyzed using simple linear regression. Results: The average variant of the serotonin levels in the affirmation-tapping treatment group was higher and thus differed significantly from the other groups. Conclusion: Affirmation-tapping as a complementary nursing intervention can increase the serotonin serum levels of the post-caesarean section patients by complementing conventional treatments. Participant pain complaints were lowest in the affirmation-tapping group with the highest serotonin levels present and these were significantly different to the other groups. Affirmation – tapping was recommended as a complementary intervention in nursing post-operative patients that complements conventional treatment.

Thrombocytopenia is the key component and important parameter in dengue infection from the potency of bleeding and life threatening condition. Angkak (red yeast rice) a fermented product of rice and red yeast (Monascus purpureus), has been used in Indonesia to increase platelet count in dengue infection. Pre-clinical research has shown that Monascus purpureus extract can increase platelet count significantly. However the mechanism has not been understood clearly. It has been suggested that the mechanisms are due to anti-inflammatory effect or the stimulation of thrombopoiesis. Research design used single blind randomized controlled trial. The subjects of this research were patients with dengue infection, hospitalized in Tropical-Infectious Disease Ward, RSUD Dr. Soetomo Surabaya. The total samples were 30 patients who divided into trial group (n=15) and control group (n=15). Trial group received standard therapy for dengue infection and Monascus purpureus extract capsule 3 times 1 capsule daily for 48 hour. Control group received standard therapy for dengue infection. TPO levels was measured before and 48 hour after treatment. The comparative analysis on both groups shows that between 15 patients in trial group and 15 patients in control group, there are decrease of TPO level (median value) from 90 pg/mL to 26,6 pg/mL, and from 130 pg/mL to 66,8 pg/mL respectively. Trial group has greater decrease of TPO level (63,4 pg/ml) than control group (63,2 pg/ml) but statistically not significant (p = 0,916). [ABSTRACT FROM AUTHOR]

ABSTRACT Immunization is a program be done to protect a human body from diseases. In Tanjung Jabung Barat District, the completeness of mmunization has not reached in MDGs (> 93%). According to the health agency information, showed that the completeness of immunization in West Tanjung Tabung regency (89%) and Kuala Tungkal II health Center (78%). The purpose of this research is to analyze factors that related with the status of basic Immunization. The type of research is qualitative method through indepth interview. This research uses cross sectional design. The research was be located on Kuala Tungkal II PHC in Tanjung Jabung Barat Regency. The population is all mothers who have children aged 12-24 months. Sampling is done by random sampling. The result showed that were a significant relationship between maternal education level (p = 0.007; OR 3.15; 95% CI 1.33-7.49), mother’s knowledge (p = 0.000; OR = 45.25; 95% CI 13.23-154.72), mother's attitude (p = 0.000; OR = 94.55; 95% CI 22.13-403.87), and mother’s motivate (p = 0.000; OR= 37.00 ; 95% CI 11.40-119.99) related to the child immunization status. It can be concluded that three variables have related to incomplete immunization. It is suggested that the health agency should improve the knowledge of health personnel in training that involves the basic immunization., so as to provide education to the public about the importance of complete basic immunization. Keywords: immunization, motivate, knowledge, attitude

The objective of this study was to analyze the elevation of osteoblast activity in bone marrow mesenchymal stem cells (BM-MSCs) in osteogenic medium by physiological doses of melatonin administration by measuring alkaline phosphatase (ALP) and osteocalcin level.This studyused BM-MSCs from Rattusnorvegiccus femur bone. Rat BM-MSCs were cultured in a-Mem medium, differentiated in osteogenic medium, and administrated melatonin up to 21 days. This study was divided into 4 groups, K0 (control group), K1 (administrated of 25 nM melatonin), K2 (administrated of 50 nM melatonin), and K3 (administrated of 100 nM melatonin). Rat BM-MSCs were characterized CD 45- and CD 105+ marker using imunocytochemistry analysis and stained with Alizarin red after 15 days treatment. ALP and osteocalcin level were measured using ELISA Kit in days 21st.There weren’t differences ofALP level beetwen groups and there are differences ofosteocalcin level between control groups (K0) withK1, K2, dan K3, and beetwen K1 and K2. The conclusion of this study was that there were an elevation of osteoblast activity in rat BM-MSCs in osteogenic medium by physiological doses of melatonin administration characterized by the elevation of osteocalcin level.

Introduction: Sirep is one of the nursing intervention to solve sleep problems. Moreover, sirep as immunomodulator for cortisol level, IFN-γRa and IL-10 is still unknown. Sleep disorder can make decrease of immunity, concentration disability, decrease of coordination, alteration of personality, etc. Decrease of immunity can caused by increase or imbalance of stress hormone (cortisol). Increase of cortisol in along time can suppresed T lymphocytes. Objective of this study was to analyze the effect of sleep therapy (sirep) as immunomodulator in elderly with sleep disorder Method: This study used Quasy-Experimental Pre-Post Test Control Group Non Randomised design. Result: Result showed that Sleep therapy (sirep) can changed IFNgRa level in serum elderly with Wilcoxon Sign Rank Test had p0.01. Discussion: Sleep therapy of elderly can released cortisol level serum changing, so sleep therapy as immunomodulator in elderly with sleep dissorder was verified. Discussion: Sleep therapy must applied on elderly with sleep disorder, because sleep therapy become immunomodulator on elderly with sleep disorder was verified.

Introduction: Blood glucose levels are controlled when the management of diabetes success. Positive perception of the strength of the spiritual aspect will improve the motivation of patients with type 2 diabetes to control it. The purpose of this study was to determine the effect of dhikr based on psychoneuroimmunology (PNI) on blood glucose levels of patients with type 2 diabetes. Methods: This study used quasi-experiment with pre-test and post-test control group design. Samples were taken from the population of patients with type 2 diabetes who were hospitalized in the Internal Medicine Rumkital Dr. Ramelan Surabaya with purposive sampling techniques. Data taken include the general characteristics of respondents, cures motivation, cortisol levels and fasting blood glucose levels. Collecting data using questionnaires and laboratory test, then analyzed using paired t-test and independent t-test, with α value

Introduction: Mental disorder remains a stigma in society, even until now. A family who have a member with mental disorder, will experience continues objective and subjective burden, experience serious stress for a lifetime, which may cause ineffective coping. Method: Design used in this study was experimental (pre post test control group design). The population was every family of patient with mental disorder in Menur Mental Hospital along the year of 2010, has been taking care there twice, in minimum, lived in Surabaya. The samples were chosen by allocation simple random. Samples were 13 persons in each treatment and control group. The intervention was given in 60–120 minute in 8 times meeting with average interval about 1 week. Data analysis was done using paired t-test and independent t-test. Result: Results in this study showed that there was significant change in total of family coping (p = 0.040), maintaining family integration, cooperation and an optimistic definition of the stuation (p = 0.009), maintaining social support, self esteem, and psychological stability (p = 0.230), understanding the medical situations through communication with other parents and concultation with medical staff (p = 0.025). Discussion: The provision of family therapy with spiritual approach (DOA) can increase family coping in taking care of patient with mental disorder.

Introduction: Management coronary artery disease required lifelong treatment. The successful management of CHD requires efective coping, intention and medication adherence of CHD’s patients. This study aimed to explain the changes of coping, intention, and medication adherence in patients with CHD after giving self management programme in RSUD Jombang based on Theory Planned Behavior.Method: This study used a quasy experimental pretest-posttest control group design and 28 respondens selected by consecutive sampling. Independent variable was self management programme while dependent variables were coping, intention, medication adherence. Data were collected by using questonnaires measuring coping level, intention and medication adherence. The statistical test used was Mann Whitney, Wilcoxone Signed Rank and t-Test. Result: The result showed that 1) self management programme improve the level of coping in patients with CHD (p < 0,001), 2) self management programme improve the level of intention in patients with CHD (p < 0,001), 3) self management programme improve the level of medication adherence in patients with CHD (p < 0,001). Discussion: To change a behavior requires improvement of coping and intentions. This is in according to the Theory of Planned Behavior that behavior change is influenced by the attitude toward the behavior, subjective norm, perceived behavioral control and intention. Keywords: self management program, coping, intention, medication adherence, coronary heart disease

Cryptocaryon irritans, known as cryptocaryonosis disease infection in fish, is a significant problem for aquarists because they not only cause the disease but also lead to high mortality in the aquarium population. This case report aims to identify Cryptocaryon irritans infection in four Indian Ocean oriental sweetlips at the Jakarta Aquarium and Safari. Before they died, a total of four fish showed signs of weakness, scratching, excessive mucus, and pale gills. The diagnosis was confirmed through clinical assessment, physical examination, and microscopic analysis of skin scrape and gill clip samples, which revealed the presence of numerous trophonts (the young immature stages) of C. irritans. These findings underscore the importance of vigilant monitoring and prompt intervention to mitigate the impact of C. irritans, especially on marine aquarium fish populations.

Background: Dental caries with necrotic pulp is a multifactorial disease that attacks enamel involving tooth pulp. The anaerobic bacteria infection in the pulp chamber could induce the formation of periapical granuloma. However, the presence of the most frequently anaerobic bacteria identified in apical periodontitis, Porphyromonas gingivalis and Prevotella intermedia, in periapical granuloma have not been confirmed. Purpose: The aims of study were to determine the presence of Porphyromonas gingivalis and Prevotella intermedia in dental caries with necrotic pulp and to determine its relation to periapical granuloma. Methods: Thirty-six patients of dental caries with necrotic pulp in Dr. Moewardi General Hospital in Surakarta, Indonesia were involved and classified into two groups, the group of patients with periapical granuloma and the group of patients without periapical granuloma. The caries tooth was extracted, and the chronic periapical tissue was swabbed and cultured on blood agar medium in anaerobic condition. The bacterial DNA was extracted from the positive cultures and subjected for Polymerase Chain Reaction (PCR). Results: Periapical granuloma was more likely found in women (OR 5.5, 95% CI=1.277-23.693; RR 2.5, 95% CI= 1.025-6.100). Black colonies bacteria were associated with periapical granuloma (OR 2.2, 95% CI=0.517-9.594; RR 1.5, 95% CI=0.655-3.623). Porphyromonas gingivalis and Prevotella intermedia were detected in group with or without periapical granuloma, however, only Prevotella intermedia was associated with periapical granuloma (OR 1.6, 95% CI=0.418-5.903; RR 1.3, 95% CI=0.653-2.393). Conclusion: The presence of Porphyromonas gingivalis and Prevotella intermedia in periapical granuloma were confirmed, however, only Prevotella intermedia were associated with periapical granuloma.Latar belakang: Karies gigi dengan pulpa nekrosis adalah penyakit multifaktorial yang menyerang enamel hingga ruang pulpa gigi. Infeksi bakteri anaerob di pulpa nekrosis dapat menginduksi pembentukan granuloma periapikal. Namun, keberadaan bakteri anaerob yang paling banyak ditemukan di periodontitis apikal, Porphyromonas gingivalis dan Prevotella intermedia, di granuloma periapikal masih perlu diteliti . Tujuan: Penelitian ini bertujuan meneliti keberadaan bakteri Porphyromonas gingivalis dan Prevotella intermedia, di karies gigi dengan pulpa nekrosis dan menganalisis kaitannya dengan granuloma periapikal. Metode: Tiga puluh enam pasien karies gigi dengan pulpa nekrosis di Rumah Sakit Umum Dr. Moewardi di Surakarta Indonesia dilibatkan dan diklasifikasikan dalam dua kelompok yaitu kelompok pasien dengan granuloma periapikal dan kelompok pasien tanpa granuloma periapikal. Gigi karies diekstraksi dan jaringan periapikal kronis diusap dan dikultur di media agar darah dalam kondisi anaerob. DNA bakteri diekstrak dari kultur yang positif dan dilakukan pemeriksaan dengan Polymerase Chain Reaction (PCR). Hasil: Granuloma periapikal lebih banyak ditemukan pada wanita (OR 5,5, 95% CI= 1,277-23,693; RR 2,5, 95% CI= 1,025-6,100). Koloni bakteri berwarna hitam diasosiasikan dengan granuloma periapikal (OR 2,2, 95% CI= 0,517-9,594; RR 1,5, 95% CI= 0,655-3,623). Porphyromonas gingivalis dan Prevotella intermedia terdeteksi di jaringan karies dental dengan atau tanpa granuloma periapikal, namun hanya Prevotella intermedia yang diasosiasikan dengan granuloma periapikal (OR 1,6, 95% CI= 0,418-5,903; RR 1,3, 95% CI= 0,653-2,393). Simpulan: Porphyromonas gingivalis dan Prevotella intermedia ditemukan di granuloma periapikal, namun hanya Prevotella intermedia yang terkait langsung dengan granuloma periapikal.

The COVID-19 pandemic has had a profound impact on the tourism industry since its emergence in late 2019. Visitor restrictions have led to a significant decline in activity across various sub-sectors of tourism, and prospective travelers have experienced burnout due to isolation. In such a situation, the digital industry has emerged as a rapid and interim solution. One intriguing digital technology that has garnered attention is Virtual Reality (VR). These efforts have been undertaken to ensure the sustainability of tourism destinations, and VR technology has piqued the interest of potential tourists. Despite its effective role in virtual promotion and learning, particularly for cultural heritage and archaeological sites like the Trowulan Site, stakeholders need to be supported through education on immersive technologies such as VR and their utilization in tourism and education, especially in the field of history. The adoption of VR technology in tourism destinations has experienced significant growth, but issues have arisen due to the lack of Human Resources (HR) related to VR Tourism content creation. As a result, the presentation of VR Tourism experiences has been delayed in terms of content updates, which can have a detrimental impact on the image of the tourism destination, potentially undermining its full potential. Awareness of this issue has been recognized by the Tourism Awareness Group (Pokdarwis) Ladewa, a stakeholder involved in the management of tourism destinations and travel packages in the Trowulan region. To address this issue, a proposed solution involves training related to VR Tourism and Social Media Content Creation as part of the digital marketing strategy for the tourism destination. This training will primarily focus on tourism themes with a sub-theme of enhancing the capacity of the Tourism Awareness Group (POKDARWIS) LADEWA.

Leptospirosis is a disease caused by Leptospira spp., zoonotic Gram-negative bacteria. This study aimed to determine the handling of a leptospirosis case in a dog at the Pet Vet Clinic, Jakarta. Handling began with anamnesis and continued by examining the patient's physical condition, followed by serological, microscopic, and polymerase chain reaction examinations. An examination revealed that the dog had Leptospirosis. The therapy given was the administration of crystalline procaine and penicillin-G antibiotics. Supportive treatment was given with hepatoprotective, lipotropic, and diuretic supplements. Ringer's lactate was used as fluid therapy. The treatment administered showed positive, progressive results in the patient.

The COVID-19 pandemic has disrupted many aspects of normal social life. The community is required not to leave the house too much if it is not necessary. Often during times of independent isolation or in personal cases, people are afraid to leave the house. They are faced with boredom so this is an opportunity for the digital entertainment industry to develop. On the other hand, many violations of COVID-19 health protocols still occur in society and people are still reluctant to stay-at-home. The question is what medium is good for persuasion as well as giving pleasure to people to entertain themselves during independent isolation and with low levels of boredom. Video games are a growing industry during the COVID-19 pandemic, unfortunately, this media has not been widely used as a means of persuading people to obey health protocols and stay-at-home. This study shows a correlation between gaming activity and the tendency not to leave the house. Besides, what types of games have the potential to keep someone from leaving the house are also discussed in this paper.