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DEPRESI, CEMAS DAN KONSUMSI KOPI BERHUBUNGAN DENGAN KEJADIAN INSOMNIA PADA MAHASISWA PSPD FK UNUD ANGKATAN 2016 Ni Made Suartiningsih; Wayan Citra Wulan Sucipta Putri; Luh Seri Ani
E-Jurnal Medika Udayana Vol 7 No 9 (2018): Vol 7 No 9 (2018): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (108.377 KB)

Mahasiswa sangat rentan untuk mengalami insomnia, angka kejadian insomnia pada mahasiswa relatif tinggi dibandingkan populasi umum. Faktor risiko insomnia seperti depresi, cemas, merokok, konsumsi kopi, jenis kelamin dan alkohol. Insomnia berdampak pada penurunan konsentrasi belajar, gangguan proses berpikir, peningkatan tekanan darah, risiko perilaku seksual dan konstipasi. Tujuan penelitian adalah untuk mengetahui hubungan antara depresi, cemas dan konsumsi kopi dengan kejadian insomnia pada mahasiswa PSPD Fakultas Kedokteran Universitas Udyana angkatan 2016. Penelitian bersifat analitik observasional cross-sectional, dilakukan dengan membagikan angket kepada 95 orang responden yang dilaksanakan pada bulan September 2017. Insomnia diukur dengan insomnia severity index (ISI), depresi dengan the centre for epidemiologic studies depression scale (CESD), cemas dengan hamilton rating scale for anxiety (HRSA) dan konsumsi kopi diukur dengan angket riwayat konsumsi kopi. Pemilihan sampel menggunakan teknik sampel acak sederhana. Data dianalisis menggunakan SPSS dengan uji kai kuadrat. Hasil penelitian didapatkan 56,8% mahasiswa mengalami insomnia. Kejadian insomnia lebih tinggi pada kelompok yang berisiko daripada yang tidak berisiko ; depresi (86,2% : 10,8%, P<0,001), cemas (75,4%: 7,7% ,P<0,001), konsumsi kopi (85,7% : 40%, P<0,001 ). Pada jenis kelamin antara lelaki dan perempuan tidak didapat perbedaan yang bermakna (53,3% : 58,5%, P>0,05 ). Dapat disimpulkan kejadian insomnia pada mahasiswa relatif tinggi sehingga perlu mendapat perhatian untuk mengurangi morbiditas. Kata kunci: Insomnia, depresi, cemas, konsumsi kopi, asosiasi

Metoclopramide-Induced Extrapyramidal Syndrome in a Child: Diagnostic Challenges and Management Ni Made Suartiningsih; Ni Made Ayu Agustini
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1323

Background: Metoclopramide, a dopamine D2 receptor antagonist, is used for its antiemetic and prokinetic properties. However, its use in pediatric populations is restricted due to a significant risk of neurological adverse effects, particularly acute extrapyramidal symptoms (EPS). These reactions, including acute dystonia, are more frequent in children compared to adults, posing diagnostic and management challenges. Case presentation: We report the case of a 10-year-old girl who presented with acute torticollis and oculogyric crisis following the administration of metoclopramide syrup for fever and vomiting. The symptoms developed approximately one day after initiating the medication. Physical examination and basic laboratory results were otherwise largely unremarkable, apart from elevated white blood cells suggestive of an underlying infection. A diagnosis of metoclopramide-induced acute extrapyramidal syndrome was made. Conclusion: The patient experienced rapid resolution of symptoms within 30 minutes following the administration of intravenous diphenhydramine. Metoclopramide was discontinued, and she was discharged without symptom recurrence. This case underscores the importance of recognizing metoclopramide-induced EPS in children, the diagnostic difficulties posed by its varied presentation potentially mimicking other serious neurological conditions, and the effectiveness of prompt management with anticholinergic agents like diphenhydramine. Clinicians must maintain a high index of suspicion, adhere to restrictive prescribing guidelines for metoclopramide in pediatrics, and consider safer antiemetic alternatives.

The Mosaic of Risk in Neonatal Asphyxia: A Systematic Review of Clinical, Placental, and Systemic Predictors Ni Made Suartiningsih; Romy Windiyanto
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1367

Background: Neonatal asphyxia, a critical failure of gas exchange during the perinatal period, remains a primary cause of neonatal mortality and long-term neurodevelopmental disability worldwide, including hypoxic-ischemic encephalopathy (HIE). Its etiology is a complex mosaic of interconnected factors. Understanding this intricate risk profile is essential for developing effective prevention and intervention strategies. The aim of this study is to systematically review and synthesize recent evidence (published 2019–2025) on the spectrum of maternal, fetal, intrapartum, placental, and systemic risk factors associated with neonatal asphyxia. Methods: This systematic review was conducted following the PRISMA guidelines. A comprehensive literature search was performed in PubMed, ScienceDirect, and Google Scholar for observational studies published between January 1st, 2019, and April 1st, 2025. Dual reviewers independently conducted study selection, data extraction, and risk of bias assessment using the Newcastle-Ottawa Scale (NOS). Due to significant clinical and methodological heterogeneity, a narrative synthesis was performed. Results: The search yielded 870 articles, from which 13 observational studies met the inclusion criteria. The synthesis of these studies revealed a consistent and powerful link between neonatal asphyxia and a wide array of predictors. Key factors included maternal comorbidities (hypertensive disorders), prenatal maternal psychological stress, intrapartum complications (prolonged labor, meconium-stained amniotic fluid), placental pathology (maternal vascular malperfusion, meconium-associated changes), fetal characteristics (low birth weight), and crucial systemic factors, such as maternal immigrant status and sociodemographic disparities. Predictive models developed in two of the included studies demonstrated good discriminative performance in identifying high-risk pregnancies, offering potential for clinical application. Conclusion: Neonatal asphyxia arises from a complex interplay of risk factors that span the entire perinatal continuum, from pre-conceptual maternal health and systemic inequities to acute intrapartum events. Effective mitigation requires a multi-pronged approach encompassing comprehensive antenatal care that addresses both physical and mental health, vigilant intrapartum monitoring, and systemic efforts to ensure equitable access to high-quality perinatal care. The integration of validated risk prediction tools into clinical practice holds significant promise for reducing the global burden of this devastating condition.

The Mosaic of Risk in Neonatal Asphyxia: A Systematic Review of Clinical, Placental, and Systemic Predictors Ni Made Suartiningsih; Romy Windiyanto
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i8.1367

Background: Neonatal asphyxia, a critical failure of gas exchange during the perinatal period, remains a primary cause of neonatal mortality and long-term neurodevelopmental disability worldwide, including hypoxic-ischemic encephalopathy (HIE). Its etiology is a complex mosaic of interconnected factors. Understanding this intricate risk profile is essential for developing effective prevention and intervention strategies. The aim of this study is to systematically review and synthesize recent evidence (published 2019–2025) on the spectrum of maternal, fetal, intrapartum, placental, and systemic risk factors associated with neonatal asphyxia. Methods: This systematic review was conducted following the PRISMA guidelines. A comprehensive literature search was performed in PubMed, ScienceDirect, and Google Scholar for observational studies published between January 1st, 2019, and April 1st, 2025. Dual reviewers independently conducted study selection, data extraction, and risk of bias assessment using the Newcastle-Ottawa Scale (NOS). Due to significant clinical and methodological heterogeneity, a narrative synthesis was performed. Results: The search yielded 870 articles, from which 13 observational studies met the inclusion criteria. The synthesis of these studies revealed a consistent and powerful link between neonatal asphyxia and a wide array of predictors. Key factors included maternal comorbidities (hypertensive disorders), prenatal maternal psychological stress, intrapartum complications (prolonged labor, meconium-stained amniotic fluid), placental pathology (maternal vascular malperfusion, meconium-associated changes), fetal characteristics (low birth weight), and crucial systemic factors, such as maternal immigrant status and sociodemographic disparities. Predictive models developed in two of the included studies demonstrated good discriminative performance in identifying high-risk pregnancies, offering potential for clinical application. Conclusion: Neonatal asphyxia arises from a complex interplay of risk factors that span the entire perinatal continuum, from pre-conceptual maternal health and systemic inequities to acute intrapartum events. Effective mitigation requires a multi-pronged approach encompassing comprehensive antenatal care that addresses both physical and mental health, vigilant intrapartum monitoring, and systemic efforts to ensure equitable access to high-quality perinatal care. The integration of validated risk prediction tools into clinical practice holds significant promise for reducing the global burden of this devastating condition.

Metoclopramide-Induced Extrapyramidal Syndrome in a Child: Diagnostic Challenges and Management Ni Made Suartiningsih; Ni Made Ayu Agustini
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1323

Background: Metoclopramide, a dopamine D2 receptor antagonist, is used for its antiemetic and prokinetic properties. However, its use in pediatric populations is restricted due to a significant risk of neurological adverse effects, particularly acute extrapyramidal symptoms (EPS). These reactions, including acute dystonia, are more frequent in children compared to adults, posing diagnostic and management challenges. Case presentation: We report the case of a 10-year-old girl who presented with acute torticollis and oculogyric crisis following the administration of metoclopramide syrup for fever and vomiting. The symptoms developed approximately one day after initiating the medication. Physical examination and basic laboratory results were otherwise largely unremarkable, apart from elevated white blood cells suggestive of an underlying infection. A diagnosis of metoclopramide-induced acute extrapyramidal syndrome was made. Conclusion: The patient experienced rapid resolution of symptoms within 30 minutes following the administration of intravenous diphenhydramine. Metoclopramide was discontinued, and she was discharged without symptom recurrence. This case underscores the importance of recognizing metoclopramide-induced EPS in children, the diagnostic difficulties posed by its varied presentation potentially mimicking other serious neurological conditions, and the effectiveness of prompt management with anticholinergic agents like diphenhydramine. Clinicians must maintain a high index of suspicion, adhere to restrictive prescribing guidelines for metoclopramide in pediatrics, and consider safer antiemetic alternatives.

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