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Suci Widhiati,1,2 Shinta Trilaksmi Dewi,3 Yefta,3 Retno Danarti,3 Hardyanto Soebono,3 Yulia Eka Irmawati,3 Monika Puspitasari,3 Niken Trisnowati,3 Tri Wibawa,4 Dewajani Purnomosari,5 Yohanes Widodo Wirohadidjojo3 1Department of Dermatology and Venereology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia; 2Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; 3Department of Dermatology and Venereology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; 4Department of Microbiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; 5Department of Histology and Cell Biology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, IndonesiaCorrespondence: Yohanes Widodo Wirohadidjojo, Department of Dermatology and Venereology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Gedung Radiopoetro, lt. 3 Sekip, Yogyakarta, 55281, Indonesia, Tel +62 274 560700, Email yohanes.widodo@ugm.ac.idBackground: Autologous non-cultured cell (ANCC) spray has been used to treat burns, chronic wounds, and vitiligo, but its use in junctional epidermolysis bullosa (JEB) has not been published previously. Chronic wounds in JEB are caused by mutations of laminin 332 (L322), whose function is to attach and act as a glue in the basal membrane. It is proposed that ANCC applications can provide keratinocytes and fibroblasts required to improve epithelization and spontaneously correct revertant keratinocytes in the wound area.Purpose: To develop a modified procedure of ANCC spray and improve epithelization using silver sulfadiazine covered with plastic wrap to treat chronic wounds of JEB.Patients and Methods: Shave excision of the donor site was performed on a 19-year-old girl with JEB. The ANCC spray was prepared and applied to the chronic wound, which was then covered with silver sulfadiazine occluded with plastic wrap.Results: Following the ANCC spray application, epithelization was successfully initiated. Unfortunately, the wounds recurred after four months of follow-up.Conclusion: The modified application method of ANCC spray provides a good alternative to treat chronic wounds in JEB.Keywords: revertant mosaicism, silver-sulfadiazine, plastic wrap, chronic wound, junctional epidermolysis bullosa

This study aims to determine family attachment and functioning on loneliness in adolescents with working mothers. This study uses a quantitative approach. The subjects were 106 adolescents with mothers working in Samarinda selected using the technique. Sampling purposive data collection methods used were the loneliness scale, the scale of attachment, and the family functioning scale. The collected data were analyzed with the help of the Statistical Package for Social Science (SPSS) 21.0 for the windows program. The results showed stickiness and functioning of the family have a significant influence on the value of F Count equal to 40 184 and p of 0000 and has an R2 of 0.438.

Metalia Puspitasari,1 Hemi Sinorita,2 Hendry Purnasidha Bagaswoto,3 Iri Kuswadi,1 Heru Prasanto,1 Yulia Wardhani,1 Wahyu Tri Kurniawan1 1Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia; 2Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia; 3Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, IndonesiaCorrespondence: Metalia PuspitasariDivision of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada - Dr. Sardjito Hospital, Jl. Kesehatan No. 1, Yogyakarta 55284, IndonesiaTel +62 811 6110 283Email puspitasarimetalia@gmail.comIntroduction: Central venous catheter (CVC) insertion is the most commonly performed clinical procedure when a patient initiates hemodialysis. Despite its clinical benefits, CVC insertion has several risks of complications. Thrombosis, venous stenosis, infection, arrhythmia, pneumothorax, and bleeding are among these complications. Malposition of the tip of the CVC can also occur with an incidence of up to 7%. One of several factors that could contribute to malposition is venous anatomy variation. Persistent left superior vena cava (PLSVC) is an extremely rare venous anatomical disorder but might have a significant clinical impact.Case Presentation: Here we report a PLSVC case that was identified in chest radiography after the insertion of a CVC catheter in a patient with end-stage renal disease (ESRD). A 40-year-old woman with a history of type 2 diabetes mellitus, hypertension, dyslipidemia, and obesity was presented in the emergency room with dyspnea for 1 week. Acute hemodialysis was required because of the ESRD and pulmonary edema. The PLSVC condition accompanied by various complications that occurred in this patient became a dilemma for the nephrologist in determining the diagnosis and proper CVC management.Discussion: PLSVC is the most common congenital abnormality of the vena cava, even though it has a very small incidence. PLSVC occurs in about 0.1– 0.5% of the total population and reaches 10% in individuals with congenital heart abnormalities. Most PLSVC presents along with normal superior vena cava and drains into the right atrium, which makes it very difficult to see the clinical signs and symptoms. Almost all PLSVC conditions are found incidentally during or after invasive procedures such as CVC insertion. CVC insertion in the PLSVC condition needs proper management to minimize the risk of complications.Conclusion: This case shows the importance of understanding the PLSVC condition, which, although very rare, is expected to increase the awareness of the nephrologist in making the diagnosis, determining appropriate management, and preventing complications, thereby improving patient safety.Keywords: persistent left superior vena cava, PLSVC, central venous catheter, CVC, malposition, hemodialysis, end-stage renal disease, ESRD

This article examines the factors influencing the adoption of digital payment methods by Micro, Small, and Medium Enterprises (MSMEs) in Manado City, Indonesia. The study finds that perceived ease of use, perceived usefulness, perceived risk, and social influence all play a role in MSMEs' attitudes towards digital payment adoption. The research suggests that strategies targeting these factors can help increase acceptance and usage of digital payment methods by MSMEs, and stakeholders can use these findings to develop policies and support programs for expanding digital payment penetration in the MSME sector. The study also highlights the benefits of digital payments for business management and sustainability. [Extracted from the article]

The Indonesian goverment’s minimum service standard (MSS) indicator stipulates that 100% of pregnant women in the country must undergo HIV checks. in 2017, however only 7% of pregnant women underwent such checks. The same condition applies to Depok City, where in 2016 only 3.6% of pregnant women were screened. Because 86.6% antenatal examinations are done within primary-care facilities, this study has to analyzed the preparedness of primary health-care resources in the implementation of HIV screening for pregnant women.The research used qualitative method with in-depth interview, FGD and document review. The Study found that human resource workers trained in HIV programs were not available at every Public Health Center (PHC) and private primary health-care (PPHC) had no such workers were trained on HIV. Roughly half (17 of 35) of PHCs Primary health care capable of HIV screening for maternal. No PPHC facilities especially inpendent midwife practice had such capabilities The number of reagents was found to be inadequate at the PHCs, and no reagents at all were found at prprivate care facilities. Counselling media was found to be lacking at both types of primary care facilities. Conclusion the implementation of HIV screening in primary health care facilities is not yet ready according to the MSS. Regulations that require PPHC facilities to be capable of HIV screening and government support for the availability of resources (especially training and reagents) are require for the achievement of the MSS. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the pattern of planting rice, mung beans and vegetables and maximizing the income of farmers in the border area of Paloh, Sambas Regency. The study used a survey method. The unit of analysis in this study is rice farming. The sample of farmers was determined by purposive sampling on the consideration of the variety of harvested area and the types of vegetable farming that varied. The number of farmer respondents as many as 30 cases was determined by purposive sampling. To analyze the data, the income analysis and Linear Programming are used. The results showed that: farming area of 0.6 ha (arable area) can be optimized with a combination of local rice farming in the wet season of 0.6 ha. In the superior rice dry season, about 0.3 ha, mung beans 0.1 ha, mustard 0.05 ha, chilli 0.05 ha and cucumber 0.1 ha. (4) Optimal solutions can maximize farmers' income by IDR 34,818,000. To optimize rice farmyng system, green beans and vegetables with an average arable land of 0.6 ha, the recommended farming pattern is in the local rice dry season 0.6 ha, superior rice dry season 0.3 ha, mung beans 0.1 ha, mustard 0.05 ha, chili 0.05 ha and cucumber 0.1 ha.

Agricultural development actors in Indonesia are currently dominated by elderly farmers and a small proportion of young farmers. Another condition is that the farming system in Indonesia is generally subsistence. Several good potentials in the context of agricultural development in Indonesia today, firstly, the productive working age group is dominated by youth, especially the millennial generation, and secondly, the growing rapidly used internet networks. The condition of subsistence farming and the lack of young actors in agriculture, but on the other hand there is the potential of the millennial generation and availability of internet networks access. This study employed a quantitative research method. The purpose of this research is to see the current condition of agricultural development in Indonesia concerning its current potential. Another objective is to design the appropriate strategy for exploiting this potential to accelerate agricultural development in Indonesia. The results obtained from this research are the high level of accessibility of rural communities as initial capital for agricultural development in Indonesia for now. The millennial generation who dominates the working age in Indonesia can maximize their role in the agricultural sector in rural areas through developing entrepreneurship based on the use of internet networks.

Background: Hemodialysis (HD) is the modality of renal replacement therapy (RRT) with the highest mortality rate. The identification of prognostic factors will help achieve better outcomes among HD patients. In this study, we sought to conduct a survival analysis and determine the predictors of mortality among adult Indonesian HD patients using data obtained from Indonesian Renal Registry (IRR)., Methods: This is a retrospective cohort study which reviewed all adult hemodialysis patients in Indonesia based on the records of IRR during 2007-2022. Variables analyzed in this study include age, sex, etiology of CKD, cause of death, HD frequency, and initial vascular access. A 5-year follow-up was performed until the outcome of death or drop out was found., Results: Among 99,552 eligible patients, the mean survival length was 1536.21 ± 2.50 days. The 5-year survival rate was 77%. Cox proportional hazard regression model revealed demographic and clinical characteristics that are significantly associated with mortality: male sex (HR: 1.038, 95% CI 1.002-1.075), age of 60 years or older (HR: 1.329, 95% CI 1.281-1.379), diabetic nephropathy (HR: 1.347, 95% CI 1.249-1.452), twice-weekly hemodialysis frequency (HR: 1.080, 95% CI 1.011-1.155), initial vascular accesses with femoral vein puncture (HR: 2.710, 95% CI 2.568-2.860), and CVC (HR: 2.992, 95% CI 2.848-3.144)., Conclusions: The 5-year survival rate of Indonesian HD patients is 77. Male sex, age of HD onset at 60 years or older, diabetic nephropathy, twice-weekly HD frequency, and the initial vascular accesses with femoral vein puncture and CVC are associated with increased risk of mortality., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: End-stage kidney disease (ESKD) carries a significant financial burden due to the need for hemodialysis (HD). Many HD patients do not achieve optimal dialysis, particularly in developing countries like Indonesia where HD is performed twice a week. To answer this issue, a study was conducted at Dr. Sardjito hospital, Indonesia to investigate the effectiveness of intradialysis aerobic exercise in improving dialysis adequacy and quality of life in conventional HD patients., Methods: This study is an experimental design with a pre-test-post-test control group. ESKD with HD patient was divided into treatment and control groups. The intervention group was subjected to 30 min of intradialysis aerobic exercise using an ergocycle within the first 2 h of the HD sessions, while the control group received regular care. Both groups were followed for 12 weeks. Dialysis adequacy is measured using Kt/V and Urea Reduction Ratio (URR). Quality of life is assessed using KDQOL-36 questionnaire., Results: There was a significant increase in Kt/V and URR (%) in the intervention group compared to the control group, (0.122 ± 0.151 vs  - 0.135 ± 0.176, p < 0.001) and (2.627 ± 4.634 vs  - 2.620 ± 3.949, p < 0.001), respectively. In addition, quality of life also improved significantly with KDQOL-36 summary score was significantly higher 73.47 (39.44-89.31) to 80.97 (43.06-92.36); p = 0.007) in the intervention group. Multivariate analysis showed that intradialysis exercise (p = 0.001), female gender (p = 0.044), and intradialysis diastolic pressure (p = 0.018) can significantly affect Kt/V changes., Conclusion: Intradialytic aerobic exercise for 12 weeks effectively improves dialysis adequacy and quality of life in routine HD patients. This suggests an opportunity for routine deployment, especially when HD resources are limited. However, further studies are needed to investigate additional efficacy aspects and improve exercise protocols for specific ESKD patients., Trial Registration: TCTR202403270002 (retrospectively registered on March 27, 2024)., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Introduction: Combined hemodialysis (HD) and hemadsorption (HA) therapy has shown the highest clearance rates for middle and large-sized uremic toxin molecules and reduced mortality rates among maintenance HD (MHD) patients. This study aimed to investigate the effectiveness of combined HD and HA therapy in patients undergoing MHD., Methods: Forty patients with end-stage renal disease (ESRD) were divided into three groups: HD only (14), HD + biweekly HA (14), and HD + weekly HA (12). The duration of the study was 8 weeks. Uremic toxins (β2-microglobulin, leptin, parathyroid hormone), inflammatory markers (interleukin-6, C-reactive protein), and symptoms (appetite, pruritus, sleep quality) were assessed before the start and at the completion of therapy. Changes in the parameters were compared between the three groups. Mean differences of parameters in each group were also compared between before and after therapy., Results: Decrease in BUN level (-61.34 mg/dL [95% CI: -71.33 to -51.34], p &lt; 0.0001) and pruritus score (-3.93 [95% CI: -6.89 to -0.97], p = 0.013) was significantly larger in HD + biweekly HA group compared to the others. Only HD + biweekly HA group showed significant reductions in CRP level (-0.10 mg/L [95%: -0.18 to -0.01], p = 0.034), VAS appetite score (10.43 [95% CI: 4.99-15.87], p = 0.001), and pruritus score (-3.93 [95% CI: -6.89 to -0.97], p = 0.013) after therapy. Both HD + biweekly HA (-2.79 [95% CI: -4.97 to -0.60], p = 0.016) and HD + weekly HA group (-2.33 [95% CI: -4.59 to -0.08], p = 0.044) exhibited a significant improvement in sleep quality score after therapy., Conclusions: HD combined with a biweekly HA is associated with a greater reduction in BUN level and better improvement of pruritus in ESRD patients compared to HD alone. HD + biweekly HA can significantly reduce CRP levels, alleviate pruritus, improve appetite, and enhance sleep quality., (© 2024 S. Karger AG, Basel.)

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., (© 2023. The Author(s).)

The treatment of epidermal necrolysis in pediatric patients remains a major challenge. Cyclosporine A has emerged as a promising therapy for epidermal necrolysis in adults; however, its efficacy in children is unclear. We present the case of a boy with Stevens-Johnson syndrome/toxic epidermal necrolysis overlap syndrome who was initially resistant to methylprednisolone monotherapy but improved after receiving the combination of cyclosporine A and methylprednisolone. Published reports on the use of cyclosporine A for pediatric epidermal necrolysis are also briefly reviewed., Competing Interests: Conflict of interest: the authors declare no conflict of interest., (©Copyright: the Author(s).)