Search

Di dalam metoda analisis desain overlay/lapis tambah terdapat suatu faktor variasi jenis beban kendaraan yang menjadi salah satu parameter penting dalam perencanaan desain overlay. Tujuan dari penelitian ini adalah untuk menganalisis struktur perkerasan eksisting dari jalan tol Jakarta-Cikampek, untuk perioda analisa antara 1988 sampai 2008 dan untuk menghitung tebal overlay yang diperlukan, berdasarkan pada data lendutan menggunakan alat Falling Weight Deflectometer (FWD). Dari data lendutan, nilai modulus resilien pada setiap lapisan dapat ditentukan. Dengan mempertimbangkan teori kerusakan kumulatif dan tekanan/tegangan yang diijinkan pada setiap lapisan, ketebalan overlay yang diperlukan dapat diperoleh. Hasil ini dapat dibandingkan dengan hasil perhitungan menggunakan metoda semi analitis, misalnya metoda AASHTO 1993. Nilai modulus resilien setiap lapisan dapat menggambarkan tingkat kelemahan suatu lapisan dalam struktur perkerasan dimana lapisan yang lemah ditunjukan oleh nilai modulus yang lebih rendah. Nilai kerusakan kumulatif (Cumulative Damage) pada setiap bagian-bagian jalan dapat menunjukkan lokasi mana yang perlu memperoleh overlay. Jika kerusakan kumulatif aktual nilainya lebih besar dari yang diijinkan, maka pada lokasi jalan tersebut perlu dilakukan overlay. Hal ini berarti struktur perkerasan tersebut berada dalam kondisi yang buruk dan perlu diperbaiki secepatnya.

Background Leptin induced weight loss is completely specific for adipose tissue loss, whereas food restriction result in both loss of adipose tissue and lean body mass in mammals. Most obese person has high endogenous leptin levels, indicating leptin resistance. There has been lack of data regarding plasma leptin level in Indonesian obese children. Objective This study was aimed to investigate the plasma leptin level and lipid profile in super-obese children. Methods This was a cross sectional study performed in Pediatric Out Patient Clinic Mangunkusumo Hospital and Private Women & Children Hospital in Eastern part of Jakarta. Super-obese is defined as children with BMI above 97 centiles CDC 2000 chart. Blood sample was obtained from all subjects, consisted of peripheral blood picture, lipid profiles and leptin level. Results Seventy nine super-obese children were eligible with age ranged between 12 months and 180 months and mean of age was 84.9 months (SD 36.8). More than 60% subjects had high LDL cholesterol, while 19% had low HDL level. The lowest leptin blood level was 2.877 μ g/dL, while the highest was 70.430 μ g/dL (mean 23.990; SD 12.726). Forty five subjects, all boys, had increased plasma leptin level. Conclusions In super-obese children, most of the subject experienced hyperlipidemia (LDL cholesterol) followed by hypertriglyceridemia. There was small number of low HDL cholesterol found. Super-obese girls had normal serum leptin level, in contrast, more than 60% super-obese boys had elevated serum leptin level.

Background: Atherosclerosis is widely viewed as an inflammatory disease with hypercholesterolemia being a dominant underlying risk factor. This study aimed to determine the effect of mangosteen pericarp in inhibition of NF-?B activation and ICAM-1 expression in rat fed with high cholesterol. Methods and Results: Various doses of crude extract mangosteen pericarp were administered to the high fat diet wistar rats and the activity of NF-?B measured by immunohistochemistry to assess nuclear NF-?B expression and the ICAM-1 expression. The high fat diet resulted significant increased serum LDL levels. Increased nuclear NF- ?B activation and ICAM-1 expression were also observed in high fat diet rats in concurrence with increased serum LDL. The inhibitory effect on NF- ?B activity and ICAM-1 expression was observed when 400 mg of mangosteen pericarp crude extract was administered and even showed a higher inhibitory effect in 800 mg of mangosteen pericap treated rats. The 800 mg extract treatment resulted in decreased ICAM-1 expression similar to those of non high fat rats. Conclusion: The administration of 800 mg mangosteen pericarp crude extract significantly inhibited NF-?B activation and reversed the expression of ICAM -1 to the normal level in high cholesterol diet rats.

This study describes the use of correspondence analysis for examining the relationship between perception of the community, residing in Cipinang Muara village and Bukit Duri village, and the performance of Ciliwung watershed management. The correspondence analysis provided a particular method that was able to describe the data in an Euclidean space such that the results could be visually examined for structure of categorical variables included in the tables. The study found that perception of the community residing in Cipinang Muara village significantly differed from that in Bukit Duri village. The attributes that might influence such differences were linked to the institution achievement, and further could be divided into two groups. The first group includes flood, landslide, soil fertility, extra/ additional incomes, and transparent activity; while the second includes drought, spring facility, road facilities and aids, when disaster occurred. The combination of both perception of the community and the performance of Ciliwung watershed management suggests that community in Bukit Duri village had a bad perception on attributes drought, spring facility, road facilities, and aids when disaster occurred. Meanwhile, there was a bad perception for the community in Cipinang Muara village toward attributes flood, landslide, soil fertility, extra/ additional incomes, and transparent activity.

The inability of industrial forestry to benefit the rural poor or address the increasing rate of deforestation in Indonesia has led to a major shift in direction of forest resource management. In national forestry meeting, July 10 until 12, 2002, Minister of Forestry declared social forestry as national forestry program. Social science as a whole has had very minor role in forest management over the last century. Economics was the sole social science discipline welcomed by forest managers in the old paradigm of forest management. Economists helped forest managers determine the optimal combination of inputs to maximize financial benefits from a given parcel of forestland. They also assisted with market analysis, labor studies, and other financial dimensions of forest management. In this paper, we will first review the conceptual of social forestry. We also review literature on sociological variables that can help policy-markers improve the quality of public involvement in social forestry planning and development. Finally, we will give alternative additional of sociological variable social forestry in Indonesia such as gender equality, fairness, appreciation for local spesies, and mutual trust in stakeholder that must be taken note.

Abstrak. Di dalam metoda analisis desain overlay/lapis tambah terdapat suatu faktor variasi jenis beban kendaraan yang menjadi salah satu parameter penting dalam perencanaan desain overlay. Tujuan dari penelitian ini adalah untuk menganalisis struktur perkerasan eksisting dari jalan tol Jakarta-Cikampek, untuk perioda analisa antara 1988 sampai 2008 dan untuk menghitung tebal overlay yang diperlukan, berdasarkan pada data lendutan menggunakan alat Falling Weight Deflectometer (FWD). Dari data lendutan, nilai modulus resilien pada setiap lapisan dapat ditentukan. Dengan mempertimbangkan teori kerusakan kumulatif dan tekanan/tegangan yang diijinkan pada setiap lapisan, ketebalan overlay yang diperlukan dapat diperoleh. Hasil ini dapat dibandingkan dengan hasil perhitungan menggunakan metoda semi-analitis, misalnya metoda AASHTO 1993. Nilai modulus resilien setiap lapisan dapat menggambarkan tingkat kelemahan suatu lapisan dalam struktur perkerasan dimana lapisan yang lemah ditunjukan oleh nilai modulus yang lebih rendah. Nilai kerusakan kumulatif (Cumulative Damage) pada setiap bagian-bagian jalan dapat menunjukkan lokasi mana yang perlu memperoleh overlay. Jika kerusakan kumulatif aktual nilainya lebih besar dari yang diijinkan, maka pada lokasi jalan tersebut perlu dilakukan overlay. Hal ini berarti struktur perkerasan tersebut berada dalam kondisi yang buruk dan perlu diperbaiki secepatnya. Abstract. An analytical method of overlay design has some advantages, such as to take into account the variation of loading types, which will give more exact and accurate results. The purpose of this research is to analyze the existing pavement structure of Jakarta-Cikampek toll road, for analysis period between 1988 to 2008 and to calculate the Overlay Thickness required, based on the deflection data using Falling Weight Deflectometer (FWD) equipment. From the deflection data, Resilient Moduli in each layer can be determined. Considering the Cumulative Damage theory and the allowable stress/strain in each layer, the overlay thickness needed were obtained. These results could be compared to the calculation results using semi-analytical method i.e. AASHTO® 2003 method. The result of Resilient Moduli in each layer shows that those values could identify the weakness layer in the pavement structure, indicated by the lower value of Moduli. The calculation of Cumulative Damage for each section showed some locations that needed to be overlaid immediately. If the actual Cumulative Damage is greater than the allowable one, the overlay is needed. This means that pavement structure was not strong enough and need to be repaired in short term.

Introduction: Arterial and venous thrombotic events in COVID-19 cause significant morbidity and mortality. For optimal thromboprophylaxis treatment for hospitalized patients, especially those with severe COVID-19 symptoms, it is still unclear whether to use full- or therapeutic-dose versus prophylactic-dose anticoagulation therapy. The study aim was to evaluate the efficacy and safety of unfractionated heparin (UFH) for thromboprophylaxis in severe degree of COVID-19., Methodology: In this cross-sectional study, the medical records of 160 COVID-19 patients at the COVID-19 Emergency Hospital Wisma Atlet, Jakarta, from March to August 2021, were collected. The predetermined inclusion criteria for patients were severe COVID-19 infection; age > 18 years; positive D-dimer level > 400 ng/mL; high-flow nasal cannula (HFNC) oxygenation; IMPROVE bleeding risk score < 7; and willingness to participate in the study. The primary outcome was activated partial thromboplastin time (APTT) target achievement, oxygenation changed to nasal cannula or ended with room air, mortality rate, and the principal safety criterion was presence of bleeding., Results: Of 160 subjects, 63.8% were male and 45.6% were aged 45-59 years old. Obesity was the most common comorbidity at 45.6% Among all subjects, 9.4% experienced bleeding, with hematuria being the most frequent type at 66.7%. All subjects released HFNC, and no deaths were reported., Conclusions: It can be concluded that administration of therapeutic doses of heparin in patients with severe COVID-19 had a low risk of bleeding and no patients were reported to have died. However, further investigation is needed to determine the long-term effects of therapeutic doses of anticoagulants., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2024 Hari Hendarto, Femmy Nurul Akbar, Prasetyo Widhi Buwono, Putri Adara Yasmin, Mega Halida, Efriadi Ismail, Nurul Rakhmawati, Hilman Tadjoedin.)

The purpose of this research is to examine; Ecosystem Services Based Mangrove Forest with Management Model Strategies, Sustainability of Coastal Natural Resources. This research design uses systematic review namely library research that examines quality and critical journals, which have been filtered with inclusion criteria and uses several Google Scholar, Pubmed, Science Direct and Research gate databases as literacy in this study. A search of 2018-2023 articles returned 17,000 keyword results. Ecosystem Services Based Mangrove Forest with Management Strategies, which were filtered into 10 journals according to the theme and analyzed by reviewing them. Ecosystem Services Based Mangrove Forest with Management Strategies. The research results show that mangrove ecosystem services with an area of 88,556 ha was Rp 6,961,126,186,194 year-1 (US$ 467,974,555.06 year-1) or Rp 78,607,444 ha-1-1 (US$ 5,284.5 ha-1year-1). Ecosystem Services Based Mangrove Forest with Management Strategies, that there are three main components that must be considered in efforts to manage and utilize mangrove ecosystems and coastal natural resources, namely; 1) social activity(social processes) provide socialization or understanding to the community about the importance of protecting mangrove forests and the benefits that the community will receive 2) the economy(economic processes) take advantage of the existing potential by planting mangrove trees, and 3) the natural resources themselves(natural processes) Mangrove forest management includes establishing protected forest areas for mangrove forest conservation so that they are well maintained and sustainable. From the socio-economic, cultural and human aspects, natural resources are needed to be able to continue their lives, on the other hand, the existence or sustainability of coastal natural resources is very dependent on human activities as the main users of natural resources.

The combination of platelet-rich plasma (PRP) and stromal vascular fraction cells (SVFs) was beneficial in accelerating wound healing. This study aims to assess the effect of this combination in balancing the inflammatory process to accelerate burn healing. Thirty eligible Wistar rats were used in this study to establish a deep dermal degree burn wound model. They were randomly divided into four groups: locally injected with the combination of SVFs and PRP (n=9), vaseline (n=9), placebo (n=9), and healthy Wistar rats group (n=3), as treatment group, positive control group, negative control group and healthy control group, respectively. The burn wound tissue was excised from three separated sacrificed rats (8, 24 and 48 hours) to examine polymorphonuclear (PMN) and lymphocyte counts through the standard hematoxylin-eosin procedure and for cyclooxygenase2 (COX-2) expression through the immunohistochemical procedure. The highest PMN, lymphocyte cell count, and COX 2 expression were found at 8 hours in the local injection with the PRP combination SVF group (28,555±11,237, 8,111±3,218, and 4,666±2,309, respectively, p <0.05 except for COX 2). The regression analysis results showed that local injection of a combination of PRP and SVF could reduce PMN cells by 1.068 times, lymphocytes by 1.786 times, and COX 2 by 1.853 times greater than topical application with vaseline. The combined injection of PRP and SVF effectively heals deep burns by acutely increasing the PMN cell and lymphocyte count, and COX 2 expression. Conversely, the treatment decreased the PMN cell and lymphocyte count but not the COX 2 expression in the sub-acute phase of wound healing., (© 2023 Euro-Mediterranean Council for Burns and Fire Disasters.)

Objective: Cell sheet transplantation is emerging as an appealing alternative for ischemic heart disease patients as it potentially can increase stem cell viability and retention. But the outcomes and safety of this treatment are still limited in literature and the result varies widely. We conduct a systematic review to look at the efficacy and safety of this promising transplantation method., Methods: A systematic review was performed according to PRISMA guidelines. A comprehensive literature search was undertaken using the PubMed, Scopus, and Embase databases. Articles were thoroughly evaluated and analyzed., Results: Seven publications about cell sheet transplantation for ischemic heart disease patients were included. The primary outcomes measured were left ventricular ejection fraction (LVEF) and New York Heart Association (NYHA) class. Safety measurement was depicted by cardiac-related readmission and deaths. The follow-up time ranged from 3 to 36 months for clinical outcomes and 8.5 years for safety outcomes. Cell sheet transplantation showed improvement in LVEF and NYHA class in most studies. Cardiac-related readmission and adverse events of cell sheet transplantation range from 0 to 30.4%, all were nonfatal as no cardiac-related death was reported. Patient preoperative status seems can affect the patient's response to cell sheet therapy., Conclusion: Cell sheet transplantation can safely improve LVEF and NYHA class in ischemic heart disease patients, even in very low ejection fraction patients with unsuccessful standard therapy before. Further studies with better patient inclusion, larger population, and long-term follow-up required to confirm these results., Competing Interests: Conflict of interestThe authors declare no competing interests., (© Indian Association of Cardiovascular-Thoracic Surgeons 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Introduction: According to the WHO's GLOBOCAN database, ~1,931,590 new colorectal cancer (CRC) cases and 915,607 CRC-related deaths occurred in 2020. The incidence of CRC in Indonesia is 8.6%, making it the fourth most common cancer. With CRC, matrix metalloproteinase-9 (MMP-9) has a role in tumour development and progression, such that patients with a higher MMP-9 expression had poorer survival. This study aimed to analyze the relationship between MMP-9 expression and clinicopathology in CRC patients., Methods: This was an analytic observational study with a cross-sectional research design. It was conducted from November 2021 to June 2022 with 52 patient tissue samples: these were subjected to MMP-9 immunohistochemistry stain, with the GeneTex (Irvine) MMP-9 monoclonal antibody. Patient data were collected with clinical variables based on medical records and histopathological examination by anatomy pathologists., Results: Primary tumour location, cancer staging, and histopathology grading were associated with MMP-9 ( P =0.016, P =0.001, P =0.049). The more proximal to the primary tumour, the higher the stage of cancer, and the higher the histopathological grade, thus the greater the expression of MMP-9., Conclusion: A significant relationship existed of primary tumour location, cancer staging, and histopathology grading with MMP-9 expression in CRC patients. MMP-9 expression could be a useful indicator for the clinical assessment of tumour biologic behaviour and prognosis in CRC patients., Competing Interests: The authors declare that they have no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Various intestine anastomosis techniques have been studied and used, but which is best is still debated. In our center, double-layer full-thickness intestine anastomosis was still considered as standard. However, a single-layer extramucosal intestine anastomosis has shown favorable results. This study created an anastomotic model to compare the anastomosis strength and leakage between double-layer full-thickness and single-layer extramucosal intestine anastomosis., Methods: This experimental study was performed in 20 randomized healthy male pigs, to be included either in Group A (Single-layer extramucosal intestine anastomosis) or Group B (Double-layer full-thickness intestine anastomosis). Enterotomy followed by an end-to-end anastomosis suture was performed in the jejunum. Fourteen days after the operation, any anastomosis leakage and its location was documented. The anastomosis strength was evaluated using manometry. Data were compared between groups using the Mann-Whitney U and Fischer Exact test, considering a significance level of P <0.05., Results: The overall mean intraluminal anastomotic bursting pressure was 4,257±1,185. Group A had a higher intraluminal anastomotic bursting pressure but was not statistically significant compared to group B (4.726±0.952 vs. 3.787±1.252 kilopascals, P =0.063). One leakage (5%, antimesenteric area) occurred in Group A and three leakages (15%, antimesenteric and mesenteric area) occurred in Group B. However, statistical analysis with Fischer exact showed no significant difference of leakage rate between those groups ( P =0.291)., Conclusions: The anastomosis strength and leakage did not differ significantly between the single-layer extramucosal intestine anastomosis group and the double-layer full-thickness anastomosis group. However, the location of leakage was most common in the antimesenteric area in the double-layer full-thickness anastomosis group., Competing Interests: The authors declare that they have no financial conflict of interest with regard to the content of this report., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Objective:  Endometriosis causes a decrease in oocyte quality. However, this mechanism is not fully understood. The present study aimed to analyze the effect of endometriosis on cumulus cell adenosine triphosphate ATP level, the number of mitochondria, and the oocyte maturity level., Methods:  A true experimental study with a post-test only control group design on experimental animals. Thirty-two mice were divided into control and endometriosis groups. Cumulus oocyte complex (COC) was obtained from all groups. Adenosine triphosphate level on cumulus cells was examined using the Elisa technique, the number of mitochondria was evaluated with a confocal laser scanning microscope and the oocyte maturity level was evaluated with an inverted microscope., Results:  The ATP level of cumulus cells and the number of mitochondria in the endometriosis group increased significantly ( p  < 0.05; p  < 0.05) while the oocyte maturity level was significantly lower ( p  < 0.05). There was a significant relationship between ATP level of cumulus cells and the number of mitochondrial oocyte ( p  < 0.01). There was no significant relationship between cumulus cell ATP level and the number of mitochondrial oocytes with oocyte maturity level ( p  > 0.01; p  > 0.01). The ROC curve showed that the number of mitochondrial oocytes (AUC = 0.672) tended to be more accurate than cumulus cell ATP level (AUC = 0.656) in determining the oocyte maturity level., Conclusion:  In endometriosis model mice, the ATP level of cumulus cells and the number of mitochondrial oocytes increased while the oocyte maturity level decreased. There was a correlation between the increase in ATP level of cumulus cells and an increase in the number of mitochondrial oocytes., Competing Interests: The authors have no conflict of interests to declare., (Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)

Platelet-rich plasma (PRP) and stromal vascular fraction (SVF) cells are clinically proven to aid in cellular regeneration and accelerate wound healing. The healing effect can be measured by epidermal growth factor (EGF) levels. This study aims to determine the effect of a combination of PRP and SVF injections on EGF levels during the healing of full-thickness burns in Wistar rats. Forty-eight adult Wistar rats were divided into 4 groups. Group A consisted of healthy rats. Groups B, C and D underwent modified full-thickness dermal burns. Group B was treated with local injections of PRP and SVF, Group C was treated with topical Vaseline, and Group D was treated with local injections of sterile water. EGF levels were subsequently assessed on days 1, 4, 7, 14 and 21 post-burn. EGF levels were generally increased in all groups, with the largest increase observed in the PRP and SVF injection group. A one-way ANOVA showed a significant increase in EGF levels on all days (p = <0.05). Based on the results of the linear regression test, local injection of PRP and SVF after full-thickness burns increases EGF levels by 27.3%. Combination PRP and SVF injections can increase EGF levels during the healing process of full-thickness burns. EGF is a critical growth factor in accelerating the healing process of full-thickness burns., Competing Interests: Conflict of interest. The authors declare that they have no conflict of interest., (© 2023 Euro-Mediterranean Council for Burns and Fire Disasters.)

Rhegmatogenous retinal detachment (RRD) is a serious and emergency condition that may cause visual disturbance. Treatment includes pars plana vitrectomy with a tamponade such as intraocular gas or silicone oil (SO). In many countries, silicone oil is still favorable compared to intraocular gases as tamponade for reattachment of retinal detachment surgery. The application provides a higher anatomical success rate, especially in cases of proliferative vitreoretinopathy (PVR) that were previously considered untreatable. Objective assessment of the retinal nerve fiber layer (RNFL) using optical coherence tomography (OCT) in the eye with silicone oil tamponade is a challenge because of the limitations and difficulties in taking images. This study aims to assess the RNFL thickness changes in rhegmatogenous retinal detachment patients using SO tamponade and its subsequent removal conducted on a total of 35 post-operative RRD patients. Central macular and RNFL thickness, as well as best-corrected visual acuity (BCVA), were recorded at the time of tamponade and after the removal of the SO at 1, 4, and 8 weeks, respectively. The results showed that the changes in RNFL thickness significantly decreased in the group of ≤6 months, especially in the superior and temporal quadrants, and BCVA increased after SO removal ( p < 0.05). Central macular thickness was significant ( p < 0.001) at the end of the visit. Improved visual acuity is associated with decreased RNFL and central macular thickness after SO removal.

This work provides consensus guidance regarding clinical diagnosis and early medical management of endometriosis within Asia. Clinicians with expertise in endometriosis critically evaluated available evidence on clinical diagnosis and early medical management and their applicability to current clinical practices. Clinical diagnosis should focus on symptom recognition, which can be presumed to be endometriosis without laparoscopic confirmation. Transvaginal sonography can be appropriate for diagnosing pelvic endometriosis in select patients. For early empiric treatment, management of women with clinical presentation suggestive of endometriosis should be individualized and consider presentation and therapeutic need. Medical treatment is recommended to reduce endometriosis-associated pelvic pain for patients with no immediate pregnancy desires. Hormonal treatment can be considered for pelvic pain with a clinical endometriosis diagnosis; progestins are a first-line management option for early medical treatment, with oral progestin-based therapies generally a better option compared with combined oral contraceptives because of their safety profile. Dienogest can be used long-term if needed and a larger evidence base supports dienogest use compared with gonadotropin-releasing hormone agonists (GnRHa) as first-line medical therapy. GnRHa may be considered for first-line therapy in some specific situations or as short-term therapy before dienogest and non-steroidal anti-inflammatory drugs as add-on therapy for endometriosis-associated pelvic pain.

The study purpose was investigated the effect of aerator masks on the oxygen saturation (SO 2 ) of mentally retarded athletes compared to medical masks. The researcher used a comparative study. Parametric test was used to test the difference in SO 2 percent and evaluate the questionnaire in the two groups. The results showed after undergoing exercise, SO 2 percent in participants was 94.60±0.55 for aerator masks and 96.60±0.55 for medical masks. The study also showed that there was no significant difference in SO 2 percent of participants wearing aerator masks and medical masks. However, the decrease in oxygen saturation percent of participants wearing aerator masks experienced a lower decrease, 1.60±0.55 compared to medical masks of 2.00±1.00. On the other hand, wearing an aerator mask is better because it does not prevent maximum performance, better comfort, the mask material feels better on the skin, does not experience difficulties breathable, and suitable for exercise. An aerator mask is a mask with an adequate supply of oxygen so that every breath is maintained even when used during sports activities., (©Copyright: the Author(s).)

Objectives: Poor complementary feeding practices have consistently contributed to the burden of child undernutrition in Indonesia. This study aimed to estimate the prevalence and predictors of the time of the introduction of solid, semi-solid, and soft foods (ISSSF), minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD)., Methods: We analyzed 4804 last-born infants aged 6-23 months from the 2017 Indonesia Demographic and Health Survey, which employed multistage cluster random sampling. The outcomes were calculated based on the 2021 World Health Organization/United Nations Children's Fund guidelines. The predictors of the 4 complementary feeding indicators were assessed using multivariate Poisson regression with robust variance adjusting for potential confounders and study design., Results: The prevalence of ISSSF, MDD, MMF, and MAD was 86.1%, 54.3%, 71.8%, and 37.6%, respectively, with younger children less likely to meet 3 out of the 4 outcomes. Parental education, the presence of a birth attendant, and maternal media consumption were among the predictors of MDD and MAD. Children from families with higher income were more likely to meet MDD than those from low-income households (adjusted prevalence ratio [aPR], 1.16; 95% confidence interval [CI], 1.05 to 1.28). Living in an urban area was positively associated with MMF (aPR, 1.09; 95% CI, 1.04 to 1.15) and MAD (aPR, 1.12; 95% CI 1.02 to 1.24). In eastern regions, the prevalence of children achieving MDD and MAD was lower than in those living in Java and Bali., Conclusions: It is crucial that more attention and efforts are made to improve the recommended practices throughout Indonesia, since the prevalence of adequate complementary feeding practices remains low.

The data on the predictors and prognosis of acute liver injury (ALI) among patients in coronavirus disease 2019 (COVID-19) patients are limited. The aim of this study was to determine the prevalence, predictors and outcomes of ALI among patients with COVID-19. A systematic review was conducted up to 10 June 2021. The relevant papers were searched from PubMed, Embase, Cochrane and Web of Science, and the data were analysed using a Z test. A total of 1331 papers were identified and 16 papers consisting of 1254 COVID-19 with ALI and 4999 COVID-19 without ALI were analysed. The cumulative prevalence of ALI among patients with COVID-19 was 22.8%. Male and having low lymphocyte levels were more likely to be associated with ALI compared with female and having higher lymphocyte level, odds ratio (OR): 2.70; 95% confidence interval (CI): 2.03, 3.60 and mean difference (MD) -125; 95% CI: -207, -43, respectively. COVID-19 patients with ALI had higher risk of developing severe COVID-19 compared with those without ALI (OR: 3.61; 95% CI: 2.60, 5.02). Our findings may serve as the additional evaluation for the management of ALI in COVID-19 patients., (© 2021 John Wiley & Sons Ltd.)

Background: While the number of cases of multisystem inflammatory syndrome in children (MIS-C) is increasing, reported cases in Asian countries are still low, particularly in Indonesia. This study aimed to describe the characteristics of patients with MIS-C in a tertiary referral hospital in Indonesia., Methods: This is a cross-sectional study with collected data of patients with MIS-C admitted to Dr. Cipto Mangunkusumo from March 2020 to April 2021., Results: The first case of MIS-C was detected 5 months after the first reported coronavirus disease 2019 case in Indonesia. Thirteen patients out of 158 positive admitted patients for COVID-19 were diagnosed with MIS-C during the study period. Of these 13 patients, 2 patients (15%) had a fatal outcome. Subjects were predominantly male, and the median age was 7.58 years (IQR 12.3) years. Most patients required mechanical ventilation (7 out of 13 patients) and intubation (8 out of 13 patients). Patients who needed intubation usually needed mechanical ventilation. All inflammatory markers, white blood cells, neutrophil counts, and all coagulation factor parameters (except for normal prothrombin time and activated partial prothrombin time) were elevated. The median time to MIS-C diagnosis was 2 days in the survivor group (n = 11) compared to 8.5 days in the non-survivor group (n = 2). Compared to the non-survivor group, those who survived spent more days in the hospital, received vasopressors earlier, and did not require mechanical ventilation as early as the non-survivors., Conclusions: Our work highlights the differences in MIS-C clinical course, treatment, and clinical outcomes between the two groups., (© The Author(s) [2022]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

The rapid transmission rate of coronavirus disease 2019 (COVID-19) is multi-factorial but primarily due to population mobility and aggregation. This research aimed at estimating the rate based on risk mapping and investigation of geospatial distribution. It was divided into different phases that included data collection through a self-identification form available online; data validation of the data collected; application of spatial statistics; comparison with official numbers of positive COVID-19; and mapping of the results. The results show that self-identification based on procurement of independent personal data online had an accuracy of 89%.

Introduction: An inguinal hernia is a protrusion of abdominal-cavity contents through the inguinal canal. Protection against an inguinal hernia depends on the integrity of fascial tissue, which is maintained by collagen. Collagen is a structural protein consisting of amino acids, the most common of which is glycine. This study aimed to determine the relationship between glycine and the appearance of lateral inguinal hernias. To this end, the researchers examined the profile of collagen and glycine levels in the tissue of the sheath of the rectus femoris in patients with lateral inguinal hernia (indirect inguinal hernia)., Methods: The study used a cross-sectional design to determine glycine levels in rectus anterior sheath tissue in patients with indirect inguinal hernia. Examination of collagen glycine levels was conducted using the ELISA (Enzyme-Linked immunosorbent assay) method. Data were analyzed using the Statistical Package for the Social Science (SPSS) program. An ANOVA test, Pearson's correlation test, and Spearman's correlation test were also performed. A p-value <0.05 was said to be significant., Results: Across 72 samples, the mean body mass index (BMI) was 22.5 kg/m2 and, the mean clinical onset was 28.02 months. Correlation tests showed a correlation between glycine levels and clinical onset (p = 0.026). The ANOVA test showed a difference between glycine levels with age group (p = 0.025) and BMI (p = 0.015). The correlation between glycine levels and clinical-grade (p = 0.416) was not statistically significant., Conclusion: There is a significant relationship between glycine levels and age, BMI, and clinical onset of indirect inguinal hernia., Competing Interests: The authors declare that they have no conflict of interests., (© 2021 The Authors.)

Background: Infection remains a major pediatric health problem in Indonesia and usually leads to longer hospitalization due to the need for extended intravenous antibiotic administration. In developed countries, pediatric outpatient parenteral antibiotic therapy (P-OPAT) is well-established and proven to be safe and effective at reducing the length of hospital stay; however, data on low- and middle-income countries such as Indonesia remain limited. This P-OPAT service is new and the first service in Indonesia. Methods: The medical records of patients attending Indonesia's first P-OPAT clinic between April 2015 and March 2017 were retrospectively investigated. Results: During the 24-month period, 32 patients received treatment at the P-OPAT clinic, saving a total of 258 bed days. The majority of patients ( n = 16; 50%) were diagnosed with urinary tract infection, followed by cellulitis ( n = 4; 12.5%) and osteomyelitis ( n = 4; 12.5%). Ceftriaxone was the most commonly used antibiotic ( n = 16; 50%). All patients used a peripheral intravenous catheter and were sent home with this device. Twelve patients (37.5%) needed to change IV access more than once. None of the patients used elastomeric infusor device. The median duration of OPAT was 5 days (range 1-27 days). All patients were successfully treated with no recurrence after 30 days. One patient (3.1%) experienced drug-related complication and another one (3.1%) was readmitted due to an underlying medical condition. All the patients complied with P-OPAT schedules. Conclusions: P-OPAT service offers a safe and effective option for the delivery of outpatient intravenous antibiotics in selected patients even in resource-poor settings., (Copyright © 2020 Hendarto, Putri, Yunita, Efendi, Prayitno, Karyanti, Satari, Hadinegoro and Chan.)

Objective: Pain management in the ED is often suboptimal, with many patients not receiving analgesia. We aimed to determine why some patients refuse it, why others do not receive it, and whether these variables impact on patient satisfaction with their pain management., Methods: We undertook a prospective, observational study in a large, Australian, tertiary referral ED (February-May 2017). A convenience sample of consecutive adult patients with a triage pain score of ≥4 were examined. Data were collected from the medical record and the treating nurses. At follow-up at least 48 hours postdischarge, patients were asked if they received analgesia in the ED (if not, then why not) and how satisfied they were with their pain management (very dissatisfied/dissatisfied/slightly dissatisfied/slightly satisfied/satisfied/very satisfied). The primary outcome was why patients refuse analgesia., Results: Of the 651 enrolled patients, 171 (26.3%) did not receive analgesia; for 30 (17.5%), patients and their nurses agreed that analgesia was refused. Patients mainly refused analgesia because their pain was not bad enough, they had recent analgesia intake, and concerns about side effects and interactions. Patients who received analgesia were more likely to be 'very satisfied' with their pain management (difference in proportions 10.8%, 95% CI 2.1 to 19.4). The satisfaction of patients who refused analgesia and those who did not receive analgesia for other reasons did not differ., Conclusion: Patient refusal is the most common reason for patients not receiving analgesia. Analgesia receipt is associated with greater patient satisfaction. However, a patient's knowledge of their analgesia receipt status may be incorrect. Disregard of the reasons for patients not receiving analgesia may underestimate the number offered analgesia., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Dengue encephalopathy or dengue hemorrhagic fever (DHF) with CNS involvement used to be considered a relatively rare condition; but the number of cases reported in human studies has been increasing every year. Diagnosis of dengue encephalopathy is based on clinically diagnosed DHF according to the W.H.O. criteria (1980), with CNS manifestations consisting of abrupt onset of hyperpyrexia, non-transient alteration of consciousness, headache, vomiting--with or without seizures--and normal CSF. Many factors may be considered to be directly or indirectly associated with CNS signs and symptoms in DHF, the main pathology being leakage of plasma into serous spaces and abnormal hemostasis, leading to hypovolemic shock and hemorrhage in many organs of the body. Acute liver failure is considered to be one of the main factors causing brain pathology. One hundred fifty-two cases of dengue encephalopathy admitted during 3 periods at the Cipto Mangunkusumo Hospital in Jakarta were studied retrospectively. The overall incidence was 152 out of 2,441 DHF cases, or 6.2%. The most pronounced symptoms were hyperpyrexia, alteration of consciousness and convulsions. Laboratory examination showed an unusually high increase of serum transaminases, hyponatremia, and hypoxia. Neurologic abnormalities detected were hemiparesis and tetraparesis of the extremities, and second nerve atrophy; such abnormalities were found in 10 out of the 152 cases, or 6.5%.

Twenty seven cases of neonatal intracranial PVH-IVH were studied. Twenty-three (83.3%) cases were born with birth weight of less than 2,500 grams; out of which 8 (29.7%) had birth weight of less than 1,500 grams. Twenty (74.1%) cases were born after less than 37 weeks gestation, and 7 (25.9%) were born after more than 37 weeks of gestation. Out of the 18 cases with known Apgar scores, 11 (61.1%) were born with asphyxia. We could not make any conclusion on the correlation between mortality of newborn infants with PVH-IVH and severity of the bleeding, as most of them had other associated illness as well, which may directly or indirectly affect the mortality.