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All Journal International Journal of Health, Economics, and Social Sciences (IJHESS)
Iman Dwi Winanto
Staff of Department of Orthopaedics & Traumatology, Fakultas Kedokteran, Universitas Sumatera Utara/Adam Malik General Hospital, Medan
Economics, Econometrics & Finance Public Health Social Sciences

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Analysis of Social Support Role Systems in the Long-Term Outcomes of Ponseti-Treated Clubfoot Patients at RSUP H. Adam Malik Medan Nico Sutanto; Otman Siregar; Iman Dwi Winanto
International Journal of Health, Economics, and Social Sciences (IJHESS) (Special Issue) - International Journal of Health, Economics, and Social Sciences (IJHESS)
Publisher : Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/ijhess.v7i2.7350

Abstract

Congenital talipes equinovarus (clubfoot), if left untreated, can result in significant physical disability. While the Ponseti method has demonstrated high efficacy as a primary treatment modality, its long-term success depends substantially on consistent postoperative management and brace compliance, factors potentially influenced by social support systems. This study examines the impact of social support structures on treatment outcomes in clubfoot patients managed with the Ponseti technique at a tertiary referral center. We conducted a cross-sectional analytical study involving 80 pediatric clubfoot cases (mean age: 29.05±35.11 months; male predominance: 57.5%). Through structured interviews and retrospective medical record review, we evaluated multiple dimensions of social support (family engagement, community resources, healthcare accessibility) and their correlation with long-term therapeutic outcomes (recurrence rates, bracing adherence, functional assessments). Statistical analysis employed chi-square tests and multivariate logistic regression models. Our findings revealed significant associations between robust family support systems (p=0.015) and community-based assistance programs (p=0.032) with favorable long-term outcomes. Multivariate analysis identified consistent primary caregiver involvement (p=0.008; prevalence ratio [PR]=4.12) and access to rehabilitation services (p=0.022; PR=2.89) as independent predictors of treatment success. Socioeconomic indicators showed no statistically significant correlation. These results underscore the critical role of multidimensional social support in optimizing Ponseti method outcomes. We recommend integrating family education initiatives and community support networks into standard clubfoot management protocols. Further multicenter prospective studies are warranted to validate these findings across diverse sociocultural contexts.
Duration of Preoperative Anti-Tuberculosis Treatment (OAT) and Clinical Outcomes Post-Surgery in Spinal TB Patients: A Systematic Review and Meta-Analysis Gusnur Gazali Ashari; Benny; Iman Dwi Winanto
International Journal of Health, Economics, and Social Sciences (IJHESS) (Special Issue) - International Journal of Health, Economics, and Social Sciences (IJHESS)
Publisher : Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/ijhess.v7i2.7352

Abstract

Spinal tuberculosis (TB) is a rare but severe infection that can lead to deformities, back pain, and neurological deficits. Preoperative administration of anti-tuberculosis drugs (OAT) is commonly used to reduce bacterial activity and inflammation before surgery. However, the optimal duration of OAT preoperatively is still debated. This study aims to systematically review and analyze the relationship between preoperative OAT duration and clinical outcomes post-surgery in patients with spinal TB. A systematic review and meta-analysis were performed on studies comparing the effects of different OAT durations preoperatively in spinal TB patients. Data were collected from PubMed, Scopus, and EMBASE. Key outcomes evaluated included Visual Analog Scale (VAS) for pain, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), wound healing, and bone fusion.The meta-analysis showed that preoperative OAT duration of 1 to 2 weeks significantly reduced inflammation, with a notable decrease in ESR and CRP post-surgery (p = 0.006 for ESR, p = 0.02 for CRP). However, no significant differences in functional recovery or wound healing were observed between shorter (1-2 weeks) and longer (2-4 weeks) OAT durations. Bone fusion results were similar across both groups. A shorter duration of OAT preoperatively (1-2 weeks) is effective in reducing inflammation and improving postoperative recovery, though it does not significantly impact bone healing or fusion. Thus, a shorter preoperative OAT regimen can be considered a viable option in managing spinal TB patients.
Comparison of Healing Outcomes Between K-Wire Pin and Screw Fixation in Lateral Humerus Condyle Fractures in Pediatric Population: A Systematic Review and Meta-Analysis Tommy Mandagi; Iman Dwi Winanto; Reza Mahruzza
International Journal of Health, Economics, and Social Sciences (IJHESS) (Special Issue) - International Journal of Health, Economics, and Social Sciences (IJHESS)
Publisher : Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/ijhess.v7i2.7526

Abstract

Lateral condylar humerus fractures are common pediatric elbow injuries, often resulting from trauma or falls. These fractures are typically seen in children aged 6 to 10 years and require appropriate fixation to prevent complications like malunion and nonunion. This systematic review and meta-analysis compare the outcomes of K-wire pin and screw fixation methods for pediatric lateral condylar humerus fractures. Data from studies published in the last decade were analyzed, focusing on clinical outcomes such as healing time, complications (delayed union, non-union, infection, stiffness), and functional recovery. Results show no significant difference in delayed union or non-union between the two methods. However, screw fixation was associated with a higher risk of non-union and avascular necrosis, although these differences were not statistically significant. In contrast, K-wire pin fixation was linked to a significantly higher risk of infection (RR 6.53) and stiffness (RR 1.77) compared to screw fixation. No significant difference was found in lateral overgrowth, fishtail deformity, or cubitus varus. These findings suggest that while screw fixation offers greater stability, K-wire pin fixation may be more prone to complications. Clinicians should carefully consider fracture type and patient-specific factors when choosing the fixation method.
Co-Authors Benny Gusnur Gazali Ashari Nico Sutanto Otman Siregar Reza Mahruzza Tommy Mandagi