Mental Health Awareness and Promotion during the First 1000 Days of Life: An Expert Consensus.

The first 1000 days of life constitute a critical phase that will determine the optimum growth and development of a child. An important factor in this phase of life is the perinatal mental health of mothers and children. Mental health awareness is an important public health issue with significant impacts on mothers, spouses, and families, as well as the long-term emotional and cognitive development of children as well. However, the awareness and promotion of mental health within the realms of reproductive health, maternal health, and infant health, i.e., the first 1000 days of life, do not receive high prioritization in Indonesia. Nonetheless, Indonesia, with its existing primary healthcare system, has the potential to raise awareness of and promote the importance of perinatal mental health for its citizens. This experts' consensus proposes several strategies to maximize the usefulness of primary healthcare facilities in Indonesia, including Community Health Centers and Integrated Healthcare Posts, to support perinatal mental health awareness and promotion during the first 1000 days of life. The success of this program, in return, will improve the health status of women and children in Indonesia.

Blindness and Visual Impairment Situation in Indonesia Based on Rapid Assessment of Avoidable Blindness Surveys in 15 Provinces.

Purpose: To report the latest data on blindness and visual impairment (VI) in Indonesia.Methods: Rapid Assessment of Avoidable Blindness (RAAB) surveys were done in 15 provinces in Indonesia between 2013 and 2017. The population of the study was people aged 50 +. In each province, the required number of clusters was selected with a probability proportionately to size. A weighted average analysis for prevalence, causes of visual impairment, and cataract surgical coverage (CSC) estimated the values of the country.Results: The prevalence of blindness in East Java was the highest at 4.4% (95% CI: 3.1-5.6%), followed by Nusa Tenggara Barat (NTB) at 4.0% (95% CI: 3.0-5.1%) and South Sumatra at 3.4% (95% CI: 2.4-4.4%). In number, blindness among people aged 50+ in East Java was the highest at 371,599, followed by West Java at 180,666 and Central Java at 176,977. Untreated cataract was the commonest cause of blindness in all provinces (range: 71.7% to 95.5%). CSCperson<3/60 and CSCperson<6/60 in Bali were the highest at 81.3% and 72.4%, respectively. Indonesia countrywide prevalence of blindness was 3.0%. The total number of people with VI (PVA less than 6/18 in the better eye) in Indonesia was 8,019,427, consisting of 1,654,595 of blindness and 6,364,832 of moderate and severe VI.Conclusion: The burden of blindness in Indonesia is high, and untreated cataract contributes the most. There is an urgent need to increase cataract surgical coverage by providing better access to cataract surgery services for all people in need.

Retinal thickness changes after phacoemulsification.

PURPOSE: To determine the effect of phacoemulsification on macular volume and thickness using spectral domain optical coherence tomography examinations. METHODS: Twenty-seven eyes of 27 subjects who underwent phacoemulsification were studied. All nine areas of the macula were examined by spectral domain optical coherence tomography preoperatively and 2 months postoperatively. Effective phacoemulsification time and absolute phacoemulsification time were also recorded. RESULTS: There were statistically significant differences in macular thickness between preoperative and postoperative spectral domain optical coherence tomography examinations in nine areas including macular volume. In the paracentral macular area, the thickness of three quadrants significantly increased (superior P=0.015; temporal P=0.001; and nasal P=0.023). Peripheral macular thickness also increased significantly in the superior (P=0.05) and temporal macular areas (P<0.001). The macular volume increased significantly after phacoemulsification (P<0.001). There were no correlations between absolute/effective phacoemulsification time and macular cellular structures (P>0.05), but a significant correlation (P=0.011) was found between absolute phacoemulsification time and change in macular volume. CONCLUSION: Macular thickness changes in the nasal, superior, and temporal quadrants of the paracentral area and the superior and temporal quadrants of the peripheral area, as well as macular volume, may be used as detailed biomarkers to measure the effects of intraocular pressure fluctuations and maneuvers in phacoemulsification intraocular surgeries.

Association of TSH receptor antibody, thyroid stimulating antibody, and thyroid blocking antibody with clinical activity score and degree of severity of Graves ophthalmopathy.

AIM: to evaluate the association between TSH receptor antibody (TRAb), thyroid stimulating antibody (TSAb), and thyroid stimulation blocking antibody (TBAb) and TSAb/TBAb ratio with clinical activity score (CAS) and degree of severity of GO. METHODS: this was a cross sectional study involving 75 consecutive Graves' disease patients admitted at Cipto Mangunkusumo hospital between December 2009 until January 2011. Bartley criteria were used as clinical criteria for GO. In addition to clinical criteria, orbital CT scan and measurement of extraocular muscle thickness and increment of retroorbital fat volume were carried out. Furthermore, TSH, FT4, FT3 and TRAb were measured using ELISA method, TSAb and TBAb using RIA method. Clinical activity of GO was measured using clinical activity score (CAS). Degree of severity of GO was measured using Eckstein modified NOSPECS system. RESULTS: subjects consisted of various different ethnic groups in Indonesia, with the range of age between 20-63 years old. There were 28 (37%) and 61 (83.6%) GO subjects with clinical-based and CT scan-based respectively. Among all GD subjects, the proportion of TSAb were 70 (93.3%) and TBAb were 13 (17.3%). There was no correlation between TRAb and CAS nor the severity of GO, either clinical-based and CT scan-based GO. There was also no correlation between TSAb and CAS. No correlation between TSAb and severity of CT scan-based GO, but significant correlation between TSAb and severity of clinical-based GO (r=0.274; p=0.009) was noted. There was no correlation between TBAb and severity of GO. We also found no correlation between TBAb and CAS of clinical-based GO, but we found strong negative correlation with CAS CT scan-based GO (r=-0.565; p=0.035). The TSAb/TBAb ratio was also strongly correlated with all parameters evaluated, CAS of clinical-based GO (r=0.730; p=0.031), CAS of CT scan-based GO (r=0.607; p=0.024), degree of severity of clinical-based GO (r=0.563; p=0.023), and degree of severity of CT scan-based GO (r=0.762; p=0.001). CONCLUSION: TRAb was not correlated with CAS and degree of severity of clinical-based and CT scan-based GO, while TSAb was correlated with degree of severity of GO. There was negative correlation between TBAb and CAS of clinical-based GO, whereas TSAb/TBAb ratio was correlated with CAS and degree of severity of both clinical-based and CT scan-based GO.