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All Journal The Journal of The Indonesian Medical Students´ Association Medical Journal of Indonesia Journal of Indonesia Vascular Access
Michael Caesario
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Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology

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Medical Students Experience with Problem-Based Learning in Asia: A Literature Review Caesario, Michael
The Journal of The Indonesian Medical Students Association Vol. I No. 01 January - June 2010
Publisher : The Journal of The Indonesian Medical Students Association

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Abstract

Since its introduction in 1969, problem-based learning (PBL) has revolutionized medical education around the world. Medical schools in Asia had started to apply PBL to their curriculum although PBL itself has a controversial history and had not yet proven to be superior to conventional curriculum. Several studies reported that medical students in Asia were gaining benefits from PBL such as improvement in communication and problem-solving skill and increasing interest in topics being studied. Same studies also reported problems such as low participation during discussion, uncomfortable feeling with independent learning method, and environment which was not conductive for discussion. These problems might be resulted from faculty and students cultural background and their unfamiliarity with PBL. However, there are evidences which showed that Asian students are able to adapt to PBL. In implementing PBL, the faculty must be prepared and able to be flexible in action. Further research is needed to reveal factors that hinder students; learning in PBL. Key words: problem-based learning, medical education, culture, Asia
Risk factors of sepsis after open congenital cardiac surgery in infants: a pilot study Fakhri, Dicky; Busro, Pribadi W.; Rahmat, Budi; Purba, Salomo; Mukti, Aryo A.P.; Caesario, Michael; Christy, Kelly; Santoso, Anwar; Djauzi, Samsuridjal
Medical Journal of Indonesia Vol 25, No 3 (2016): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (402.46 KB) | DOI: 10.13181/mji.v25i3.1450

Abstract

Background: Postsurgical sepsis is one of the main causes of the high mortality and morbidity after open congenital heart surgery in infants.  This study aimed to evaluate the role of cardiopulmonary bypass duration, thymectomy, surgical complexity, and nutritional status on postsurgical sepsis after open congenital cardiac surgery in infants.Methods: A total of 40 patients <1 year of age with congenital heart disease, Aristotle Basic Score (ABS) ≥6 were followed for clinical and laboratory data before and after surgery until the occurrence of signs or symptoms of sepsis or until a maximum of 7 days after surgery. Bivariate analyses were performed. Variables with p≤0.200 were then included for logistic regression.Results: Duration of cardiopulmonary bypass ≥90 minutes was associated with 5.538 increased risk of postsurgical sepsis in comparison to those ≤90 minutes (80% vs 25%, RR=5.538, p=0.006). No association was observed between the incidence of postsurgical sepsis with poor nutritional status (86% vs 84%, RR=1.059, p=1.000), thymectomy (and 50% vs 76%, RR=0.481, p=0.157), and Aristotle Basic Score (p=0.870).Conclusion: Cardiopulmonary bypass time influences the incidence of sepsis infants undergoing open congenital cardiac surgery. Further studies are needed to elaborate a number of risk factors associated with the incidence of sepsis in this population.
Restenosis risk factor and the primary patency rate of arteriovenous fistula after initial percutaneous transluminal angioplasty: a retrospective cohort study Utari, Siti Ayu Meisa; Tua, Ivan Joalsen Mangara; Christian, David H; Caesario, Michael
Journal of Indonesia Vascular Access Vol. 5 No. 2 (2025): Available online : 1 December 2025
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v5i2.67

Abstract

Background: Arteriovenous fistula (AVF) is the optimal vascular access for patients because of its prolonged patency and limited problems. Nevertheless, maintenance is sometimes obstructed by stenosis. This study aimed to determine the factors associated with restenosis and primary patency rate in 12 months after Percutaneous Transluminal Angioplasty  (PTA). Method: A retrospective study of patients who underwent initial PTA   between January 2018 and October 2023. The clinical variables, laboratory indicators, and surgical data were observed in this study. The restenosis factors were analyzed by univariate analysis, Cox - Regression test, and Hosmer-Lemeshow test. The Receiver Operating Characteristic (ROC) Analysis identified the cut-off Platelet Count (PC). The primary patency of AVF with restenosis risk was evaluated using the Kaplan-Meier analysis and log-rank test. Result: A total of 54 patients were included. The Cox proportional hazard model revealed PC (p=0.004) was a risk factor for AVF restenosis. The Hosmer-Lemeshow test (χ2 = 11.130, p = 0.194) indicates our logistic regression model fits the data. Analysis of ROC identified a cut-off value of PC ≥ 210.5 x 109/L (sensitivity 85.7 %, specificity 46.2%). Primary patency rates of AVF with PC ≥ 210.5 x 109/L at 6 and 12 months (64.1% and 35.8%) were lower than those with PC< 210.5 x 10 9 /L (80.0%, 66.6%). Conclusion: Balloon type (Drug Coated Balloon and Plain Balloon), predilating balloon, balloon diameter, and inflammatory markers showed no association with restenosis in 12 months after PTA. Platelet Count is statistically significant associated with AVF restenosis, which can predict the primary patency of  AVF after initial PTA. It assists physicians in establishing the follow-up schedule and appropriate intervention to prevent HD vascular access failure within 12 months post-PTA.  
Co-Authors Anwar Santoso Budi Rahmat Busro, Pribadi W. Christian, David H Christy, Kelly Dicky Fakhri Mukti, Aryo A.P. Purba, Salomo Samsuridjal Djauzi Tua, Ivan Joalsen Mangara Utari, Siti Ayu Meisa