Kebijakan Pengelolaan Kualitas Udara Terkait Transportasi di Provinsi DKI Jakarta

-(Peer Reviewer)\ud Judul : Kebijakan pengelolaan kualitas udara terkait transportasi di Provinsi DKI Jakarta\ud Penulis : Andi Alfian Zainuddin\ud Karya Ilmiah : Jurnal Ilmiah Nasional Terakreditasi \ud 281- 28

Peer Review

-Peer Review Andi Alfian Zainuddin, judul karya ilmiah: Kebijakan Pengelolaan Kualitas Udara Terkait Transportasi di Provinsi DKI Jakarta, Jurnal Kesehatan Masyarakat Nasional,\ud ISSN 1907-7505, Volume 4, Nomor 6, Juni 201

Characteristics of Cognitive Status in Sub-Population of Sub-Acute Stage of Ischemic Stroke Patients in West Nusa Tenggara, Indonesia

Cognitive decline is a significant complication that affects most stroke survivors. Early detection of cognitive decline in ischemic stroke patients and identification of risk factors improves their clinical outcomes. This study aimed to determine the characteristics of cognitive status in the sub-acute phase of ischemic stroke. A cross-sectional study was conducted on 89 sub-acute ischemic stroke patients in three hospitals in West Nusa Tenggara recruited consecutively from August 2019 to April 2020. The data collected were demographic and clinical characteristics, cognitive status, and functional outcome. The association between clinical and demographic characteristics and cognitive decline was analyzed using logistic regression. In addition, the relationship between cognitive status and functional outcomes of these patients was examined using the chi-square test. This study revealed that the prevalence of cognitive decline in these subjects was 71.9%. Multiple logistic regression showed that age was the only characteristic associated with cognitive decline in the subjects (OR = 5.12,95% CI = 1.08-24.28). Furthermore, the frequency of cognitive decline in these subjects was significantly associated with functional outcomes (p-value =0.014). Thus, there was a high prevalence of cognitive decline in sub-acute ischemic stroke patients associated with increasing age and poor functional outcomes

Estimated VO2 max Analysis with Six-Minute Walking Test on Obese Patients in Primary Health Care in Makassar

Introduction: Obesity poses a severe threat to global health, making it a significant epidemiological concern that requires special attention. It is associated with several risk factors for various diseases. Alarmingly, one in three Indonesian adults is obese, with the obesity rate steadily increasing. Studies have shown that excess fat mass is linked to higher mortality and morbidity from cardiovascular disease, which is currently Indonesia's leading cause of death. To assess a person's functional capacity and ability for basic physical activity, the 6-minute walking test (6MWT) is utilized, as it proves to be a powerful predictor of morbidity and mortality rates. Therefore, this study aims to analyze the association between VO2 max using 6MWT in obese patients of Makassar City. Methods: This study was a cross-sectional study. The samples comprised all obese individuals who provided signed approval letters and were registered at Makassar City's 20 Public Health Centers. Consecutive sampling was used to gather the samples. Subsequently, the samples were examined and categorized based on their level of obesity.   The 6MWT results are then used with Nury's Formula to produce an estimated VO2max result. To analyze the association between VO2 max using 6MWT and obesity, statistical analysis was conducted using the Mann-Whitney test, with significant results indicated by (p < 0.05). Results: A total of 163 participants comprised the study's sample, with the majority being female and aged 50 years or older. After filling out the questionnaire, data show that most of the obese participants had a family history of cardiovascular disease (CVD), experienced significant stress levels, and had average BMIs falling into the category of obesity. According to the study, the average distance covered in the 6-minute walking test was 340.18 meters (±82.6 meters). When the study participants were ranked by their estimated VO2 max, the average value was 15.10±5.52 for those with first-degree obesity. Following them were participants with second-degree obesity, with results averaging 15.03±5.39 (p = 0.021). Conclusion: A significant inverse association exists between obesity and VO2 max, which means that the more obese a person is, the lower their VO2 max tends to be.

Effectivity of Repetitive Transcranial Magnetic Stimulation Improving Depressive Symptoms and Motoric Strength Ischemic Stroke

Introduction: Post-stroke depression often causes problems. Depression can slow motor recovery. Giving antidepressants takes one month, and thus Transcranial Magnetic Stimulation (TMS) was developed, especially repetitive Transcranial Magnetic Stimulation (rTMS). This study aims to assess the effectiveness of rTMS in improving depressive symptoms and motor strength in ischemic stroke patients. Methods:  An experimental study with a randomized pretest-posttest control group design was conducted at Wahidin Sudirohusodo Hospital and a network hospital in Makassar from August to October 2022. The treatment group received standard therapy for ischemic stroke, antidepressants, and rTMS; the control group received standard therapy for ischemic stroke and antidepressants for ten days. In this study, the Hamilton Depression Rating Scale (HDRS) and the Medical Research Council (MRC) scale were used and measured in the treatment and control groups on the first and tenth days. Results: A total of 40 subjects met the criteria and were divided into a treatment group (n = 20) and a control group (n = 20). The HDRS score in the treatment group was smaller than in the control group. The value of left extremity motor strength in the treatment group was greater than that of the control group using the Wilcoxon Test. The correlation of the HDRS score to motor strength in the treatment and control groups showed a negative correlation of the HDRS score to the left extremity using the Spearman Test.   Conclusions:  rTMS effectively improves depressive symptoms and motor strength in ischemic stroke, given standard ischemic stroke therapy, antidepressants, and rTMS

Factors affecting tumor response to transarterial chemoembolization (TACE) therapy in patient with hepatocellular carcinoma (HCC)

Hepatocellular carcinoma (HCC) is a major problem of global health.Transarterial chemoembolization (TACE) is the treatment of choice for unresectable HCC. The TACE is routinely conducted in major hospitals in Indonesia, however it rarely published.The use of modified response in evaluation criteria in solid tumors (mRECIST) was introduced as an accurate method of measuring tumor response in HCC. This study aimedto investigate the factorsaffecting tumor response to TACE therapy in HCC patients by using mRECIST. It was a retrospective cohort study conducted on 30 patients who successfully underwent the first TACE procedure in the Department of Radiology, Dr. Wahidin Sudirohusodo General Hospital, Makassar, Indonesia from January 2016 to August 2019. The multiphase abdominal computed tomography before and after as well as laboratory examination results before TACE were collected and analyzed. Chi-Square and Spearman-tests were used for the statistical analysis. A significant relationship between tumor location (p=0.016), number of tumor (p=0.001) and Child-Pugh score with tumor response to TACE therapy (p = 0.016) was observed. Solitary tumors tend to have a better therapeutic response, meanwhile, tumors located in the left lobe of patients with Child-Pugh B scores showed a decreased tumor response. Furthermore, no a significant relationship between age (p=0.920), sex (p=0.303), tumor size> 5 cm (p=0.082) and alpha-fetoprotein (AFP) levels (p=0.414) with tumor response was observed. In conclusion, TACE is preferably therapy for multinodular and unresectable HCC. Tumor response after TACE can be well assessed using mRECIST. The factorsaffecting tumor response to TACE therapy arenumber of tumor, location, and Child-Pugh scor

Korelasi Sudut Lumbosakral Berdasarkan MRI Lumbosakral dengan Oswestry Disability Index (ODI Score) pada Degenerative Disk Disease

Pengukuran sudut lumbosacral merupakan salah satu parameter dalam mengevaluasi kemungkinan etiologi dari nyeri punggung bawah yang disebabkan oleh degenerative disc disease. Oswestry Disability Index (ODI) Score digunakan untuk mengukur disabilitas pada nyeri punggung bawah. Penelitian ini bertujuan untuk mengetahui apakah ada korelasi antara sudut lumbosakral  berdasarkan MRI Lumbosakral dengan Oswestry Disability Index (ODI) Score pada degenerative disk disease. Penelitian ini menggunakan desain cross sectional yang dilaksanakan di Departemen Radiologi RS dr. Wahidin Sudirohusodo Makassar mulai bulan Mei sampai September 2020, didapatkan sampel sebanyak 67 pasien dengan keluhan nyeri punggung bawah dan telah mengisi kuisioner Oswestry Disability Index (ODI) Score serta menjalani pemeriksaan MRI lumbosacral. Pengukuran sudut lumbosacral dilakukan pada irisan mid sagital di work station MRI, derajat degenerative disc disease dinilai berdasarkan klasifikasi Pfirrmann. Metode  yang digunakan adalah uji korelasi Spearman dan Chi Square. Hasil penelitian menunjukkan adanya korelasi antara sudut lumbal lordosis (p=0,014), sudut sacral inclination (p=0,002), sudut sacral horizontal (p=0,034), umur  (p=0,0001) dengan degenerative disk disease. Tidak terdapat korelasi antara sudut lumbosacral disc (p=0,250), jenis kelamin (p=0,796), index massa tubuh (p=0,707) dengan degenerative disk disease. Adanya korelasi antara sudut lumbal lordosis (p=0,046), umur (p=0,0001), index massa tubuh (p0,0001) dengan ODI score. Tidak terdapat korelasi antara sudut lumbosacral disc (p=0,072), sudut sacral inclination (p=0,090), sudut sacral horizontal  (p=0,143),  jenis  kelamin  (p=0,337)  dengan  ODI   score. Adanya korelasi antara derajat degenerative disk disease dengan derajat ODI score (p=0,0001

Significance of Serum Prostate Specific Antigen with Histopathological Grading in Men with Prostate adenocarcinoma at Makassar, Indonesia

Prostate adenocarcinoma is the second most common malignancy in men after lung cancer worldwide. In Makassar, South Sulawesi, prostate adenocarcinoma cases increased significantly, from 2017, 2018 and 2019 respectively, the cases reached 31, 43 and 51 cases. Although not specific, Prostate Specific Antigen (PSA) is the first-line test in the screening of prostate adenocarcinoma. Gleason grading is one of the most powerful predictors of biological behavior and when combined PSA with Gleason score and clinical stage. It improves the prediction of the pathological stage for prostate carcinoma. The aim of this study was to determine the association between serum PSA concentration and the new (2016 modified) This was a retrospective study of the correlation between age of patients, serum PSA and grade group of Gleason score of patients diagnosed as Prostate Adenocarcinoma with HE staining at Anatomical Pathology Laboratory, Faculty of Medicine, Hasanuddin University. The age of patients and  the serum PSA values  were retrieved from  laboratory files. Histological slides of appropriate cases were reviewed to confirm the Gleason score and group grade. There were 27 cases fulfilled criteria, from September 2020 to November 2021. The data obtained were subjected to statistical analysis to look for associations and correlations serum PSA and group grade of prostate adenocarcinoma. This study showed that there was a significant correlation between serum PSA level with histopathological grading based on Gleason score of prostate adenocarcinoma (p<0,05)

Comparison of Cardiac Size in Posteroanterior Chest X-Ray and Echocardiography

Cardiac size is important to determine the presence of cardiac enlargement caused by left ventricular enlargement or right ventricular enlargement. Although echocardiography is considered to be the gold standard for cardiac enlargement, its availability is limited, expensive and requires trained experts. The posteroanterior (PA) chest X-ray (CXR) is the most common imaging used as a reliable alternative. The aim of this study was to compare cardiac size using cardiothoracic ratio (CTR) and transverse left cardiothoracic ratio (TL-CTR) in PA chest X-ray and echocardiography. This cross- sectional study involved 88 inclusion sample, aged 20-60 years. On the basis of provisional clinical diagnosis, the patients were divided three groups, consist of: (i) Group with normal cardiac size, (ii) Group with left ventricular enlargement (LVE) dan (iii) Group with right ventricular enlargement (RVE). All patients underwent PA CXR and M-Mode echocardiography examinations. The results of the two modalities were compared. CTR and TL-CTR, transverse diameter (TD) and transverse left (TL) in PA chest X-ray showed a strong positive correlation with total ventricular dimension (TVD) and left ventricular internal dimension (LVID) in echocardiography. CTR, TL-CTR, TD and TL in the PA chest X-ray are very good indicators for TVD and LVID in echocardiography. Chest X-ray is a reliable alternative for the diagnosis of cardiomegaly/cardiac enlargement in the absence of echocardiography.

Penyerupa dan Penyerta Tuberkulosis Paru yang Terdiagnosis Berdasarkan Gambaran CT-scan Toraks Pada Rumah Sakit Rujukan Tersier

Latar belakang: Sistem rujukan berjenjang dapat mempengaruhi karakteristik lesi pada CT-scan toraks pasien terduga tuberkulosis (TB) paru pada rumah sakit rujukan tersier. Hal ini dapat menyamarkan keberadaan penyerupa dan penyerta TB paru. Metode Penelitian: Sampel adalah pasien yang terdiagnosis TB paru oleh ahli radiologi pada periode Oktober 2018 hingga Juni 2019. Analisis Chi-square dilakukan untuk menguji kesesuain 12 karakteristik CT-scan toraks (Konsolidasi, kavitas, tree-in-bud, fibrokalsifikasi, air-bronchogram-sign, lesi noduler, efusi pleura, atelektasis, bercak infiltrat, lymphadenopathy, bronchiectasis, ground glass opacity) dengan diagnosis akhir klinisi. Pencatatan penyerupa dan penyerta TB dilakukan setelah diagnosis akhir ditegakkan. Hasil: Dari 137 sampel, hanya 61 (44.5%) pasien yang terdiagnosis sebagai TB paru aktif, 38 (27.7%) terdiagnosis sebagai bekas TB paru dan 38 (27.7%) lainnya terdiagnosis sebagai penyakit paru bukan tuberkulosis. Dari 12 variabel yang dievaluasi, karakteristik yang sesuai dengan diagnosis klinisi adalah tree-in-bud (p = 0.019) dan lymphadenopathy (p = 0.039). Penyakit penyerupa dan penyerta terbanyak adalah tumor paru dan infected bronchiectasis. Simpulan: Gambaran CT-scan pasien TB paru sangat beragam pada rumah sakit rujukan tersier. Diperlukan ketelitian ahli radiologi dan kerja sama yang baik dengan klinisi untuk mendeteksi berbagai kemungkinan diagnosis yang dapat menyerupai dan menyertai TB par