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BACKGROUND: Diabetes, which causes various complications, involves pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), nuclear factor kappa B p65 (NF-κB p65), interleukin-6 (IL-6), cluster of differentiation 4 (CD4), and matrix metalloproteinase-9 (MMP-9). Magnesium has demonstrated anti-diabetic properties, but its anti-inflammatory effects in preventing cardiovascular complications remain unclear. This study aimed to evaluate the anti-inflammatory effects of magnesium citrate, alone and in combination with metformin, by measuring TNF-α, NF-κB p65, IL-6, CD4, and MMP-9 expression in diabetic model rats. METHODS: Thirty male Wistar rats were divided into five groups: normal control, diabetes control, metformin (treated with 9 mg/200 g/day metformin), magnesium citrate (treated with 3.6 mg/200 g/day magnesium citrate), and combination therapy (treated with 4.5 mg/200 g/day metformin + 1.8 mg/200 g/day magnesium citrate). Diabetes was induced in all groups except the normal control group using streptozotocin (STZ) and nicotinamide (NA). TNF-α, NF-κB p65, IL-6, CD4, and MMP-9 expression levels were measured using enzyme-linked immunosorbent assay (ELISA). RESULTS: Significant differences in TNF-α, NF-κB p65, IL-6, CD4, and MMP-9 expression levels were observed across all groups (p

Introduction: Cancers of unknown primary (CUPs) present a diagnostic challenge as their origin is unidentified at diagnosis. Massive pleural effusion (MPE), indicative of lung metastasis in CUP, categorizes the condition into an unfavorable subset with a poor prognosis. Patients in this subset may exhibit a lower response to specific therapies. Case Presentation: A 62-year-old woman presented with cough, severe dyspnea, and MPE in the left lung. Thoracocentesis was performed, extracting 1,200 mL of hemorrhagic fluid, followed by the placement of an indwelling pleural catheter. The cytological examination of the pleural effusion indicated an adenocarcinoma, with immunohistochemistry revealing positive CK7 and negative CK20, Napsin A, and TTF-1. Additionally, elevated levels of Ca-125 (1,605 U/mL) and Ca 15-3 (242 U/mL) raised suspicion of gynecological malignancy. Thorax and abdominal CT scans, breast and thyroid ultrasounds showed no signs of malignancy, leading to the diagnosis of CUP. The patient’s performance status according to the Eastern Cooperative Oncology Group (ECOG) score was 4. Initial carboplatin 5 AUC and paclitaxel 175 mg/m2 administration resulted in improvement in performance status with ECOG score of 1, alleviation of dyspnea, reduction in pleural effusion 1 week after chemotherapy, with minimal effusion observed at 3 weeks, and Ca-125 levels decreased to 33.6 U/mL thereafter. Discussion: Empiric chemotherapy using carboplatin and paclitaxel is a feasible option for managing CUP with MPE mimicking gynecological malignancies with elevated Ca-125 and Ca 15-3 markers; initiating chemotherapy in poor performance status patients is beneficial with proper clinical judgment.

Introduction: The biological maturity period is the time or tempo of progress toward adulthood or maturity. The hormonal fluctuations play an important role in changing the characteristics of human body tissues during the biological maturity period. However, changes in tissue characteristics during biological maturity period have not been revealed. Skeletal muscle tissue is one of those believed to experience changes. Muscle fibers are thought to experience switching types from type 2 muscle fibers to type 1 muscle fibers. The transition of muscle fibers from type 2 to type 1 requires miR-499 activity from the expression of the Myh7b gene. MiR-499 directly inhibits FNIP-1. However, the biological maturity period of changing FNIP-1 expression has not been confirmed. Objective: This study aimed to analyse the effect of the biological maturity period on FNIP-1 expression and capillary density in the gastrocnemius muscle. Methodology: Thirty-six male mice were divided into mature groups aged eight weeks and immature groups aged four weeks. This study analyzed FNIP-1 and capillary density gastrocnemius muscle of mice using immunohistochemistry. Results: FNIP-1 expression test showed higher in immature mice than mature mice. In comparison, the capillary density test and endurance showed higher expression in mature mice than in immature mice. Conclusion: This study concludes maturation was characterized by a low distribution of FNIP-1 expression in the gastrocnemius muscle and a longer duration ability to run on the treadmill. Unfortunately the capillary density was not a specific mark to determine maturation in mice.

Background: Encouraging early detection and prompt treatment of precancerous lesions is the key to preventing cervical cancer in women who are fertile. IVA examinations are used to detect precancerous lesions early on. Thus far, both nationally and at Mojo Health Center, the IVA examination has been achieved. Women of reproductive age may not be as aware of early diagnosis of precancerous lesions as they should be, which could contribute to the low IVA examination achievement. Due to a lack of understanding regarding the early diagnosis of precancerous lesions, women of reproductive age have low awareness. Method: A lecture and leafleting approach were used to conduct this health counseling. This kind of study uses a quasi-experimental pretest-posttest one group design, which is experimental in nature. carried out in Surabaya City at the Mojo Health Center. A straightforward random sampling methodology was used to choose the sample of 84 WUS, who were then split into two groups: the treatment group, which received an intervention counseling lecture style, and the control group, which received a leaflet intervention. A questionnaire was utilized to collect the data, and the Wilcoxon signed rank test was used to evaluate it. Independent Samples Test (p0.05) was the outcome of the test to determine the value of differences in knowledge factors between the treatment group and the control group. Conclusion: There is no difference in WUS knowledge between the lecture method and leaflet media distribution when it comes to counseling, but there is a shift in the outcomes of WUS knowledge about early detection of cervical cancer before and after receiving counseling.

Introduction: Muscle strength strongly affects soccer players’ activities, but chronic ankle injuries can reduce the ability of athletes to achieve their best performance. No report exists in the literature about the role of certain muscles in affecting the vertical jump height of soccer players. Therefore, this study aimed to analyze the differences in leg muscle strength that affect the vertical jump height of soccer players after chronic ankle injury. Materials and Methods: To achieve the aim of this study, a cross-sectional design was employed by involving one team consisting of 25 Surabaya Football Association (PERSEBAYA) players. They were divided into injury and noninjury groups, according to the questionnaire. The participants were determined based on their normal body mass index (BMI), age (17-40 years), male gender, and PERSEBAYA players. The collected data included vertical jump, ankle muscle construction, and hamstring muscle data. The data were statistically analyzed using the t test and Pearson correlation (P

This research aims to analyze the effect acute intervention of banana drink enriched with egg white to premenstrual symptoms, mood and levels of serotonin in collegiate female athletes with Premenstrual Dysphoric Disorder (PMDD). This experimental study was randomized, double blind, and used a pre and post placebo-control group design. Purposive sampling technique was used to select the research sample. Purposive sampling technique was used to select research samples and divided into two groups, namely the placebo drink group and the banana drink group. Each participant was in the late luteal phase at the time of data collection. efore the test, records were made regarding the characteristics of the research subjects, menstrual cycle calculations, cervical fluid observations and basal body temperature measurements. The PSST-A is used to diagnose moderate/severe PMDD, mood respons were assessed using 24 BRUMS Research items with the Brunel Mood Scale. Serotonin analysis was carried out using the Elisa Kit Human Serotonin. Before and after intervention (pre-post-test) both groups were given a push up test for 60 seconds. Intervention was given 3 hours before completing the PSST-A, BRUMS questionnaires and push up test. Statistical tests of research data were carried out using SPSS version 23. Based on the results of the PSST-A analysis, it was reported that banana drink was able to significantly reduce (*p

PURPOSEThere has been a global increase in early-onset colorectal cancer (EOCRC), yet there has been very limited exploration of its impact in Indonesia. This study aimed to determine the clinicopathologic characteristics and the overall survival (OS) of EOCRC compared with those of average-onset colorectal cancer (AOCRC).METHODSMedical records were retrospectively reviewed from all patients presenting with colorectal cancer (CRC) at Dr Sardjito General Hospital (Yogyakarta, Indonesia) between 2016 and 2019. Sociodemographic, clinicopathologic, and treatment variables were extracted. t Tests were used to compare characteristics of EOCRC and AOCRC patient groups. The Cox proportional hazards regression model was used to analyze age and other potential prognostic factors.RESULTSThe total population (N = 1,276) comprised EOCRC (n = 149; 11.7%) and AOCRC (n = 1,127; 88.3%) patients. EOCRC patients were more likely to have a higher education level, be single, have out-of-pocket insurance, be underweight, and have signet ring histology (all P values

Energy drinks are popular among various groups of people, such as teenagers and working individuals. These beverages are consumed to provide additional energy and improve focus. This research investigates the relationship between energy drinks and blood pressure and heart rate in students of the Faculty of Medicine at Universitas Airlangga, Surabaya, Indonesia. The study used the open trial – randomized cross-over study method and collected primary data through experiments. The sample consisted of students from the Faculty of Medicine at Universitas Airlangga, aged 19 to 22 years, with a normal body mass index ranging from 18.5 to 24.9. The systolic, diastolic, and heart rate values were measured before and after consuming energy drinks. A total of 38 research samples were used, including 22 males (57.8%) and 16 females (42.1%). Energy drinks such as Kratingdaeng and Extra Joss showed a significant increase in blood pressure. However, no significant changes were observed in heart rate. The results of the Wilcoxon statistical test, comparing systolic and diastolic conditions before and after consuming Extra Joss, showed p

Context: Anterior cruciate ligament (ACL) reconstruction often faces challenges due to poor integration of the tendon with bone. Aims: To evaluate the potential benefits of alendronate and platelet-rich plasma (PRP) in enhancing tendon-to-bone osteointegration in ACL surgery. Methods: This was a post-test only control group experimental study with Ovis aries Linnaeus sheep as experimental animals. The sample was divided into four groups: the control group ACL reconstruction with calcaneal tendons given NaCl, the group given PRP, alendronate, and PRP and alendronate. Bone healing biomarkers (NF-kB, TNF-α, MMP-9, TGF-β1, and COL1A1) were examined through immunohistochemical analysis and histological studies to assess osteoblast counts and inflammatory tissue. Results: There was a statistically significant (p0.05). The intervention did not affect NF-kB and TGF-β1 (p> 0.05). Conclusions: These results show that the administration of alendronate and PRP improves the healing of tendon-calcaneal ACL reconstruction surgery in sheep.

This study analyzes the effect of adding brown sugar to young coconut water post-High Intensity Interval Training (HIIT) on plasma osmolarity, oxygen saturation, and pulse rate. Utilizing a pre and post-test control group design, the experiment involved 20 male subjects aged 19-22 with a normal body mass index. The participants were divided into three groups: (K1) receiving mineral water, (K2) receiving young coconut water, and (K3) receiving young coconut water with added brown sugar. Each subject underwent a 30-minute ergo cycle HIIT session. Blood samples were collected at three intervals: before exercise, immediately after, and an hour post-rehydration. The results indicated plasma osmolarity levels showed no significant change from Pre-HIIT (0.939) to Post-HIIT (0.780). However, Post-Rehydration, an increase was observed across the three groups (p=0.004). Pulse rate measurements revealed no significant difference from Pre-HIIT (0.788) to Post-HIIT (0.411), but Post-Rehydration, a significant decrease was noted between the groups (p=0.034). Oxygen saturation levels remained consistent Pre-HIIT (0.902), Post-HIIT (0.602), and 1-hour post-HIIT (0.611) within the third group. In conclusion, adding brown sugar to young coconut water post-HIIT resulted in higher plasma osmolarity, did not affect oxygen saturation levels, and contributed to a lower pulse rate. Keyword: Plasma osmolarity; oxygen saturation; pulse rate; brown sugar; young coconut water

Background: Maternity leave is a right of female workers granted by the government. Pregnant women have the right to rest for 1.5 months before giving birth and 1.5 months after giving birth according to Law No. 13 of 2003. Pregnant women who take late maternity leave are at risk of experiencing a longer second period. This study aims to determine the relationship between maternity leave and energy balance and the length of the second stage of labor. Method: The research method uses a comparative study approach because researchers will compare the energy balance and length of the second stage of labor in working mothers who take maternity leave and those who delay taking maternity leave. The sample in this study was mothers giving birth at RSI Jemursari Surabaya who met the inclusion criteria. The instruments used were medical record books, partograph sheets and data collection sheets. Research data was analyzed using Fisher's exact test. Result: The results showed that majority of respondents (77%) had a negative energy balance and majority of respondents (80.9%) experienced the second stage of labor in less than 90 minutes. The statistical test results of the maternity leave period with energy balance obtained a value of p = 1.000 and the results of statistical tests between the period of maternity leave and the second stage of labor obtained a value of p = 0.421. Conclusion: These data show that there is no relationship between the period of maternity leave and energy balance and there is no significant relationship between the period of maternity leave and the second stage of labor in working mothers.

Objectives: To analyze the impact of exercise under hypoxic exposure versus normoxic exposure on blood glucose level, insulin level, and insulin sensitivity in people at risk of Type 2 diabetes mellitus (T2DM). Materials and Methods: We systematically performed electronic searching on PubMed, Web of Science, ProQuest, and Scopus. Primary studies that met the inclusion criteria were analyzed using Revman 5.4.1. Results: Nine randomized controlled trials were included in this meta-analysis. We found that physical exercise under hypoxic exposure had no significant effect on improving blood glucose levels, insulin levels, and insulin sensitivity in the elderly and sedentary people compared to normoxic condition. However, physical exercise during hypoxic exposure had a significant effect on lowering blood glucose levels in overweight/obese individuals (pooled Standardized Mean Difference = 0.29; 95% confidence interval = 0.01–0.57; P = 0.04). Conclusions: Exercising under hypoxic exposure can be an alternative strategy for reducing blood glucose levels in overweight/obese people. Nevertheless, in other populations at risk of T2DM, exercising in hypoxic conditions gives similar results to normoxic conditions.

Introduction: Little is known about Indonesian metastatic CRC patients’ survival and prognostic factors, although this malignancy is one the most frequent cancer in the country. We aimed to investigate the survival outcome and the factors influencing local CRC patients presenting with a metastatic stage at diagnosis. Methods: A retrospective cohort study was done on 441 data of synchronous metastatic CRC cases treated between January 2016 and December 2019 at Dr. Sardjito Hospital, Yogyakarta, Indonesia. Secondary data were collected from the CRC clinical registry database. Demographic, clinicopathology and the type of treatment were collected. Survival staus was obtained from the registry database and communication to patients or caring families. Kaplan-Meier curves were used to estimate the overall survival (O.S). The Cox proportional hazards regression mode was applied to analyzethe potential factors affecting survival. Results: The median follow up of the recent study was 17 months, The median overall survival was 13 months. Two-year overall survival was 37% and the estimated 5-year overall survival was 16.1%. Multivariate cox analyses identified poor performance status (HR 2.639, 95% CI 1.438-4.842, p = 0.002), elevated carcinoembryonic antigen (CEA) (HR 2.795, 95% CI 1.509-5.176, p = 0.001) and higher histological grade (HR 2.019, 95% CI 1.112-3.667, p = 0.021) were associated with poorer overall. Conclusion: Poor performance status, high CEA level, and higher histological grade as factors that were associated with unfavourable overall survival of patients with synchronous metastatic colorectal cancer in Yogyakarta, Indonesia.

Most cases of colorectal cancer develop from adenomatous polyps, slowly progressing within an average period of 8–10 years. McKittrick-Wheelock syndrome (MKWS) is a rare manifestation of tubulovillous adenoma. It generally presents as hypersecretory diarrhea with severe electrolyte and fluid depletion. Roughly, 5% of the published cases have reported malignant histopathology associated with MKWS, with little to no data regarding the malignant transformation process of those patients. Our patient was a 53-year-old Asian woman suffering from chronic secretory diarrhea, resulting in severe volume, electrolyte depletion, and prerenal azotemia, consistent for MKWS. Her symptoms initially improved with sulfasalazine but eventually worsened. She demonstrated signs of systemic (elevated leukocyte, CRP, and LDH) and local inflammation (dense lymphocyte infiltration in colorectal tissue) throughout the course of her disease. Serial pathological results showed rapid neoplastic progression of adenomatous polyp to adenocarcinoma within 1 year period. Surgical resection resulted in complete symptom resolution. Molecular examination showed a favorable profile of exon 4 Kirsten rat sarcoma viral oncogene homolog mutation, normal NRAS, BRAF, CDX2, and CK20 expressions. Her molecular pattern did not reflect the profile of an aggressive disease, suggesting the possibility of oncogenic processes outside the major pathways of adenoma to carcinoma progression. Chronic inflammation is a well-established risk factor for colorectal cancer, and prostaglandin E2 (PGE2) has been observed as one of the key regulators of tumor initiation and growth. PGE2 is also responsible for hypersecretory diarrhea associated with MKWS.

Previously, FNIP-1 was found to play a critical role in the coupling of mitochondria function to restore ATP. Mitochondria was need to be supplied sufficient oxygen by myoglobin in the myocyte. We proposed that FNIP-1 also regulated myoglobin levels to support endurance performance. This study aimed to investigate whether FNIP-1 expression in muscle was correlated with myoglobin level and endurance performance on the treadmill run test. Male adult balb/c mice performed a run on the treadmill for as long as possible. The duration of running was measured as endurance performance. Its calf muscles were analyzed for myoglobin level and FNIP-1 expression. Lower FNIP-1 expression in calf muscle was found on higher levels of myoglobin and the longer duration of running on a treadmill. The Pearson test showed that the P value was

Introduction: Sepsis causes significant damage to the endothelial glycocalyx layer, which albumin can protect against. Unfortunately, human albumin is quite expensive, so cheaper substitutes must be found without sacrificing effectiveness. Albumin extract Channa striata is one that is commonly used in Indonesia. Objectives: Conducted a non-inferiority study between human albumin and Channa striata extract in protecting the glycocalyx layer through syndecan-1 levels. Materials and methods: Prospective cohort study of adult patients with early sepsis with hypoalbuminemia (

الملخص: أهداف البحث: يساهم الانتشار المرتفع لتدخين التبغ في ارتفاع معدل الإصابة بالسكتة الدماغية الحادة في إندونيسيا. من المعروف أن تصلب الشرايين الكبير هو سبب مهم للسكتة الدماغية الحادة. هدفت الدراسة الحالية إلى تقييم العلاقة بين السكتة الدماغية الحادة وتصلب الشرايين بناءً على قياسات سماكة الطبقة الداخلية للشريان السباتي في مستشفى المستشفيات التخصصية الإندونيسية. طريقة البحث: إجمالا، تم تضمين 79 مريضا يعانون من السكتة الدماغية الحادة (مجموعة دراسة الحالة) و 79 فردا بدون سكتة إقفارية حادة (مجموعة التحكم). تم استخدام اختبار كاي تربيع ونسب الأرجحية لمقارنة المجموعات وتحديد ارتباطها. أخذنا في الاعتبار أيضا عوامل مثل العمر، ومؤشر كتلة الجسم، والجنس، وداء السكري من النوع 2، وارتفاع ضغط الدم، وعادات التدخين، وعسر شحميات الدم، والحالة الاجتماعية والاقتصادية، والمستوى التعليمي في التحليلات الإحصائية. النتائج: أظهر التقسيم الطبقي لتصلب الشرايين في دراسة الحالة ومجموعات الضبط فيما يتعلق بجميع متغيرات الدراسة علاقة معنوية بين تصلب الشرايين وجميع المتغيرات باستثناء الحالة الاجتماعية والاقتصادية المنخفضة والمستوى التعليمي المنخفض. أظهر تحليل الانحدار أن مؤشر كتلة الجسم 25 كجم / م 2 كان مرتبطا بخطر الإصابة بتصلب الشرايين بمقدار 2.139 ضعفا من مؤشر كتلة الجسم الطبيعي الاستنتاجات: ارتبطت السكتة الدماغية الحادة بتصلب الشرايين على أساس قياسات سماكة الطبقة الداخلية للشريان السباتي مع مراعاة العمر، ومؤشر كتلة الجسم، والجنس، وارتفاع ضغط الدم من النوع 2، وعادات التدخين، وخلل شحميات الدم، والحالة الاجتماعية والاقتصادية، ومستوى التعليم لدى السكان الإندونيسيين Abstract: Objectives: A high prevalence of tobacco smoking contributes to a high incidence of acute ischemic stroke (AIS) in Indonesia. Large-artery atherosclerosis is known to be a significant cause of AIS. The present study was aimed at evaluating the association between AIS and atherosclerosis on the basis of carotid intima-media thickness (CIMT) measurements in a tertiary care hospital in Indonesia. Methods: A total of 79 patients with AIS (case study group) and 79 individuals without AIS (control group) were included. Chi-squared tests and odds ratios were used to compare the groups and determine associations. We also considered factors such as age, body mass index (BMI), sex, type-2 diabetes mellitus (T2DM), hypertension, smoking status, dyslipidemia, socioeconomic status, and educational level in the statistical analyses. A p-value 0.05) between atherosclerosis and all variables except low socioeconomic status (p = 0.265) and low educational level (p = 0.180). Regression analysis demonstrated that a BMI ≥25 kg/m2, compared with a normal BMI, was associated with a 2.139-fold higher risk of atherosclerosis. Conclusions: AIS was associated with atherosclerosis, on the basis of CIMT measurements, according to age, BMI, sex, T2DM, hypertension, smoking status, dyslipidemia, socioeconomic status, and education level in the Indonesian population.

Abstract End-stage renal disease patients on haemodialysis (HD) have been largely excluded from SARS-CoV-2 vaccine trials due to safety reasons and shown to mount lower responses to vaccination. This study aims to evaluate the immunogenicity and safety of inactivated COVID-19 vaccine among HD patients compared to healthy controls. All subjects who received the primary inactivated COVID-19 vaccination had their blood samples tested 21 days after the second dose. We report the immunogenicity based on anti-RBD IgG titre (IU/mL), the inhibition rate of neutralizing antibodies (NAbs) (%) to RBD, and seroconversion rates. Adverse events were assessed within 30 min and on the 7th day after each dose. Among 75 HD patients and 71 healthy controls, we observed no significant difference in all immunogenicity measures: anti-RBD IgG GMT (277.91 ± 7.13 IU/mL vs. 315.50 ± 3.50 IU/mL, p = 0.645), NAbs inhibition rate (82% [53–96] vs. 84% [39–98], p = 0.654), and seroconversion rates (anti-RBD IgG: 86.7% vs. 85.9%, p = 0.895; NAbs: 45.3% vs. 60.6%, p = 0.065). The number of adverse events is not significantly different between the two groups. The primary inactivated SARS-CoV-2 vaccination elicits an adequate antibody response and can be safely administered in haemodialysis patients.

This paper discusses the ability of the Kerinci people to adapt during the recovery process after the earthquake catastrophic in June 1909, when they had to deal with massive damage, environmental changes, various internal limitations, inadequate support from external elements, and the impact of colonial political and military annexation. The research utilizes colonial government report documents, written records of eyewitnesses, newspaper reports, and oral traditions. Inspired by the concept of "everyday forms of resistance" from James C. Scott, the daily life of Kerinci people is understood as a resistance which is able to break free from dependency by utilizing its own socio-cultural potential. The Kerinci people fought against the disruption of the earthquake and were able to transform helplessness into strength. They did not depend on the colonial government in the process of rebuilding and recovering after the earthquake, because adat which has synergized with religion and love for the homeland, is able to make the population survive.

One of the most prevalent zoonotic illnesses in the world, toxoplasmosis, affects both humans and animals and is caused by the parasite Toxoplasma gondii. The infection will trigger the immune system to increase antibody production. This study aims to determine the dose of toxoplasma that causes necrosis in rats placental and fetal hearts. This study was laboratory experimental research with a Randomized Control Trial (RCT). The study design used a post-test only with a control group design. The Ig G variable obtained from the control group (CG) and treatment group 3 (TG3) is the most significant because the mean value difference was the largest (176.56). The Ig M variable obtained from the control group with treatment group 3 (TG3) is the most significant because the mean value difference is the largest (33.47). The fetus weight variable obtained from the control group with treatment group 3 (TG3) is the most significant because the mean value difference is the largest (2.6). The body length variable obtained from the control group between treatment group 3 (TG3) is the most significant because the mean value difference is the largest (1.26). There was a significant difference in placental tissue necrosis (p = 0.034) and heart (p = 0.025) between the control group (CG) and treatment group 3 (TG3). Therefore, there was a significant difference in Ig G, Ig M, fetus weight, body length, placental tissue necrosis, and fetal heart at the 10³ dose compared to the 102, 101, and normal doses.

This study aims to analyze herbal supplements that have the potential to accelerate recovery from exercise-induced muscle damage through a systematic review. Article searches were carried out using electronic databases originating from Pubmed and Scopus published from 2019 to 2022 using the keywords herbal, curcumin, garlic, ginger, tribulus, cinnamon, biomarkers, muscle pain, inflammatory markers, and antioxidant effects. The inclusion criteria in this literature review resulted in 14 selected articles resulting from a screening process of 90 articles. The results presented in this literature review reveal the fact that there are significant changes related to EIMD after consuming herbal supplements from 14 selected articles with doses varying between 500-2000 grams per day. In addition, other results showed that intervention with herbal products affected biomarkers and oxidative stress. Therefore, this systematic review provides evidence that supplemental intake strategies are essential for the average athlete or individual to minimize the negative effects of strenuous and excessive training. This systematic review concluded that herbal ingredients such as cinnamon, curcumin, garlic, ginger, and tribulus terrestris may help athletes or individuals recover from EIMD. Keywords: Biomarkers, EIMD, Inflammation, Nutrition, Supplementation, Recovery

Propolis is an herbal medicinal plant that contains caffeic acid phenethyl ester. This natural polyphenol compound acts as an antioxidant and can reduce blood glucose levels and increase body weight. This study aims to determine the effectiveness of Gunung Lawu propolis in lowering blood glucose levels and increasing body weight in diabetic rats. The Wistar rats were induced with STZ 45 mg/kg BW and nicotinamide 110 mg/kg BW as diabetic model rats. Research subjects were taken randomly and divided into five groups: (1) Normal, (2) DM with no propolis, (3) DM 14 days + propolis 100 mg/kg BW/day (P1), (4) DM 14 days + Propolis 200 mg/kg BW/day (P2), and (5) DM 0 day + Propolis 200 mg/kg BW/day (P3). Propolis extract was given orally once a day for 14 consecutive days (in groups 3 and 4) and 28 consecutive days (in group 5). Blood glucose levels in the treatment group (P1, P2, and P3) decreased significantly (P1: 115.28 ± 4.7 mg/dL; P2: 98.36 ± 4.8 mg/dL; and P3: 87.36 ± 4, 2 mg/dL) compared with that in the DM group (272.07 ± 3.9 mg/dL). The body weight of the treatment group (P1, P2, and P3) increased significantly (P1: 180.60 ± 5.7 g; P2: 180.60 ± 4.2 g; and P3: 208.00 ± 5.1 gr) compared with that in the DM group (160.00 ± 3.2 gr). In conclusion, Propolis is effective in reducing blood glucose levels and improving (increasing) body weight in diabetic model rats.

Abstract Background A significant decrease in antibody titres several months after COVID-19 primary vaccination in end-stage kidney disease (ESKD) patients receiving maintenance haemodialysis has recently been reported. The waning in antibody titres has led to the recommendations for a booster dose to increase the antibody titres after vaccination. Consequently, it is crucial to analyse the long-term humoral immune responses after COVID-19 primary vaccination and assess the immunogenicity and safety of booster doses in haemodialysis (HD) patients. Methods Patients on maintenance haemodialysis who received the primary vaccine of CoronaVac (Sinovac) vaccine were administered with BNT162b2 (Pfizer-BioNTech) as the booster dose. The immunogenicity was assessed before (V1), one month (V2) and eight months (V3) after the primary vaccination, as well as one month after the booster dose (V4). Patients were followed up one month after the booster dose to assess the adverse events (AEs). Results The geometric mean titre (GMT) of anti-SARS-CoV-2 S-RBD IgG antibody at 8 months after the primary vaccination increased significantly to 5,296.63 (95%CI: 2,930.89–9,571.94) U/mL (p = 0.9999). The most common AEs after the booster dose included mild pain at the injection site (55.26%), mild fatigue (10.53%), and swelling at the injection site (10.53%). No serious AEs were reported. Conclusions The majority of ESKD patients on haemodialysis mounted a good antibody response to the BNT162b2 booster vaccination with tolerable adverse events.

Malaria is known to be a significant risk factor and also a potential complicating factor during the treatment of lymphoid malignancy. There has not been a reported case of malaria reactivation that occurred weeks after cytotoxic chemotherapy completion, especially in non-endemic regions. Our patient was a 47-year-old man with a history of repeated falciparum malaria infection experiencing 2 months of progressive unilateral nasal blockage and recurrent anterior epistaxis, which was diagnosed as diffuse large B-cell lymphoma (DLBCL) through pathological examination. He was treated with six cycles of classical R-CHOP, resulting in complete remission. One month after remission, he experienced shivering, fever, sweating, and a return to normal temperature, which repeated irregularly for roughly 1 week. His laboratory result showed anaemia, leucopenia, and profound thrombocytopenia. Immunochromatographic testing (ICT) confirmed the diagnosis of falciparum malaria. This case was considered a relapse since our centre is not in the malaria-endemic region. He was cured with a combination of dihydroartemisinin-piperaquine and primaquine. Our case demonstrated the duality of malaria as potential aetiology and treatment complicating factor in DLBCL.

Highlights: 1. Menstrual cycle disturbance is related to organic and non-organic factors. 2. BMI, waist circumference, and energy adequacy did not have a significant correlation with menstrual cycle frequencies among medical students. Abstract Introduction: Menstrual cycle disturbance is related to irregular reproductive hormones, which are influenced by organic and non-organic factors. This study aimed to determine the correlation between energy adequacy, body composition, and menstrual cycle disorder. Methods: This was an observational analytic study with a case-control design. The population of this study was medical and midwifery students in the Faculty of Medicine, Universitas Airlangga, Surabaya. 72 subjects consisted of 36 women with a normal menstrual cycle between 24–38 days and 36 women with a menstrual cycle length of 38 days. Data about body composition, energy adequacy, and menstrual cycle were all collected by questionnaire. Data were analyzed by Spearman and Continency Coefficient correlation. Results: Most participants (66.7%) had normal body mass index (BMI), while 19.4% were overweight. Meanwhile, waist circumference in 63.9% of subjects was categorized as not obese. The participants' physical activities ranged from sedentary to vigorous (0 to 7386 MET-minutes/week). Less than one-third of the participants (27.8%) had an energy balance, while in most subjects (56.9%), energy adequacy was classified as deficit or negative energy balance. The statistics showed a p-value >0.05 in BMI (p = 0.231), waist circumference (p = 0.141), and energy adequacy (p = 0.389) with the menstrual cycle, indicating no correlation between BMI, energy adequacy, and waist circumference with menstrual cycle frequencies. Conclusion: Statistical analysis showed no correlation between energy adequacy, BMI, and waist circumference with menstrual cycle frequency disorder in students in the Faculty of Medicine, Universitas Airlangga, Surabaya.

Background: Early recognition of phallic size abnormalities is essential to identify underlying endocrine and genetic disorders. Parents are concerned regarding their son’s penis length, especially obese and short-stature boys. This study aimed to investigate the factors of penile length in prepubertal boys aged 9-11 in Surabaya. Methods: A cross-sectional analytic observational study was conducted between October and November 2021 during the community services program of the Andrology Study Program, Universitas Airlangga. One hundred forty-eight healthy boys aged 9-11 years were enrolled in this study. Penile parameters and anthropometric measures were recorded. Data were analyzed with Spearman Rho’s formula to correlate the variables studied. Results: The average penile lengths and penile circumference of the penis were 6.3±1.4 and 5.2±1.0 cm, respectively. This study found two boys with micropenis (1.35%) with normal and overweight body mass index (BMI). The penile length was positively correlated with height but not with BMI. Conclusion: Androgen and growth hormones significantly influence penile length. Children with abnormal BMI tend to have smaller penile sizes, associated with increasing androgen aromatization.

The practice of vaginal douching remains as one of the most attentive topics in the public health domain. The prevalence of vaginal douching in Indonesia about 75% both married and unmarried, despite its risks towards health and well being. This practice can be prevented and avoided by managing the factors behind its practice, which were studied through consideration of the role of social media, health services, knowledge, attitude, culture, and experience. The purpose of this study is to identify the major factors behind the practice of vaginal douching among women according to their marital status. This research was designed as an observational analysis study with cross sectional survey and 152 samples were collected with simple random sampling. Bivariate analysis were done using Chi-square while multivariate analysis were done with logistic regression to determine the dominant factor behind the practice. Factors being considered in the analysis were social media, health services, knowledge, attitude, culture, and experience. The most significant factors according to marital status were social media (OR = 6,2; CI: 1,83 – 21,11; p value = 0,003) and health services (OR = 3,0; CI: 1,23 – 7,42; p value = 0,016).

Background: An interrupted menstrual cycle can indicate reproductive system problems. However, there are several factors that can affect the length of the menstrual cycle such as nutritional status, diet, stress, hormonal drugs, smoking, and sleep quality. The current COVID-19 pandemic has had a major impact, one of which is an increase in stress, especially for health workers who serve COVID-19 problems. This study aims to analyze the relationship between stress levels with the length of the midwife's menstrual cycle during the COVID-19 pandemic. Methods: The type of research that will be used is an observational analytic study using a cross sectional design. The number of samples used were 47 midwives who work in RSUD Dr. Soetomo Surabaya during the COVID-19 pandemic. Bivariate analysis using Spearman tests. Results: There were 63.8% of midwives who had moderate stress levels and 88.2% of midwives with normal menstrual cycle length. The results of the analysis showed that there was no relationship between the midwife's stress level with the length of her menstrual cycle with p=0,660 and p = 0.568. Conclusion: Based on the results of this study, it can be concluded that there is no relationship between stress levels with the length of the menstrual cycle in midwives during the COVID-19 pandemic, so education and information about stress handling mechanisms are needed so that stress does not increase. Keywords: Stress level, menstrual cycle length, COVID-19 pandemic

BACKGROUND: Anthrax is a zoonotic disease caused by Bacillus anthracis, whose endospores stimulate the release of pro-inflammatory cytokines and promote oxidative stress. Propolis, a natural resource that can be found in Indonesia, has been proven to have anti-apoptotic and antioxidant role which might be a potential adjuvant therapy for anthrax treatment. Hence in this study we aimed to investigate effect of propolis as an anti-inflammatory, anti-apoptotic, and antioxidant in anthrax rats model by examining the level of tumor necrosis factor (TNF)-α, caspase-3, and malondialdehyde (MDA), respectively. METHODS: This was an experimental post-test only study with 40 male rats weighed 180-200 g that were induced by anthrax spores injected subcutaneously. The rats were divided into one control positive group and four intervention groups that were administered with 200 mg/kgBW propolis extract for 7 to 14 days. The levels of serum TNF-α, caspase-3, and MDA were measured using enzyme-linked immunosorbent assay (ELISA) and analyzed with bivariate analysis. RESULTS: TNF-α, caspase-3, and MDA level were found lower in anthrax rats model given ethanol extract of propolis than the control group. The lowest concentration of TNF-α value was found in group administered with propolis extract 200 mg/kgBW for 7 days before the anthrax induction (6.136±0.205 pg/mL). The results were similar to the MDA serum and caspase-3 which were the lowest when the propolis was administered 7 days earlier (1.893±0.188 nmol/mL and 2.040±0.067 ng/mL). There was significant difference in the TNF-α, caspase-3, and MDA serum levels (p≤0.001) compared to control group. CONCLUSION: Propolis has anti-apoptotic and antioxidant effects which can be used as complementary therapy in anthrax infection. KEYWORDS: propolis, anthrax, anti-apoptotic, antioxidants

Introduction: Type 2 diabetes mellitus (T2DM) is a non-communicable disease with a high prevalence in Indonesia. T2DM is caused by insulin resistance and relative insulin deficiency. One of the therapy for T2DM is insulin administration which is injected into the subcutaneous tissue. The absorption of insulin in the subcutaneous tissue is influenced by many factors, one of which is the thickness of subcutaneous fat. This study aimed to determine the correlation between the skinfold thickness of T2DM patients with the total daily dose of insulin needed every day. Methods: This was an observational analytic study using a cross-sectional design to analyze the correlation between subcutaneous fat thickness represented by skinfold thickness and the total daily dose of insulin of T2DM patients. Measurement of skinfold thickness was carried out on the triceps using a skinfold caliper. Data on the patient's total daily dose of insulin were obtained from medical records. Results: A total of 53 patients were included in this study. The patient's mean triceps skinfold thickness was 26.29±8.72 mm. The mean total daily dose of insulin was 40.96±18.01 IU. The results of the Spearman Rank correlation test showed a significant correlation between skinfold thickness on the triceps and the patient's total daily dose of insulin (p

BACKGROUND: Cisplatin is one of the most potent chemotherapy drugs to treat various types of cancer, however the use of cisplatin has some the adverse effect, such as the increase of oxidative stress and inflammation by malondialdehyde (MDA) and nuclear factor kappa B (NF-kB) activation. Since the dosing of cisplatin is critical, we observed the effect of single and multiple doses of cisplatin injection on rats’ inflammation and oxidative stress level. METHODS: Total of 27 male Sprague-Dawley rats were divided into 9 sub-groups, each consisted of 3 rats. The baseline sub-group received no treatments; Group 1 (sub-group 1.1, 1.2, 1.3, and 1.4) were administered one single dose of 5 mg/kg BW/intravenously (i.v) of cisplatin; and Group 2 (sub-group 2.1, 2.2, 2.3, and 2.4) were given 0.2 mg/kg BW/i.v of cisplatin twice a week for two months. Rats were observed for their body weight, NF-kB, and MDA level based on the assigned group. RESULTS: Body weight loss was observed in the 1st week after treatment for Group 1, and 7th week for Group 2. Group 1 and Group 2 showed increasing level of NF-kB and MDA since the 1st observation, which was the 1st week and 5th week, respectively. NF-kB and MDA and levels were also significantly increasing in both groups for every week of observation (p

Background: Hearing loss and deafness are still an issue in Indonesia, especially in West Java, with a prevalence of 2.5% and 0.06%, respectively. Cochlear implants are intended for patients with severe sensorineural hearing loss to stimulate the remaining auditory nerves. Based on their competency standards, Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) Specialists are expected to be able to inform patients and families about the cochlear implantation procedures. This study aimed to explore the level of knowledge, attitudes, and behavior of ORL-HNS Specialists in West Java towards cochlear implants. Methods: This study was a descriptive study with a cross-sectional approach. Primary data were collected through a questionnaire filled out by ORL-HNS Specialists who were actively working in West Java in 2021–2022. Results: Data from 157 specialists showed that 41.4% (n=65) had good knowledge about cochlear implants, and 43.9% (n=69) had adequate knowledge, however, 62.4% (n=98) showed a negative attitude. In addition, 99.3% (n=156) showed good behavior. Conclusions: ORL-HNS Specialists in West Java have a sufficient level of knowledge, negative attitude, and good behavior towards cochlear Implants. The negative attitude of the specialists need to be bettered, updating their knowledge about how cochlear implants work and their effectiveness for patients with hearing impairments might give them a new perspective and hopefully change their attitude towards cochlear implants.

Introduction: Plumbago zeylanica grows widely in many tropical countries. In Indonesia, this plant, known as Daun Encok, has some beneficial effects on human health. Aim: This exploration study aimed to identify the plumbagin compound in P. zeylanica roots from Indonesia. Materials and methods: Dried roots of P. zeylanica were manually ground and then the powder was macerated using ethanol and chloroform for 24 hours at room temperature. All extracts of P. zeylanica were then analyzed using gas chromatography-mass spectrometry (GC-MS). Plumbagin concentration was measured by comparing the extract with pure plumbagin.Results: GC-MS analysis of ethanol extract and chloroform extract of P. zeylanica roots showed the presence of plumbagin as the highest peak. Plumbagin concentration in ethanol extract was 13%, while in chloroform extract it was 81%.Conclusions: The chloroform extract of P. zeylanica root from Indonesia demonstrates a higher concentration of plumbagin compared to ethanol extract.

Due to the nature of the disease, end-stage renal disease (ESRD) patients suffer from dysfunction of the adaptive immune system, which leads to a poorer response to vaccination. Accordingly, it is crucial to evaluate the efficacy and safety of management strategies, including vaccinations, which could potentially reduce the risk of respiratory diseases, such as pneumonia, influenza, or COVID-19, and its associated outcomes. We searched PubMed, CENTRAL, ScienceDirect, Scopus, ProQuest, and Google Scholar databases using designated MeSH keywords. The risk of bias was assessed using ROBINS-I. The quality of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Relative risk (RR) and 95% confidence interval (CI) were calculated. Heterogeneity was investigated using forest plots and I2 statistics. This systematic review included a total of 48 studies, with 13 studies of influenza (H1N1 and H3N2) vaccination and 35 studies of COVID-19 vaccination. H1N1 vaccination in ESRD patients undergoing hemodialysis induced lower seroconversion rates (RR 0.62, 95% CI: 0.56–0.68, p

Background: The prevalence of middle ear inflammation in West Java is still relatively high. General practitioners are at the forefront who see and treat the patients directly; thus, the number of cases can be reduced by increasing the competence of general practitioners. This study aimed to determine the level of knowledge, attitude, and practices of general practitioners in West Java towards middle ear inflammation, as an evaluation for improving health services in the community. Methods: This research was a descriptive study with a questionnaire conducted in August–December 2021 conducted online with a probability sampling technique of at least 368 general practitioners in West Java. The level of knowledge, attitude, and practices were calculated using the Guttman scale. The data were presented as a frequency distribution. Results: The results showed that the majority of the general practitioners still had poor knowledge of middle ear inflammation (n=325; 84.6%) as well as the attitude (n=333; 86.7%) and the level of practice (n=340; 88.5%). Conclusions: The level of knowledge, attitude, and practices of general practitioners in West Java towards middle ear inflammation is poor. Special interventions and approaches are needed to improve the competence of general practitioners in West Java based on the Standard Competency of Indonesian Doctors.

Abstract Background: Perineal tear is the tearing of the pelvic floor muscles. Based on the literature review and previous research, perineal tear often occur in labor, especially in primigravida. Pregnancy exercise is a physical activity that carried out by pregnant women. This study aims to determine the relationship between pregnancy exercise and perineal tear in normal labor at the Pratama Anugrah Clinic in Surabaya. Methods: This study uses an observational analytic method with a retrospective time approach. The number of samples was 34 case groups (perineal tears) and 34 control groups (no perineal tears) in normal delivery using purposive sampling. The instruments used are medical records, written interviews, cameras and checklists. Data analysis used chi square statistical test with a significance level of 0.05. Results: The results showed that there were still many mothers who did not do pregnancy exercise during their pregnancy as many as 43 (63.2%). Mothers who did not practice pregnancy exercise experienced more perineal tears as much as 27 (79.4%), while mothers who did practice pregnancy exercise experience perineal tear in normal labor that is 18 (53%). Result of chi square statistical tests obtained p value 0.006 (p

Abstract Background: Exclusive breastfeeding has benefits as a natural contraceptive method, the Lactational Amenorrhea Method (LAM). The coverage of exclusive breastfeeding in East Java Province in 2018 only reached 74.3% and coverage of active family planning was still at 75.3% (Health Office of East Java, 2018). The results of a preliminary study of 10 Children’s Health Specialist Doctor Education Program of Airlangga University showed exclusive breastfeeding, but only 20% managed to menstruate for more than 6 months. This study aims to determine the description of exclusive breastfeeding as LAM at Dr Soetomo Hospital Surabaya. Method: This type of research uses a descriptive method to mix method research with survey analytic methods. The number of samples used was 16 people with simple random sampling technique. Results: PPDS who got LAM success during exclusive breastfeeding, by giving on demand and frequency more than 8 times was only 37.5%, while the remaining 62.5% PPDS failed to achieve LAM. The inhibiting factors are not being able to give immediately, time for pumping, and inadequate rest. The support received by PPDS is tolerance for pumping, high determination of exclusive breastfeeding, and family support. How to give breast milk is to breastfeed directly and by bottle. The reason for using the bottle is to work. The number of PPDS with amenorrhea duration 1-3 months was 7 people, and only 1 PPDS experienced amenorrhea for 12 months. Conclusion: Nearly half of PPDS have successfully used LAM as a contraceptive.

Abstract Background: The quality and quantity of sleep can affect blood glucose levels, so it is at risk of hyperglycemia. Hyperglycemia in women childbearing age can affect the cycle of menstruation and fertility. Based on previous research shows that more than half of students have poor sleep quality and found an increase in blood glucose levels in students who sleep less than 7 hours. This study aims to analyze the relationship between quality and quantity of sleep with blood glucose levels in women of childbearing age. Methods: This research method was observational analytic with cross sectional design. The number of samples was 43 students with a purposive sampling technique. The independent variable is the quality and quantity of sleep measured using the PSQI questionnaire, while the dependent variable is the blood glucose level which is checked during fasting for at least 8 hours. Analysis using the spearman rho statistical test. Results: The results showed that 27.9% of students had good sleep quality, including 4.6% with low blood glucose levels and 23.3% with normal blood glucose levels. 72.1% of students have poor sleep quality, including 65.1% with normal blood glucose levels and 7% with high blood glucose levels. The results of the analysis between sleep quality with blood glucose levels obtained rs = 0.345 and p value = 0.023, while the quantity of sleep with blood glucose levels obtained rs = 0.359 and p value = 0.018. Conclusions: The quality and quantity of sleep is significantly associated with blood glucose levels. Women childbearing age should maintain quality and quantity of sleep to prevent increased blood glucose levels. Health workers need to pay attention to the quality and quantity of patient’s sleep especially in women childbearing age.

This study aims to analyze the acute effect of omega 3 supplementation on serum TNF-α levels, pain intensity, and muscle strength after high-intensity weight training. A total of 20 adult males with a BMI of 18.00-24.99 were enrolled in this study. Subjects were divided into 2 groups, namely (K1) with placebo and (K2) with omega 3 supplementation with a dose of 1000 mg (540 mg EPA and 360 mg DHA). The intervention was carried out 24 hours after high-intensity weight training. The data in this study were taken before and after the intervention. Measurement of serum TNF-α levels using a human ELISA kit, measurement of pain intensity using visual analog scale (VAS), measuring muscle strength using a leg dynamometer. The data analysis technique is used if the data is normally distributed, namely Paired t-test and Independent t-test, if the data has not normally distributed the analysis used is the Wilcoxon signed-rank test. Omega 3 supplementation significantly reduced serum TNF-α levels (p-0.035), significantly reduced pain levels (p-0.007), and did not significantly decrease the strength (p-0.100). Omega 3 supplementations can reduce serum TNF-α levels, pain intensity, and omega 3 supplementations can maintain muscle strength after high-intensity weight training as evidenced by the absence of a significant decrease in muscle strength after high-intensity weight training.

Abstract Background: East Java is one of the regions in Indonesia that has received more attention regarding stunting because the incidence has around 36%. Stunting is a phenomenon of malnutrition that occurs in children where there are growing problems related to the length or height of the child. The history of choric energy deficiency in the mother during pregnancy, birth weight, and birth length is closely related to the incidence of stunting. The incidence of stunting at the Puskesmas Tambak Wedi Surabaya in 2018 was 18.9%. This data has increased from 2017 to 2.7%. Therefore, this study aims to determine the relationship between birth weight and birth length with the incidence of stunting under five at Puskesmas Tambak Wedi Surabaya. Methods: This study used observational analytic with a cross-sectional approach. The sample used was 30 toddlers with a simple random sampling technique. Stunting in toddlers is included in the dependent variable, while birth weight and birth length are included in the independent variables. Spearman's test was used to analyze the data in this study. Results: This study shows that there is a relationship between birth weight and the incidence of stunting in children under five who obtained a correlation coefficient value of 0.450 with a p-value of 0.012 with sufficient strength and there was a relationship between birth length and the incidence of stunting under-five children who obtained a correlation coefficient value of 0.463 with a p-value of 0.010 with sufficient relationship strength. Conclusion: Birth weight and birth length are associated with the incidence of stunting under five. Mothers need to follow the advice of health workers in maintaining nutrition during preconception, antenatal, natal, and post-natal periods with the help of the husband and family.

The pandemic of Covid-19 affected entire daily human life worldwide, including sports activities among athletes. An athlete was pushed to suit their routine activities with a new health protocol for Covid-19 prevention. Some of them were programmed to train at home with a moderate density of exercise, but others were still in a high density of exercise. This study compared the serum level of hemoglobin (Hb), interleukin-6 (IL-6), and hepcidin among athletes with a high versus moderate exercise density training program during the pandemic. Thirty-four indoor soccer athletes of a soccer football school in Malang voluntarily registered as a subject. Half of them received moderate exercise density exercise programs, and others received high-density exercise programs during June-July 2020. Interleukin-6 and hepcidin level mean was found significantly lower in the moderate group compared to the high-density group. Hemoglobin level mean was found not different between those groups. The lower density of exercise influenced on IL-6 and hepcidin serum level of athlete, but not on hemoglobin level.

Abstrak Latar Belakang: Kehamilan dan persalinan merupakan proses alamiah bagi wanita namun peluang terjadinya komplikasi bisa saja terjadi. Komplikasi yg terjadi selama persalinan menjadi penyumbang angka kematian ibu di Indonesia seperti kala II memanjang. Primigravida merupakan faktor risiko terjadinya kala II memanjang, jika lebih dari 2 jam berisiko 1.42 kali menyebabkan trauma jalan lahir dan perdarahan. Upaya pemerintah untuk mencegah komplikasi tersebut dengan menyelenggarakan senam hamil untuk menyeimbangkan emosional, mental, fisik dan spiritual sehingga mengurangi risiko persalinan lama. Penelitian ini bertujuan untuk mengetahui perbedaan pada durasi lama kala II persalinan pada primigravida yg mengikuti senam hamil dan tidak senam hamil. Metode: Penelitian ini adalah anlitik observasional dengan rancangan cross-sectional, jumlah sampel 92 responden dengan teknik total sampling. Variabel independen adalah senam hamil dan variabel dependen yaitu lama kala II persalinan. Instrumen yang digunakan adalah rekam medis dan kuesioner. Analisis data menggunakan uji Mann Whitney Test. Hasil: Hasil penelitian menunjukkan variabel durasi kala II persalinan p = 0,000 (p

Pada sepsis, endothelial glycocalyx (EG), dapat rusak dan luruh melepaskan syndecan-1 ke dalam plasma. Kerusakan EG akan mengganggu mikrosirkulasi, menimbulkan hipoperfusi jaringan, dan meningkatkan kadar laktat. Gangguan profil lipid pada sepsis terjadi karena gangguan metabolisme dan kerusakan langsung hepatosit akibat meluruhnya EG. Penelitian ini bermaksud menganalisis syndecan-1, laktat, dan profil lipid sebagai faktor risiko keparahan dan mortalitas pada pasien sepsis. Penelitian ini adalah penelitian analitik observasional pada 39 pasien dewasa yang memenuhi kritera sepsis-3. Keparahan sepsis diklasifikasikan menjadi sepsis dan syok septik dan ditentukan dalam 6 jam setelah time zero berdasarkan penggunaan vasopresor, kecukupan resusitasi cairan, dan nilai laktat ulangan. Kematian 7 hari dihitung sejak time zero sepsis. Syndecan-1, laktat, dan profil lipid diambil dalam jam pertama setelah time zero dianalisis sebagai faktor risiko keparahan dan mortalitas 7 hari. Analisis data dilakukan dengan uji logistik regresi bivariat dan multivariat. Pada penelitian ini didapatkan 20 pasien dengan sepsis, 19 pasien dengan syok septik. Berdasar atas mortalitas 7 hari, 10 pasien meninggal dan 29 pasien bertahan hidup. Laktat dan syndecan-1 merupakan prediktor keparahan pada sepsis. Laktat merupakan variabel yang lebih superior dibanding dengan syndecan-1 sebagai prediktor keparahan sepsis. Laktat merupakan prediktor untuk mortalitas 7 hari pada pasien sepsis. Simpulan penelitian ini adalah laktat dan syndecan-1 merupakan prediktor keparahan pada sepsis. Laktat merupakan prediktor kematian 7 hari pada sepsis.

Gastrointestinal lymphoma accounts for up to 20% of all extranodal lymphoma cases. Among them, the ileum is the second most commonly affected site after the stomach. The majority of gastrointestinal lymphoma originates from the B cell lineage. We report the case of 60-year-old male with persistent anemia, hematochezia, and poor performance status (PS). After thorough workup, imaging, and pathological study, the patient was diagnosed with diffuse large B-cell lymphoma of the terminal ileum. He was treated with R-CHOP based chemotherapy with dose tailoring to accommodate his poor PS. His symptoms promptly subsided after the first chemotherapy cycle. After eight cycles of chemotherapy, terminal ileum wall thickening was gone and the patient was disease-free for 6 months. This case report shows that chemotherapy can be beneficial in patients with gastrointestinal lymphoma despite poor PS. Therefore, it should be given when possible with proper dose tailoring.

This study aimed to determine the relationship between mothers with history of diabetes mellitus with Infants with Anti-GAD65. This study was an observational analytic study with a cohort study design. The case studied was the relationship between maternal history of diabetes mellitus and infants with Anti-GAD65. This study was conducted at Jemursari Hospital in Surabaya. Sample examination was performed with a GAD65 autoimmune rapid test. Then, a statistical test was performed to determine its relationship with other variables. There was no relationship between mothers with history of diabetes mellitus and infants with Anti-GAD65, but there was a significant relationship between Anti-GDA65 Mothers with Infants with Anti-GAD65. Thus, there was a possibility of transplacental antibody transfer and viral infections during pregnancy that cause damage to pancreatic beta cells. History of diabetes mellitus was not related to infants with Anti-GAD65, but there was a relationship between Anti-GAD65 Mothers with Anti-GAD65 BAyi so that there is a transfer of transplacenta antibodies and viral infections during pregnancy that can cause damage to beta pancreatic cells in infants.

The growth and development of the body goes through two phases of rapid growth. First phase (0-5 years) and second phase (10-17 years). This study aimed to compare anthropometry and physical abilities between trained and untrained individuals in the second rapid growth phase (adolescence). This research method used analytic observational with cross sectional design. The sample study used adolescents aged 14 years old, consisted of trained adolescent groups (n=25) and untrained adolescent groups (n=32), with categorized throught the International Physical Activity Questionnaires (IPAQ). Each group measured height, weight, chest circumference, vital lung capacity (VC), oxygen saturation (SpO2), heart rate resting, heart rate exercise, and VO2Max. The results of the different test between trained and untrained groups with a significance level of p

Abstract Background : Trained woean who experiencing menstrual disoders are found with high blood cholesterol level. This situation is contrary to who don’t experience menstrual disorder. Mentrual disorder condition has a low estrogen level. The low estrogen level is associated with endothelial disfunction which causes blood cholesterol increase. The benefit of omega 3 supplementation have been clinically proven to prevent atherosclerosis, decrease blood cholesterol levels, and playong an important role in modulating inflamation. Omega 3 supplementation is expected to decrease blood cholesterol levels in trained women. Method: This research is using field experimental with case control method. The samples are 30 trained womens contained by 15 are controlled and 15 are given treatment. The sampling technique is randomized allocation. The independent variabel is omega 3 300mg supplementation and the dependent variabel is blood cholesterol levels. Data are analized using parametric statistic paired T-test. Result: The bivariate analysis showed there is a meaningful difference on blood cholesterol levels in the treatment group p=0,0027 and no change in control group p=0,191 during treatment for 8 weeks. Conclusion: Omega 3 supplementation decrease a blood cholesterol levels in trained women.

This paper discusses the function of history as a science that can be used to formulate strategies to face various challenges as well as present and future opportunities based on knowledge, understanding, and their meaning of the past. Responding to the present worldwide Covid-19 pandemic, this paper aims to build awareness among historians to strategic issues by learning from the history of diseases through interdisciplinary historical research. The existence of adequate knowledge and understanding of the past of the aforementioned issues will provide space for history as a science to make contributions that can be used as a policy, in which history is a science for thinking forward through the past.

Pelatihan yang berat dan melelahkan yang dilakukan oleh atlet, tentunya memiliki dampak negatif pada kesehatan. Tujuan penelitian ini adalah untuk menganalisis gangguan menstruasi pada atlet putri selama pelatihan yang intensif. Penelitian ini menggunakan pendekatan analitik observasional dengan metode survey test. Populasi penelitian ini adalah 15 atlet putri pada tim softball Jawa Tengah yang dipersiapkan untuk Pekan Olahraga Nasional (PON) 2021. Teknik sampling dalam penelitian ini adalah total sampling. Teknik analisis data menggunakan deskriptif presentase. Data yang berhasil dikumpulkan yaitu: karakteristik responden, siklus menstruasi, dan ovulasi. Hasil penelitian menunjukkan bahwa karakteristik responden penelitian ini memiliki usia rerata 20,46 ± 2,09, rerata tinggi badan 159,6 ± 5,13, rerata berat badan 58,13 ± 8,12, rerata IMT 22,95 ± 2,34, dan rerata skor GPAQ 11363 ± 1621,03. Hasil pemeriksaan ouvutest menunjukkan 47% dari responden penelitian mengalami ovulasi, sedangkan 53% dari responden penelitian mengalami anovulasi. Kesimpulan penelitian ini hampir keseluruhan responden memiliki periode menstruasi yang normal, tetapi yang mengejutkan adalah lebih dari setengah dari populasi atlet putri yang mengikuti pelatihan intensif mengalami gangguan menstruasi berupa anovulasi. Maka dari itu perlu dilakukan upaya pemulihan gangguan tersebut untuk mencegah efek negatif seperti penurunan performa fisik. Selain itu, perlu juga dilakukan pemeriksaan kesehatan lebih lanjut untuk memastikan tidak terdapat gangguan kesehatan lainnya.

This article explains the implications of political-economic shock on the development of two towns; Baubau and Kendari in the 1950s to 1960s. Indonesia in the 1950s general and especially Southeast Sulawesi were politically and economically unstable. This situation happened because the country is still on the stage of finding a balance and political and economic consolidation has not reached the point of equilibrium. As a result, political shock occurred in certain areas due to differences in views, including in South Sulawesi and Southeast Sulawesi. One of the political disturbances that influenced the development of the towns was the DI / TII rebellion in the 1950s. One of the effects of political turmoil in two cities, Buton and Kendari, is the flow of rural populations into towns. Military operations to eliminate security disturbances in the towns of Baubau and Kendari support the improvement of infrastructure for access to the town and expand morphology of towns. The author examines, reads, and examines documents archives carefully in South and Southeast Sulawesi. The facts in the archives show that political and economic shocks have a good effect on one thing and not good on another side. The events of political turmoil in Southeast Sulawesi provide important lessons and knowledge about the other side of political and economic shocks.