Category: Publikasi

Pelvic organ prolapse (POP) adalah organ dasar panggul yang turun dari tempat seharusnya. Kondisi ini terjadi akibat otot dan ligamen yang menyokong organ-organ di sekitar daerah panggul melemah. Kondisi ini merupakan gangguan umum di kasus ginekologi, dengan sekitar 37% pasien melakukan pengobatan medis. Meskipun POP tidak menyebabkan kematian atau keparahan penyakit yang signifikan, POP dapat menyebabkan penurunan kualitas hidup wanita.
Beberapa faktor risiko yang terkait dengan POP telah diidentifikasi dan dipelajari, termasuk usia, paritas, status menopause, indeks massa tubuh, ras, genetika, gangguan jaringan ikat, merokok, peningkatan tekanan perut kronis seperti pekerjaan fisik atau penyakit paru-paru kronis, sembelit kronis, dan riwayat operasi sebelumnya.

Secara molekuler, perubahan matriks ekstraseluler (ECM) pada jaringan ikat struktur dasar panggul termasuk ligamen sakrouterina, ligamen kardinal, dan fasia endopelvis dapat berkontribusi pada kejadian prolaps organ panggul (POP).

Berkurangnya kandungan kolagen, perubahan rasio jenis kolagen dan perubahan kolagen dikaitkan (cross-linking) pada sistem pendukung dasar panggul, termasuk ligamen sakrouterina, ligamen kardinal, dan fasia endopelvis pada wanita dengan POP. Namun berbagai penelitian masih menunjukkan hasil dan data yang dapat diberdebatkan karena minimnya ukuran sampel, lokasi biopsi dan metodenya.

Selengkapnya di: bit.ly/Paper-Akbar

Caregiver memainkan peran utama dalam perawatan pasien pasca stroke. Sejumlah besar perawatan, terutama untuk melakukan aktivitas hidup sehari-hari, sangat penting bagi penderita stroke untuk meningkatkan status fungsional mereka. Oleh karena itu, caregiver disarankan untuk terlibat dalam perawatan pasien pasca stroke untuk meningkatkan kualitas manajemen pasien. Saat ini, terdapat banyak penelitian terkait pengalaman merawat pasien pasca stroke. Namun, peran dan masalah yang dikelola oleh caregiver saat merawat pasien pasca stroke di Indonesia belum banyak diteliti. Oleh karena itu, penelitian ini bertujuan untuk mengeksplorasi peran dan masalah caregiver pasca stroke di Indonesia.

Selengkapnya: bit.ly/Paper-Paryono

Nurjanah, N., Manglapy, Y. M., Handayani, S., Ahsan, A., Sutomo, R., Dewi, F. S. T., Chang, P., Kusuma, D.

Abstract

BACKGROUND: Indonesia has the second highest smoking prevalence among adult males in the world, with over 61.4 million current smokers. However, there is no national regulation on outdoor tobacco advertising.

OBJECTIVE: >To assess the density of outdoor tobacco advertising around schools in Semarang City, Indonesia.

METHODS: We conducted geospatial analyses using buffer and hotspot analyses based on advertising and school data in ArcMap 10.6. We statistically tested the significance of different densities, including between 100 m and 100–300-m buffers from schools using Stata 15.1.

RESULTS: We found a total of 3453 tobacco advertisements, of which 3026 (87%) were at least medium in size (1.3 m x l.9 m), and 2556 (74%) were within 300 m of schools. We also found hotspots with a 45% higher density of adverts within 100 m of schools (compared to within 100–300 m). A total of 378 schools (39%) were in these advertising hotspots.

CONCLUSION: There was high density of outdoor tobacco advertising, with significant clusters in close proximity to schools in Semarang City. The policy implications of this are discussed.

Density of tobacco advertising around schools

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Viera Wardhani, Jitse Pieter van Dijk & Adi Utarini

Background
Hospital accreditation is widely adopted as a visible measure of an organisation’s quality and safety management standards compliance. There is still inconsistent evidence regarding the influence of hospital accreditation on hospital performance, with limited studies in developing countries. This study aims to explore the association of hospital characteristics and market competition with hospital accreditation status and to investigate whether accreditation status differentiate hospital performance.

Methods
East Java Province, with a total 346 hospitals was selected for this study. Hospital characteristics (size, specialty, ownership) and performance indicator (bed occupancy rate, turnover interval, average length of stay, gross mortality rate, and net mortality rate) were retrieved from national hospital database while hospital accreditation status were recorded based on hospital accreditation report. Market density, Herfindahl-Hirschman index (HHI), and hospitals relative size as competition indicators were calculated based on the provincial statistical report data. Logistic regression, Mann-Whitney U-test, and one sample t-test were used to analyse the data.

Results
A total of 217 (62.7%) hospitals were accredited. Hospital size and ownership were significantly associated with of accreditation status. When compared to government-owned, hospital managed by ministry of defense (B = 1.705, p = 0.012) has higher probability to be accredited. Though not statistically significant, accredited hospitals had higher utility and efficiency indicators, as well as higher mortality.

Conclusions
Hospital with higher size and managed by government have higher probability to be accredited independent to its specialty and the intensity of market competition. Higher utility and mortality in accredited hospitals needs further investigation.

Selengkapnya:
https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4187-x

Maya Dian Rakhmawatie, Tri Wibawa, Puspita Lisdiyanti, Woro Rukmi Pratiwi, Mustofa

Abstract

The main obstacle in antimycobacterial discovery is the extremely slow growth rates of pathogenic mycobacteria that lead to the long incubation times needed in antimycobacterial screening. Some in vitro testings has been developed and are currently available for antimycobacterial screening. The aim of the study was to compare Resazurin Microplate Assay (REMA) and Crystal Violet Decolorization Assay (CVDA) for testing mycobacteria susceptibility to isoniazid and rifampicin as well as for antimycobacterial screening of natural products (NP). Mycobacterium tuberculosis strain H37Rv and Mycobacterium smegmatis strain mc2 155 were used as tested mycobacteria. Serial two-fold dilutions from 0.0625 to 1.0 μg/mL for the isoniazid and rifampicin and from 6.25 to 100.0 μg/mL for the NP A and B were prepared. Tested mycobacteria were then incubated with tested drugs or NPs in each growth medium at 37 °C for 7 days for M. tuberculosis and 3 days for M. smegmatis. MIC values against M. tuberculosis were interpreted 24–48 h after adding resazurin or at least 72 h after adding crystal violet, whereas MIC values against M. smegmatis were interpreted 1 h after adding resazurin or 24 h after adding crystal violet. The MIC values against M. tuberculosis interpreted by REMA were 0.0625, 0.0625, 6.25, and >100 μg/mL for rifampicin, isoniazid, NP A, and NP B, respectively, and those interpreted by CVDA were 0.0625, 0.0625, 6.25, and >100 μg/mL for rifampicin, isoniazid, NP A, and NP B, respectively. Moreover, the MIC values against M. smegmatis interpreted by REMA were 0.0625, >1, 6.25, and 100 μg/mL for rifampicin, isoniazid, NP A, and NP B, respectively, and those interpreted by CVDA were 0.125, >1, 6.25, and >100 μg/mL for rifampicin, isoniazid, NP A, NP B respectively. In conclusion, REMA is faster and easier than CVDA to interpret MIC values, however CVDA produces higher MIC values than REMA for rifampicin and NP B in M. smegmatis susceptibility testing. Therefore, REMA and CVDA can be used for antimycobacterial screening.

Selengkapnya:
https://www.cell.com/heliyon/fulltext/S2405-8440(19)35923-7?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2405844019359237%3Fshowall%3Dtrue

Wikan Kurniawan, Marsetyawan Heparis Nur Ekandaru Soesatyo, Teguh Aryandono

Background:
Treatment of urethral trauma is currently done after urethral stricture occurs. Stricture therapy after occurrence gives unsatisfactory success rates. Several genes, such as transforming growth factor beta 1 (TGF-β1), matrix metalloproteinase 1 (MMP-1), connective tissue growth factor (CTGF), and plasminogen activator inhibitor 1 (PAI-1), have a proven role in urethral stricture development. The purpose of this study was to assess the effect docetaxel and/or captopril on the RNA expression of those genes.

Methods:
The subjects of this research were 26 male New Zealand rabbits aged 230 ± 20 days weighing 4–5 kg that underwent urethral rupture by endoscopic resection under anesthetized conditions. Subjects were divided into five groups; control, stricture, captopril (captopril 0.05 mg/rabbit/day), docetaxel (docetaxel 0.1 mg/rabbit/day), and docetaxel-captopril (docetaxel 0.1 mg/rabbit/day and captopril 0.05 mg/rabbit/day). Each group consisted of 4–6 rabbits. Each rabbit received a water-soluble transurethral gel containing drug according to its group for 28 days. After the treatment period, rabbits were sacrificed with 200 mg Pentothal, and the corpus spongiosum was then prepared for real-time PCR examination.

Results:
TGF-β1 RNA expression in the stricture group was statistically different from that in the control, docetaxel and docetaxel-captopril groups (p = 0.016; p = 0.016; p = 0.004). The stricture group did not exhibit any statistical difference from the captopril group (p = 0.190). The control group did not show any statistically difference from the captopril, docetaxel, and docetaxel-captopril groups (p = 0.114; p = 0.190; p = 1.000). Docetaxel-captopril suppresses expression of TGF-β1 RNA most significantly. MMP-1 RNA expression showed no significant differences among groups (p = 0.827). The docetaxel group and stricture group pair was most significant (p = 0.247), compared with other pairs of stricture groups in MMP-1 RNA expression. CTGF RNA expression in the stricture group was statistically different from that of control, captopril, docetaxel, and docetaxel-captopril groups (p = 0.003; p = 0.019; p = 0.005; p = 0.005). The control group did not exhibit any statistically difference from the captopril, docetaxel, and docetaxel-captopril groups (p = 0.408; p = 0.709; p = 0.695). There was no statistical difference among treatment groups. Docetaxel and docetaxel-captopril groups suppress the most significant expression of CTGF RNA expression.

PAI-1 RNA expression in the stricture group differed statistically significantly from the control and docetaxel groups (p = 0.044; p = 0.016). The stricture group did not show any statistically significant difference from the captopril and docetaxel-captopril groups (p = 0.763; p = 0.086). The control group did not exhibit any statistical difference with any of the treatment groups (p = 0.101; p = 0.637; p = 0.669).

Conclusion:
Docetaxel-captopril gel proved to be able to inhibit RNA expression of TGF-β1 and CTGF significantly. Captopril gel proved to be able to inhibit RNA expression of CTGF significantly. Docetaxel gel proved to be able to inhibit RNA expression of TGF-β1, CTGF, and PAI-1 significantly. There were no differences in MMP-1 expression among all study groups. Longer follow up after therapy discontinuation and greater sample size is needed to determine the therapeutic effect.

Selengkapnya:
https://journals.sagepub.com/doi/10.1177/1756287220927994