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Introduction. The consumption of fructose in excessive quantities has been implicated in the onset of obesity and a spectrum of metabolic dysfunctions. Physical exercise is posited as a potent intervention to ameliorate obesity-induced metabolic anomalies, ostensibly through the elevation of adiponectin concentrations. However, the underlying molecular mechanisms of this effect remain inadequately understood. Objective. This study aims to demonstrate the impact of exercise intensity on increasing adiponectin levels in high-fructose-induced mice, highlighting the underlying molecular mechanisms. Methods. The experiment was carried out on 36 male mice (Mus musculus), aged ±8 weeks, with body weight ± 20 – 25 grams, in healthy condition and without defects. Mice were randomly divided into four groups. Control group without training (CN; n = 9); the low-intensity swimming training group with a 3% load of the mice's body weight (LI; n = 9); the moderate-intensity swimming training group with a 6% load of the mice's body weight (MI; n = 9); the heavy intensity swimming training group with a 9% load of the mice's body weight (HI; n = 9). The frequency of swimming training was carried out 3 times/week for 8 weeks, and the duration of swimming training was calculated as 80% of the maximum swimming time every session. All groups were orally (oral ad libitum) given 30% fructose solution for 8 weeks. Adiponectin levels were quantified via ELISA. Statistical interrogation employed one-way ANOVA and Tukey's HSD post hoc test, with a significance threshold set at 5%. Results. The results indicated a statistically significant divergence in adiponectin levels (p ≤ 0.001). Tukey's HSD post hoc test analysis revealed substantial disparities between CN and LI (p = 0.196), CN and MI (p = 0.0001), CN and HI (p = 0.001), LI and MI (p = 0.001), LI and HI (p = 0.001), and MI and HI (p = 0.001). Conclusion. This study found that moderate-intensity swimming training was more optimal in increasing adiponectin levels in fructose-induced mice compared to high-intensity, low-intensity, and control groups. Additionally, this research identified specific molecular pathways activated by moderate-intensity training, providing new insights for therapeutic interventions in tackling obesity-related metabolic dysfunctions.

Introductions: In Indonesia, a median of 6.1% of people diagnosed with depression disorder are people over 15 years old. Only 9% of that amount underwent medical treatment, while the rest, 91%, did not undergo treatment for their depressive conditions. Inadequate and inappropriate treatment of depression will lead to Treatment-Resistant Depression (TRD). Using ketamine as a pharmacotherapy opens up new possibilities for TRD treatments. Methods: This study uses a retrospective observational study design with a systematic review approach, in which all variable data were collected from previous studies aimed at measuring the effectiveness of ketamine pharmacological therapy in patients diagnosed with treatment-resistant depression (TRD) using placebo as a benchmark of the effectiveness of ketamine in reduced clinical symptoms of TRD using secondary data in the form of study results and analyzes from published studies of the effectiveness of ketamine therapy. Results: Administration of ketamine at doses of 0.4 mg/kg and 0.5 mg/kg is more effective as an antidepressant compared to placebo in adults and is effective in the elderly at doses above 0.2 mg/kg with a maximal effect at 24 hours post-administration and disappeared by about 7 days post-administration. Conclusions: The administration of ketamine therapy is more effective at reducing depressive symptoms in diagnosed patients (TRD) than the use of placebo and repeated administration of ketamine can increase the likelihood that TRD sufferers respond to therapy and experience remission.

Indonesia is located on the Pacific Ring of Fire with various disasters occurring frequently and causing tremendous impacts. Recently, Mamuju Regency in West Sulawesi was hit by an earthquake during the COVID-19 pandemic, making primary health care (PHC) a major community health care provider facing several issues. This study aims to explore the challenges and supporting factors of the recovery of PHC after the earthquake during the COVID-19 pandemic using a descriptive phenomenology grounded in Edmund Husserl's philosophy. The Bamboo PHC (Puskesmas Bambu) was selected as the only PHC in Mamuju which was most affected by the earthquake. A focus group discussion method was conducted by involving 15 participants selected using purposive sampling and divided into three groups (health workers, health cadres, and community members). As a result, the community members acknowledged that the Bamboo PHC services programs in general were favorable before the pandemic, there were several basic and superior health service programs that the community felt were valuable. Yet, the COVID-19 pandemic worsened the situation and the use of healthcare facilities decreased. Coupled with the occurrence of natural disasters in vulnerable areas, it is increasingly causing fatalities. Therefore, disaster preparedness and community empowerment are the key to successful disaster management.

Introduction: Endometriosis is a common gynecological problem, globally around 10% (190 million) of women’s reproductive age. Several factors increase the risk of endometriosis, including patient’s age, length of menstrual cycle, age of giving birth to first child, number of parity, breastfeeding, use of hormonal contraception, flour albus, body mass index (BMI), and caffeine consumption. This study aims to determine the difference and the correlation of risk factors between endometriosis cysts and nonendometriosis cysts. Methods: This research was a cross-sectional study. The subjects of total 194 patients were chosen by consecutive sampling. This research used medical record methods and interviews. The findings were analyzed using univariate methods and binary logistic regression. Results: Clinical parameters such as patient’s age, hormonal contraception, frequency of recurrence flour albus, breastfeeding, BMI, and caffeine consumption had no significant correlation with endometriosis cysts case. Meanwhile, the number of parity, age of giving birth to first child, length of menstrual cycle, and characteristics of flour albus have a significant correlation with endometriosis cysts. Conclusions: There are correlation between clinical parameters as a number of parity, age of giving birth to first child, length of the menstrual cycle, and characteristics of flour albus with ovarian endometriosis cyst. Screening risk factors such as nulliparous, flour albus, giving birth for the first time at >30 years, and having a long menstrual cycle could prevent late diagnostic of endometriosis.

Cosmos caudatus leaves are one of around 7500 types of plants that are known to have herbal or medicinal plant properties in Indonesia. This research determines the effectiveness of Cosmos caudatus as an antioxidant agent against cells, biomolecules, and bone density. Forty-three male rat aged 3–4 months were divided into four groups.Group P0 was only given distilled water. Group P1 was given kenikir leaf extract at a dose of 0.91 mg/kg. Group P2 was given kenikir leaf extract at a dose of 1.82 mg/kg. And group P3 was given kenikir leaf extract at 3.64 mg/kg ad libitum once a day for 28 days. The highest average SOD level was in the 1.82 mg/bb P2 conversion dose group (1.09 ± 1.76). The lowest mean CTX level was in the P2 group (8.30 ± 1.10). There was a significant increase in mean trabecular bone in the P2 group (43.33 ± 5.32). The number of osteoblast cells increased significantly at P2 (103.94 (SD 38.14)). The number of osteoclasts decreased from the control group (P0) to 0.60 (SD 0.43) at P2. Indicate that the Cosmos caudatus extract may have advantages as an antioxidant support agent for bone metabolism.

Desa Kare di Kabupaten Madiun, memiliki potensi sebagai tempat wisata. Dalam rangka menunjang pengembangan destinasi wisata nasional, harus didukung dengan stamina yang prima terutama para lifeguard di tempat wisata. Tujuan pengabdian masyarakat bertema ekowisata adalah membentuk desa wisata yang berwawasan lingkungan dengan mengutamakan aspek konservasi alam, aspek pemberdayaan sosial budaya ekonomi masyarakat lokal, serta aspek pembelajaran dan Pendidikan dalam semua sektor seperti kesehatan, sosial, ekonomi, budaya dan lingkungan. Kegiatan dilakukan dalam tiga tahap: perencanaan, pelaksanaan, dan tindakan tindak lanjut. Masyarakat setempat diedukasi tentang cara deteksi dan mengendalikan kelelahan kerja secara berkelanjutan melalui program PPDB berupa seminar manajemen kelelahan kerja berbasis audiovisual, berupa paparan tentang penggunaan detektor kelelehan kerja dan paparan aspek kesehatannya. Selain mendapatkan edukasi, masyarakat dapat mencoba langsung detektor kelelahan tersebut. Alat ini bersifat preventif dan dapat mencegah terjadinya kelelahan. Kegiatan ini dapat meningkatkan kesehatan dan kualitas hidup masyarakat Desa Kare.

Desa Kare di Kabupaten Madiun memiliki beragam potensi wisata. Namun potensi wisata tersebut belum terkemas secara optimal. Perlu diformulasikan ekowisata Kare untuk mengembangkan desa wisata, meningkatkan pemahaman tentang pemasaran desa wisata, dan mewujudkan pariwisata yang berkelanjutan. Kegiatan ini menggunakan pendekatan pelatihan, seminar dan workshop untuk meningkatkan kemampuan masyarakat desa dalam mendukung desa wisata. Universitas Airlangga melalui Program Pengembangan Desa Binaan (PPDB) imemberikan seminar untuk mengenali identitas potensi budaya lokal dan pemertahanan budaya, pelatihan Bahasa Inggris, dan pelatihan pembuatan batik kepada ibu PKK dan pengrajin batik Desa Kare. Hasil kegiatan pengabdian masyarakat ini adalah meningkatkan kemampuan masyarakat mengidentifikasi potensi wisata, berbahasa Inggris sebagai alat komunikasi dengan wisatawan asing dan meningkatkan kemampuan menggambar dan padu padan penempatan motif batik agar corak batik menarik dan indah.. Semua kemampuan yang diajarkan melalui berbagai pelatihan ini akan menyempurnakan kemampuan masyarakat dalam mengawal desa wisata Kare dan siap bersaing sebagai Desa Wisata berstandard internasional.

Context: Although have been proven able to control the prevalence of coronavirus disease-19 (COVID-19), Pfizer-BioNTech and Moderna COVID-19 vaccines are reported to have possible side effects on the heart. Aims: To know the magnitude of adverse events in the cardiac after messenger ribonucleic acid (mRNA)-based vaccination. Methods: An electronic search in PubMed, Web of Science, Scopus, and Ebsco/Cinahl was performed. The keywords were: “COVID-19 vaccine”, “SARS-CoV-2 vaccine”, “myocarditis”, “myopericarditis”, “pericarditis”, “myocardial infarction”, and “myocardial injury”. The electronic search was updated until March 2022. STATA/MP Statistical Software: Release 14 (StataCorp LLC, College Station, Texas) was used in this study to perform a meta-analysis of a random-effect for myocarditis, pericarditis, myocarditis, myocardial infarction, and myocardial injury. Results: Twenty-one case reports/case series studies with a total of 62 individuals who had been vaccinated against COVID-19 mRNA (Pfizer-BioNTech and Moderna) were included in the systematic review. Whereas seven observational cohort studies had 170,053,333 people who had been vaccinated, 245 of whom had myocarditis. In addition, two observational cohort studies with 13,948,595 vaccinated individuals, 16 of whom developed pericarditis. There was only one observational cohort study that had a total of 7,183,889 people who had been vaccinated and 11 had myopericarditis. Based on the pooled incidence, the result is

Hypertension is a non-communicable disease that is one of the main causes of premature death in the world. Pharmacologically by administering anti-hypertensive drugs. In non-pharmacological management of hypertension can be done with a healthy lifestyle. A study states that the most appropriate non-pharmacological treatment for people with hypertension is exercise. This research is quantitative research with a quasi-experimental design. The dependent variable in this study was walking physical exercise, while the independent variables in this study consisted of heart rate, systolic blood pressure, and diastolic blood pressure. The subjects of this study were 30 members of the pedestrian community, who were divided by purposive sampling into the treatment group and the control group. The tools used to obtain primary data in this study were the results of measuring blood pressure before and after walking. The results of the study: 1) there is a difference in the average pulse rate between the pretest and post-test in both the treatment and control groups; 2) there is an effect of walking physical exercise on pulse rate; 3) there is a difference in the mean systolic blood pressure and diastolic blood pressure between pretest and post-test; 4) there is a difference in the average blood pressure between the pretest and post-test of the control group; 5) there is no effect of physical exercise walking on blood pressure; 6) There was no difference in blood pressure and pulse between the treatment and control groups. In conclusion, the physical exercise of walking for 1 week could reduce pulse rate but could not reduce systolic blood pressure and diastolic blood pressure.

Desa Kare adalah salah satu desa di wilayah Kabupaten Madiun yang potensial untuk pengembangan wisata dan produk alam. Pengabdian masyarakat bertema ekowisata bertujuan (1) mengembangkan kawasan wisata berbasis partisipatif-kolaboratif, (2) meningkatkan pola kesadaran masyarakat terhadap kesehatan, (3) memberikan fasilitas kesehatan sesuai protokol kesehatan, (4) menarik minat para wisatawan melalui promosi media sosial, (5) menambah wawasan tentang cara pengolahan limbah dan produk unggulan ciri khas Desa Kare. Pelaksanaan kegiatan berlangsung dalam tiga level tahapan yaitu perencanaan kegiatan, pelaksanaan kegiatan dan tindak lanjut acara. Ekowisata dijalankan menitikberatkan pada peran aktif masyarakat setempat dan dalam kegiatan Program Pengembangan Desa Binaan (PPDB) telah dilakukan pembinaan produk dan kemasan terstandar destinasi wisata pada Unit Mikro Kecil dan Menengah (UMKM). Melalui pengmas PPDB, masyarakat setempat diberikan edukasi untuk menyiapkan masyarakat supaya sadar akan potensi alam untuk ikut menjaga dan melestarikan. Kegiatan secara berkelanjutan diharapkan untuk meningkatkan kesejahteraan serta taraf hidup masyarakat Desa Kare.

Background: The maternal mortality rate in Indonesia is still high and still far from the established target of SDG's, which is 307 maternal deaths per 100,000 live births. Adequate antenatal cares are needed to reduce maternal mortality. This study aims to determine the quality of antenatal care (ANC) services at public health centers by the framework of systems (Input, process, and output). Methods: This study is a descriptive study with qualitative designs. Data collection was conducted in 12 health centers and the sample size is 12 midwives in the health centers. Midwives were interviewed about input, process and output components related to integrated antenatal program (ANC Terpadu 10T). In addition, it was observed also the availability of facilities, infrastructure and K1 and K4 rate related to ANC in health centers. Results: Human resources in the implementation of the integrated antenatal program by midwives at the Surabaya's Health Center still do not meet the minimum health human resources standards. Public Health Centers observed have facilities and infrastructure to support integrated antenatal care.

Introduction: Sleep disorder commonly happens to teenagers and adults because of light exposure during sleep that affects sleep quality, but the relation of lamp light exposure during sleep and sleep quality of medical students hasn’t been determined previously. Objective: This research aimed to determine the relation of lamp light exposure and sleep quality of Universitas Airlangga’s medical students and to give further information about the right adjustment of lamp light exposure to improve the sleep quality of medical student. Methods: Variables in this cross-sectional designed research were lamp light exposure (on or off) as the independent variable and sleep quality as a dependent variable. The research used the PSQI questionnaire to decide the sleep quality of 115 subjects once a week in a month. The collected data were analyzed by chi-square and fisher’s exact test. Results: Based on the chi-square test, the p-value for lamp light exposure and sleep quality was more than 0.05 (p = 0.863). The results also showed that 74.8% of medical students had bad quality sleep. Conclusion : In conclusion, there was no relation between lamp light exposure and sleep quality. This research also indicated that most of the subjects had a bad sleep quality so that student should increase their needs for better sleep quality to maintain performance.

Background and Aim: Metaflammation plays a significant role in the pathogenesis, development, and complication of diabetes mellitus (DM). This inflammation is associated with insulin resistance. Therefore, the inflammatory pathways have been targeted for pharmacological treatment. Petiveria alliacea can decrease blood glucose levels and has anti-inflammatory and antioxidant activities; however, there are still insufficient data regarding its efficacy for the treatment of DM. This study aimed to investigate the effect of the self-nanoemulsifying drug delivery system (SNEDDS) of P. alliacea leaf extract on the homeostatic model assessment (HOMA)-insulin resistance (IR) value and interleukin (IL)-6 and tumor necrosis factor-α (TNF-α) levels in a streptozotocin (STZ)-induced diabetic rat model. Materials and Methods: Thirty-five diabetic rat models were randomly divided into five groups. The first group received the SNEDDS of P. alliacea leaf extract at a dose of 50 mg/kg body weight (BW), the second group received it at a dose of 100 mg/kg BW, the third group received it at a dose of 200 mg/kg BW, the fourth group received 18 mg of metformin, and the fifth group only received the SNEDDS formula. The treatment was administered once a day, orally, for 14 days. On the 15th day after treatment, the rats were sacrificed to obtain blood samples for cardiac examination. The IL-6, TNF-α, and insulin levels in the serum were measured using the enzyme-linked immunosorbent assay method. The HOMA-IR value was calculated using a formula. Results: The mean IL-6 and TNF-α levels were low in the group that received the SNEDDS of P. alliacea leaf extract. There was no significant difference in the insulin level in all treatment and control groups. However, a significant difference in the HOMA-IR value was noted between the group that received the SNEDDS of P. alliacea leaf extract and metformin and the group that did not receive treatment (p

ABSTRACT Long-Acting Reversible Contraceptives (LARCs) is a contraceptive method recommended by the government which has long-term protection and high effectiveness with a failure rate of 0.5 to 2 pregnancies / 100 women in the first year of usage. The use of LARCs are influencing by the role of health officers and decision-makers. This study aimed to analyze relationship between the role of health officers and decision-makers with the use of LARCs. Methode used is an observational analytic study using a cross-sectional approach. with 92 samples respondents. The technique used in sampling was consecutive sampling. The independent variables were the role of health officer and decision-makers while , the dependent variable was LARCs usage. The bivariate analysis test used the chi-square test and fisher’s exact. The Result shows the most common of contraceptive usage was non-LARCs. The results of chi-square analysis showed p-value 0,05 stated non statistically associated between decision makers and LARCs usage (0,793). Conclusions: Concluded that the role of health officers associated with LARCs while decision makers aren’t associated with LARCs usage.

Abstract Background: The prevalence of pelvic organ prolapse (POP) increases as the age increment. Uterine prolapse is the most common type of POP cases. Although uterine prolapse is not a life-threatening condition, it can affect a woman's quality of life. Either operative or non-operative therapy can affect reproductive or sexual function. The purpose of this study was to analyze differences in sexual function scores in uterine prolapse patients between operative and non-operative therapy. Methods: This is an analytic observational study with a cross-sectional design. Sampling technique used convenience sampling and data were analyzed by Mann-Withney test using SPSS. Results: There were 30 samples, 14 of them did operative therapy and 16 of them did non-operative or pesarry therapy. Data analysis using Mann-Withney test shown that the operative group had median score of 16,6 while the non-operative group had median score of 19,9 with p=0,124 (p>0,05). Conclusion: There was no significant difference of sexual function scores between patients with operative therapy and non-operative therapy.

Abstrak Latar Belakang : Exercise dapat menyebabkan terbentuknya reactive oxygen species (ROS). Ketidakseimbangan antara antioksidan endogen dan ROS dapat menyebabkan stres oksidatif. Stres oksidatif dapat menyebabkan infertilitas pada wanita melalui berbagai mekanisme. Endometrium yang tidak sempurna karena ROS tidak dapat mendukung embrio dan perkembangannya. Penelitian ini bertujuan untuk menganalisa perbedaan ketebalan endometrium pada mencit yang exercise intensitas tinggi. Metode : Penelitian ini true experimental dengan rancangan randomized posttest only design. Besar sampel adalah 7 ekor tiap kelompok, yang terdiri dari 2 kelompok. Kelompok kontrol dan kelompok exercise intensitas tinggi. Data yang didapatkan adalah ketebalan endometrium mencit. Hasil : hasil uji mann-whitney menunjukkan hasil yang signifikan dengan P=0,006. Kesimpulan : exercise intensitas tinggi dapat mempengaruhi ketebalan endometrium.. Abstract Background: Reactive Oxygen Species (ROS) is formed by exercise. Oxidative stress is caused by an imbalance between endogenous antioxidants and ROS. Oxidative stress causes infertility in women through mechanisms. Because of ROS, endometrium can not support the embryo and its development. This research aim to analyze different of endometrial thickness mice with high intensity exercise. Methods: This research is true experimental researh with randomized posttest only design. The sample size is 7 female mice each group, devided into 2 groups. The control group, and the high-intensity exercise group. Data obtained from mice endometrial thickness Results: mann-whitney gave significant result at level p=0.006. Conclusion: high intensity exercise can effect the thickness of the endometrium.

Abstrak Latar Belakang : Aktivitas belajar merupakan proses belajar, baik kegiatan fisik maupun psikis. Aktivitas belajar siswa dipengaruhi oleh beberapa faktor. Keluhan yang sering dirasakan oleh remaja putri yaitu nyeri saat menstruasi (dismenorea). Dismenorea adalah rasa nyeri perut bagian bawah yang menjalar ke kaki ataupun punggung yang timbul saat atau menjelang haid. Pada anak remaja usia sekolah, dismenorea dapat mengganggu aktivitas belajar sehari-hari. Saat seorang remaja putri mengalami dismenorea, hal tersebut dapat membuat mereka tidak masuk sekolah. Penelitian ini bertujuan untuk mengetahui hubungan antara dismenorea primer dengan aktivitas belajar. Metode : Penelitian ini adalah analitik observasional dengan desain cross sectional di SMAN 8 Surabaya yang dilakukan bulan maret sampai juni 2019. Sampel yang digunakan sebanyak 58 siswi SMAN 8 Surabaya yang diambil dengan metode Purposive Sampling. Data dianalisa menggunakan analisis bivariat menggunakan uji Chi Square. Hasil : Hasil uji statistik menunjukkan tidak ada hubungan yang bermakna antara dismenorea primer dengan aktivitas belajar pada siswi SMAN 8 Surabaya dengan (P 0,834). Kesimpulan : Tidak terdapat hubungan antara dismenorea primer dengan aktivitas belajar. Abstract Background: Learning activities are a learning process both in physical and psychological activities. Student learning activities are influenced by several factors. Complaints that are often felt by female adolescents are menstrual pain (dysmenorrhea). Dysmenorrhea is a pain in the lower abdomen that spreads to the legs or back that arises during or before menstruation. In adolescents, dysmenorrhea can interfere with daily learning activities. When a female adolescents experiences dysmenorrhea, it can make them not attend school. This study aims to determine the relationship between primary dysmenorrhoea and learning activities. Method: This study was an observational analytic with cross sectional design at SMAN 8 Surabaya conducted in March to June 2019. The sample used were 58 female students of SMAN 8 Surabaya taken by purposive sampling method. Data were analyzed using bivariate analysis using the Chi Square test. Result : The results of the statistical test showed there is no significant relationship between primary dysmenorrhea and learning activities in female students of SMAN 8 Surabaya with (P 0.834).Conclusion : There is no relationship between primary dysmenorrhoea and learning activities.

Introduction: Chronic obstructive pulmonary disease (COPD) exacerbations are still the leading causes of mortality. Eosinophil counts were recommended in assessing the risk of exacerbations. This additional examination was preferred rather than the pulmonary function test (PFT), which was considered less precise and had vast differences. Therefore, an analysis of the correlation between the FEV1% predicted and blood eosinophil counts were needed as a reference in the diagnosis of COPD exacerbation. This study aimed to determine the correlation between FEV1% predicted and blood eosinophils counts in patients with COPD exacerbations. Methods: This was a retrospective cross-sectional study by analyzing medical records of patients with COPD exacerbations at Dr. Soetomo General Hospital, Surabaya, from 2017 to 2018. Results: The characteristics of patients with exacerbations of COPD consisted of 91.7% male patients. Most of them were in the age group of 61-70 years old, 58.3% were in the private sector, 75% had a high school diploma, and 41.7% had normal body mass index (BMI). The percentage of the FEV1% predicted is directly proportional to the percentage of blood eosinophils with weak and statistically insignificant strength. Conclusion: The FEV1% predicted and blood eosinophil counts had a very weak correlation and statistically insignificant strength. Thus, it could not be used as a reference for diagnosis using one of the variables. Further research is needed with sputum eosinophils and biopsy as consideration for more accurate results.

Stunting is one of the main nutritional problems that is still common in children under five and has serious health impacts. The results of National Health Research (Riskesdas) in 2018 showed the prevalence of stunting at 30.8%, indicating that 1 out of 3 Indonesian children are still stunted. Probolinggo Regency is a priority area for stunting handling in 2019 with a prevalence of 50.2% according to a report from the National Team for the Acceleration of Poverty Reduction (TNP2K). One of the factors that directly affect the incidence of stunting is low birth weight (LBW), while the mothers' knowledge level of health is an indirect factor that affects the growth conditions of children under five. The purpose of this study was to analyze the effect of providing stunting early detection education on maternal knowledge regarding stunting prevention. This is a pre experimental research study with one group pre-post test design, children aged 0-24 months as the research subjects. The case group consisted of stunted children (BL/A

There have been several studies reporting the effect of hypercholesterolemia on cortical thickness, but it remains a controversy. Some studies suggest that hypercholesterolemia can decrease osteoblast activity and increase osteoclast activity. Meanwhile other studies suggest that hypercholesterolemia is a protective factor of osteoporosis. Therefore, it is necessary to conduct a study to determine the effect of hypercholesterolemia on cortical bone thickness. Method: This study used 8 rats (Rattus norvegicus) that were divided into 2 groups, including control group (K0) that was given standard diet and experimental group (K1) that was given high fat diet for 28 days and all were executed to obtain the femur bone. The cortical bone thickness was measured by using Optilab Viewer and Optilab Image Raster software. Result: The data analysis was conducted using independent t-test. A p value of

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.

Abstract Background: Active management of third stage of labour is an intervention that is considered to reduce the risk of post partum hemorrhage which is the leading cause of maternal mortality. The results of a preliminary study conducted in the labour ward of Dr.Tadjuddin Chalid Makassar hospital it was found that active management was a midwifery care during third stage of labour, besides catheterization and exploration of the uterus routinely carried out in all normal childbirth as part of midwifery care during third stage of labour. This routine interventions can increase the risk of infection and not suitable with the midwives philosophy which states that childbirth is normal physiological processes. Objectives: This study aimed to explore the influence of midwives’ perceptions toward attitudes and behaviour during third stage of labour. Method: A descriptive research study using qualitative methods was conducted in Dr.Tadjuddin Chalid Makassar Hospital. A purposive sample of 5 midwives’ who represent different characteristics participated in this study. Data collection was carried out through in-depth interview and observations. The data analysed according to thematic analysis methods. Findings: The findings included three main themes, 1) Midwives believe that third stage of labour is the most risky phase for all women during childbirth, 2) Midwives’ efforts to minimize the risk of post partum haemorrhage by implementing active management of third stage of labour, 3) Midwives’ perceptions influence attitudes and behaviors in providing care by using risk management approach. Conclusion: Midwives’ perceptions have a pivotal role in attitudes and behaviour during third stage of labour. The application of medical models identified as a result of this perception. Midwives’ need to understand the philosophy of midwifery care to avoid unnecessary medical interventions in all normal childbirth.

Introduction: Hormonal injection contraception is the most widely used method of contraception in Indonesia. In long-term use, one of the side effects of injection contraception is changes in lipid metabolism in the body caused by the accumulation of hormones in the body. Two types of injectional contraception are widely used in Indonesia, namely combined injection and DMPA injection; different hormonal content has various side effects on the lipid profile. This study aimed to compare the total cholesterol level between acceptors of DMPA injection and combined injection. Methods: This study used an observational analytic method with a cross-sectional approach. The sample size is 60 respondents, including 30 DMPA injection acceptors and 30 combination injection acceptors. The sampling method uses a purposive sampling technique The independent variable in this study was the total cholesterol level of the acceptor, and the dependent variable was the acceptor of DMPA injection and the combination injection acceptor. Analysis of research data used the Independent T-test with α=0.05. Results: The results of the bivariate analysis found significant differences in total cholesterol levels in the DMPA injection contraception acceptor and combination injection with p= 0.037. It was found that overall cholesterol levels of DMPA injection acceptors were higher. Conclusion: There is a difference in total cholesterol levels in the DMPA injection contraception acceptor with a combination injection contraception acceptor.

Introduction: Diarrhea is a collection of symptoms in the form of decreased stool consistency accompanied by more than normal frequency of defecation. Diarrhea is the second largest cause of death in children under five years old. In 2010, East Java was ranked first in the frequency of outbreaks in Indonesia. This study described the profile of diarrhea patients in children less than 5 years old in the Children's Ward of Dr. Soetomo General Hospital Surabaya in 2016-2018. Dr. Soetomo General Hospital Surabaya was chosen for data collection because it is one of the main referral hospitals in Indonesia, thus it has diverse cases. This study aimed to describe the profile of diarrhea patients in children less than 5 years old in the Children's Ward of Dr. Soetomo General Hospital Surabaya in 2016-2018. Methods: This study was a retrospective study by assessing the patient's medical record and analyzed descriptively. Results: There were 650 patients (425 male and 225 female), at most 6-11 months (34.6%). Most patients were classified as malnourished (45.4%). The type of diarrhea was dominated by acute watery diarrhea (94.8%). Mild-to-moderate dehydration (84.2%) was found in most patients. The comorbidities were found in 83.4% of patients, with malnutrition (45.4%) and febrile seizures (30.3%) as the most common contributors. The therapy used was intravenous rehydration (99.7%), antibiotics (45.7%), zinc (98.2%), and probiotics (96.3%). Conclusion: Most diarrhea patients in this study were male, aged 6-11 months, mild-to-moderate dehydration, malnourished, suffering from acute water diarrhea, accompanied by comorbidities, and treated with intravenous rehydration.

Motoric disorder in child increased every year, especially cerebral palsy. Children with motoric disorder which is majority experiencing long immobilization results in their general condition declining. One of this declining appears on body temperature in child, even lead to hypothermia. A simple exercise which applicatively performed at home can be a simple solution to maintain general condition, especially body temperature. The purpose of this study was to determine effect of adaptive exercise on body temperature change in children with motoric disorder. This study was an experimental study of one group pre and posttest. A total of 31 children (11 girls and 20 boys) aged 2-10 years old performed adaptive exercise consist of warming up 5 minutes, core movement 25 minutes, cooling down 5 minutes. Data were analyzed by paired T test. Body temperature in pretest was 36.12 ± 0.53oC, and body temperature in posttest was 36.63 ± 0.6oC, with p = 0.00. Adaptive exercise can increase body temperature but still in normal range.

ABSTRACT Ovulation induction with clomiphene citrate is a hormonal therapy for infertile women with impaired ovarian function caused by dysregulation of the hypothalamus and pituitary, affecting egg development and ovulation. Several factors, such as obesity, influence the success rate of treatment with clomiphene citrate. According to the Asia-Pacific classification, obesity was classified into two categories, obesity type I (25-29,9 kg/m2) and obesity type II (≥30 kg/m2). The success rate of ovulation induction with clomiphene citrate in obese infertile women at Graha Amerta Fertility Clinic in Dr. Soetomo General Hospital on July 2019 – July 2020 was about 22.8%. The research aimed to analyze the correlation between obesity with successful ovulation induction with clomiphene citrate. This research method was observational analytic research with a cross-sectional approach. The data were collected from medical records of infertile obese women who undergo ovulation induction with clomiphene citrate. According to inclusion criteria, the number of samples is 79 cycles of infertile obese women who undergo ovulation induction with clomiphene citrate. Data analysis using Chi-square test. The result showed that successful ovulation induction in obese type I was 17.7% and in obese type II was 5.1%. There was a correlation between obesity with successful ovulation induction with clomiphene citrate (p=0.009). In conclusion, there was a correlation between obesity with successful ovulation induction. Keyword : ovulation induction, clomiphene citrate, obese Correspondence : sri-r-d@fk.unair.ac.idation induction.

Introduction. Moleac (MLC) 901 is a traditional Chinese medication approved by the Sino Food and Drug Administration in 2001 for treating stroke. This study aims to analyze the efficacy of MLC901 in animal stroke models after medial cerebral artery occlusion (MCAO). Methods. Literature selection was performed according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) 2015. Inclusion criteria for the experimental studies were the use of animal models, publication in English between 1990 and 2020, information regarding the intervention technique used, and outcomes regarding the efficacy of MLC901 administration. Results. MLC901 administration resulted in significantly less infarction volume by a mean difference of 17.17 compared to the control group (p < .00001). The MLC901 group resulted in significant improvement in 5-bromo-20-deoxyuridine (BrdU)-positive cells expression by a mean difference of 662.79 (p < .00001) and neurological function, which was indicated by a mean difference in the Bederson Neurological Outcome Score of 1.40 (p < .00001). Conclusions. MLC901 administration in an animal stroke model resulted in a better reduction in infarction volume and improvement in BrdU expression and neurologic function. These data could help in further determining the efficacy of MLC901 for acute ischemic brain injury in humans.

ABSTRACT Exercise was a planned and structured physical activity in which there was a movement repetition to maintain or enhance one or more components of physical fitness. The physical exercise on biological functions gave positive effects such as improving, but in certain circumstances, it could also give a negative effect such as inhibiting or disturbing the level of individual, system, cell, and molecular. Likewise the effect of physical exercise on bones, many factors affected bone both positively and negatively, among others; the dose of physical exercise which included frequency, intensity, type and time. The dosage of physical exercise was individual on each person. Some studies found that moderate intensity physical exercise provided positive benefits on bones. One of them was affecting the process of proliferation and differentiation of osteoblast, which was one of bone cells that had a function to form bone matrix. Moderate intensity physical exercise combined with salmon calcitonin would increase mouse bone density. Moderate-speed walking exercise would cause changes in IL-6 serum levels which had a role in the process of stem cell differentiation into osteoprogenitor and directly affected adult osteoblasts, whereas changes in PTH serum levels in the sub-acute phase of exercise played a role in the positive uncoupling process of bone remodeling directly. Keywords : moderate intensity physical exercise, bone health Correspondence to : gadis-m-s@fk.unair.ac.id ABSTRAK Olahraga adalah latihan fisik yang merupakan bagian dari aktivitas fisik yang terencana, terstruktur, terdapat repetisi gerakan, dan mempunyai tujuan mempertahankan atau meningkatkan salah satu atau lebih komponen kebugaran fisik. Pengaruh latihan fisik terhadap fungsi biologis dapat memberi pengaruh positif yaitu bersifat memperbaiki, akan tetapi pada keadaan tertentu dapat pula memberikan pengaruh negatif yaitu menghambat atau mengganggu baik pada tingkat individu, sistem, sel maupun molekul. Demikian juga pengaruh latihan fisik terhadap tulang, banyak faktor yang mempengaruhi tulang secara positif maupun negatif, antara lain adalah dosis latihan fisik yang meliputi frekuensi, intensitas, jenis dan waktu melakukan latihan fisik. Dosis latihan fisik bersifat individual pada setiap orang. Beberapa penelitian menunjukkan bahwa latihan fisik intensitas sedang memberikan manfaat positif pada tulang. Antara lain mempengaruhi proses proliferasi dan diferensiasi sel osteoblas yaitu salah satu sel tulang yang berfungsi membentuk matriks tulang. Latihan fisik intensitas sedang dikombinasikan dengan salmon kalsitonin akan meningkatkan kepadatan tulang tikus. Latihan jalan dengan kecepatan sedang akan menyebabkan perubahan kadar IL-6 serum yang berperan pada proses diferensiasi stem cell menjadi osteoprogenitor dan secara langsung berpengaruh pada osteoblas dewasa, sedangkan perubahan kadar PTH serum pada fase subakut latihan berperan pada proses positive uncoupling remodeling tulang secara langsung. Kata kunci : latihan fisik intensitas sedang, kesehatan tulang Korespondensi : gadis-m-s@fk.unair.ac.id

Pendahuluan: Kafein adalah zat utama yang terkandung dalam kopi yang merupakan minuman yang digemari oleh masyarakat di seluruh dunia. Pengaruh kafein terhadap kadar gula dalam darah masih belum jelas apakah dapat menaikkan atau menurunkan kadar gula darah. Beberapa penelitian membuktikan bahwa kafein dapat meningkatkan kadar gula darah melalui efeknya terhadap penurunan sensitivitas insulin. Sebaliknya, penelitian lain membuktikan bahwa kafein dapat memberikan efek perlindungan tubuh terhadap diabetes mellitus melalui pengaruhnya dalam meningkatkan sensitivitas insulin. Tujuan: Untuk mengetahui efek pemberian kafein per oral terhadap kadar gula darah pada tikus normal maupun tikus hiperglikemia. Metode: Penelitian ini menggunakan 36 tikus (Rattus norvegicus) yang dibagi menjadi 4 kelompok, yaitu kelompok tikus hiperglikemia yang diberi perlakuan (K1), kelompok tikus hiperglikemia kontrol (K2), kelompok tikus normal yang diberi perlakuan (K3) dan kelompok tikus normal kontrol (K4). Kelompok perlakuan (K1 dan K3) diberi kafein dengan dosis 3,22 mg/200 gram BB per oral setiap hari selama 3 hari. Kadar gula darah diukur sebelum dan setelah perlakuan. Analisis data menggunakan paired t-test dan effect size yang memberikan hasil signifikan apabila p < 0,05. Hasil: Hasil menunjukkan bahwa pemberian kafein secara oral memberikan efek yang signifikan terhadap kadar gula darah tikus normal dan hiperglikemia. Kesimpulan: Efek pemberian kafein terhadap kadar gula darah pada tikus normal dan hiperglikemia sebesar 81,1% dan 97,7%. Sehingga dapat disimpulkan bahwa pemberian kafein per oral terhadap kadar gula darah tikus normal dan hiperglikemia dapat meningkatkan kadar gula darah pada tikus normal dan hiperglikemia.

Introduction: Anaemia in female adolescents tends to have a negative impact that is likely to later arise in pregnancy, labour and childbirth. The prevalence of iron deficiency anaemia in female adolescents in Indonesia is thirty percent. Indonesia runs an iron tablet program for female adolescents. However, with the running of the program, it is not clear what factors are correlated with the intention of iron tablet consumption among female adolescents. The purpose of this study was to analyse the factors correlated with the intention of iron tablet consumption among female adolescents. Methods: This research used a cross-sectional design. The sample consisted of 100 students in senior high school in Surabaya, chosen by proportional random sampling. The independent variables were parent income, knowledge, perceived susceptibility, perceived seriousness, perceived threats, perceived benefits, perceived barriers, and perceived self-efficacy. The dependent variable was female adolescent intention related to consuming iron tablets. The data was collected using a questionnaire and analysed by a chi square test with a level of significance α

Introduction: This study is conducted to determine the correlation between patient’s age and advanced response time with the outcome of Cardio Pulmonary Resuscitation in cardiac arrest patients. Methods: This was an analytic observational cross-sectional study, evaluating correlation between patient’s age and advanced response time with the outcome of Cardio Pulmonary Resuscitation in cardiac arrest patients. This study used the primary data from Cardio Pulmonary Resuscitation sheets from February to August 2018 at Dr. Soetomo General Hospital, Surabaya. The data were analysed with Chi Square and Contingency Coefficient using SPSS version 22.0. Results: The results showed that 84.6% cardiac arrest patients who experience ROSC are over 40 years old, and 92.3% cardiac arrest patients who experience ROSC have advanced response time ≤ 5 minutes. After being tested using Chi Square, patient’s age was not statistically influencing the outcome in cardiac arrest patients (p = 0.507), but advanced response time was statistically influencing the outcome in cardiac arrest patients (p = 0.001). Conclusion: There was no statistically influence of patient’s age towards the outcome in cardiac arrest patients, but there was a significant influence of advance response time towards the outcome in cardiac arrest patients.

Glucocorticoid is widely used in medical treatment as an immune system or an inflammation therapy. However its long term administration can cause life-threatening side effects. One of them is bone mass loss which increases the risk of bone fractures in the long-term use. Bone lining cells derived from mesenchymal stem cells, which serve as a backup cell bone-forming osteoblasts. Glucocorticoids acting directly on osteoblasts, bone lining cells when reduced due to increased apoptosis, the reserve cells to bone formation will be decreased. The aim of this study was to count the amount of apoptotic bone lining cells after long term glucocorticoid administration. This study used Rattus norvegicus females aged 3 months that were divided into 3 groups, each group consisted of 7 rats. The groups are: (1) control group; (2) treatment group 1 were given glucocorticoid 0.01 mg/day; (3) treatment group 2 were given glucocorticoid 0.2mg/day. The treatment carried out for 4 weeks and at the end of treatment, rats were sacrified and continued with preparation, and the number of bone lining cells that undergoing apoptosis was calculated through examination of the femur bone tissue metaphysis section using immunohistochemical technique. All data were analyzed with statistical analysis Anova. The result showed that the number of apoptotic bone lining cells increased in group with glucocorticoid administration 0.01 mg/day and 0.2 mg/day compared to control group with p = 0.000 (p