Faculty of Medicine

Tujuan penelitian ini adalah menguji efektivitas Model Pembelajaran Matematika Sains Terpadu Beorientasi Pemecahan Masalah Open-Ended Argumentatif dalam meningkatkan penguasaan konsep, keterampilan berpikir divergen, dan pengembangan kemampuan pemecahan masalah. Penelitian ini merupakan penelitian kuasi eksperimen yang dilakukan di enam Sekolah Menengah Pertama di Provinsi Bali. Subjek penelitian terdiri atas 220 siswa kelas eksperimen dan 215 siswa kelas kontrol. Hasil penelitian menunjukkan bahwa Model dan Sistem Asesmen Pembelajaran Matematika Sains Terpadu Berientasi Pemecahan Masalah Open-Ended Argumentatif lebih efektif dari model pembelajaran reguler dalam hal meningkatkan kemampuan siswa dalam pemahaman konsep, berpikir divergen, dan pengembangan kemampuan pemecahan masalah. Kata Kunci : pemecahan masalah, open-ended argumentatif, penguasaan konsep, berpikir divergen, dan pemecahan masalah.

The present study examined the prevalence rate of depression and anxiety among college students living in a disaster-prone area of Aceh, Indonesia. College students enrolled in two public Universities in Banda Aceh were randomly selected to participate in the self-administered standardized questionnaires for depression and anxiety. The prevalence rates of depression and anxiety were 18.8% and 27.4%, respectively. Depression was associated with gender and BMI while anxiety was only associated with gender. Depression is also positively correlated to anxiety. Depression and anxiety are prevalent among college students living in a disaster prone area. Early detection and timely treatment of mental disorders should be beneficial to the students living in this circumference.

Working with street children and adolescents who lived through the 2010 earthquake in Port-au-Prince, this paper aims to assess the prevalence of symptoms of PTSD, anxiety and depression in relation to peritraumatic distress, and age, and to explore other risk factors and socio-demographic characteristics, four years after the events. Between March and June 2014, with a sample of 128 children and adolescents (120 boys and 8 girls) aged between 7 and 18, of an average age of 13.88 (SD=2.15), all living on the streets of Port-au-Prince, we used the following scales: the Trauma Exposure (TE), the Life Events Subscale of the CAPS; the Peritraumatic Distress Inventory (PDI); the Children's Revised Impact of Event Scale (CRIES-13) and the Children Depression Inventory (CDI); (BAI). Our study reveals a high prevalence of PTSD, depression and anxiety among street children. It also demonstrates that this prevalence is lower than that of several other groups of children who were also vict...

Background The current outbreak of the COVID-19 pandemic has distorted the physical, mental, and psychological condition of frontline healthcare providers in health facilities. This study aims to investigate the prevalence, and risk factors of depression, anxiety, and stress among nurses working in a COVID-19 referral hospital in Indonesia. Methods A cross-sectional study was conducted among 491 nurses, aged between 31, and 56 years, using a self-administered questionnaire. The Depression Anxiety Stress Scale (DASS21), and demographic questions were used to screen the presence of psychological problems, and their associated factors. Results The prevalence of moderate to extremely severe depression, anxiety and stress was 8.5 %, 20.6 and 6.3 %, respectively. Regression analysis showed that anxiety was significantly higher among nurses working in non-COVID wards (p = .01), those who experienced social rejection (p < .05), and those who frequently watched television (p < .05). Th...

Dengue diseases pathogenesis is not yet completely understood. Several human immunities are controlled by the expression of human leukocyte antigen (HLA) and expressions of HLA molecules are increased in dengue viral (DENV) infection. The role of cytotoxic T lymphocyte recognizing DENV epitopes presented by the HLA is the basis for immunity of DENV infection. The genes encoding HLA class I (HLA-A, -B, -C) and class Ⅱ (HLA-DR, DQ and DP) are the most polymorphic in the human genome, and several specific polymorphisms in these genes influence peptide epitope binding. Here we have reviewed the implication of HLA and HLA-related gene polymorphisms on DENV infection susceptibility, protection and severity. We found several studies have identified HLA alleles associated with DENV infection susceptibility and severity such as A

Background: Chronic pain is very common in Asian communities. It is a major cause of activity limitation and has a significant impact on individuals and society. One of the most common ailment for which patients seek for medical care is pain. This study was performed in the urban area to study the association of some of the modifiable risk factors of chronic pain. Objective: To estimate the prevalence and associated risk factors of chronic pain among adults residing in the Urban area of Udupi Taluk in Karnataka, India. Methods: The cross-sectional study included 360 participants of above 18 years of age. The participants were recruited using Simple Random Sampling technique from January 2017 to June 2017. Descriptive and analytical methods were used to estimate the prevalence and to identify the associated risk factors. Results: It was observed during the study that prevalence of chronic pain for adults older than 18 years was 62%. Low back pain and knee pain were the common ailments reported. About 50% of those who reported chronic pain, had the complaint for more than 5 years and reported more than six in Visual analogue scale. The postural factors associated with chronic pain were lifting weight, bend trunk heavily during work, repetitive movement of neck, trunk and shoulder, lifting hand above shoulder level and experience of fall. Conclusion: Present research revealed that higher prevalence of chronic musculoskeletal pain exists in the urban population of Udupi Taluk, which was influenced by repetition of same joint movement, trauma and depression irrespective of the other risk variables.

Purpose: Vesicovaginal fistula (VVF) is one of the most devastating surgical complications that can occur in women. The primary cause remains an abdominal hysterectomy. Approach to this condition can be transvaginal or transabdominal. Laparoscopic repair of VVF may be an alternative approach to this treating rare condition. We present seven cases of VVF treated with transperitoneal laparoscopic technique and our results. Methods: We retrospectively reviewed the charts of 7 women ranging from 37 to 74 years in age (mean age 52.8 years) at our institution who underwent laparoscopic transperitoneal repair of VVF between February 2004 and March 2006. Etiology of the VVF, surgical technique, operative time, length of hospital stay, and complications were reviewed. Results: Six of the seven VVFs we repaired laparoscopically resulted from gynecologic procedures, and one patient presented with a VVF after a ureterolithotripsy. Mean operative time ranged from 130 to 420 minutes (mean 280 minutes), and mean hospital stay was 7 days. In one patient conversion to open surgery was necessary due to prolonged operative time. Two complications occurred: a urinary tract infection in one patient and an inferior limb compartment syndrome in another. Conclusion: Transvaginal laparoscopic repair of VVF is feasible and safe and provides excellent results. It is a good alternative to the abdominal approach. However, advanced laparoscopic skills are mandatory.

Several epidemiology studies suggest that host genetic factors play important roles in susceptibility, protection and progression of tuberculosis infection. Here we have reviewed the implications of some genetic polymorphisms in pathways related to tuberculosis susceptibility, severity and development. Large case-control studies examining single-nucleotide polymorphisms (SNPs) in genes have been performed in tuberculosis patients in some countries. Polymorphisms in natural resistance-associated macrophage protein 1 (NRAMP1), toll-like receptor 2 (TLR2), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-a), interleukin-1 receptor antagonist (IL-1RA), IL-10, vitamin D receptor (VDR), dendritic cell-specific ICAM-3-grabbing non-integrin (DC-SIGN), monocyte chemoattractant protein-1 (MCP-1), nucleotide oligomerization binding domain 2 (NOD2), interferon-gamma (IFN-c), inducible nitric oxide synthase (iNOS), mannosebinding lectin (MBL) and surfactant proteins A (SP-A) have been reviewed. These genes have been

Dengue diseases pathogenesis is not yet completely understood. Several human immunities are controlled by the expression of human leukocyte antigen (HLA) and expressions of HLA molecules are increased in dengue viral (DENV) infection. The role of cytotoxic T lymphocyte recognizing DENV epitopes presented by the HLA is the basis for immunity of DENV infection. The genes encoding HLA class I (HLA-A,-B,-C) and class Ⅱ (HLA-DR, DQ and DP) are the most polymorphic in the human genome, and several specific polymorphisms in these genes influence peptide epitope binding. Here we have reviewed the implication of HLA and HLA-related gene polymorphisms on DENV infection susceptibility, protection and severity. We found several studies have identified HLA alleles associated with DENV infection susceptibility and severity such as A*

a Medical Research Unit, School of Medicine Syiah Kuala University, Banda Aceh, Indonesia b Tropical Disease Center, School of Medicine Syiah Kuala University, Banda Aceh, Indonesia c Research Affiliate, Centre for Genes, Environment and Health, National Jewish Health, Denver, CO, USA d Computational Bioscience Program, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA e Graduate Institute of Medical Science, Taipei Medical University, Taipei, Taiwan f Institute of Medical Microbiology and National Reference Center for Systemic Mycosis, University Medical Center Goettingen, Goettingen, Germany g Pulmonology Department, School of Medicine, Syiah Kuala University, Banda Aceh, Indonesia

Background This study aimed to evaluate the outcomes of modified Enhanced Recovery After Surgery (ERAS) protocol and standard of care (SC) in bladder cancer patients who underwent radical cystectomy (RC). The length of stay and complications rates were the primary outcomes. Time functional recovery, bowel movement, mobilization, drain removal, and other perioperative outcomes were the secondary outcomes. Methods A cohort retrospective study was conducted to investigate the effectiveness of the modified ERAS protocol compared to SC in 61 patients who underwent RC (36 ERAS vs. 25 SC). Results The modified ERAS protocol was associated with shorter length of stay (9.3 ± 5.0 days vs. 12.6 ± 6.7 days, P  = 0.032) and reduction in important postoperative milestones, including days to first solid diet (3.5 ± 1.6 vs. 5.5 ± 1.5, P  = 0.000), days to first defecation (4.8 ± 2.4 vs. 7.2 ± 2.4, P  = 0.001), days to first walking (4.7 ± 2.2 vs. 7.9 ± 2.4, P  = 0.000), and days to drain removal (3...

Background Most of the outcomes after radical cystectomy (RC) are directly associated with the type of urinary diversion. This study sets out to evaluate the outcomes of ileal conduit (IC) and transuretero-cutaneostomy (TUC) urinary diversion after RC. Methods This retrospective study included 52 patients (IC, n  = 30; TUC, n  = 22) at Dr. Sardjito Hospital between January 2014 and December 2019. The clinical outcomes were compared using Chi-squared tests and independent t tests. Multivariable logistic regression analysis was performed to determine the odds of developing related complications. Results Demographically, both groups were similar in terms of age, gender, ASA score, staging, body mass index, and comorbidities. IC was associated with a high incidence of postoperative complications than TUC (56.7% vs. 27.3%; p  = 0.035). Long-term postoperative complications stoma stenosis was more common in the TUC than IC ( p  = 0.010). Multivariate analysis showed TUC was a significant ...

Tuberculosis (TB) is an infectious disease typically affects the lungs and other parts of the human body. Various risk factors have been associated with TB and epidemiology studies suggest that the human genetic factors play important roles in susceptibility, protection, progression and outcome of TB. This book discusses the human genetic factors extensively, focusing on single-nucleotide polymorphisms in gene of mannose receptor, dendritic cell-specific ICAM-3-grabbing nonintegrin (DC-SIGN), toll-like receptor, complement receptor 3, nucleotide oligomerization domain 2, vitamin D nuclear receptor, purinergic P2X7 receptor, CD14, surfactant protein-A, mannose-binding lectin, tumor necrosis factor alpha, interferon-gamma, interleukin (IL)-12, IL-10, IL-6, IL-18, IL-1β, IL-8, IL-1 receptor antagonist (IL-1RA), monocyte chemoattractant protein 1, RANTES (CCL5), CXCL10, inducible nitric oxide synthase and solute carrier protein 11A1.

Background: Enhanced recovery after surgery (ERAS) protocol is multimodal perioperative care designed to achieve enhanced postoperative outcomes. Unfortunately, all these elements are not always fully applied due to each center’s limitations. In this study, the ERAS protocol was modified and implemented in patients with bladder cancer who underwent laparoscopic radical cystectomy (LRC). This study aimed to evaluate the outcomes of the modified ERAS protocol in LRC surgery. Methods: The retrospective study design was used to evaluate 35 patients (27 males and 8 females) who underwent LRC with the application of the perioperative modified ERAS protocol. All information relating to perioperative, intraoperative, and postoperative patient data was obtained from medical records. All complications that occurred were classified according to the Clavien-Dindo classification.Results: The mean age in this study was 58.3 ± 9.2, and the most common pathological finding was urothelial carcinoma....

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was firstly identified in China and has been declared a global pandemic. Several serious extrapulmonary manifestations due to SARS-CoV-2 infection have also been reported and associated with hypercoagulability thrombotic vasculopathy. In addition, cases of Mycobacterium-leprae infection have also been known associated with blood coagulation abnormality. Methods: Here, we report a 56-year-old male with coronavirus disease-19 (COVID-19) with concomitant leprosy infection with manifestation of glans penile necrosis, presented to the emergency department with acute penile pain. This case is unique because no occlusion blood flow to the penile was observed in the radiographic imaging. We described the potential pathophysiology in this case through a literature review. Results: The patient received treatment according to the COVID-19 protocol and was given low molecular weight heparin (LMWH) therapy for 4 d...

Artisanal gold mining activities in developing countries are still in concern with environmental and health issues regarding the impact which results from the activities. Amalgamation technique using mercury was commonly applied in extracting gold from the ore. During the process, mercury releases into the environment in its metallic form and mercury vapor. Mercury releases to environment can harm population who work or live near mining area. Mercury is a highly toxic metal and it can penetrate nervous systems as the main target organ. Acute and chronic neurological disturbances can also be experienced by the communities. The aim of this study was to determine the relationship between occupation in the mining process, length of time of mercury exposure and neurological status disturbances in communities near artisanal gold mining area in West Aceh, and is known now as Aceh Jaya district, Aceh Province, Indonesia. A cross sectional design was conducted with 78 respondents who lived in villages namely, Paya Seumantok, Panggong, and Curek. Samples were collected by random sampling and respondents were interviewed and given general physical examination. Data were analyzed by Chi-Square test at α = 0.05. The results of this study showed that occupation in mining process has relationship with neurological status disturbances (p=0.004) whereas length of time of mercury exposure showed no relationship to neurological status disturbances (p=0.650). Respondents have experienced neurological disturbances such as headache (48.7%), insomnia (37.2 %), tremor (10.3%), memory loss and mood changes (9.0%), hearing impairment and somatosensory disturbances (3.8%). It can be concluded that efforts for monitoring and evaluation on artisanal gold mining in the areas have to be made by local government and stakeholders to prevent widespread of epidemy on mercury disasters. It is also needed to follow up the neurological status disturbances of the respondents clinically through intensive examination.