The Correlation between Work From Home (WFH) Frequency and Body Mass Index (BMI) profile

COVID-19 pandemic has become the major problem over the world since 2019. This spreading has affected every section in Indonesia. Therefore, social distancing and restriction have been the primary solution this far. However, this policy trigger high sedentary behavior and could affect Body Mass Index (BMI) profile. This study aimed to investigate the correlation between Work From Home (WFH) frequency and BMI profile during COVID-19 based on physical activity. A total of 205 participants aged 18 and over who were students, private and government employees were participated in a cross-sectional study. Participants were given a questionnaire through google form online and completed the questions about duration of WFH, BMI status, and physical activity. All of the variables were analyzed. Participants engaged in this study were 40% students, 33% private employees, 27% government employees. The majority of the population had overweight BMI status (39.2%). Furthermore, most participants were doing light physical activity (74.5%). About 46.1 % of the participants rarely doing WFH (1-2 days). On the other side, a population with overweight BMI status were often doing WFH. Based on the research about the effect of pandemic on BMI profile, it can be concluded that the BMI status of the majority of respondents is overweight, and most of the respondent’s physical activity are rare. The amount of WFH frequencies can affect BMI status profile.

Virtual Bronchoscopy as the Guide for Fiberoptic Bronchoscopy in Evaluating Tracheobronchial Disorders in the Bronchogenic Carcinoma

Fiberoptic bronchoscopy (FOB) is one of the important modalities in helping to uphold the diagnosis and stadium of bronchogenic carcinoma. However, FOB has some limitations, namely invasive, time-consuming, requiring sedation, intolerable in patients who are critically ill, and difficult to evaluate distal airway side of severe stenosis. To identify the imaging capability of virtual bronchoscopy (VB) examinations in evaluating abnormalities in the tracheobronchial in bronchogenic carcinoma. Observational study with total sampling. Data was obtained from the histopathologic with diagnosis of bronchogenic carcinoma in 1 year. Retrospectively, the data were obtained from the archives of thoracic CT examinations in Radiology and FOB examination in Lung Operating Room. The variables assessed were the finding of mass of endobronchial based on its location, the main bronchi constriction, lobar bronchi constriction, segmental bronchi constriction, and compression/tracheal deformity. The results of VB were examined by three radiologists independently and were then compared with the results of FOB. The observation results of VB and FOB were used to analyse the degree of conformity. There is a low level of agreement on the finding of endobronchial mass, lobar bronchi and segmental bronchi constriction, sufficient level of agreement on the main bronchial constriction finding. VB has a limited capacity to evaluate abnormalities of the tracheobronchial compared with FOB, but VB has an advantage in evaluating the patency of the distal airway of severe obstruction.

The Effectiveness of the Use of Digital Media in Improving Knowledge on Cadres of Colorectal Malignancy in the Era of Pandemi COVID-19

This study increasing the role of cadres as public health providers in the initial screening of high-risk patients and colorectal cancer patients in the community, especially in the era of the COVID-19 pandemic, and as public health providers who can help increase awareness and knowledge about colorectal cancer, to help reduce the incidence of colorectal cancer and early detection. The research design was cross sectional with pre and post test conducted in October 2020. The sample was divided into 3 groups based on region. All groups received education on colorectal cancer online and were evaluated through pre / post-tests both directly and via google form. The sampling technique used was accidental sampling by distributing questionnaires to respondents in order to obtain secondary data. Repetition of the test on education that has been given previously within 2 months without the provision of active material from the counselor, to evaluate the retention of the educational understanding that has been given is attached or not. The results obtained, have a very good response by evaluating that there is a pre- / post-test, although they still have not achieved the expected results, namely more than 70% success, but achieved success as much as 100% from the attendance of invited participants which indicates that memory retention is still good. The counseling that was carried out received positive responses from cadres and many enthusiasts in the counseling that was carried out.There was an increase in participants' knowledge of colorectal cancer after counseling by the authors. All participants showed improved knowledge outcomes as measured by the posttest score indicator and showed good memory retention

Study of Human Neutrophil Elastase Levels and the Correlation with ARDS Severity in Thoracic Trauma Patients

Introduction: Thoracic trauma is trauma that hits the thoracic wall or intra-thoracic organs, either due to blunt trauma or due to sharp trauma. In thoracic trauma often causes impaired ventilation perfusion due to damage to the lung parenchyma. This results in impaired tissue oxygenation, which is one of the causes of Acute respiratory distress Syndrome (ARDS). These changes are caused by the release of pro-inflammatory mediators, plasmatic proteins and proteases into the alveolar space associated with ongoing edema, as well as oxidative products that ultimately result in severe inhibition of the surfactant system. Method: This study will examine the relationship between plasma elastase levels as a predictor of the incidence of ARDS in thoracic trauma patients in Malang. This study is an observational cohort study. The research subjects were thoracic trauma patients who fit the criteria. Result: I t can be concluded that there is a significant relationship between elastase levels and BGA-3. The elastase level is below the value of 11.65 ±1.85, the patient is likely not to experience ARDS in the future. If the value of elastase levels is limited to 23.79 ±3.95, the patient will experience mild type ARDS. Meanwhile, if the value of elastase levels is limited to 57.68 ±18.55, in the future the patient will experience moderate type of ARDS. Meanwhile, if the elastase level is between 107.85 ± 5.04, the patient will likely experience severe ARDS. Conclusion: Based on the characteristic test of the sample characteristics, diagnosis and action, there are significant differences in the causes of ARDS. Neutophil elastase levels correlate with the degree of ARDS incidence.

Delayed Anastomotic Urethroplasty in Children and Adolescence with Pelvic Fracture Urethral Injury (PFUI): Experiences in Two Centers of Reconstructive Urethral Surgery in Indonesia

Introduction: Incidence of pediatric pelvic fracture urethral injury (PFUI) is rare. This study reviews the experience of anastomotic urethroplasty surgery in children and adolescence PFUI in the last 3 years in two center of reconstructive urethral surgery in Indonesia. Method: This study retrospectively reviewed PFUI cases in Hasan Sadikin Hospital and Saiful Anwar Hospital from 2013-2016. The data cases were analysed base on aetiology of the trauma, urethral gap, and previous operations. The operation time and intra operative additional procedure to achieve tension free anastomotic was also noted. Result: A total 31 children and adolescence patients with PFUI were recorded in two institutions. Twenty patients were in Hasan Sadikin Hospital while 11 patients were in Saiful Anwar Hospital. The trauma mechanisms for PFUI were 28 (90.3%) cases due to motorcycle accidents and 3 (9.7%) cases due to high falls accidents. All patients underwent delayed urethral reconstruction in median 6 months (3-72). The median operation time was 150±101 minutes for children and 160±50.5 minutes for adolescence. The average length of the urethral gap in children cases was 2.8±1.2 cm, meanwhile 4±1.9 cm for adolescence cases. In order to achieve the tension free of anastomotic urethroplasty, 5 (16.1%) of PFUI patients underwent crural separation, 16 (51.6%) patients underwent inferior pubectomy and 3 (9.7%) patients for supracrural re-routing. Posterior pubectomy with omental wrap via transpubic approach was performed in one patient. The success rate for children cases was 83.3% and 88% for adolescence cases. Thus, the overall success rate after anastomotic urethroplasty for pediatric PFUI was 83.9%. Conclusions: In short-term follow up, delayed repair urethral reconstructive surgery by transperineal and transpubic anastomotic urethroplasty in children and adolescence with PFUI achieved a significant good result and showed promising outcome.

Nonsurgical Correction of Cryptotia in Newborn: A Case Report

Objective: To report on the result of nonsurgical correction of deformational auricular anomaly (cryptotia) using moulded silicone as a splint. Methods: Congenital auricular anomalies can be categorized as either malformed or deformational. Cryptotia as a deformational anomaly is defined as an ear having normal chondrocutaneous components with an abnormal architecture; therefore, it can be manipulated digitally into normal shape. Auricular deformation commonly affect the helix and antehelix. Since neonatal auricle is extremely pliable, we used early splinting to correct deformational ear anomalies. These splints are made from silicone, moulded into a small bar and held in place with the Steri-Strips™. The type of the auricular anomaly was documented both clinically and photographically before and two months after the cessation of treatment. Assessment of the result was made by comparing the pre- and post-treatment photograph. Result: In this case report, we applied this method to two newborn with cryptotia and the correction was achieved completely in two months after application of the silicone bar. The parents felt that auricular splinting is worthwhile. Conclusion: Deformational congenital auricular anomaly can be corrected nonsurgically using splinting therapy. The treatment is effective if initiated in the first three months of life. Patients and parents persistence is essential to reach satisfactory outcome. Adherence to treatmenr is crucial to negate the need for surgical treatment of congenital auricular anomalies.

Ebstein Anomaly Focusing on Pre-excited Atrial Fibrillation Management

Introduction: Ebstein’s anomaly is a rare abnormality of the heart associated with atrialization right ventricle and apical (downward) displacement of the tricuspid valve functional annulus. Twenty percents of patients with Ebstein’s anomaly accompanied with accessory pathway. The dilatation of atrium and aging process may develop atrial fibrillation (AF).Case Description: A 35 years old patient with recurrency palpitation, accompanied with dizziness and epigastric discomfort. He had history of taking propafenone 3 x 150 mg for long time while the palpitation recurrent. He was hospitalization due to propafenone could not suppress the palpitation. During monitor in hospital revealed haemodynamic stable with heart rate 160-180 beats/minute irregularly irregular. The electrocardiography showed atrial fibrillation with pre-excitation WPW syndrome. We performed electrical cardioversion 100 joule. Then the atrial fibrillation was convert to sinus rhythm with WPW pattern. The propafenone 3 x 150mg was continued. The patient was performed catheter radiofrequency ablation of the accessory pathway. Electrophysiology showed AV fusion at right anteroseptal pathway and preexcited atrial fibrillation with shortest RR interval 220 ms that converted by cardioversion. The ablation was successfully performed. Discussion: The accessory pathway is a complication of ebstein anomaly. Digoxin, beta-blockers, diltiazem, verapamil, and amiodarone are potentially harmful in pre-excited atrial fibrillation. Propafenone reduces fast inward potential by sodium channels, reduces spontaneous automaticity and prolongs the effective refractory periode so could be used in this case. Catheter ablation of accessory pathway in Ebstein anomaly with WPW syndrome was class I recommendation. In our case, the accessory pathway was successfully ablated.

Periapical Radiograph has a High Accuracy and an Alternative Imaging Modality in the Third Molar Impaction Cases

Introduction: Impaction is a condition when a tooth suffers from a complete eruption failure on its right position due to the lack of curvace room on the jaw. Periapical radiography has an important role in detecting third molar impaction disease. Recently, panoramic radiograph has become the standard in diagnosing the third molar impaction. Objective: The objective set for this study is to evaluate the accuracy of the periapical radiograph based on the standard which is the panoramic radiograph on the third molar impaction cases.Materials and Method: This study belongs to that of analytic observational by employing diagnostic testing method on primary data. It employed 35 samples which were then cross tabulated using 2x2 analysis table.The result of the grouping was then inserted into the formula for sensitivity, spesificity, positive predictive value, negative productive value, accuracy and ROC graphic. Result: The result of this study shows that the score for sensitivity reaches 96%, 33.3% for spesificity, 80.6% for positive predictive value, 75% for negative predictive value, 80% for accuracy, and 77.8% for ROC graphic. Conclusion: periapical radiograph can be used as an alternative checking up in diagnosing third molar impaction cases. However, it is not used as a panoramic substitute which still serves as the standard.

Chronic Hepatitis C Infection among Renal Failure Patients on Hemodialysis at RSUD dr. Saiful Anwar Malang

Hemodialysis patient are at particular high risk for blood-borne infections. It has been estimated that among patient on hemodialysis, the prevalence of HCV infection is much higher than in general population. Research Objective: To know the prevalence and factors related with Hepatitis C infection in Chronic Kidney Failure patients who underwent chronic hemodialysis in RSUD Dr. Saiful Anwar Malang. Methods: This is a descriptive cross-sectional study. Data was obtained from medical record of hemodialysis patient at Hemodialysis Unit RSUD Dr. Saiful Anwar Malang period April 1, 2016 - March 31, 2017. Results: 688 patients underwent hemodialysis were included in this study, 71 patients (10.323%) positive HCV infection, male 33 patient (46.47%) and female 38 patient (53.53%). The highest positive anti HCV at the age of 48-56 year (24 patient). Patient with blood transfusion were positive 69 patient (97.20%) (p<0.05). Patient on Hemodialysis 5-10 years with positive HCV (60.56%) (p<0.05). From frequency HD one times a week 39 patient and two times a week 32 patient (p<0.05). Based on access type; manual access 48 patient (67.61%), AV shunt 15 patient (21.13%), double lumen 8 patient (11.26%) (p>0.05). Conclusions: Prevalence of chronic hepatitis C infection in CKD on HD is 10.3 %. There is correlation between blood transfusions, duration and frequency of hemodialysis on anti HCV positive. No relationship between access type of hemodialysis with anti HCV positive.

Role of proteins in MAPK pathways on Cleft Lip Patients of Protomalayid Race in East Nusa Tenggara Province, Indonesia

Cleft lip is a disruption which happens in the upper lip joining process due to multifactorial causes such as genetic, nutritional, environmental, and socio-economic. East Nusa Tenggara is a province in Indonesia with Protomalayid race population that has a high incidence of cleft lip of 5-6 per 1000 births. This study therefore aims to determine the expression and relationship of proteins in the Mitogen-activated Protein Kinase (MAPK) pathway of cleft lip in the Protomalayid race of East Nusa Tenggara Province. The method used was Hematoxylin-Eosin staining and Immunohistochemical technique to identify the expression of Transforming Growth Factor Alpha (TGF-α) protein, Extracellular signal-regulated kinases (ERK1), Activator Protein (AP-1), Transforming Growth Factor Beta-1 (TGF-β1), p38, Soluble Vascular Endothelial Growth Factor Receptor 1 (sVEGFR1), Epidermal Growth Factor Receptor (EGFR), and Fibroblast Growth Factor 2 (FGF- 2) in cleft lip cells. The result shows that the expressions of TGF-α, EGFR, FGF-2, and ERK-1 decreased, but that of AP-1, TGF-β1, p38, and SVEGFR1 increased. Meanwhile, the results of the Pearson correlation analysis showed the TGFα-ERK1, TGFβ1-p38, AP1-p38, EGFR-ERK1, and FGF2-p38 had a positive relationship. All the factors in the study have correlations (except FGF2 - ERK1). The relationship between FGF2-ERK1 was not significant, while SVEGFR1- p38 protein has a negative relationship.