Evaluation of a Guest Lecture on Medical Emergency of Box Jellyfish Envenomation Pathophysiology and First Aid for Medical Students.

Introduction: Lethal box jellyfish envenomation has been reported in Indonesia and other countries; therefore, medical students should be equipped with related knowledge. The aim of this study was to evaluate the results of summative exams by student cohort and gender and determine the factors that contribute to success in the summative exams after novel intensive instruction in box jellyfish envenomation pathophysiology and first aid in undergraduate medical students in Surabaya, Indonesia. Methods: This study used explanatory sequential mixed methods, consisting of a cross-sectional study and interviews. A total population sampling of 203 sixth-semester students was employed. Student cohort, gender, previous semester grade point average (GPA), and English proficiency test (EPT) were considered. All statistical tests were carried out using IBM® SPSS® Statistics version 24.0 for Macintosh. The study was complemented by interviews conducted with 20 students. Results: The one-way ANOVA test showed that students from the 2016 cohort had significantly higher mean scores in the exam than the 2015 and 2014 cohorts (p=0.002). Independent samples t-test showed that such differences were not gender-specific (p=0.249). In the binary logistic regression, the GPA in the previous semester was the only factor that contributed to success in the summative exam (OR 3.031, 95% CI: 1.520-6.044). All students commented that the lecture and practicum were interesting and beneficial. However, some considered that the language barrier might have prevented them from understanding the topic well. Conclusion: Results of the summative exam differed by the student cohorts, and previous semester GPA was a predictor of success in the summative exam.

Age, Benign Prostatic Hyperplasia, Geography of Residence, and Occupation are Predictors of Bladder Calculi in Men: A Three-Year Data Analysis.

BACKGROUND: The formation of bladder calculi is a complex multifactorial process. Our objective was to identify predictors of bladder calculi in men. METHODS: This cross-sectional study was conducted at a regional public hospital. We used medical records from 2017 to 2019 for men diagnosed with urinary calculi or benign prostatic hyperplasia (BPH). The diagnosis of urinary calculi was based on urinalysis, plain x-ray, and ultrasonography (USG). The diagnosis of BPH was based on digital rectal examination (DRE), USG, and American Urological Association (AUA) Symptom Index to assess the severity of BPH. The data were analyzed using Kruskal-Wallis, Mann-Whitney U, Chi-square tests, and binary logistic regression. RESULTS: Of 2010 study participants, 66.0% were men with urinary calculi, 39.7% had BPH, 21.0% were aged 70 years or more, 12.5% lived in limestone mountain areas, and 24.6% had occupations that were mainly outdoors. Urinary calculi in men with BPH were found in the urethra (3.0%), bladder (27.6%), ureter (2.2%), and kidney (1.1%). Of all men with urinary calculi, the odds of having bladder calculi in men aged 70 years or more was 13.484, 95% confidence interval (95% CI): 8.336-21.811; In men with BPH was 11.182, 95% CI: 6.440-19.416; In men who lived in limestone mountain area was 1.894, 95% CI: 1.242-2.887; In men whose occupation is mainly outdoor was 3.240, 95% CI: 1.954-5.375, compared to reference groups. CONCLUSIONS: Age, BPH, geography of residence, and occupation were predictors of bladder calculi in men.

Age, Benign Prostatic Hyperplasia, Geography of Residence, and Occupation are Predictors of Bladder Calculi in Men: A Three-Year Data Analysis

Background: The formation of bladder calculi is a complex multifactorial process. Our objective was to identify predictors of bladder calculi in men. Methods: This cross-sectional study was conducted at a regional public hospital. We used medical records from 2017 to 2019 for men diagnosed with urinary calculi or benign prostatic hyperplasia (BPH). The diagnosis of urinary calculi was based on urinalysis, plain x-ray, and ultrasonography (USG). The diagnosis of BPH was based on digital rectal examination (DRE), USG, and American Urological Association (AUA) Symptom Index to assess the severity of BPH. The data were analyzed using Kruskal-Wallis, Mann-Whitney U, Chi-square tests, and binary logistic regression. Results: Of 2010 study participants, 66.0% were men with urinary calculi, 39.7% had BPH, 21.0% were aged 70 years or more, 12.5% lived in limestone mountain areas, and 24.6% had occupations that were mainly outdoors. Urinary calculi in men with BPH were found in the urethra (3.0%), bladder (27.6%), ureter (2.2%), and kidney (1.1%). Of all men with urinary calculi, the odds of having bladder calculi in men aged 70 years or more was 13.484, 95% confidence interval (95% CI): 8.336–21.811; In men with BPH was 11.182, 95% CI: 6.440–19.416; In men who lived in limestone mountain area was 1.894, 95% CI: 1.242–2.887; In men whose occupation is mainly outdoor was 3.240, 95% CI: 1.954–5.375, compared to reference groups. Conclusions: Age, BPH, geography of residence, and occupation were predictors of bladder calculi in men (AU)

Medical perspective of reproductive health education in Indonesian schoolbooks.

The current provision for equipping young Indonesians with a comprehensive knowledge of reproductive health is inadequate. In Indonesian primary and secondary schools, reproductive health education is integrated into various subjects, including Science, Biology, Sport, and Health Education. In this paper, we compared the accuracy of the material related to reproductive health education to scientific evidence published in medical scientific journals or medical textbooks. Even though the schoolbooks were used in Indonesia's 2006 minimum standard requirements of subject matter (KTSP) curriculum, we found much inaccurate information that is not based on the scientific literature and unnecessarily detailed information on therapy and technology. Schoolbooks should emphasize promoting a healthy lifestyle, preventing high-risk sexual behaviors, encouraging openness and discussion about reproductive health in the family, improving self-confidence to refuse and avoid sexual harassment, encouraging positive sexual behaviors, and increasing awareness for treatment-seeking behavior.

Embolic stroke, left atrial myxoma and gigantism in a patient with Carney complex with additional features suggestive of Marfan syndrome.

A 16-year-old boy presented to the emergency department with a sudden weakness on the right side of the body and was diagnosed as having embolic stroke. Later on, the patient was diagnosed as having Carney complex (CNC). The neurological complication might be caused by left atrial myxoma as a feature of CNC. Surprisingly, the patient showed some additional features such as positive wrist and thumb signs, pectus carinatum deformity and plain flat feet, suggestive of Marfan syndrome. This case demonstrated that both of these syndromes might coexist in the same patient, suggesting that proper diagnostic and management were key factors that affected prognosis. He showed an improved condition after he had received medical treatments, undergone tumour excision and physiotherapy. Further evaluation was needed to improve patient outcomes.

Beyond sexual desire and curiosity: sexuality among senior high school students in Papua and West Papua Provinces (Indonesia) and implications for HIV prevention.

When it comes to sexuality and norms, young Indonesians are becoming more open. Concern about this is related to the rapid increase in HIV prevalence in Indonesia, especially in Papua and West Papua Provinces. While much research has been conducted among youth who have left school, little is known about senior high school students' sexuality and sexual practices in these provinces. Using qualitative and quantitative data, we explore perspectives on and experiences of sexuality, contraceptive use, unintended pregnancy and unsafe abortion among 1082 Year 11 students from 16 senior high schools in both provinces. Findings suggest that around 38.3% of students reported having had sexual intercourse and 36.5% of these having had their first sexual encounter before they were 15 years old. Furthermore, contraceptive use among sexually active students was very low. Around 32% of female students who reported having had sexual intercourse also reported having an unintended pregnancy and the majority of them had had unsafe abortions. The paper points to the implications of students' high-risk sexual behaviours for HIV prevention.

Plasma organochlorine levels and prostate cancer risk.

A case-control study was conducted to determine the association between plasma organochlorine levels and prostate cancer risk. Male clinic patients scheduled for prostate core biopsy or seeing their urologist for other conditions from 1997 through 1999 in Kingston, Ontario were eligible, excluding those with an earlier cancer. Age frequency matched controls (n=329) were compared with 79 incident prostate cancer cases. Before knowledge of diagnosis, the patients completed a questionnaire and donated 15 ml of blood for the measurement of 14 PCBs, and 13 organochlorine pesticides by gas chromatography. At least 70% of patients had detectable levels of nine PCB congeners and seven pesticides, and these chemicals were included in the risk analysis adjusted for total lipids. Geometric means for these PCB congeners, total PCBs, and p,p'-DDE are slightly lower for cases than controls, whereas the levels of p,p'-DDT and other pesticides are virtually equal. Adjusting for age and other confounders in multivariable logistic regression, odds ratios (ORs) are consistently below 1.0 for PCB congeners and total PCBs. For pesticides, most ORs are very close to the null. This study suggests that long-term low-level exposure to organochlorine pesticides and PCBs in the general population does not contribute to increased prostate cancer risk.