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Cardiac damage in an adolescent patient with COVID-19: a case report Pujowaskito, Prihati; Tartila, Tamia S; Tafriend, Novaro A; Jannah, Fatimah D K; Mayasari, Elsy
ACTA Medical Health Sciences Vol. 1 No. 2 (2022): ACTA Medical Health Sciences
Publisher : ACTA Medical Health Sciences

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COVID-19 has been found to affect the cardiovascular system leading to myocardial damage. A study of 41 patients in Wuhan, China, found that 12% of COVID-19 patients experienced virus-related acute cardiac damage.Subsequent bigger Chinese studies also found acute cardiac damage in 7.2% to 27.8% of hospitalized patients. As a chronicsequela, this condition may result in cardiomyopathy. We report acase of an adolescent COVID-19 survivor with dilated cardiomyopathy with no underlying heart disease. A male patient aged 16 years old was admitted to our outpatient clinic with the primary symptom of exhaustion and had recovered frommild to moderate COVID-19 one month prior to the visit. No previous history of heart disease was documented. Physical examination showed no abnormalities. Laboratory results revealed substantially elevated NT-proBNP (7705 pg/mL) and D-dimer (1850 ng/mL). ECG presented normal sinus rhythm with poorR wave progression. Echocardiography revealed all chamber dilatation, eccentric left ventricular hypertrophy, globalhypokinetic, moderate mitral regurgitation, and reduced ejection fraction (22%). We diagnosed the patient with new-onset dilated cardiomyopathy and began treatment with candesartan, bisoprolol, furosemide, spironolactone, rivaroxaban, and trimetazidine. The recovery was steady at three-month follow-up visit. The emergence of new-onset cardiomyopathy in this previously healthy adolescent raisesthepossibility of COVID-19 acting asthe sole cause of myocardial injuryin the absence of underlying heart disease. To avoid further complications, comprehensive evaluation and effective therapy should be implemented during hospitalization and post-discharge. Additional tests such as cardiac magnetic resonance imaging and endomyocardial biopsies shouldbe performed to support final proof. DOI : 10.35990/amhs.v1n2.p88-96 REFERENCES Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506. https://doi.org/10.1016/S0140-6736(20)30183-5 World Health Organization. COVID-19 weekly epidemiological update [updated 22 March 2022; cited 22 March 2022]. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20220322_weekly_epi_update_84.pdf?sfvrsn=9ec904fc_4&download=true Tosepu R, Effendy DS, Ahmad LOAI. The first confirmed cases of COVID-19 in Indonesian citizens. Public Health of Indonesia. 2020;6(2):70–71. https://doi.org/10.36685/phi.v6i2.337 Indonesian Ministry of Health. COVID-19 situation in Indonesia [updated 22 March 2022; cited 22 March 2022]. Available from: https://covid19.go.id/artikel/2022/03/22/situasi-covid-19-di-indonesia-pdate-22-maret-2022 Mesquita RR, Junior LCFS, Santana FMS, Oliveira TF, Alcantara RC, Arnozo GM, et al. Clinical manifestations of COVID-19 in the general population: systematic review. Wien Klin Wochenschr. 2021;133:377–382. https://doi.org/10.1007/s00508-020-01760-4 Hendren NS, Drazner MH, Bozkurt B, Cooper LT. Description and proposed management of the acute COVID-19 cardiovascular syndrome. Circulation. 2020;141(23):1903–1914. https://doi.org/10.1161/CIRCULATIONAHA.120.047349 Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061–1069. https://doi.org/10.1001/jama.2020.1585 Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol. 2020;5(7):802–810. https://doi.org/10.1001/jamacardio.2020.0950 Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020;5(7):811–818. https://doi.org/10.1001/jamacardio.2020.1017 Zaman S, MacIsaac AI, Jennings GLR, Schlaich MP, Inglis SC, Arnold R, et al. Cardiovascular disease and COVID-19: Australian and New Zealand consensus statement. Med J Aust. 2020;213(4):182–187. https://doi.org/10.5694/mja2.50714 Limongelli G, Crotti L. COVID-19 pandemia and inherited cardiomyopathies and channelopathies: a short-term and long-term perspective. Orphanet J Rare Dis. 2020;15:157. https://doi.org/10.1186/s13023-020-01444-2 Fried JA, Ramasubbu K, Bhatt R, Topkara VK, Clerkin KJ, Horn E, et al. The variety of cardiovascular presentations of COVID-19. Circulation. 2020;141:1930–1936. https://doi.org/10.1161/CIRCULATIONAHA.120.047164 Driggin E, Madhavan MV, Bikdeli B, Chuich T, Laracy J, Biondi-Zoccai G, et al. Cardiovascular considerations for patients, health care workers, and health systems during the COVID-19 pandemic. 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Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020;18:1094–1099. https://doi.org/10.1111/jth.14817 Ramacciotti E, Agati LB, Calderaro D, Aguiar VCR, Spyropoulos AC, de Oliveira CCC, et al. Rivaroxaban versus no anticoagulation for post-discharge thromboprophylaxis after hospitalisation for COVID-19 (MICHELLE): an open-label, multicentre, randomised, controlled trial. Lancet. 2022;399:50–59. https://doi.org/10.1016/S0140-6736(21)02392-8 Al-kuraishy HM, Al-Gareeb AI, Welson NN, Batiha GES. Trimetazidine and COVID-19-induced acute cardiac injury: a missed key. Int J Clin Pharm. 2022;44:832–833. https://doi.org/10.1007/s11096-022-01408-5

Description of injury to the victim of motorcycle traffic accident Rusman, Andri A; Aflah, Livaldi N; Kusuma, Andri A
ACTA Medical Health Sciences Vol. 1 No. 2 (2022): ACTA Medical Health Sciences
Publisher : ACTA Medical Health Sciences

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Road accidents are events that can lead to injury or death. The number of fatalities from traffic accidents is the eighth highest in the world. In Southeast Asia, up to 316,000 people die each year in road accidents. Motorcycles are the type of vehicle with the highest number of accidents compared to other types of vehicles. The increase in motorcycle purchases in Indonesia is associated with an increase in road accidents. Road accident injuries can occur on multiple parts of the body and can cause different types of injuries. The purpose of this study is to determine the description of the victims of motorcycle traffic accidents in Southeast Asia. This research is a descriptive study using literature study method by searching various literature that uses electronic databases such as Google Scholar, ResearchGate, PubMed, NCBI, WHO, Ministry of Health, ScienceDirect, and Springer to search related literature. Keywords used when searching for items are injuries, car accidents, motorcycles, and Southeast Asian descriptions. A total of seven articles were selected for analysis using synthetic matrices, and the results showed that working-age and male gender were most frequently involved in motorcycle road accidents. Extremities injuries are the most common site of injury and the majority of injuries obtained are soft tissue injuries. In order to add data on the most common types of injuries to motorcycle traffic accident victims in Indonesia, this study needs to be further conducted in Indonesia on the most common types of injuries to motorcycle traffic accident victims. DOI : 10.35990/amhs.v1n2.p97-104 REFERENCES World Health Organization. Global status report on road safety 2018: Summary. Geneva: WHO; 2018. ISBN: 9789241565684. World Health Organization. Road safety in the Southeast Asia Region 2015. New Delhi: WHO Regional Office for South-East Asia; 2016. Saukko P, Knight B. 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Relationship between backpack weight and incidence of low back pain in senior high students Djajasasmita, Daswara; Jacob Manoe, Zacarja; Wulandari, Feby
ACTA Medical Health Sciences Vol. 1 No. 3 (2023): ACTA Medical Health Sciences
Publisher : ACTA Medical Health Sciences

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Low back pain (LBP) is one of the most common musculoskeletal disorders that can impair daily activities. The causes of LBP are mostly non-specific, including the abnormalities in the soft tissues or form of muscles, ligament injuries, and muscle spasms or fat igue. One of the causes of LBP is carrying excess weight. If the load carried exceeds 15% of body weight, the person who carried the weight will experience musculoskeletal disorders. Students may carry a backpack with a weight that exceeds the recommended weight and this weight will put pressures on the muscles, ligaments, and tendons, causing tension and acute neck pain. These students then will have a higher risk of suffering LBP. The aimed of this study was to identify the relationship between the backpack load and the incidence of low back pain in students. Using the cross-sectional analytical method, this study was performed on a total of 63 students from a senior high school in Cimahi, Indonesia. Subjects were selected using the multistage random sampling and data on the sociodemographic, backpack load, and low back pain were collected and analyzed using the chi-square test. Results showed that 45 students (71.4%) experienced LBP, while the average weight of the backpack carried by these students 6.59 kg (p <0.001). Thus, there is a significant relationship between the excessive backpack weight and the incidence of LBP among students. DOI : 10.35990/amhs.v1n3.p105-111 REFERENCES Amyra Natasha A, Ahmad Syukri A, Siti Nor Diana MK, Ima-Nirwana S, Chin KY. The association between backpack use and low back pain among pre-university students: A pilot study. J Taibah Univ Med Sci. 2017;13(2):205-9. Walsh E. Finite Element Analysis. Section I, Chapter 11. Elsevier; 2017. p. 168. Barkhordari A, Ehrampoush MH, Barkhor M. Assessment of school backpack weight and other characteristics in elementary schools, Yazd, Iran. J Community Health Res. 2013;2(1):2-7. Epidemiologic features of chronic low-back pain. The National Musculoskeletal Medicine Initiative; 2000. p. 585. Cooper P. Low Back Pain. Clinical Reference System. McKesson Health Solution LLC; 2003. p. 16. Bener A, Alwash R, Gaber T, Lovasz G. Obesity and low back pain. Coll Antropol. 2003;27(1):95-104. Kędra A, Czaprowski D. Epidemiology of back pain in children and youth aged 10–19 from southeast Poland. Biomed Res Int. 2013;2013:506823. Rahmi SA. Analisis faktor sedentary lifestyle dan konsumsi jajanan terhadap kejadian stunted obesity pada anak sekolah dasar di Kabupaten Magelang [dissertation]. Universitas Negeri Semarang; 2020. Wheeler A. Low back pain and sciatica. 2013. Available from: https://www.researchgate.net/publication/300909291_Low_Back_Pain_and_Sciatica Fathoni H, Handoyo, Swasti KG. Hubungan sikap dan posisi kerja dengan low back pain pada perawat di RSUD Purbalingga. Jurnal Keperawatan Soedirman. 2012;7(2). Lailani TM, Dewi DRL, Handoko W. Hubungan antara peningkatan indeks massa tubuh dengan kejadian nyeri punggung bawah pada pasien rawat jalan di poliklinik saraf RSUD Soedarso Pontianak. Dokter. 2013;3(1). Moore KL, Dalley AF. Anatomi berorientasi klinis. 5th ed. Vol. 2. 2013. Tortora GJ, Derrickson BH. Principles of anatomy and physiology. 12th ed. Danvers: John Wiley & Sons; 2009. Guyton AC, Hall JE. Buku ajar fisiologi kedokteran. 11th ed. Rachman RY, Hartanto H, Novrianti A, Wulandari N, editors. Jakarta: EGC; 2007. Battié MC, Videman T, Levalahti E, Gill K, Kaprio J. Heritability of low back pain and the role of disc degeneration. Pain. 2007;131(3):272-80. Siivola SM, Levoska S, Latvala K, Hoskio E, Vanharanta H, Keinänen-Kiukaanniemi S. Predictive factors for neck and shoulder pain: A longitudinal study in young adults. Spine (Phila Pa 1976). 2004;29(15):1662-9. Alghamdi RS, Nafee H, El-Sayed A, Alsaadi SM. A study of school bag weight and back pain among intermediate female students in Dammam City, Kingdom of Saudi Arabia. J Nurs Educ Pract. 2018;8(12):105. Ernawati TS, Andriani R, Yanti SN. Hubungan penggunaan tas ransel terhadap kejadian nyeri punggung bawah pada siswa kelas IX Madrasah Tsanawiyah Negeri 2 Pontianak. Jurnal Cerebellum. 2016;2(2):468-78. Dumondor SV, Angliadi E, Sengkey L. Hubungan penggunaan ransel dengan nyeri punggung dan kelainan bentuk tulang belakang pada siswa di SMP Negeri 2 Tombatu. E-CliniC. 2015;3(1). Al Fageeh A. The effect of school bag weight on pain, posture, and vital capacity of lung of elementary school students in Bethlehem District, Palestine. Middle East J Family Med. 2009;7(7):7-14. Keselamatan dan kesehatan kerja: Manajemen dan implementasi K3 di tempat kerja. Surakarta: Harapan Press; 2008.

Development of a novel diagnostic kit candidate to detect dengue antibody, using IgY and protein a positive Staphylococcus aureus Noneng Nawangsih, Eka; Siti Halimah, Lia; Reni Yuslianti, Euis; Putu Yuni Paryati, Sayu
ACTA Medical Health Sciences Vol. 1 No. 3 (2023): ACTA Medical Health Sciences
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Early diagnosis of dengue hemorrhagic fever (DHF) is very important in determining further management. Diagnostic kits are intended as relatively faster, easier, and cheaper diagnostic tools. The objectives of this experimental laboratory study was to prepare a diagnostic kit candidate to detect dengue antibody in human serum using co -agglutination methods by utilizing protein A positive Staphylococcus aureus as a carrier to bind Fc immunoglobulin fractions without altering its ability to bind antigen. To enhance the sensitivity and specificity of the diagnostic kit, chicken IgY was used as one of the components. Rabbit immunoglobulin chicken anti-IgY was used as an intermediary connection between protein A positive and Staphylococcus aureus with chicken IgY. Solution A contains Staphylococcus aureus Cowan I and rabbit immunoglobulin chicken anti-IgY serum while Solution B contains anti-dengue chicken serum and dengue antigen. The laboratory experiments produced a formula of A: B = 1~3: 1~3 (v/v), which was then tested to human serum and compared with IgM and IgG ELISA tests as the gold standard. Data on the results of the test were statistically analyzed using chi - square test. Of the 65 qualified samples used, 47.69% resulted in true positive and 41.54% resulted in true negative. Meanwhile, the remaining samples demonstrated false negative (6.15%), positive predictive value (91.2%) and negative predictive value (87.1%). The sensitivity and specificity were 89% and 90%, respectively, with no significant diffe rences (p>0.05). Therefore, co-agglutination method using S. aureus with protein A positive as a carrier can be proposed as a diagnostic kit candidate to detect human serum dengue antibody to screen dengue hemorrhagic fever cases. DOI : 10.35990/amhs.v1n3.p112-120 REFERENCES World Health Organization (WHO). Global Strategy for Dengue Prevention and Control, 2012–2020. Geneva: WHO Press; 2012. World Health Organization (WHO). Dengue and severe dengue: fact sheet; 2022. Ranjit S, Kissoon N. Dengue hemorrhagic fever and shock syndromes. Pediatr Crit Care Med. 2011;12(1):90–100. Centers for Disease Control and Prevention (CDC). Serologic test for dengue virus for healthcare provider; 2019. Pramiladevi R, Kaivalya, Kora S. Study of rapid serological tests for diagnosis of dengue. Scholars J Appl Med Sci. 2013;5:548–551. World Health Organization. Dengue hemorrhagic fever: diagnosis, treatment, prevention and control. 2nd ed. Geneva: WHO; 2009. Andries AC, Duong V, Ngan C, Ong S, Huy R, Sroin K, et al. Field evaluation and impact on clinical management of a rapid diagnostic kit that detects dengue NS1, IgM and IgG. PLoS Negl Trop Dis. 2013;6:e1993. Greenfield EA. Antibodies: A Laboratory Manual. 2nd ed. Cold Spring Harbor: Cold Spring Harbor Laboratory Press; 2012. Hanly WC, James E, Artwohl J, Bennett BT. Review of polyclonal antibody production, procedures in mammals and poultry. ILAR J. 1995;37:97–118. Castello L, Martinez BL, Heronodez K. Comparison of the agar gel precipitation, virus neutralization and enzyme-linked immunosorbent assay in the determination of antibodies to infectious bursal disease virus. Vet Mex. 1987;18:317–323. Halstead SB. Neutralization and antibody-dependent enhancement of dengue viruses. Adv Virus Res. 2003;60:421–467. doi:10.1016/S0065-3527(03)60011-4 Lardo S, Utami Y, Yohan B, Tarigan, Santoso WD, Nainggolan L, Sasmono RT. Concurrent infections of dengue virus serotypes 2 and 3 in a patient with severe dengue from Jakarta, Indonesia. Asian Pac J Trop Med. 2015;9:134–137. Silveira GF, Meyer F, Delfraro A, Mosimann ALP, Coluchi N, et al. Dengue virus type 3 isolated from a fatal case with visceral complications induces enhanced proinflammatory responses and apoptosis of human dendritic cells. J Virol. 2011;11:5374–5383. European Centre for the Validation of Alternative Methods (ECVAM). The production of avian (egg yolk) antibodies: IgY. The report and recommendation of ECVAM Workshop 21. Altern Lab Anim. 2000;24:925–934. Panbio® Dengue Duo IgM and IgG Capture ELISA. Product document. 2017. Available from: http://www.alere.com/en/home/product-details/panbio-dengue-duo-igm-and-igg-capture-elisa.html Penn State Science. Sensitivity, specificity, positive predictive value, and negative predictive value. Stat 507: Epidemiological Research Methods. 2017. Available from: https://onlinecourses.science.psu.edu/stat507/node/71 Paul WD. Fundamental Immunology. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2008. p. 174–176. Van Stralen KJ, Stel VS, Reitsma JB, Dekker FW, Zoccali C, Jager KJ. Diagnostic methods I: sensitivity, specificity, and other measures of accuracy. Kidney Int. 2009;75:1257–1263. Huang J, Doria-Rose NA, Longo NS, Laub L, Lin CL, Turk E, et al. Isolation of human monoclonal antibodies from peripheral blood B cells. Nat Protoc. 2013;8:1907–1915. Halimah LS. Study of specific polyclonal rabbit serum against chicken immunoglobulin for the development of diagnostics [Master's thesis]. Bogor: Bogor Agricultural Institute; 2001.

The effect of celery ethanol extract (Apium graveolens l.) against fatty liver in rat model of hyperlipidemia Trimurtini, Indarti; Pradini, Astri; Vita Nirmala Sari, Vania; Sovia, Evi
ACTA Medical Health Sciences Vol. 1 No. 3 (2023): ACTA Medical Health Sciences
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Fatty liver is a disorder of liver characterized by the accumulation of fat liver cells. The incidence of fatty liver in Indonesia is 30%. Fatty liver can be caused by hyperlipidemia. Hyperlipidemia triggers an increase of oxidative stress that leads to fatty liver. Treatment is usually carried out using statins, but long-term consumption of statin may lead to several side effects. Other treatment that can lower cholesterol levels traditionally is celery. This study aimed to determine the effect of ethanol extract of celery on the microscopic appearance of the liver induced by hypercholesterolemia in experimental rats. This was an posttest control group experimental on 25 rats that were divided into 5 groups: negative control group, positive control group, and three (3) treatment groups. Each treatment group was given a high-fat diet for 14 days, followed by a provision of high-fat diet with different celery extract doses of 37.5 mg/KgBW/day, 75 mg/KgBW/day, and 150 mg/KgBW/day. After the treatment completed, the rats were sacrificed and dissected, and their liver was for histopathological preparations. Data on the in the average fat score between the control group and the three treatment groups were collected and analyzed using one way ANOVA if they were normally distributed with the Kruskal Wallis test as the alternative test. To determine whether there was a significant difference between two treatment groups, a post-hoc statistical test was performed. A significant change was observed in the histological presentations of the liver between control and treatment groups (p <0.5). There was a marked improvement of cytoplasm, sinusoid and cell nucleus in the treatment groups compared to positive control group with a dose of 37.5 mg/KgBW/day as the most effective celery ethanol extract to improve liver fat due to fat accumulation. DOI : 10.35990/amhs.v1n3.p121-127 REFERENCES Wulandari RL, Susilowati S, Murnik A. Pengaruh kombinasi ekstrak etanol daun sirsak (Annona muricata) dan simvastatin terhadap kadar kolesterol total dan Low Density Lipoprotein (LDL) tikus yang diinduksi pakan tinggi lemak. Hiperkolesterol, Ekstrak Etanol Daun Sirsak, Koles Total LDL. 2015;(LDL):24–32. Syafitri V, Arnelis A, Efrida E. Gambaran profil lipid pasien perlemakan hati non-alkoholik. J Kesehat Andalas. 2015;4(1):274–8. Yao YS, Li TD, Zeng ZH. Mechanisms underlying direct actions of hyperlipidemia on myocardium: An updated review. Lipids Health Dis. 2020;19(1):1–6. Setiawan SI, Kurniawan J, Bhakti Asih R, Tangerang K, Hepatobilier D. Pilihan tatalaksana penyakit perlemakan hati non-alkohol (Non-Alcoholic Fatty Liver Disease/NAFLD). Cermin Dunia Kedokt. 2021;48(3):173–5. Chitturi S, Farrell GC, Hashimoto E, Saibara T, Lau GKK, Sollano JD. Non-alcoholic fatty liver disease in the Asia-Pacific region: Definitions and overview of proposed guidelines. J Gastroenterol Hepatol. 2007;22(6):778–87. Neuschwander-Tetri BA. Non-alcoholic fatty liver disease. BMC Med. 2017;15(1):1–6. Oktavianie DA. Hiperkolesterolemia, benalu mangga, trigliserida, histopatologi hepar. Laporan Penelitian. Fakultas Kedokteran Universitas Halu Oleo; 2020:1–8. Sanchez P, Chetty G, Sarkar P. Not the typical winter cough. BMJ Case Rep. 2009. Guyton AC, Hall JE. Buku Ajar Fisiologi Kedokteran. Edisi ke-12. Jakarta: ECG; 2006. Hariadini AL, Sidharta B, Ebtavanny TG, Minanga EP. Hubungan tingkat pengetahuan dan ketepatan penggunaan obat simvastatin pada pasien hiperkolesterolemia di apotek kota Malang. Pharm J Indones. 2020;5(2):91–6. Hartono H, Handayani S. Pengaruh pemberian seledri (Apium graveolens) terhadap penurunan hiperkolesterolemia pada lansia di Panti Wreda Darma Bhakti Kasih Surakarta. Interes J Ilmu Kesehat. 2017;6(2):217–23. Handayani L, Widowati L. Analisis lanjut pemanfaatan empiris ramuan seledri (Apium graveolens) oleh penyehat tradisional. J Kefarmasian Indones. 2020;31–41. Yao Y, Sang W, Zhou M, Ren G. Phenolic composition and antioxidant activities of 11 celery cultivars. J Food Sci. 2010;75(1):9–13. Susanti R, Yuniastuti A. Efektivitas ekstrak tanin seledri terhadap profil lipid tikus putih hiperkolesterolemia. Life Sci. 2012;1(2). Rusdiana T. Telaah tanaman seledri (Apium graveolens) sebagai sumber bahan alam berpotensi tinggi dalam upaya promotif kesehatan. Indones Nat Res Pharm J. 2018;3(1):1–8. Priatna RD. Efek anti-hiperkolesterolemia ekstrak etanol daging buah plum (Prunus salicina) pada tikus jantan galur Wistar yang diinduksi diet tinggi lemak. Tesis. Universitas Jenderal Achmad Yani; 2020. Kleiner DE, Brunt EM, Van Natta M, et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology. 2005;41(6):1313–21. Badan Pengawas Obat dan Makanan Republik Indonesia. Acuan Sediaan Herbal. BPOM RI; 2020:1–58. Sunarjono H. Bertanam Sayuran Daun & Umbi. Jakarta: Penebar Swadaya Grup; 2018. Pujiwidodo D. Formularium Obat Herbal Asli Indonesia. Vol. III. Jakarta: Kementerian Kesehatan RI; 2016.

The Comparison between Spinal Anesthesia Bupivacaine and Sevoflurane Anesthesia for Cesarean Section on Apgar Score Bisri, Tatang; Noer Rochmah, Elly; Kurniawan, Arief; Stella, Angela
ACTA Medical Health Sciences Vol. 1 No. 3 (2023): ACTA Medical Health Sciences
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The use of the anesthetic technique for cesarean section is still debatable because of the side effects caused by anesthesia for mothers and neonates. The succeed to determine anesthetic technique can be seen from the outcome of the final condition of the mother and the neonates. The assessment of the succeed to determine anesthetic technique in neonates has been using the Apgar score by assessing the clinical status of the newborn in the first and fifth minutes. This research is aimed to understand the comparison between Apgar scores in cesarean section using general anesthesia sevoflurane and spinal anesthesia bupivacaine. This research is analytical retrospective with a cross-sectional study approach, using a total sample of 40 patients who performed cesarean section from August to November 2021, the samples were taken by consecutive sampling. The data was taken from the medical records of the Melinda Mother and Child Hospital, Bandung. The results of this research showed that there was no significant difference in the APGAR Score first minute between general anesthesia and spinal anesthesia (p=0,054) in the fifth minute (p=0,708). There was no effect on APGAR scores in the general anesthesia sevoflurane group and spinal anesthesia bupivacaine group, and both anesthetic groups had a good effect on neonates DOI : 10.35990/amhs.v1n3.p128-136 REFERENCES Prawirohardjo S. Ilmu Bedah Kebidanan. In: Wiknjosastro, Hanifa, editors. Edisi 1. Jakarta: Yayasan Bina Pustaka Sarwono Prawirohardjo; 2007. p. 133. Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI. Hasil Rikesdas 2013. Jakarta: Kementerian Kesehatan RI; 2013. p. 174. BKKBN, BPS, Kementerian Kesehatan RI. Survei Demografi dan Kesehatan Indonesia 2017 Provinsi DKI Jakarta. 2012. Available from: http://demografi.bps.go.id/phpfiletree/sdki/BahanAjarSDKI2007/Lainnya/PublikasiSDKI02-03/RingkasanSDKI02-03.pdf Butterworth JF, Mackey DC, Wasnick JD. Morgan & Mikhail’s Clinical Anesthesiology. 5th ed. New York: McGraw-Hill Education; 2013. Tawfik MM, Tolba MA. Chestnut’s Obstetric Anesthesia: Principles and Practice. Anesth Analg. 2019;129(5):e170. Tsen LC, Bateman BT. Anesthesia for Cesarean Delivery. In: Chestnut DH, Wong C, editors. Chestnut’s Obstetric Anesthesia: Principles and Practice. 6th ed. Philadelphia: Elsevier; 2020. Datta S, Kodali BS, Segal S. Obstetric Anesthesia Handbook. 5th ed. New York: Springer; 2010. Katzung BG, Masters SB, Trevor AJ. Farmakologi Dasar dan Klinik. 12th ed. New York: McGraw-Hill Companies, Inc; 2010. Prawirohardjo S. Ilmu Kebidanan Sarwono. 4th ed. Jakarta: PT Bina Pustaka Sarwono Prawirohardjo; 2010. p. 678–81. Wilson DDMJ. Spinal anaesthesia for caesarean section. J Soc Obs Gynaecol Can. 1998;20(8). Neal JM, Rathmell JP. Complications in Regional Anesthesia and Pain Management. 2nd ed. Philadelphia: Lippincott Williams & Wilkins, a Wolters Kluwer business; 2007. Chumpathong S, Chinachoti T, Visalyaputra S, Himmunngan T. Incidence and risk factors of hypotension during spinal anesthesia for cesarean section at Siriraj Hospital. J Med Assoc Thail. 2006;89(8):1127–32. Hadzic A. Hadzic’s Textbook of Regional Anesthesia and Acute Pain Management. 2nd ed. New York: McGraw-Hill Education; 2017. Watterberg KL, Aucott S, Benitz WE, et al. The Apgar Score. Pediatrics. 2015;136(4):819–22. Thavarajah H, Flatley C, Kumar S. The relationship between the five-minute Apgar score, mode of birth, and neonatal outcomes. J Matern Fetal Neonatal Med. 2018;31(10):1335–41. Rumahorbo FT. Perbandingan Nilai Apgar Neonatus pada Seksio Sesar antara Anestesia Umum dan Anestesia Spinal. e-CliniC. 2014;2(2). Christiana M, Bisri T. Perbandingan antara Anestesi Umum dengan Anestesi Spinal untuk Seksio Sesarea terhadap Skor Apgar. Anesthesia dan Critical Care. 2015;(10):99–106. Septivani A, Tanuwidjaja S, Santosa D. Perbandingan skor Apgar bayi yang lahir melalui seksio sesarea terhadap penggunaan anestesi umum dan anestesi lokal di RSUD Al-Ihsan. Prosiding Pendidikan Dokter Universitas Islam Bandung. 2018;519:673–82. Flora L, Redjeki IS, Wargahadibrata AH. Perbandingan efek anestesi spinal dengan anestesi umum terhadap kejadian hipotensi dan nilai Apgar bayi pada seksio sesarea. J Anestesi Perioper. 2014;2(2):105–16. Karaman S, Akercan F, Aldemir O, et al. The maternal and neonatal effects of the volatile anaesthetic agents desflurane and sevoflurane in caesarean section: a prospective, randomized clinical study. J Int Med Res. 2006;34.

Bipolar disorder - difficulties in managing emotional ups and down in an entertainer life: a case report Wulandari, Arlisa; D Kusuma, Meily; Pancarani, Rachmaditya
ACTA Medical Health Sciences Vol. 1 No. 3 (2023): ACTA Medical Health Sciences
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Bipolar disorder is a chronic and recurrent disorder, a brain disorder that causes changes in a person’s mood, energy, and ability to function. Patients have alternate increased mood and activities (mania, hypomania, or “ups” period) and declining mood and activities (depressive or “downs” period) in their life. Symptoms of the manic episodes of bipolar disorder include sensitive feelings, lack of rest, and shot up self-esteem, while the depressive episodes bring loss of interest, more or less sleep than usual, anxiety, a feeling of worthlessness, and lack of concentration. Bipolar disorder is a severe mental disorder with a fairly high prevalence of 1%- 2% and is the 5th cause of disability in the world. Many factors have been considered to contribute to this disorder. While there is strong evidence that some genetic and environmental factors are associated with bipolar disorder, only a few can provide sufficient evidence to establish causality. This report discusses the case of a new manic episode of bipolar disorder that occurs in a woman aged 25 years old who works as a public figure, announcer, and entertainer. The patient has been hospitalized several times and received various pharmacotherapy and psychotherapy but still having difficulties in managing the ups and downs of her emotion. A lot of individual factors must be considered in managing patients with bipolar disorder DOI : 10.35990/amhs.v1n3.p137-143 REFERENCES Shang, Y., & Shi, Z. (2020). Rural-urban migration and migrants’ mental health: Based on the analysis of CLDS data. Northwest Population Journal, 41, 104–113. Vos, T., Barber, R. M., Bell, B., Bertozzi-Villa, A., Biryukov, S., Bolliger, I., Charlson, F., Davis, A., Degenhardt, L., Dicker, D., et al. (2015). Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: A systematic analysis for the Global Burden of Disease Study 2013. The Lancet, 386, 743–800. Pusat Data dan Informasi Kementerian Kesehatan RI. (2019). Situasi Kesehatan Jiwa di Indonesia. Chou, P. H., Tseng, W. J., Chen, L. M., Lin, C. C., Lan, T. H., & Chan, C. H. (2015). Late onset bipolar disorder: A case report and review of the literature. Journal of Clinical Gerontology and Geriatrics, 6, 27–29. Maslim, R. (2003). Diagnosis Gangguan Jiwa: Rujukan Ringkas PPDGJ III. Jakarta: Bagian Ilmu Kedokteran Jiwa FK Unika Atma Jaya. Dell’Osso, L., Pini, S., Cassano, G. B., Mastrocinque, C., Seckinger, R. A., & Saettoni, M. (2002). Insight into illness in patients with mania, mixed mania, bipolar depression, and major depression with psychotic features. Bipolar Disorders, 4, 315–322. Centers for Disease Control and Prevention (CDC). (2011). Mental illness surveillance among adults in the United States. MMWR. Dattani, S., Ritchie, H., & Max, R. (2021). Mental Health. Our World in Data. Retrieved March 21, 2022, from https://ourworldindata.org/mental-health Fiorillo, D., Lubrano Lavadera, G., & Nappo, N. (2020). Structural social capital and mental health: A panel study. Applied Economics, 52, 2079–2095. Donkin, A., Goldblatt, P., Allen, J., Nathanson, V., & Marmot, M. (2017). Global action on the social determinants of health. BMJ Global Health, 2. Han, J., Jia, P., Huang, Y., Gao, B., Yu, B., Yang, S., Yu, J., Xiong, J., Liu, C., Xie, T., et al. (2020). Association between social capital and mental health among older people living with HIV: The Sichuan Older HIV-Infected Cohort Study (SOHICS). BMC Public Health, 20, 581. Lu, N., & Zhang, J. (2019). Social capital and self-rated health among older adults living in urban China: A mediation model. Sustainability, 11, 5566. Le, Z., & Liang, H. (2020). The impact of social capital on individual health of the rural elderly. Journal of South China Agricultural University, 19, 34–45. Mohan, I., & Sagar, R. (2006). Chronic mania: An unexpectedly long episode. Indian Journal of Medical Sciences, 60(5). Smoller, J. W., & Finn, C. T. (2003). Family, twin, and adoption studies of bipolar disorder. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 123C, 48–55.

Description of term pregnant women in labor with COVID-19: a literature review Iman Gurnadi, Jeffry; Nur Rokhmawansyah, Zulfi; Quintina Indriyana, Sri
ACTA Medical Health Sciences Vol. 1 No. 3 (2023): ACTA Medical Health Sciences
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The coronavirus disease 2019 (COVID-19) pandemic has brought a major impact to health systems and societies worldwide. However, knowledge about the effect of COVID-19 infection during pregnancy and the perinatal outcome is still limited and no specific recommendations available yet on the management of this condition. This was a literature review study on the characteristics of pregnant women, types of delivery, and neonatal outcomes associated with COVID-19. The database used as the literature source were PubMed, AJOG, NCBI, RCOG, and Google Scholar and the search was performed on the articles published from July 2021 to August 2021 that meet the inclusion criteria. Eleven articles were included in this study and were extracted and analyzed using statistic summary. The majority of the term pregnant women in labor with COVID-19 were 21-35 years old (86.4%) and 55.5% were multiparous, with the majority of them delivered their baby through caesarean section (74.3%). The perinatal outcomes demonstrated that a small percentage of newborns experienced low birth weight (10.9%) and asphyxia (3.3%). Further studies are needed regarding vertical transmission from women in labor with COVID-19 to their baby. DOI : 10.35990/amhs.v1n3.p144-149 REFERENCES World Health Organization. Coronavirus novel – China. 2020. Tersedia di: https://www.who.int/csr/don/12-january-2020-novel-coronavirus-china/en. Diakses pada 21 Oktober 2020. Perhimpunan Dokter Paru Indonesia. Pneumonia COVID-19 Diagnosis dan Penatalaksanaan di Indonesia. Jakarta: PDPI; 2020. Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19). 2021. Tersedia di: https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/assessing-risk-factors.html. Diakses pada 22 Desember 2020. Cascella M, Rajnik M, Cuomo A, et al. Features, Evaluation and Treatment of Coronavirus (COVID-19). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020. Tersedia dari: https://www.ncbi.nlm.nih.gov/books/NBK554776 Laelatul U. Parity, age and gestational age links with care trimester III’s length during COVID-19. JIKK. 2020;16:133–6. Juan WJ, Ni ZY, Hu Y. Clinical chart of Coronavirus Disease 2019 in China. N Engl J Med. 2020. doi:10.1056/NEJMoa2002032. Center for Strategic and International Studies. Characteristics and Spread of COVID-19 in Indonesia: Preliminary Findings. Jakarta: CSIS; 2020. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506. doi:10.1016/S0140-6736(20)30183-5. Perkumpulan Obstetri dan Ginekologi Indonesia (POGI). Rekomendasi Penanganan Infeksi Coronavirus (COVID-19) pada Ibu Hamil. Surabaya: POGI; 2020. Yan J, Guo J, Fan C, et al. Coronavirus Disease 2019 in Pregnant Women: A Report Based on 116 Cases. Am J Obstet Gynecol. 2020;223:111.e1–111.e11. Karimi-Zarchi M, Neamimzadeh H, Dashbeb SA, et al. Vertical transmission of COVID-19 from infected pregnant mothers to neonates: A review. Fetal Pediatr Pathol. 2020;39(3):246–250. doi:10.1080/15513815.2020.1747120. Peng YD, Meng K, Guan HQ, et al. Clinical characteristics and outcomes of cardiovascular disease patients infected with 2019-nCoV. Zhonghua Xin Xue Guan Bing Za Zhi. 2020;48. Andersen AM. Fever in pregnancy and the risk of congenital malformations: A cohort study. BMC Pregnancy Childbirth. 2017;17(1):1–9. Khan S, Peng L, Siddique R, et al. Impact of COVID-19 infection on pregnancy outcomes and the risk of maternal-to-neonate transmission during birth. Infect Control Hosp Epidemiol. 2020;41(6):748–750. doi:10.1017/ice.2020.84. Yu N, Li W, Kang Q, et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-center, descriptive study. Lancet Infect Dis. 2020;20(5):559–564. doi:10.1016/S1473-3099(20)30176-6. Chen S, Liao E, Cao D, et al. Clinical analysis of pregnant women with 2019 novel coronavirus pneumonia. J Med Virol. 2020;92(9):1556–1561. doi:10.1002/jmv.25789. Chen H, Guo J, Wang C, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review. Lancet Infect Dis. 2020;395:809–815. doi:10.1016/S0140-6736(20)30360-3. Zheng T, Guo J, He W, et al. COVID-19 in pregnancy: Two case reports on maternal and neonatal outcomes in Yichang city, Hubei, China. Medicine (Baltimore). 2020;99(29):e21334. Khan S, June L, Nawsherwan, et al. Association of COVID-19 with pregnancy outcomes in healthcare workers and general population women. Clin Microbiol Infect. 2020;26(6):788–790. doi:10.1016/j.cmi.2020.03.034. Gao L, Ren J, Xu I, et al. Placental pathology of third trimester pregnant women with COVID-19. Diagn Pathol. 2021;16(8). doi:10.1186/s13000-021-01067-6. Ferrazzi E, Poterio L, Savasi V, et al. Vaginal delivery in 5 SARS-CoV-2-infected pregnant women in Northern Italy: A retrospective analysis. BJOG. 2020;127(9):1116–1121. doi:10.1111/1471-0528.16278. Maraschini A, Corsi E, Salvatore MA, Donati S. Coronavirus and pregnancy in Italy: Results of a national population-based cohort study. Ann Ist Super Sanita. 2020;56(3):378–389. doi:10.4415/ANN_20_03_17. Arnest N, Ira S. The characteristics of pregnant women with COVID-19 at Surakarta Hospital. 2021;8:31–6. Selvi İ, Cevher FA. A retrospective analysis of clinical features, maternal and neonatal outcomes of COVID-19 cases in obstetrics clinic in Ankara, Turkey. J Obstet Gynaecol. 2021;31(2):72–76.

Description of breast cancer patients at Hasan Sadikin hospital Bandung based on age and stadium Lokarjana, Lukmana; Hamidah Abbas, Endah; Aida Fathya, Nurul; Wahyuni Kartika, Ajeng
ACTA Medical Health Sciences Vol. 2 No. 1 (2023): ACTA Medical Health Sciences
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Breast cancer is a disease when normal cells are genetically mutated and become abnormal. Cells can divide and proliferate abnormally and invade breast tissue originating from the ductal epithelium or its lobules. Malignant disease caused by breast cancer is a significant problem faced by women around the world. In 2017, breast cancer experienced by women ranked firstin new cases, namely 252,710 cases. Every increase in age is thought to be one factor influencing breast cancer incidence due to long-term hormonal exposure. The study’s objective was to describe the age and stage levels of the patients with breast cancer at Hasan Sadikin Hospital Bandung, employing descriptive method. The collected data was obtained from the medical records of breast cancer patients recorded between January to December 2018 at the Surgical Oncology Unit of Hasan Sadikin Hospital Bandung. Sampling was carried out using a total sampling technique. The results showed there were 414 patients with breast carcinoma. Breast cancer was primarily found at the age of 36-50 years in 52.7% of cases. The most prevalent stage of breast cancer is stage III B, with 41.1%. Breast cancer incidence increases with age, and the high proportion in stage III is due to the lack of information and awarenessabout early detection and a delay in seeking treatment. In order to reduce the number of breast cancer cases, it is recommended that related regional health installations/facilities provide further education and information regarding the dangers of breast cancer for women. DOI : 10.35990/amhs.v2n1.p1-8 REFERENCE Kementerian Kesehatan RI. (2015). Pusat Data dan Informasi Kesehatan: Stop Karsinoma. Infodatin-Karsinoma, 1–82. Hall, J. E., & Guyton, A. C. (2014). Guyton dan Hall Buku Ajar Fisiologi Kedokteran (edisi ke-12). Laktasi. Elsevier, Singapore, hlm. 973–978. Mescher, L. A. (2011). Histologi Dasar Janqueira: Teks dan Atlas (edisi ke-12). Kelenjar Payudara. McGraw Hill Medical, hlm. 396–402. American Cancer Society. (2017). Cancer Facts and Figures 2017. Genes & Development, 21, 2525–2538. GLOBOCAN & International Agency for Research on Cancer (IARC). (2012). Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012. Tersedia di: http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx [Diakses 23 Desember 2021]. Humaera, R., & Mustofa, S. (2017). Diagnosis dan Penatalaksanaan Karsinoma Mammae Stadium 2. Jurnal Kedokteran Fakultas Kedokteran Lampung, 7(April), 103–107. Pusat Data dan Informasi. (2016). InfoDatin Bulan Peduli Karsinoma Mammae. Kementerian Kesehatan Republik Indonesia, 1–68. Sander, M. A. (2011). Profil Penderita Karsinoma Mammae Stadium Lanjut di RS Hasan Sadikin Bandung. Jurnal Farmasains, 1, 1–93. Faida, E. W. (2016). Analisa Pengaruh Faktor Usia, Status Pernikahan dan Riwayat Keluarga terhadap Pasien Karsinoma Mammae di RS Onkologi Surabaya. Jurnal Ilmiah, 2(1), 1–7. Dewi, G. A. 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Strategy for implementation of School child immunization month program In covid-19 pandemic at batujajar health center Quintina Indriyana, Sri; Linasari, Desy; Masruroh, Enung
ACTA Medical Health Sciences Vol. 2 No. 1 (2023): ACTA Medical Health Sciences
Publisher : ACTA Medical Health Sciences

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The COVID-19 pandemic has hindered one of the government’s health sector programs, the School Child Immunization Month (BIAS). The complete immunization program must still follow the schedule to protect children from immunization-preventable diseases. This study sought strategies, processes, and obstacles in implementing the BIAS program during the COVID-19 pandemic at Batujajar Health Center from December 2020 to January 2021. The study design was a qualitative method by conducting in-depth interviews. The informants were selected through a purposive sampling technique to obtain the information required for the study. The results showed that immunization was only administered in safe zones, and socialization was distributed from the Community Health Centre to schools by WhatsApp (WA) application. The school used WA to deliver the socialization to parents, then recorded the students to immunize, and chose places fulfilling health protocols. The BIAS process during the COVID-19 pandemic was the selection of place, time, and the number of people involved for BIAS with the health protocol, monitoring by the immunization program coordinator through field officers reporting, and evaluations during monthly workshops. Some problems occurring in the BIAS program were there were external obstacles like school’s difficulty applying health protocols during the administration, and some parents’ resistance to children’s immunization, misinformation that it was a vaccine for COVID-19 or the vaccine was expired, children were sick of afraid of the syringe. Better socialization and coordination on the implementation of this program was needed DOI : 10.35990/amhs.v2n1.p9-20 REFERENCE Soedjatmiko, Sitaresmi, M. N., Rezeki, S., Hadinegoro, S., dkk. (2020). Jadwal Imunisasi Anak Umur 0–18 Tahun: Rekomendasi Ikatan Dokter Anak Indonesia Tahun 2020. Satuan Tugas Imunisasi IDAI. Sari Pediatri, 22(4), 252–260. Kementerian Pendidikan dan Kebudayaan Republik Indonesia. (2020). Surat Edaran Nomor 15 Tahun 2020 tentang Pedoman Penyelenggaraan Belajar dari Rumah dalam Masa Darurat Penyebaran COVID-19. Indriyana, S. Q., et al. (2020). Panduan Penyelenggaraan Pembelajaran pada Tahun Ajaran 2020/2021 dan Tahun Akademik 2020/2021 di Masa Pandemi COVID-19. Kemendikbud RI. Direktorat Surveilans dan Karantina Kesehatan, Kementerian Kesehatan RI. (2020). Petunjuk Teknis Pelayanan Imunisasi pada Masa Pandemi COVID-19. Jakarta. (2020). Imunisasi Selama Pandemi COVID-19. United Nations Children’s Fund. Kementerian Kesehatan RI. (2019). Profil Kesehatan Indonesia 2019. Jakarta: Kemenkes RI. Kementerian Kesehatan RI. (2017). Pedoman Pencegahan dan Pengendalian Difteri. Jakarta: Kemenkes RI. Puskesmas Batujajar. (2019). Penilaian Kinerja Puskesmas di Wilayah Kerja Puskesmas Batujajar Tahun 2019. Puskesmas Batujajar. (2020). Penilaian Kinerja Puskesmas di Wilayah Kerja Puskesmas Batujajar Tahun 2020. Irawati, N. (2020). Imunisasi Dasar dalam Masa Pandemi COVID-19. Jurnal Kesehatan Unila, Lampung. Ikatan Dokter Anak Indonesia (IDAI). (2020). Childhood Immunization Recommendations in COVID-19 Pandemic. Tersedia di: https://www.idai.or.id/about-idai/idai-statement/childhood-immunizationrecommendations-in-covid-19-pandemic Kementerian Kesehatan RI & UNICEF Indonesia. (2020). Imunisasi Rutin Anak Selama Pandemi COVID-19 di Indonesia: Persepsi Orang Tua dan Pengasuh. Triana, V. (2015). Faktor yang Berhubungan dengan Pemberian Imunisasi Dasar Lengkap pada Bayi. Jurnal Kesehatan Masyarakat Andalas, Padang. Direktorat Jenderal Pencegahan dan Pengendalian Penyakit, Kemenkes RI. (2018). Petunjuk Teknis Pelaksanaan Bulan Imunisasi Anak Sekolah (BIAS). Jakarta. Kementerian Kesehatan RI. (2017). Peraturan Menteri Kesehatan Republik Indonesia Nomor 12 Tahun 2017 tentang Penyelenggaraan Imunisasi. Jakarta: Kemenkes RI. Kementerian Kesehatan RI. (2014). Buku Ajar Imunisasi. Jakarta: Kemenkes RI. Sukmana, C., & Permatasari, V. R. (2021). Evaluasi Pelaksanaan dan Cakupan Program Imunisasi di Posyandu Lingkungan Rancapetir Ciamis. Indonesian Journal of Adult and Community Education, 3(2), Desember. Weiss, W. M., Winch, P. J., & Burnham, G. (2009). Factors Associated with Missed Vaccination during Mass Immunization Campaigns. Journal of Health, Population and Nutrition, 27(3), 358–367. Mkopi, A., Mtenga, S., Festo, C., Mhalu, G., Shabani, J., Tilly, R., et al. (2021). Vaccine, 39(41), 6041–6049. McKee, C., & Bohannon, K. (2016). The Journal of Pediatric Pharmacology and Therapeutics, 21(2), 104–109. Solida, A. (2016). Peran Orang Tua dalam Pemberian Imunisasi Campak pada Anak di Sekolah Dasar Luar Biasa Jambi Tahun 2015. Scientia Journal, 5(02), Desember.

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Siska Telly Pratiwi

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amhs@fk.unjani.ac.id

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+6281322585754

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amhs@fk.unjani.ac.id

Editorial Address
Faculty of Medicine University Jenderal Ahmad Yani Jl. Terusan Jend.Sudirman PO BOX 148 Cimahi.

Location
Kota cimahi,

Jawa barat

INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name Siska Telly Pratiwi

Contact Email amhs@fk.unjani.ac.id

Phone +6281322585754

Journal Mail Official amhs@fk.unjani.ac.id

Editorial Address Faculty of Medicine University Jenderal Ahmad Yani Jl. Terusan Jend.Sudirman PO BOX 148 Cimahi.

Location Kota cimahi, Jawa barat INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
Siska Telly Pratiwi

Contact Email
amhs@fk.unjani.ac.id

Phone
+6281322585754

Journal Mail Official
amhs@fk.unjani.ac.id

Editorial Address
Faculty of Medicine University Jenderal Ahmad Yani Jl. Terusan Jend.Sudirman PO BOX 148 Cimahi.

Location
Kota cimahi,

Jawa barat

INDONESIA