Comparison of the sacral ratio between children with Hirschsprung disease and non-Hirschsprung

Background: Hirschsprung's disease is a congenital gastrointestinal disorder that is the most common cause of intestinal obstruction in children. One of the factors that influence gastrointestinal disorders is the sacrum bone. The sacral index can review the evaluation of the sacral bone, an instrument that can evaluate the development of the sacral bone in different clinical conditions. This study assessed the value of the sacral ratio in children with Hirschsprung's disease and non-Hirschsprung's disease at Dr. Hospital. Hasan Sadikin Bandung.

Methods: This study was a descriptive-analytic study with a case-control design. Sampling was done retrospectively by collecting medical record data and the enema barium readings from October 2019 to July 2020. The study was conducted at the Department of Radiology Hospital Dr. Hasan Sadikin Bandung from September to October 2020. Data processing uses an unpaired T-test.

Results: The total sample was 58 objects, consisting of 29 with Hirschsprung’s disease and 29 non-Hirschsprung, with an average age of Hirschsprung’s disease was 3.14±3.905 years. In the Hirschsprung’s disease group, the mean sacral ratio value was 0,62 and, and the mean sacral ratio in the non-Hirschsprung group was 0,74. Statistical test results with unpaired T-test showed significant mean differences in the case and control groups (p=0.0001).

Conclusion: The sacral ratio value in children with Hirschsprung’s disease compared to non-Hirschsprung were different significantly. 

Root cause analysis of maternal deaths at Dr. Soetomo General Academic Hospital Surabaya, Indonesia in 2019

Introduction: Maternal mortality in Indonesia especially in dr. Soetomo General Hospital is still very high, and the biggest problem is obstetric complications. It is possible that the mother who has obstetric complications is safe and recovered or died. This study aimed to identify the root cause of maternal death at Dr. Soetomo General Academic Hospital in 2019.

Methods: This is a descriptive retrospective study with the Root Cause Analysis method to analyze total of 87 maternal deaths at Dr. Soetomo General Academic Hospital in 2019.

Results: There were 87 cases of maternal death at Dr. Soetomo General Academic Hospital in 2019. Direct maternal death was the leading cause of maternal death, contributing 59 cases (67.8%). From 59 cases, 31 cases (35.6%) direct maternal deaths were caused by preeclampsia/eclampsia. Contributing factors that influence maternal mortality are including organizational management, medical personnel, equipment, materials, & ward, environmental, and family barriers factors. Organizational management factors, the most common factor that causes maternal death is a poor information sharing system at the referring hospital, as many as 17 cases (27.4%). Medical personnel factors, maternal death was mostly caused by lack of knowledge and skills during antenatal care, as many as 42 cases (44.2%). Equipment, materials,  and ward factors, the most common cause was the unavailability of the ward, contributing 5 cases (55.6%). Family barrier factors, most maternal deaths were caused by the families that did not understand about the emergency condition of the patient, as many as 52 cases (67.5%).

Conclusion: The maternal deaths at Dr. Soetomo General Academic Hospital in 2019 were mostly caused by the family barrier factor which did not understand about patient’s emergency condition, followed by the medical personnel factor which was lack of knowledge and skills during antenatal care.

Functional Movement Screen (FMS) as a determinant factor to assess the risk of injuries in young athletes at Jakarta Province, Indonesia

Background: Lower extremity injuries are the most common injuries in young athletes due to running, jumping, sudden change of movement, and contact with the other player in most of the sport’s activities. Preventive efforts are the most effective ways to decrease the risk of lower extremity injuries. Functional Movement Screen (FMS) can be considered effective ways in helping to identify risk factors in the young athlete. This study aims to evaluate the FMS as a determinant factor to assess the risk of injuries in young athletes in Jakarta Province, Indonesia

Methods: Participants were young athletes who train in Provincial Student Sports Training Center (PSSTC), South Jakarta. Athlete age less than 18 years old, agree to participate in this research and has normal physical health will be included in this research and proceed to be asked time exposure of training and history of injuries; body posture and FMS examination. Analysis bivariate dan multivariate were done to see if there is the association of seven components of FMS, sex, time exposure of training, history of injuries, body posture and lower extremity injuries. Data were analyzed using SPSS version 20 for Windows.

Results: There was 87 participant that participated in this research. The data showed that ankle (36.7%), thigh (36.7%) and knee (16.0%) were the three most common lower extremity injuries. Bivariate analysis showed a significant association between hurdle step, time exposure of training, and histories of injuries with the incidence of injuries (p<0.25). Logistic regression multivariate analysis showed that history of injuries (OR=4.276; 95%CI=1.599-11.437) and time exposure of training (OR=3.470; 95%CI=1.274-9.448) had a significant association with incidence of injuries (p<0.05)

Conclusions: There was no association of seven components of FMS with lower extremities injuries. However, there was a significant association of injury histories and training exposure with the incidence of injuries.

RUMI DOPING application development as Anti-doping information media for Indonesian national paralympic comittee Athletes

Introduction: Doping is an invisible cheating act in a match; therefore, it is necessary to provide an anti-doping understanding to overcome doping behavior in a competition. The research purpose was to produce a product in the Rumi Doping application as a medium for anti-doping understanding in Indonesian NPC athletes.

Methods: This research used R&D with the Agile Sprint planning model, which consists of (1) planning (planning for the preparation of software components); (2) developing (start software development); (3) testing (software testing); (4) delivering (present the software product); and (5) assessing (assess and provide feedback on the products that have been made). Data were collected by observation, interviews, and questionnaires. The testing stage used experts' product validation, and the assessment stage used product users (Indonesian National Paralympic Committee athletes). Aiken V Coefficient for validity testing and descriptive percentages to measure user ratings in the form of practicality and effectiveness of the Rumi Doping application.

Results: The results showed that the average Aiken V value was 0.89 > 0.77, so it could be stated that the application developed was valid. The practicality assessment of the Rumi Doping application showed an average percentage of 80% (24/30) of athletes stated that it was practical to use. The effectiveness assessment of the Rumi Doping application showed that 90% (27/30) athletes disagreed about doping in sports, which means athletes have understood that doping is prohibited in sports. Conclusion: The research concluded that the Rumi Doping application is valid, practical, and effective in providing information about doping. 

Short cervix, wide anterior cervical angle and low cervical consistency index as a predictor of preterm birth: a case-control study

Objective: To determine and compare either change in length, anterior angle, and consistency of cervix can be used as the predictors of preterm labor or not.

Methods: This case-control study involved 54 pregnant women with gestational age 20 - 37 weeks, which the case group is women in preterm labor and the control group were not in labor at Sanglah General Hospital, Bali, Indonesia from November 2018 to October 2019. The samples were examined using Transvaginal Sonography (TVS) to collect Cervical Length (CL), Anterior Cervical Angle (ACA), and Cervical Consistency Index (CCI) data.

Results: Short CL could increase the risk of preterm labor by 9 times (OR = 8.80, 95% CI = 2.50-30.97, p-value 0.001). Wide ACA could increase the risk by 10 times (OR = 10.45, CI 95% = 2.92-37.39, p = 0.001). Low CCI could increase the risk by 7 times (OR = 7.43, 95% CI = 1.80-30.67, p = 0.003). Anterior cervical angle has the greatest role in the occurrence of preterm labor, followed by CL and CCI, although statistically insignificant (p=0.138; p=0.212= p:0.203).

Conclusion: Performing cervical examination using TVS as the antenatal care routine can help predict and prevent preterm delivery.

Implementation of child nutrition anthropometry pocketbook for early childhood education to increase the ability of teachers to assess nutritional status of early childhood education students in Gianyar Regency, Bali, Indonesia

Introduction: The age of preschool children is the golden age where the physical and psychological is rapidly developing then it is necessary to fulfil the nutritional needs. This is a period that is vulnerable to under-nutrition and over-nutrition. To deal with these problems, nutritional monitoring status must be carried out jointly between teachers, parents, and health care workers. Most early childhood education teachers have not assessed children's nutritional status and only weighed them. Based on these problems, the early childhood education Anthropometry Pocket Book was made to assist teachers in determining the nutritional status of children.

Method: The study used a different subject design and was carried out in April-October 2021 involving 52 samples, divided into two groups, namely the Control Group with 26 people and the Treatment Group with 26 people. The data collected such as sample identity and data on the ability of teachers to assess nutritional status using the BW/Age, Height/Age, BW/H, and BMI/A indexes before and after the intervention in the Control and Treatment Group. The data were analyzed descriptively by looking for the mean, standard deviation, and different tests were carried out to determine the difference in the effect of treatment on the control group and the treatment group, statistical tests Independent samples t-test at significance level (0.05) used on homogeneous data and Mann Whitney test on inhomogeneous data.

Result: The results showed that the average ability of teachers to assess children’s nutritional status in the Treatment Group was higher than the Control Group after being given the intervention. The enhancement before and after intervention in the control group with body weight/age (BW/A) index was 69.1%, height/ age (H/A) was 67.0%, BW/A was 71.5%, and body mass index/age (BMI/A) was 95.4%. While the increase in the Treatment Group with index BW/A 235.9%, H/A 220.5%, body weight/height (BW/H) 225.8%, and BMI/A 141.5%. 

Conclusion: Statistical analysis Independent samples t-test at the significance level ?=0.05 showed that there was a significant difference (p<0.05) in the teacher's ability to assess the nutritional status of children with the index BW/A, H/A, BW/H, and BMI/A in the control group with treatment after intervention. The teachers of early childhood education are always expected to make it a habit to monitor children's nutritional status using a pocketbook on child nutrition anthropometry that has been applied.

Management of Spinal Cord Injury During COVID-19 Era

Coronavirus disease (COVID-19) was declared a pandemic in March 2020 and has the potential to overload health system, compromise hospital staffs and use up essential hospital supplies. Patients with Spinal Cord Injuries (SCI) are classified as patient with disability and has increased morbidity from COVID-19 due to physiological changes from the nature of pathology, subsequently their clinical and social characteristics puts them in high risk of contracting COVID-19. Patients with SCI might present different symptoms of COVID-19 than others. Weakness in thoraco-abdominal and diaphragm muscles might impair cough, reduce lung volumes, and reduce flow rates. Interrupted pathway between hypothalamus and efferent nerves (sympathetic and motoric) might results in temperature dysregulation (poikilothermia) and dysfunction of febrile response. Patients with injuries at higher levels would present with more severe symptoms. The pandemic of COVID-19 further complex the situation of delivering adequate and dignified treatment. Therefore, the main goal is for complete avoidance of infection in this specific population and should be considered with high index of suspicion when mild symptoms of COVID-19 are present. This vulnerable group of patients deserves more attention when presented with extraordinary situations such as pandemics or earthquakes. This overview summarizes the symptom and pathophysiology of SCI in COVID-19 pandemic. 

A rare case of porokeratosis mibelli in 3-year-old boy

Introduction: Porokeratosis mibelli is a rare, chronic, and slowly progressive genodermatotic characterized by abnormality of keratinization. The clinical manifestations are hyperkeratotic papules or plaques surrounded by a thread-like elevated border that widens centrifugally. Rarity of this case means the science behind it is underdeveloped. Thus, we present this case as an educational vehicle and to further develop the body of knowledge surrounding this disease.

Case report: We reported a 3 years old boy, suspect of porokeratosis mibelli. His mother complained of a few reddish spots and patches that sometimes itchy, healed into white and brownish patches with atrophic centers in the last 5 months before admission. Physical examination: few lesions on the back, waist, left side of buttock, back of the neck, and lateral upper left arm. Hypopigmented and hyperpigmented patches with atrophic centers, and erythematous plaques with central erosion were found. No abnormality of internal organs or laboratory findings. Histopathology examination showed epidermis contains of invagination rete malpighia filled keratin. Slightly thinned stratum germinativum with corneum contains basket weave pattern. Topical therapy with 1% 5-fluorourasil cream twice daily showed mild improvement after 10 days.

Conclusion: Although clinical examinations of the lesions on this patient did not fit the criteria of porokeratosis mibelli, however, the results of histopathology examination supported the diagnosis. Treatment with 1% 5-fluorourasil cream showed slow but progressive healing on the patient