HUBUNGAN PARITAS DAN USIA IBU HAMIL DENGAN PREEKLAMPSIA DI RUMAH SAKIT KOTA BANDA ACEH

Preeklampsia merupakan salah satu komplikasi selama kehamilan dan persalinan yang menyebabkan 15% kematian ibu di negara maju seperti Amerika Serikat dan 7-10% kematian ibu di negara berkembang seperti Indonesia. Preeklampsia dapat menyebabkan eklampsia, sindrom HELLP, dan solusio plasenta pada ibu, serta dapat menyebabkan kelahiran prematur bahkan kematian pada janin. Banyak faktor risiko yang dapat mempengaruhi terjadinya preeklampsia yang jika diketahui lebih awal dapat dilakukan pencegahan secara cepat dan tepat. Penelitian ini bertujuan untuk mengetahui hubungan paritas dan usia ibu hamil dengan kejadian preeklampsia di rumah sakit kota Banda Aceh. Jenis penelitian adalah descriptive correlative dengan desain cross sectional study. Penelitian ini dilakukan secara observasi non-partisipan dengan total sampling berjumlah 88 dokumen rekam medik menggunakan lembar observasi sebagai alat pengumpul data. Analisis bivariat menggunakan uji chi square. Hasil penelitian didapatkan tidak ada hubungan antara paritas dengan preeklampsia (p-value = 0,489) dan terdapat hubungan antara usia ibu hamil dengan preeklampsia (p-value =0.036). Dari hasil peneltian, dapat di sarankan bagi petugas kesehatan untuk meningkatkan pelayanan ANC, melakukan penapisan awal preeklampsia pada kunjungan pertama kehamilan dan memberi edukasi terkait preeklampsia dalm kehamilan, sedangkan untuk ibu hamil di sarankan untuk mengikuti jadwal pemeriksaan kehamilan secara teratur dan mengikuti saran yang di berikan petugas terkait preeklampsia.Kata kunci: paritas, usia ibu hamil, preeklampsia

Severe COVID-19 during pregnancy and the subsequent premature delivery

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Part prematurCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Parto prematuroCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Premature deliveryCoronavirus disease 2019 (COVID-19), which is caused by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a pandemic in January 2020. Although most of the cases in pregnant women are mild, there are reports of increasing severe infection in pregnancy. Only a few case of SARS-CoV-2 infection in preterm neonates delivered by mothers with COVID-19 have been reported till date. The possibility of in utero transmission of SARS-CoV-2 is highly controversial.1,2 While SARS-CoV-2 has been detected in several neonates by reverse transcriptionpolymerase chain reaction (RT-PCR) of nasopharyngeal swabs collected in the early hours or days of life,3,4 the reliability of these swabs is under scrutiny, as there is a chance of contamination by coronavirus-infected maternal body fluids

Management of pregnancy-related hypertensive disorders in patients infected with SARS CoV-2: pharmacological and clinical issues

Aims: Coronavirus-19 infection (COVID-19) continues to spread throughout the world. It is known that among patients with hypertension, diabetes, chronic respiratory disease, or cardiovascular (CV) diseases, COVID-19 is associated with greater morbidity and mortality compared to patients without these conditions. This correlation is of great importance in pregnant women affected by COVID-19 since it usually leads to the development of a serious clinical complication. In particular, managing hypertensive disorders in pregnancy can be problematic because anti-hypertensive medications may interact pharmacologically with drugs used to treat COVID-19. This review focuses on the safety of drug treatment for COVID-19 in pregnant women treated with anti-hypertensive medication. Methods and results: Several databases were searched to identify relevant literature. A few anti-hypertensive drugs and antithrombotic treatments are known for having a beneficial effect in the management of hypertension and hypertensive disorders in pregnancy. In this review, we focus on the expected drug-drug interactions with the experimental agents mostly used to treat COVID-19. Conclusions: The current indication for the management of hypertension-related disorders in pregnancy maintain their validity, while the risk of pharmacological interaction with the currently tested anti-SARS-CoV-2 medications is relatively low

Estimating disparities in breast cancer screening programs towards mortality, case fatality, and DALYs across BRICS-plus

Background: Numerous studies over the past four decades have revealed that breast cancer screening (BCS) significantly reduces breast cancer (BC) mortality. However, in BRICS-plus countries, the association between BCS and BC case fatality and disability are unknown. This study examines the association of different BCS approaches with age-standardized mortality, case-fatality, and disability-adjusted life years (DALYs) rates, as well as with other biological and sociodemographic risk variables, across BRICS-plus from a national and economic perspective. Methods: In this ecological study applying mixed-effect multilevel regression models, a country-specific dataset was analyzed by combining data from the Global Burden of Disease study 2019 on female age-standardized BC mortality, incidence, and DALYs rates with information on national/regional BCS availability (against no such program or only a pilot program) and BCS type (only self-breast examination (SBE) and/or clinical breast examination (CBE) [SBE/CBE] versus SBE/CBE with mammographic screening availability [MM and/or SBE/CBE] versus SBE/CBE/mammographic with digital mammography and/or ultrasound (US) [DMM/US and/or previous tests] in BRICS-plus countries. Results: Compared to self/clinical breast examinations (SBE/CBE) across BRICS-plus, more complex BCS program availability was the most significant predictor of decreased mortality [MM and/or SBE/CBE: − 2.64, p &lt; 0.001; DMM/US and/or previous tests: − 1.40, p &lt; 0.001]. In the BRICS-plus, CVD presence, high BMI, second-hand smoke, and active smoking all contributed to an increase in BC mortality and DALY rate. High-income and middle-income regions in BRICS-plus had significantly lower age-standardized BC mortality, case-fatality, and DALYs rates than low-income regions when nationwide BC screening programs were implemented. Conclusions: The availability of mammography (digital or traditional) and BCS is associated with breast cancer burden in BRICS-plus countries, with regional variations. In light of high-quality evidence from previous causal studies, these findings further support the preventive role of mammography screening for BCS at the national level. Intervening on BCS related risk factors may further reduce the disease burden associated with BC.</p

The adverse effect of gestational diabetes mellitus and hypertensive disorders of pregnancy on maternal–perinatal outcomes among singleton and twin pregnancies:A retrospective cohort study (2011–2019)

Background: Gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) are the predominant pregnancy complications among singleton and twin pregnancies worldwide. Our primary objective was to explore the adverse effect of GDM and HDP on maternal–perinatal outcomes compared with non-GDM and non-HDP in singleton and twin pregnancies. The secondary objective was to find the risk of adverse maternal–perinatal outcomes in twin pregnancies compared with singleton pregnancies complicated with GDM and HDP in Hubei, China. Methods: A tertiary hospital-based retrospective study was conducted at Wuhan University Renmin Hospital, Hubei Province, China, from 2011 to 2019. A chi-square test was used to determine the difference in adverse maternal–perinatal outcomes between singleton and twin pregnancies. A multiple binary logistic regression model and a joinpoint regression model were used to determine the association of GDM and HDP with adverse maternal–perinatal outcomes and GDM and HDP temporal trend among singleton and twin pregnancies. Results: The trend of HDP [average annual percentage change (AAPC) 15.1% (95% confidence interval (95%CI): 5.3, 25.7)] among singleton pregnancies and GDM [AAPC 50.4% (95%CI: 19.9, 88.7)] among twin pregnancies significantly increased from 2011 to 2019. After adjusting for confounding factors, GDM is associated with an increased risk of C-section (adjusted odds ratio (aOR), 1.5; 95%CI: 1.3, 1.6) and macrosomia (aOR, 1.3; 95%CI: 1.1, 1.6) in singleton and preterm birth (PTB) (aOR, 2.1; 95%CI: 1.2, 3.3) in twin pregnancies compared with non-GDM. HDP was associated with a higher risk of C-section, PTB, perinatal mortality, and low birth weight (LBW) in both singleton and twin pregnancies compared with the non-HDP. Compared with singleton pregnancies complicated with GDM and HDP, twin pregnancies showed higher odds of C-section [(aOR, 1.7; 95%CI: 1.1, 2.7), (aOR, 4.6; 95%CI: 2.5, 8.7), respectively], PTB [(aOR, 22.9; 95%CI: 14.1, 37.3), (aOR, 8.1; 95%CI: 5.3, 12.3), respectively], LBW [(aOR, 12.1; 95%CI: 8.2, 18.1), (aOR, 5.1; 95%CI: 3.6, 7.4), respectively], and low Apgar score [(aOR, 8.2; 95%CI: 4.4, 15.1), (aOR, 3.8; 95%CI: 2.4, 5.8), respectively] complicated with GDM and HDP. Conclusion: In conclusion, GDM showed an increased risk of a few adverse maternal–perinatal outcomes and HDP is associated with a higher risk of several adverse maternal–perinatal outcomes in singleton and twin pregnancies compared to non-GDM and non-HDP. Moreover, twin pregnancies complicated with GDM and HDP showed higher odds of adverse maternal–neonatal outcomes compared with singleton pregnancies complicated with GDM and HDP.</p

The adverse effect of gestational diabetes mellitus and hypertensive disorders of pregnancy on maternal–perinatal outcomes among singleton and twin pregnancies:A retrospective cohort study (2011–2019)

Background: Gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) are the predominant pregnancy complications among singleton and twin pregnancies worldwide. Our primary objective was to explore the adverse effect of GDM and HDP on maternal–perinatal outcomes compared with non-GDM and non-HDP in singleton and twin pregnancies. The secondary objective was to find the risk of adverse maternal–perinatal outcomes in twin pregnancies compared with singleton pregnancies complicated with GDM and HDP in Hubei, China. Methods: A tertiary hospital-based retrospective study was conducted at Wuhan University Renmin Hospital, Hubei Province, China, from 2011 to 2019. A chi-square test was used to determine the difference in adverse maternal–perinatal outcomes between singleton and twin pregnancies. A multiple binary logistic regression model and a joinpoint regression model were used to determine the association of GDM and HDP with adverse maternal–perinatal outcomes and GDM and HDP temporal trend among singleton and twin pregnancies. Results: The trend of HDP [average annual percentage change (AAPC) 15.1% (95% confidence interval (95%CI): 5.3, 25.7)] among singleton pregnancies and GDM [AAPC 50.4% (95%CI: 19.9, 88.7)] among twin pregnancies significantly increased from 2011 to 2019. After adjusting for confounding factors, GDM is associated with an increased risk of C-section (adjusted odds ratio (aOR), 1.5; 95%CI: 1.3, 1.6) and macrosomia (aOR, 1.3; 95%CI: 1.1, 1.6) in singleton and preterm birth (PTB) (aOR, 2.1; 95%CI: 1.2, 3.3) in twin pregnancies compared with non-GDM. HDP was associated with a higher risk of C-section, PTB, perinatal mortality, and low birth weight (LBW) in both singleton and twin pregnancies compared with the non-HDP. Compared with singleton pregnancies complicated with GDM and HDP, twin pregnancies showed higher odds of C-section [(aOR, 1.7; 95%CI: 1.1, 2.7), (aOR, 4.6; 95%CI: 2.5, 8.7), respectively], PTB [(aOR, 22.9; 95%CI: 14.1, 37.3), (aOR, 8.1; 95%CI: 5.3, 12.3), respectively], LBW [(aOR, 12.1; 95%CI: 8.2, 18.1), (aOR, 5.1; 95%CI: 3.6, 7.4), respectively], and low Apgar score [(aOR, 8.2; 95%CI: 4.4, 15.1), (aOR, 3.8; 95%CI: 2.4, 5.8), respectively] complicated with GDM and HDP. Conclusion: In conclusion, GDM showed an increased risk of a few adverse maternal–perinatal outcomes and HDP is associated with a higher risk of several adverse maternal–perinatal outcomes in singleton and twin pregnancies compared to non-GDM and non-HDP. Moreover, twin pregnancies complicated with GDM and HDP showed higher odds of adverse maternal–neonatal outcomes compared with singleton pregnancies complicated with GDM and HDP.</p

Kualitas Sanitasi di Sekolah dan Dampaknya terhadap Kesehatan dan Gizi Anak : Systematic Literature Review

Latar Belakang: Layanan sanitasi yang tidak memadai di sekolah dapat berdampak buruk pada kesehatan dan gizi anak. Tinjauan sistematis ini bertujuan untuk mengeksplorasi dampak kualitas sanitasi di sekolah terhadap kesehatan dan gizi anak. Metode: Pencarian komprehensif dilakukan di berbagai database termasuk PubMed, Scopus, dan Google Scholar untuk mengidentifikasi studi yang relevan yang diterbitkan antara tahun 2016 hingga 2023. Sebanyak 18 penelitian memenuhi kriteria inklusi dan dimasukkan dalam tinjauan sistematik review. Hasil: Temuan dari penelitian menunjukkan hubungan yang kuat antara kualitas sanitasi yang buruk di sekolah dan hasil kesehatan yang negatif di antara anak-anak. Hasil kesehatan ini termasuk peningkatan risiko diare, infeksi parasit, dan malnutrisi. Kesimpulan: Temuan dari tinjauan sistematis ini menyoroti pentingnya meningkatkan kualitas sanitasi di sekolah untuk melindungi dan meningkatkan kesehatan dan gizi anak-anak &nbsp;Latar Belakang: Layanan sanitasi yang tidak memadai di sekolah dapat berdampak buruk pada kesehatan dan gizi anak. Tinjauan sistematis ini bertujuan untuk mengeksplorasi dampak kualitas sanitasi di sekolah terhadap kesehatan dan gizi anak. Metode: Pencarian komprehensif dilakukan di berbagai database termasuk PubMed, Scopus, dan Google Scholar untuk mengidentifikasi studi yang relevan yang diterbitkan antara tahun 2016 hingga 2023. Sebanyak 18 penelitian memenuhi kriteria inklusi dan dimasukkan dalam tinjauan sistematik review. Hasil: Temuan dari penelitian menunjukkan hubungan yang kuat antara kualitas sanitasi yang buruk di sekolah dan hasil kesehatan yang negatif di antara anak-anak. Hasil kesehatan ini termasuk peningkatan risiko diare, infeksi parasit, dan malnutrisi. Kesimpulan: Temuan dari tinjauan sistematis ini menyoroti pentingnya meningkatkan kualitas sanitasi di sekolah untuk melindungi dan meningkatkan kesehatan dan gizi anak-anak &nbsp

Prediction of Bone Marrow Cellularity from Aspiration as compared to Trephine Biopsy

Background: Bone marrow cellularity is an essential and integral part of the bone marrow examination report. Cellularity could be obtained from both bone marrow aspirations and biopsies. Predicting marrow cellularity from aspiration as opposed to biopsy would give the clinician the convenience of an early diagnosis and timely management. In this study, we aimed at knowing the degree of correlation between the bone marrow aspiration cellularity that could be ready within a short period of time to that of bone marrow biopsy cellularity that could take days to have a positive impact on the management, especially for acute blood disorders. Materials and Methods: We collected 200 consecutive bone marrow aspirations from the Nanakaly Teaching Hospital. All the bone marrow biopsy slides belonging to the same group of patients were also collected from the main histology center at Rizgary Teaching Hospital. Five expert hematopathologists were given the chance to report on the cellularity for both the aspirations and the biopsies. The study was performed in sessions, limiting each session to 20 aspirations and 20 biopsies. Cellularity was rated in percentage points of 5 giving the observer the chance to rate the cellularity from 0% to 100%. Results: Microsoft Excel spreadsheet was used to record all the data obtained from the observers. Mean values from all the five observers for each aspiration and biopsy was used for statistical analysis. We found a strong direct positive correlation between the bone marrow biopsy cellularity and bone marrow aspiration cellularity. Conclusion: A simple practical equation could be created to measure bone marrow biopsy cellularity from the usually available aspiration cellularity. Marrow biopsy cellularity was found to be 0.96 of the aspiration cellularity