The effect of red fruit oil (Pandanus conoideus Lamk.) emulgel on angiogenesis and collagen density in incisive wound healing in mice (Mus musculus).

Pandanus conoideus Lamk. or commonly known as red fruit oil (RFO) can be used to accelerate wound healing because it contains tocopherols, carotenoids, oleic acid, linoleic acid, and linolenic acid. The RFO in this study was formulated in the form of an emulgel because it has the most convenient and effective drug delivery system. The aims of this study were to determine the activity of RFO emulgel on increasing the amount of angiogenesis and collagen density in incised wound healing and to determine the optimal dose of RFO emulgel to increase the amount of angiogenesis and collagen density in incised wound healing. This was a true experimental study with a posttest only control group design that included five treatment groups: a positive control group (10% povidone-iodine), a negative control (gel base), and three groups that varied the concentration of RFO emulgel used at 5%, 10%, and 15%. Parameters observed were the amount of angiogenesis using Image Raster software and the percentage of areas of collagen density using ImageJ software. The data were analyzed using a one-way ANOVA test and continued with the least significant difference test. The results of this study showed that RFO emulgel was able to increase the amount of angiogenesis and collagen density in the wound healing process with P = 0.000. An increase in the amount of angiogenesis and collagen density occurred in mice treated with RFO compared to the positive and negative control groups. It can be concluded that RFO emulgel has activity toward increasing the amount of angiogenesis and collagen density in the wound healing of mice incisions. The optimal dose concentration of RFO emulgel for increasing the amount of angiogenesis and collagen density in incision wound healing was shown in RFO emulgel with a concentration of 15%.

Effect of dehydration during pregnancy on birth weight and length in West Jakarta.

Nutrition and maternal behavior are critical factors in fetal development. Maternal water intake is necessary to regulate metabolism and may influence fetal growth. This study aims to determine the effect of dehydration during pregnancy on birth weight and length. This cohort-prospective study took place in the area of Kebon Jeruk District Health Centre. A total of 38 subjects of pregnant women in their second trimester were examined. Subject characteristics were collected through direct measurements and interviews. Urine and blood samples were collected at the sixth trimester (32-34 and 35-37 weeks) to determine hydration status. Nutritional status was collected through food recall, while birth weight and length were obtained from the anthropometric measurements 30 min after birth. From a total of 38 subjects, 20 were dehydrated, and 18 were well hydrated. There was a significant relationship between hydration status and water intake, birth weight and length, head circumference, and chest circumference. After being corrected to the level of water intake, the difference in birth weight and length between the two groups were 500⋅6 g and 0⋅4 cm, and 0⋅8 cm and 1⋅4 cm for the head circumference and chest circumference (P < 0⋅05). It is recommended for mothers to monitor their weight and ensure fluid intake of 3⋅0 l per day. Further research requires more subjects to observe the effects of chronic maternal dehydration on pregnancy output and a cohort study that monitors infant development in the first six months of life.

Increased fire hazard in human-modified wetlands in Southeast Asia.

Vast areas of wetlands in Southeast Asia are undergoing a transformation process to human-modified ecosystems. Expansion of agricultural cropland and forest plantations changes the landscape of wetlands. Here we present observation-based modelling evidence of increased fire hazard due to canalization in tropical wetland ecosystems. Two wetland conditions were tested in South Sumatra, Indonesia, natural drainage and canal drainage, using a hydrological model and a drought-fire index (modified Keetch-Byram index). Our results show that canalization has amplified fire susceptibility by 4.5 times. Canal drainage triggers the fire season to start earlier than under natural wetland conditions, indicating that the canal water level regime is a key variable controlling fire hazard. Furthermore, the findings derived from the modelling experiment have practical relevance for public and private sectors, as well as for water managers and policy makers, who deal with canalization of tropical wetlands, and suggest that improved water management can reduce fire susceptibility.

Hospital information system user acceptance factors: User group perspectives.

This study aimed to identify and rank user acceptance factors regarding the implementation of hospital information systems (HIS) based on the views of the following user groups: doctors, nurses, hospital management, and administrative staff (operators). The results should provide guidance for hospital management and HIS developers on meeting user requirements. The study was carried out using both qualitative and quantitative methods. The authors conducted interviews and distributed questionnaires to doctors, nurses, hospital management, and administrative staff in a government-owned Indonesian public hospital. Entropy measurements were used to analyze the questionnaire data. The study identified 15 important HIS user acceptance factors, which were ranked differently by each user group. The results show that non-technological dimensions, such as human and organizational dimensions, influence HIS user acceptance to a greater extent than technological dimensions. More work should be carried out to gain a better understanding of the relationship between user acceptance factors in order to increase the success of HIS implementations.

Acceptance model of a Hospital Information System.

PURPOSE: The purpose of this study is to develop a model of Hospital Information System (HIS) user acceptance focusing on human, technological, and organizational characteristics for supporting government eHealth programs. This model was then tested to see which hospital type in Indonesia would benefit from the model to resolve problems related to HIS user acceptance. METHOD: This study used qualitative and quantitative approaches with case studies at four privately owned hospitals and three government-owned hospitals, which are general hospitals in Indonesia. The respondents involved in this study are low-level and mid-level hospital management officers, doctors, nurses, and administrative staff who work at medical record, inpatient, outpatient, emergency, pharmacy, and information technology units. Data was processed using Structural Equation Modeling (SEM) and AMOS 21.0. RESULTS: The study concludes that non-technological factors, such as human characteristics (i.e. compatibility, information security expectancy, and self-efficacy), and organizational characteristics (i.e. management support, facilitating conditions, and user involvement) which have level of significance of p<0.05, significantly influenced users' opinions of both the ease of use and the benefits of the HIS. This study found that different factors may affect the acceptance of each user in each type of hospital regarding the use of HIS. Finally, this model is best suited for government-owned hospitals. CONCLUSIONS: Based on the results of this study, hospital management and IT developers should have more understanding on the non-technological factors to better plan for HIS implementation. Support from management is critical to the sustainability of HIS implementation to ensure HIS is easy to use and provides benefits to the users as well as hospitals. Finally, this study could assist hospital management and IT developers, as well as researchers, to understand the obstacles faced by hospitals in implementing HIS.

Prevalence of urinary incontinence, risk factors and its impact: multivariate analysis from Indonesian nationwide survey.

AIM: to describe the profile of urinary infection (UI) and to analyze its risk factors and impacts. METHODS: subjects were enrolled consecutively from pediatric, urology, obstetrics and gynecology, and geriatric outpatient clinics at six teaching hospitals in various regions of Indonesia. Those with urinary tract infection and diabetes mellitus were excluded. The UI questionnaire was adapted from the 3 Incontinence Questions (3IQ). Written informed consent was obtained prior to the interview. RESULTS: about 2765 completed questionnaires were obtained. The overall UI prevalence was 13.0%, which consisted of prevalence of stress UI (4.0%), urgency UI/wet OAB (4.1%), dry OAB (1.6%), mixed UI (1.6%), overflow UI (0.4%), enuresis (0.4%), other UI (0.7%). The prevalence of UI was significantly higher (p<0.001) in geriatric population (22.2%) compared to the adult (12.0%), and pediatric population (6.8%). There was no prevalence difference (p>0.05) between male and female subjects. Enuresis and urgency UI/wet OAB were the most common UI in pediatric population. The prevalence was 2.3% and 2.1% respectively. Urgency UI and stress UI were the two most common type in adult and geriatric population. Both have an equal prevalence of 4.6%. The multivariate analysis showed that the prevalence of UI increased with LUTS (PR 4.22, 95%CI 2.98-5.97), chronic cough (PR 2.08, 95% CI 1.32-3.28), and fecal incontinence (PR 1.85, 95% CI 1.03-3.32). We found that UI impaired family life (25.3%), sexual relationship (13.6%), and job/school performance (23.7%). Frequent toilet use and reducing fluid intake were the two most common behavior changes. CONCLUSION: the prevalence of UI in Indonesia is nearly similar to other Asian countries. It increases with age and is not affected by gender. LUTS, chronic cough, and fecal incontinence may have significant effects on the prevalence. UI seems to impact daily life and behavior.

Test - retest reliability of the Indonesian version of the Overactive Bladder Symptom Score (OABSS) and its correlation with standard assessment tools.

AIM: to evaluate the test-retest reliability of the Indonesian version of OABSS and its correlation with other validated assessment tools for OAB. METHODS: eligible patients aged 18 years with established OAB were instructed to complete 3-day micturition diaries and the OABSS, International Prostate Symptom Score (IPSS) and Patient Perception of Bladder Condition (PPBC) on two separate visits: Week 0 and Week 2. Test-retest reliability was examined using the internal correlation coefficient (ICC) and weighted Kappa coefficients between first and second applications of the OABSS. Pearson or Spearman correlation coefficients were calculated to test the correlation of OABSS with IPSS, IPSS Quality of Life (QOL) item, PPBC and clinical variables of the 3-day voiding diary. RESULTS: ICC for the OABSS total score was 0.83. The weighted Kappa coefficients of individual scores in OABSS were 0.55-0.66. In the first and second applications of OABSS, the Pearson correlation coefficients were 0.46-0.56 and 0.36-0.53 between OABSS and three clinical variables of the 3-day voiding diary (frequencies of micturition, urgency and urge incontinence). At Visit 1, the Spearman correlation coefficients were 0.41 between OABSS and IPSS total score, 0.47 between OABSS and IPSS QOL, and 0.34 between OABSS and PPBC. At Visit 2, the Spearman correlation coefficients were 0.45 between OABSS and IPSS total score, 0.55 between OABSS and IPSS QOL, and 0.44 between OABSS and PPBC. CONCLUSION: the Indonesian version of OABSS showed excellent test-retest reliability in Indonesian OAB patients. A satisfactory correlation with IPSS total and QOL scores, PPBC and several clinical variables of the 3-day voiding diary was obtained, particularly with urgency frequency.

Food-dependent Cushing's syndrome mediated by aberrant adrenal sensitivity to gastric inhibitory polypeptide.

BACKGROUND: Some patients with Cushing's syndrome have nodular adrenal hyperplasia. In most the disease is corticotropin-dependent, but in others it is corticotropin-independent. The cause of the adrenal hyperplasia in the latter patients is not known. METHODS: We studied a 49-year-old woman with Cushing's syndrome and nodular adrenal hyperplasia in whom food stimulated cortisol secretion. Plasma cortisol concentrations were measured in response to the ingestion of mixed meals, glucose, protein, and fat and after the administration of various gastrointestinal and other types of hormones. We also studied the ability of the long-acting somatostatin analogue octreotide to prevent the food-induced increase in plasma cortisol concentrations and to ameliorate the clinical manifestations of Cushing's syndrome in this patient. RESULTS: The patient's fasting plasma cortisol concentrations were subnormal, ranging from 3.0 to 7.5 micrograms per deciliter (83 to 207 nmol per liter), and they increased to as high as 16.5 micrograms per deciliter (455 nmol per liter) after a mixed meal. Her urinary cortisol excretion ranged from 164 to 250 micrograms per day (453 to 690 nmol per day) and could not be suppressed by a large dose of dexamethasone. Plasma corticotropin concentrations were virtually undetectable at all times. The ingestion of glucose, protein, and fat increased plasma cortisol concentrations to 3.6, 2.2, and 4 times the base-line value, respectively; the meal-induced and glucose-induced increases were inhibited by octreotide. The infusion of gastric inhibitory polypeptide (GIP) increased the patient's plasma cortisol concentration to 3.7 times the base-line value, but had no effect in normal subjects. The patient's fasting plasma GIP concentrations were normal both before and after a meal, and there was a close correlation between her plasma cortisol and GIP concentrations. Treatment with octreotide decreased urinary cortisol excretion and ameliorated the clinical manifestations of Cushing's syndrome. CONCLUSIONS: The development of aberrant adrenal sensitivity to GIP can result in food-dependent adrenal hyperplasia and therefore in Cushing's syndrome.