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All Journal Medical Journal of Indonesia Universa Medicina Paediatrica Indonesiana Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Oto Rhino Laryngologica Indonesiana Majalah Kedokteran Neurosains Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia ASEAN Journal of Community Engagement JOURNAL OF COMMUNITY MEDICINE AND PUBLIC HEALTH RESEARCH Indonesia Journal of Physical Medicine and Rehabilitation Indonesia Journal Physical Medicine and Rehabilitation Sriwijaya Journal of Neurology Occupational and Environmental Medicine Journal of Indonesia Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Retno Asti Werdhani
Department Of Community Medicine Faculty Of Medicine Universitas Indonesia
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Economics, Econometrics & Finance Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Physics Public Health Social Sciences Other

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Pengaruh latihan Brandt Daroff dan modifikasi manuver Epley pada vertigo posisi paroksismal jinak Widjajalaksmi Kusumaningsih; Andy Ardhana Mamahit; Jenny Bashiruddin; Widayat Alviandi; Retno Asti Werdhani
Oto Rhino Laryngologica Indonesiana Vol 45, No 1 (2015): Volume 45, No. 1 January - June 2015
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2466.573 KB) | DOI: 10.32637/orli.v45i1.105

Abstract

Latar belakang: Latihan Brandt Daroff (BD) dan latihan Modifikasi Manuver Epley (MME) merupakan rehabilitasi vestibular sebagai terapi latihan mandiri di rumah bagi penderita Vertigo PosisiParoksismal Jinak (VPPJ) yang menggunakan sistem sensori terintegrasi. Secara fisiologis, BD berperandalam proses adaptasi sistem vestibular dan MME berperan dalam reposisi otolit. Tujuan: Untukmengetahui dan membandingkan efek terapi latihan vestibular mandiri BD dan MME terhadap perbaikangangguan keseimbangan penderita VPPJ. Metode: Studi pendahuluan dengan desain kuasi eksperimenpada 23 subjek VPPJ yang diperoleh secara consecutive sampling, laki-laki dan perempuan  berusia 2060 tahun. Secara random dibagi menjadi dua kelompok yaitu kelompok BD(n=12) dan kelompokMME(n=11)untuk latihan mandiri di rumah. Nilai  Symptoms Severity Score (SSS) dianalisis menggunakanuji McNemar dan nilai posturografi dianalisis dengan uji t berpasangan atau uji Wilcoxon Signed Rank bila sebaran data tidak normal. Hasil: Terdapat perbedaan bermakna pada nilai SSS pada latihan BD danlatihan MME (p<0,05). Tidak ditemukan perbedaan bermakna pada nilai posturografi dengan latihan MME.Ditemukan perbedaan bermakna (p<0,05) pada sepuluh variabel posturografi dengan latihan BD. Tidakditemukan perbedaan bermakna (p>0,05) dari nilai SSS dan posturografi antara latihan Brandt Daroff dan MME. Kesimpulan: Terdapat perbaikan bermakna nilai SSS yang lebih cepat  pada kelompok yang diberi latihan Brandt Daroff dibandingkan dengan kelompok MME. Kata kunci: VPPJ, BD, MME , SSS, PosturografiABSTRACT Background: Brandt Daroff (BD) and modified Epley maneuver (MEM) are independent vestibular rehabilitation therapeutic home program exercises for Benign Poxysmal Positional Vertigo (BPPV)patients using sensory integration. BD is an adaption process in vestibular system and MEM is based oncanalith reposition. Purpose: To find out and compare the effects of BD and MEM on improving symptomsof balance disorder in BPPV patients. Methods: A pilot study with quasi experimental design for 23BPPV subjects,  taken by consecutive sampling. Subjects are male and female, aged 20-60 years old. Byrandomization, subjects were allocated into two groups, group BD (n=12) and group MEM (n=11). Thevalue of symptoms severity was scored using McNemar test. The posturography result was evaluated byPair t test or Wilcoxon Signed Rank test. Result: There was a significant difference on SSS value (p<0,05)of BD exercise and MEM exercise. No significant difference was found on posturography scores withMEM exercise. There was a significant difference (p<0,05) on ten posturography variables using BDexercise. No significant difference was found between BD and MME from SSS and posturography value(p>0,05). Conclusion: This study found out that there was a significantly faster improvement of SSS inthe BD group compared with the MME group. Keywords: BPPV, BrandtDaroff, MEP, SSS, posturography
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)
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

Show Abstract | Download Original | Original Source | Check in Google Scholar

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.
Co-Authors Agus Rizal Ardy Hariandy Hamid, Agus Rizal Ardy Hariandy Agus Sugiharto 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 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 Michelle, Michelle Muchtaruddin Mansyur 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 Rini Sekartini Rino Alvani Gani Rusli, Noer Triyanto Salim Harris Savira, Missy 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