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Evaluation of Swallowing Disorder in Ischemic Stroke Patients By Flexible Endoscopic Nur Indah Lestari Lestari; Widjajalaksmi Kusumaningsih; Salim Harris; Susyana Tamin; Retno Asti Werdhani
Indonesian Journal of Physical Medicine & Rehabilitation Vol 7 No 01 (2018): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (286.104 KB) | DOI: 10.36803/ijpmr.v7i01.130

Abstract

Introduction: Dysphagia is one of the complications of stroke and closely associated with increasing of aspiration pneumonia. Evaluation of dysphagia was necessary to prevent pneumonia due to aspiration has effectively done by fiberoptic endoscopic evaluation of swallowing (FEES).Methods: The study was a cross sectional study with convenience sampling. The subjects were stroke outpatients from July to December 2018. The FEES was conducted to assess the swallowing dysfunction and the data were collected.Results: There was six post ischemic stroke subjects, mean age (SD) was 55.17 (9.13) years and 4 subjects were male. All subjects had standing secretion in pre-swallowing assessment. 3 subjects used nasogastric tube (NGT) to fulfill the intake safely. In swallowing assessment, all subjects had residue at vallecula and/or pyriformis sinus. 2 subjects had penetration only and 4 subjects had penetration with aspiration. There was inadequate cough reflex in 2 subjects.Conclusion: Standing secretion and residue became the most dominant findings in post ischemic stroke patients, which a risk to have Aspiration.Keywords: Swallowing Disorder, Stroke, Flexible Endoscopic Evaluation of Swallowing (FEES)
A Cohort Retrospective Study of Framingham Score and ECG Abnormality among Coal Mining Workers Anandita, Faizal Ablansah; Firdaus, Isman; Gani, Rino Alvani; Werdhani, Retno Asti; Mansyur, Muchtaruddin
Occupational and Environmental Medicine Journal of Indonesia Vol. 1, No. 1
Publisher : UI Scholars Hub

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Abstract

Introduction. ECG is widely used for detecting cardiovascular disease in coal mine worker’s medical check-up. As the study has proven, coal mine workers have a double cardiovascular risk from their workplace hazard and their own medical risks as individuals. An early detection and risk assessment method is needed to predict ECG abnormalities in the future. This study will analyze the relationship between ECG abnormality and Framingham Risk Score on coal mine workers’. Methods. We examine ECG result from medical check-up of male coal worker during 2018 and 2021. Using Minnesota Code, we determine ECG abnormality categories in the 2021 result, then compare it with coal handling type worker and Framingham Score in 2018 as the main medical factor. Results. Among 755 male coal workers with normal ECG in 2018, 158 (20,9%) were found with ECG abnormalities in 2021. Cohort’s multivariate study shows that type of coal worker is considered a determinant, but Framingham risk score still has the highest influence (p multivariate
Perceptions, practices, and associated factors towards expressed breastfeeding among mothers in Jakarta, Indonesia Pambudi, Wiyarni; Dewanto, Naomi Esthernita Fauzia; Yusra, Yusra; Werdhani, Retno Asti; Endaryanto, Anang; Fahmida, Umi; Alatas, Fatima Safira; Hegar, Badriul
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.168-75

Abstract

Background Expression of breast milk is a strategy to ensures continuous breastfeeding during temporary separation of infant from the mother. Handling and storage of expressed breast milk (EBM) should be based on established recommendations because these practices can affect milk quality and safety. Objective To describe perceptions and practices of EBM handling and storage, compare with commonly used recommendations and associated factors influencing these practices among mothers in Jakarta, Indonesia, Methods Mothers who practiced expressed breastfeeding (EBF) to their 6-12 weeks-old infants completed questionnaires about their peceptions and practices on how they handle and storage EBM. The differences in perceptions and practices about expressed breastfeeding management were analyzed using the Chi-square or Fisher's exact test. Results Among 30 mothers, 14/30 gave EBF exclusively, 19/30 used breast pump, and 26/30 expressed ³6 times/day. Infants in this study received expressed milk 5-10 times per day. Maternal age and resource of information were factors significantly associated with mother’s perceptions, while maternal age, education, and parity were significantly associated with the practices of EBM handling and storage. Conclusion This study reveals inconsistent perceptions and practices on expressed milk handling and storage by the mothers. They have good knowledge about the theoretical aspects of expressed breastfeeding, but some other techniques are poor, which can be detrimental to the health of the infants. Further study is needed to find more efficient and optimal methods of expressed milk handling and storage, necessitating thoughtful consideration of better practices and recommendations.
The Relationship Between Shift Work Patterns and Cognitive Function Disorders in Health Workers at Hospital X, West Java, Indonesia Malau, Bintang Leonard; Amilya Agustina; Pukovisa Prawiroharjo; Winnugroho Wiratman; Retno Asti Werdhani
Sriwijaya Journal of Neurology Vol. 2 No. 2 (2024): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v2i1.105

Abstract

Introduction: Jobs with shift work patterns, especially irregular ones, can disrupt circadian rhythms and sleep quality, which then impacts cognitive function. Despite its importance, research on cognitive domain vulnerabilities related to shift work patterns is still limited. Sleep quality and cognitive function are critical in the context of hospital health services, where decisions and actions must be taken quickly and precisely to support patient safety. Methods: This research is a cross-sectional observational analytical study to determine the relationship between shift work patterns and impaired cognitive function. To measure sleep quality, the Pittsburgh Sleep Quality Index Indonesian (PSQI-Ina) is used, while cognitive function and cognitive domains were measured using Oxford Cognitive Screen (OCS) Indonesian (OCS-Ina), a cognitive instrument for stroke patients, which has been validated. The minimum sample size in this study was 72 samples. Correlation, principal component analysis, demographic analysis, and regression were used to characterize the relationship between PSQI-Ina, OCS-Ina, and other research variables. Results: A total of 83 health workers met the inclusion criteria and were included in the research. The results showed that 16 respondents (19.3%) experienced impaired cognitive function in the Attention domain and 2 respondents (2.4%) experienced impairment in 2 cognitive domains (Attention and Number Management). The results of statistical analysis showed a significant relationship with health workers who had part-time jobs having a 12.8-fold risk (OR 12.8; 95% CI 1.7-91; p = 0.011) of experiencing cognitive impairment. Then health workers who experience poor sleep quality (with a PSQI value >5) have a 40.3 times greater risk (OR 40.3; 95% CI 2.2-708.1; p = 0.011) of experiencing cognitive impairment. Likewise, health workers with irregular shift work patterns have a 5.4 times risk of experiencing cognitive impairment (OR 5.4; 95% CI 0.1-26.6; p = 0.036). Conclusion: There is a relationship between shift work patterns and impaired cognitive function in the workplace. Hospitals should prioritize ergonomic shift work schedules, emphasizing speed and clockwise rotation, to support the well-being of their healthcare workers.
How Community – Oriented Medicine is Implemented in Medical Education Werdhani, Retno Asti; Kusuma Dewi, Dian; Findyartini, Ardi; Ramlan, Andi Ade; Sugiharto, Agus
Journal of Community Medicine and Public Health Research Vol. 5 No. 1 (2024): Journal Community Medicine and Public Health Research
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jcmphr.v5i1.47512

Abstract

The Community Oriented Medical Education (COME) approach to medical education focuses on the population and individuals while covering all elements of health problem priorities. The World Health Organization (W.H.O) Strategic Framework identifies five key strategic directions for enhancing basic medical education to meet existing health concerns. A long-term, integrated module across disciplines is one strategy that the Faculty of Medicine at Universitas Indonesia has experienced in its implementation in both community and clinical medicine. The module includes a variety of field practices (hospital and primary care) as well as inter-departmental personnel (committees and tutors). The module has bridged the gap between community medicine and clinical medicine, with integrated staff as well as collaboration between the departments of community medicine and clinical medicine. Community medicine has been seen as important not only for epidemiological concerns but also as part of the clinical teaching approach that prepares students for careers in hospitals or primary care after graduation. COME can be taught in multidisciplinary or inter-departmental collaboration to accomplish applied learning outcomes for individuals and community health activities. COME ensures our education system produces medical graduates to meet health system needs with the help of faculties and teachers who are also responsible for community health and well-being.
Stone recurrence among Indonesian kidney stone formers: a comprehensive analysis of genetic polymorphism, demographic, and clinical factors Atmoko, Widi; Savira, Missy; Fajriani, Rosalina; Wistara, Sevita Sathya; Asmarinah; Harahap, Alida Roswita; Witjaksono, Fiastuti; Werdhani, Retno Asti; Safriadi, Ferry; Hamid, Agus Rizal Ardy Hariandy; Birowo, Ponco; Rasyid, Nur; Taher, Akmal
Medical Journal of Indonesia Vol. 33 No. 3 (2024): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247596

Abstract

BACKGROUND The recurrence rate of kidney stone disease (KSD) can exceed 50% within 5 years. This study aimed to investigate factors associated with stone recurrence based on single nucleotide polymorphisms (SNPs) of the calcium-sensing receptor (CaSR) rs1801725 and rs1042636, demographic, and clinical profiles. METHODS We collected data on the demographic and clinical characteristics of 80 adult kidney stone formers from April 2021 to September 2022, including peripheral blood samples, morning and 24-hour urine, and 7-day water intake records. Real-time polymerase chain reaction was used to evaluate SNP. Comparisons were made between patients with recurrent and first-time stones. RESULTS 41% of 80 patients have experienced stone recurrence. Recurrent stone formers exhibited significantly higher 24-hour urine calcium excretion (p = 0.03) and lower serum calcium levels (p = 0.019) than first-time stone formers. Hypocitraturia (100%), low urine volume (78%), and hyperoxaluria (55%) were the main abnormalities of all patients. No significant differences were found in CaSR gene polymorphisms and other demographic, biochemical, or clinical parameters. CONCLUSIONS Recurrent stone formers had higher 24-hour urine calcium excretion and lower serum calcium levels. Other risk factors and CaSR polymorphisms may insignificantly affect KSD recurrence.
Evaluation of anti-diphtheria toxoid antibody persistence in school-age children in Jakarta, Indonesia Santi, Theresia; Prayitno, Ari; Munasir, Zakiudin; Hadinegoro, Sri Rezeki S.; Harahap, Alida Roswita; Werdhani, Retno Asti; Sah Bandar, Ivo Novita; Jo, Juandy; Hegar, Badriul
Paediatrica Indonesiana Vol. 64 No. 5 (2024): September 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.5.2024.447-53

Abstract

Background Diphtheria can be effectively prevented by adequate immunization. A combined vaccine against diphtheria toxoid, pertussis, and tetanus toxoid (DPT) is currently used in routine pediatric immunizations. Outbreaks of diphtheria could emerge in Indonesia as a consequence of declining routine vaccination during the COVID-19 pandemic. Objective To analyze the impact of the first (administered at 18-24 months of age ) and second diphtheria boosters (administered at 5-7 years of age ) in retaining protective levels of anti-diphtheria toxoid antibodies. We also investigated for relevant factors associated with anti-diphtheria toxoid antibody titers. Methods This cross-sectional study was conducted in the Senen District of Jakarta, Indonesia. The inclusion criteria were healthy children aged 6 to 7 years with documented history of DPT vaccination. Primary vaccination defined as 3 doses of DPT at age less than 1 year , first booster was DPT vaccination at 18-24 years of age, and second booster was diphtheria-tetanus (DT) vaccination received at 5 to 7 years of age. Peripheral blood specimens were obtained from participating children, after informed consent was provided by their parents. Antibodies against diphtheria in sera specimens were assessed by commercial anti-diphtheria toxoid immunoglobulin G (IgG) enzyme-linked immunosorbent assay. Results There were 154 children included in the study, with a female majority (61%). Overall, specific humoral immunity against diphtheria was observed in 113 children (73.4%). There was no statistical difference in immunity level between genders. Importantly, children who received the first and second diphtheria booster had significantly higher anti-diphtheria antibody level than those who did not receive both diphtheria booster (P<0.001). Conclusion Booster vaccinations are crucial among school-age children in Indonesia to improve their anti-diphtheria immunity and to minimize a risk of diphtheria outbreaks.
Effect of the family medicine approach in reducing stunting among toddlers Werdhani, Retno Asti; Koloi, Vican Sefiany; Tantri, Julietta; Mahardika, Abiyyu Ghiyats; Widjaja, Lydia Rosalina; Michelle, Michelle; Tiffany, Tiffany
Universa Medicina Vol. 44 No. 1 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.50-56

Abstract

BackgroundOne health indicator assessed for achieving the Sustainable Development Goals (SDGs) is the nutritional status of toddlers. Stunting, indicating chronic malnutrition in children, remains a pressing concern globally, especially in low‑ and middle‑income countries. Stunting is still prevalent in Jakarta as the capital city of Indonesia. The study's objective was to evaluate the implementation of the family medicine approach on stunting in toddlers in Koja Sub-District, North Jakarta. MethodsA pre- and post-test design study was conducted involving 40 toddlers who were diagnosed with stunting. Outcome variables were body weight, height, and stunting while the independent variable was the family medicine approach (home visits, family education, and monitoring for 3 months). The Friedman test was used to determine the difference in height and weight after 3 months of the family medicine approach. ResultsAfter 3 months of the family medicine approach, consisting of holistic history taking, performing a thorough physical examination, educating parents about toddlers' nutritional issues, and conducting routine monthly home visits, the toddlers’ body weight increased by 0.68 kg and their height increased by 1.37 cm (p<0.001). The total number of cases of stunting after the family medicine approach decreased by 30% (12/40) from 40 to 28. ConclusionsThere is a decrease in the number of stunting cases after the family medicine approach, but further research is needed. The study findings will help to improve policy measures focusing on the family medicine approach to reduce childhood stunting.
Frekuensi Keteraturan Senam dan Penurunan Tekanan Darah Anggota Klub Jantung Sehat Pondalisa, Jakarta Tahun 2000 - 2005 Werdhani, Retno Asti
Kesmas Vol. 1, No. 5
Publisher : UI Scholars Hub

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Abstract

Prevalensi hipertensi di Indonesia meningkat bersamaan dengan meningkatnya usia. Untuk itu, upaya pencegahan hipertensi dan komplikasinya perlu dilakukan sejak dini jauh sebelum usia lanjut. Olahraga khususnya jenis aerobik diketahui dapat mengendalikan tekanan darah. Penelitian ini bertujuan mengetahui hubungan frekuensi dan keteraturan senam terhadap penurunan tekanan darah pada peserta program latihan. Desain studi yang digunakan adalah kohort retrospektif dengan metoda analisis Cox Regression. Penelitian dilakukan terhadap sumber data sekunder 132 anggota KJS Pondalisa yang merupakan salah satu sarana olahraga masyarakat, selama periode satu tahun keanggotaan. Hasil penelitian memperlihatkan bahwa tidak ada anggota yang melakukan senam 3xper minggu sesuai program dengan keteraturan senam anggota maksimum selama 15 minggu. Penelitian ini menemukan bahwa seluruh anggota KJS Pondalisa belum melakukan olah raga sesuai dengan anjuran. Efek frekuensi senam 2xper minggu terhadap penurunan tekanan darah tidak berbeda secara bermakna dengan efek frekuensi senam < 2xper minggu. Penurunan tekanan darah pada frekuensi senam 2xper minggu didapatkan bila dilakukan selama > 8 minggu berturut-turut. The prevalence of hypertension in Indonesia increases with age. Health promotion is needed to prevent hypertension and its complications among those who have not yet reached old age. Sport especially aerobic type has been known to control blood pressure. The objective of the study is to evaluate the association among frequency and regularity of exercise with blood pressure reduction. A Retrospective cohort study and Cox Regression analysis was conducted using secondary data of members of KJS Pondalisa during the first year of membership. The result of study showed that there were no member doing exercise three times weekly as programmed. The maximum exercise’s regularity was 15 weeks. There is no statistically significant effect of two times weekly exersices on reduction of blood presure compared to frequency of less than two times weekly. Reduction of blood presure will be occured if the exercise is conducted for more than 8 weeks continuously.
Validity and Reliability of the Medical Student e-Learning Management System Readiness Scale Sugiharto, Agus; Cantika, Wastucitra; Werdhani, Retno Asti
Jurnal Pendidikan Indonesia Gemilang Vol 3, No 2 (2023)
Publisher : Gemilang Maju Publikasi Ilmiah (GMPI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53889/jpig.v3i2.237

Abstract

The degree to which a person is seen as having the attitudes and traits necessary for success in studies in the future is known as e-learning management system (EMAS) ready. This study evaluated the EMAS preparation measure for medical students. The study's methodology makes use of the Borg and Gall five-step streamlined research design. The EMAS preparedness scale is measured using ten items and five dimensions. 117 students at the Faculty of Medicine, at a public university in Depok, Indonesia, were given the questionnaire. the relationship between the reliability test, Cronbach's Alpha, and the validity test, Pearson's Product Moment. These are the study's findings: All items had values of α .05, testing the instrument's validity on 10 item questions indicates that all question items are declared valid with a value greater than r table 0.1816. While test reliability indicates an alpha value of Cronbach 0.678, the tested instrument can be declared reliable or consistent. According to the results, ten items possessed high validity and reliability.
Co-Authors Adriani, Ance Agus Rizal Ardy Hariandy Hamid, Agus Rizal Ardy Hariandy Agus Sugiharto Agustina, Amilya Akbar, Resti Rahmadika Akmal Taher Amilya Agustina Anandita, Faizal Ablansah Anang Endaryanto Ance Adriani Andy Ardhana Mamahit Ardi Findyartini, Ardi Ari Prayitno, Ari Aria Kekalih Asmarinah Badriul Hegar Cantika, Wastucitra Dewanto, Naomi Esthernita Fauzia Dian Kusumadewi Elsa P. Setiawati Fajriani, Rosalina Fatima Safira Alatas, Fatima Safira Fedri R. Rinawan Ferry Safriadi Fiastuti Witjaksono Harahap, Alida Roswita Hartono Gunadi Isman Firdaus Ivo Novita Sah Bandar Jenny Bashiruddin Jeo, Wifanto Saditya Juandy Jo Khoe, Levina Chandra Koloi, Vican Sefiany Kusuma Dewi, Dian Mahardika, Abiyyu Ghiyats Malau, Bintang Leonard Mardiastuti H Wahid Maria Melania Muda Maria, Nove Michelle, Michelle Muchtaruddin Mansyur Muda, Maria Melania Muhammad Arvianda Kevin Kurnia Nove Maria Nur Indah Lestari Lestari Nur Rasyid Pambudi, Wiyarni Ponco Birowo Pukovisa Prawiroharjo Ramdhani, Aris Ramlan, Andi Ade Retno Wibawanti Retno Wibawanti Rini Sekartini Rino Alvani Gani Rusli, Noer Triyanto Salim Harris Savira, Missy Setyawati Budiningsih Setyawati Budiningsih Sri Rezeki S. Hadinegoro, Sri Rezeki S. Suharto, Wuryantoro Sulistomo, Astrid Susyana Tamin Tanoto, Rodri Tantri, Julietta Theresia Santi, Theresia Tiffany, Tiffany Umi Fahmida Widayat Alviandi Widi Atmoko Widjaja, Lydia Rosalina Widjajalaksmi Kusumaningsih Widjajalaksmi Kusumaningsih Winnugroho Wiratman Wistara, Sevita Sathya Yefta Moenadjat Yusra, Yusra Zakiudin Munasir