Healthcare Quality Received by Insured Patients in Two Indonesian Regional Public Hospitals.

Background: Hospitals are required to improve the quality of health services provided to patients. Purpose: Evaluating and comparing the healthcare quality received by insured patients hospitalized in two Indonesian regional public hospitals. Methods: Secondary data analysis used the 2019 and 2020 Indonesian National Health Insurance e-claim databases of Hospital A and Hospital B. Descriptive and crosstabs analyses were used to determine INA-CBGs diagnoses that were categorized as high volume, high risk, and high cost. Results: The admissions that caused financial loss at the Hospital A were 21.1% in 2019 and 19.8% in 2020, while 30.3% in 2019 and 27.5% at the Hospital B. More than 60% of these admissions were placed in the 3rd class of inpatient wards of the two hospitals. Of these admissions, < 5% at the Hospital A and >5% at the Hospital B were readmitted within 30 days, although more than 90% were previously discharged based on physicians' approval. Conclusions: Inadequate healthcare quality received by insured patients. Hence, an integrated clinical pathways based professional nursing practice model is highly recommended to increase patient outcomes and decrease 30 days hospital readmission rates.

Ginger potency on the prevention and treatment of breast cancer.

BACKGROUND: Cancer is a type of disease caused by the uncontrolled growth of abnormal cells that can destroy body tissues. The use of traditional medicine naturally uses plants from ginger with the maceration method. The ginger plant is a herbaceous flowering plant with the Zingiberaceacea group. METHODS: This study uses the literature review method by reviewing 50 articles from journals and databases. RESULTS: A review of several articles, namely ginger has bioactive components such as gingerol. Ginger is used as a treatment in complementary therapies using plants. Ginger is a strategy with many benefits and functions as a nutritional complement to the body. This benefit has shown the effect of anti-inflammatory, antioxidant, and anticancer against nausea and vomiting due to chemotherapy in breast cancer. CONCLUSION: Anticancer in ginger is shown by polyphenols associated with anti-metastatic, anti-proliferative, antiangiogenic, anti-inflammatory, cell cycle arrest, apoptosis, and autophagy. Therefore, consuming ginger regularly affects natural herbal therapy with the prevention and treatment of breast cancer and serves as a prevention against the effects of chemotherapy.

FOXP3 regulatory T cells on prognosis of breast cancer.

BACKGROUND: FOXP3 Tregs have been found in breast cancer patients, both humoral and tumor. Survival or prognosis of breast cancer patients seems to correlate with the increase and decrease in FOXP3 Treg. OBJECTIVES: This review aims to provide insights regarding the FOXP3 Tregs involved and their mechanisms in breast cancer prognosis. METHODS: The literature study method is used from primary and secondary libraries. The library search used online-based search instruments such as NCBI-PubMed, Google Scholar, and Elsevier. The data obtained were then arranged according to the framework, data on the relationship between FOXP3 Regulatory T Cells and breast cancer, and writing a journal review was carried out according to the given format. Regulators (Tregs) can inhibit anti-tumor immunity and promote tumor growth. Tregs also play a role in inhibiting cytotoxic T lymphocyte cells by inhibiting the release of granules from CD8+, where CD8+ is important in killing tumor cells. FOXP3 is a Treg-specific biomarker and plays an important role in the development and function of Tregs. RESULTS: Studies on the presence of FOXP3+ Tregs in tumors have shown controversial results. Studies in some tumors reported the presence of FOXP3+, indicating a poor prognosis, whereas studies in other tumors found that FOXP3+ correlated with a good prognosis. CONCLUSION: Regulatory T lymphocytes and TILs in invasive breast carcinoma are still not established. Therefore, further research on the Effect of FOXP3 expression of regulatory T lymphocytes on breast cancer is still important.

The Effects of the Task Balance Training Program on the Glial Cell Line-Derived Neurotrophic Factor Levels, Cognitive Function, and Postural Balance in Old People.

Exercise in the form of physical activity can provide neuroprotective benefits. The purpose of this study is to determine the effect of the task balance training program (TBT program) on the glial cell-derived neurotrophic factor levels, cognitive function, and postural balance in old people. The population of this study was the old people members of the Batara Hati Mulia Gowa Foundation who were willing to participate in the study (n = 66). The sample of this study was obtained through a random sampling technique to determine the treatment (n = 32) and control (n = 34) groups. Before and after implementing the TBT program, glial cell-derived neurotrophic factor (GDNF) level measurement and cognitive function and postural balance assessment were performed. Cognitive function was measured by using Montreal cognitive assessment (MoCA). Postural balance was measured in two ways by using the timed up and go (TUG) test and Tinetti performance-oriented mobility assessment (POMA). The treatment group showed significantly greater changes than the control group in GDNF levels (2.24 (±0.63) vs. 1.24 (±0.43), P = 0.001), cognitive function (24.66 (±3.42) vs. 19.18 (±2.67), P = 0.001), and postural balance (TUG [14.00 (±4.04) vs. 18.68 (±3.98)]; POMA [26.53 (±1.74) vs. 23.47 (±3.06)], P = 0.001) after training. The treatment group also showed a significant relationship between GDNF levels and cognitive function (r = 0.840, P = 0.001) and postural balance (TUG [r = 0.814, P = 0.001]; POMA [r = 0.630, P = 0.001]). The TBT program affects the levels of GDNF in old people. The TBT program involves cognitive function improvement and affects postural balance changes in old people.

Review: Correlation between bladder obstruction with bladder function and erectile dysfunction in mice.

Bladder obstruction, including due to benign prostate enlargement (BPH), will trigger its anatomy and physiological function changes. Men with BPH have a 6 times higher risk of erectile dysfunction than those without BPH. Morphological and functional changes in subjects with partial bladder outlet obstruction (pBOO) occur differently depending on the duration of pBOO that has been experienced. The underlying pathophysiology of BPH is closely related to erectile dysfunction. Anatomically, functionally, and psychologically changes due to BPH will also have an impact on sexual function. Chronic pBOO causes lower urinary tract symptoms (LUTS) through a complex pathophysiological pathway. LUTS and bladder obstruction can lead to erectile dysfunction. The severity of LUTS and sexual dysfunction is inversely related to the quality of life. The treatment of LUTS symptoms will also enhance sexual function.

Mean arterial pressure and the endothelin-1 levels in preeclampsia.

OBJECTIVE: This study aims to determine the correlation between Endothelin-1 levels and mean arterial pressure (MAP) with preeclampsia so that their combination can be used as the predictor of PE in early pregnancy. METHOD: This study used a cross-sectional study with a case-control design carried out in February to June 2020 in several hospitals and health centers in Makassar city, namely Dr. Wahidin Soedirohusodo General Hospital, Hasanuddin University State University Hospital, health center Bara Baraya, health center Mamajang, and health center Antang. Respondents in this study were divided into 37 pregnant women with preeclampsia and 53 pregnant women with normotension. This study's criteria for respondents were 20-35 years old, single pregnancy with > 20 weeks gestational. Data collected included education, body mass index (BMI), parity, the interval of pregnancy, and gestational age. ET-1 levels were determined using th ET-1 Elisa Kit with the ELISA method, and MAP was collected by measuring blood pressure when pregnant women came to health facilities. RESULTS: The mean serum ET-1 levels in the preeclampsia were highest than normotensive with a significant p-value of 0.001 (p<0.05). The MAP in the preeclampsia was highest than normotensive too, with a significant value of p-value 0.001 (p<0.05), and there is a positive correlation between ET-1 and MAP with r=0.34 and p-value 0.001 (p<0.05). CONCLUSION: The combination of ET-1 and MAP can be considered as a prognostic factor to detect PE in early pregnancy.

Comparison of nitric oxide levels, roll over test value, and body mass index in preeclampsia and normotension.

OBJECTIVE: The study aims to compare levels NO, the ROT, and BMI values in preeclampsia and normotension. METHOD: This study was an observational analytical study that combined the draft case-control study and a cross-sectional study (hybrid method) conducted in February-June 2020. This study was conducted in the Hospital Dr. Wahidin Sudirohusodo Makasar, Antang Health Center, Barabaraya Health Center, and Mamajang Health Center. Respondents in this study were pregnant women divided into two groups, 108 mothers with normal pregnancies and 42 mothers with preeclampsia. The criteria of the study respondents were single pregnancies, pregnancy of more than 20 weeks, and the gestational age of 20-35 years old. Data collected includes age, parity, gestational age, pregnancy interval, body mass index (BMI), and education. In addition, Nitric oxide levels are determined using Elisa Kit, and roll over test is collected by performing blood pressure measurements at two different positions. RESULTS: The mean serum NO levels in the preeclampsia 176.43±50.8 and 152.75±51.3 in normotension, and there is a meaningful relationship p=0.012. Mean value of ROT in preeclampsia 23.21±8.54 and 19.63±8.85 in normotension p=0.026. There is a meaningful difference in IMT with preeclampsia p=0.003. CONCLUSION: NO, ROT and BMI are significantly higher in pregnant mothers with preeclampsia than in normal pregnancies.

The influence of macronutrient intake, stress and prostaglandin levels (pgf2α) of urine with the incidence of dysmenorrhea in adolescents.

OBJECTIVES: This study aimed to analyze the influence of macronutrient intake, stress, and prostaglandin levels (pgf2α) on adolescent dysmenorrhea incidence. METHOD: This type of study is observational analytic with a cohort study draft done in January-March 2020 at High junior school 21 Makassar. Respondents in this study were grade X and XI students divided into 64 teenagers who had dysmenorrhea and 64 adolescents who did not experience Dysmenrhea. The criteria of the respondent in this study were the reproductive age, already experiencing menstruation, knowing the time and date of menstruation, menstrual cycles were regular, and willing to be respondents. The study used Menstrual Symptoms Questionnaire (MSQ) and used an ultrasonography (ultrasound) examination to perform the sample cervical. Food recall 24 hours to assess the intake of macronutrients, Depression Anxiety Stress Scales (DASS 42) to measure stress levels, and an examination of urine prostaglandin levels using the method Enzyme-Linked Immunosorbent Assay (ELISA). Urine intake is carried out on the second day as much as 2-5cc. Data were analyzed by the Chi-square test and logistics regression backward. RESULT: A multivariate analysis showed a variable that strongly affects dysmenorrhea is stress with the value p=0.000 and the level of prostaglandins with p-value=0.003 compared to other variables. CONCLUSION: Stress and prostaglandin levels significantly affect the occurrence of dysmenorrhea in adolescents.

The use of aromatherapy in primary dysmenorrhea.

OBJECTIVE: The purpose of this review is to determine the use of aromatherapy in primary dysmenorrhea. METHOD: This is a literature review by searching article databases through Google Scholar, PubMed, ScienceDirect, Microsoft Academic, ProQuest, Semantic Scholar. The selection period for article publication is from 2015 to 2021. A total of 96 articles were obtained, and 30 articles could be entered according to the inclusion criteria. RESULTS: Thirty articles were analyzed, it is shown that aromatherapy effectively reduces the intensity of primary dysmenorrheal pain. The sample size of the 30 articles varied from 16 samples to 200 research samples, and the research design used experiments, clinical trials, and ex vivo, in vivo, and in vitro studies. CONCLUSION: Aromatherapy is an effective alternative intervention that can be used to reduce the intensity of primary dysmenorrhea pain.

Evaluation of health care quality among insured patients in Indonesian mother & child hospital: A secondary data analysis.

OBJECTIVE: This study aimed to evaluate the health care quality among insured patients hospitalized in the Indonesian mother and child hospital. METHOD: A secondary data analysis was performed to evaluate the health care services received by the insured patients hospitalized in the Indonesian mother and child hospital. Data were extracted from the BPJS health insurance e-claim database from January 1 to December 31, 2019 and from January 1 to June 30, 2020. A descriptive and bivariate analysis were used to examine total patients and hospital admissions; INACBGs diagnoses, procedures by severity; types of inpatient wards; length of stay; discharge status; hospital costs; and 30-day readmissions. RESULTS: Total inpatient unit admissions were 2870 in 2019 and 1533 in 2020. From total hospital admissions in 2019 and 2020, over 50% were admitted to the 3rd class of inpatient units, less than 10% had length of stays more than 5 days, and over 98% were discharged based on physician approval. However, hospital readmissions were also found for about 20.1% in 2019 and 2.9% in 2020 and about 42.9% in 2019 and 61.3% in 2020 were found causing hospital financial losses. Older patients, longer hospital stays, inpatient ward class 1 & 2, high hospital tariff, inadequate clinical pathway implementation, lack of interprofessional collaboration, and ineffective nurse manager supervision were identified as contributing factors to the hospital financial losses. CONCLUSION: Integrated clinical pathways with interprofessional collaboration that are implemented through professional nursing practice model are suggested for health care quality improvement.

Mean arterial pressure and the endothelin-1 levels in preeclampsia

Objective: This study aims to determine the correlation between Endothelin-1 levels and mean arterial pressure (MAP) with preeclampsia so that their combination can be used as the predictor of PE in early pregnancy. Method: This study used a cross-sectional study with a case-control design carried out in February to June 2020 in several hospitals and health centers in Makassar city, namely Dr. Wahidin Soedirohusodo General Hospital, Hasanuddin University State University Hospital, health center Bara Baraya, health center Mamajang, and health center Antang. Respondents in this study were divided into 37 pregnant women with preeclampsia and 53 pregnant women with normotension. This study's criteria for respondents were 20–35 years old, single pregnancy with > 20 weeks gestational. Data collected included education, body mass index (BMI), parity, the interval of pregnancy, and gestational age. ET-1 levels were determined using th ET-1 Elisa Kit with the ELISA method, and MAP was collected by measuring blood pressure when pregnant women came to health facilities. Results: The mean serum ET-1 levels in the preeclampsia were highest than normotensive with a significant p-value of 0.001 (p < 0.05). The MAP in the preeclampsia was highest than normotensive too, with a significant value of p-value 0.001 (p < 0.05), and there is a positive correlation between ET-1 and MAP with r = 0.34 and p-value 0.001 (p < 0.05). Conclusion: The combination of ET-1 and MAP can be considered as a prognostic factor to detect PE in early pregnancy. (AU)

The influence of macronutrient intake, stress and prostaglandin levels (pgf2a) of urine with the incidence of dysmenorrhea in adolescents

Objectives: This study aimed to analyze the influence of macronutrient intake, stress, and prostaglandin levels (pgf2α) on adolescent dysmenorrhea incidence. Method: This type of study is observational analytic with a cohort study draft done in January–March 2020 at High junior school 21 Makassar. Respondents in this study were grade X and XI students divided into 64 teenagers who had dysmenorrhea and 64 adolescents who did not experience Dysmenrhea. The criteria of the respondent in this study were the reproductive age, already experiencing menstruation, knowing the time and date of menstruation, menstrual cycles were regular, and willing to be respondents. The study used Menstrual Symptoms Questionnaire (MSQ) and used an ultrasonography (ultrasound) examination to perform the sample cervical. Food recall 24 hours to assess the intake of macronutrients, Depression Anxiety Stress Scales (DASS 42) to measure stress levels, and an examination of urine prostaglandin levels using the method Enzyme-Linked Immunosorbent Assay (ELISA). Urine intake is carried out on the second day as much as 2–5 cc. Data were analyzed by the Chi-square test and logistics regression backward. Result: A multivariate analysis showed a variable that strongly affects dysmenorrhea is stress with the value p = 0.000 and the level of prostaglandins with p-value = 0.003 compared to other variables. Conclusion: Stress and prostaglandin levels significantly affect the occurrence of dysmenorrhea in adolescents. (AU)

Comparison of nitric oxide levels, roll over test value, and body mass index in preeclampsia and normotension

Objective: The study aims to compare levels NO, the ROT, and BMI values in preeclampsia and normotension. Method: This study was an observational analytical study that combined the draft case–control study and a cross-sectional study (hybrid method) conducted in February–June 2020. This study was conducted in the Hospital Dr. Wahidin Sudirohusodo Makasar, Antang Health Center, Barabaraya Health Center, and Mamajang Health Center. Respondents in this study were pregnant women divided into two groups, 108 mothers with normal pregnancies and 42 mothers with preeclampsia. The criteria of the study respondents were single pregnancies, pregnancy of more than 20 weeks, and the gestational age of 20–35 years old. Data collected includes age, parity, gestational age, pregnancy interval, body mass index (BMI), and education. In addition, Nitric oxide levels are determined using Elisa Kit, and roll over test is collected by performing blood pressure measurements at two different positions. Results: The mean serum NO levels in the preeclampsia 176.43 ± 50.8 and 152.75 ± 51.3 in normotension, and there is a meaningful relationship p = 0.012. Mean value of ROT in preeclampsia 23.21 ± 8.54 and 19.63 ± 8.85 in normotension p = 0.026. There is a meaningful difference in IMT with preeclampsia p = 0.003. Conclusion: NO, ROT and BMI are significantly higher in pregnant mothers with preeclampsia than in normal pregnancies. (AU)

The use of aromatherapy in primary dysmenorrhea

Objective: The purpose of this review is to determine the use of aromatherapy in primary dysmenorrhea. Method: This is a literature review by searching article databases through Google Scholar, PubMed, ScienceDirect, Microsoft Academic, ProQuest, Semantic Scholar. The selection period for article publication is from 2015 to 2021. A total of 96 articles were obtained, and 30 articles could be entered according to the inclusion criteria. Results: Thirty articles were analyzed, it is shown that aromatherapy effectively reduces the intensity of primary dysmenorrheal pain. The sample size of the 30 articles varied from 16 samples to 200 research samples, and the research design used experiments, clinical trials, and ex vivo, in vivo, and in vitro studies. Conclusion: Aromatherapy is an effective alternative intervention that can be used to reduce the intensity of primary dysmenorrhea pain. (AU)

Evaluation of health care quality among insured patients in Indonesian mother & child hospital: A secondary data analysis

Objective: This study aimed to evaluate the health care quality among insured patients hospitalized in the Indonesian mother and child hospital. Method: A secondary data analysis was performed to evaluate the health care services received by the insured patients hospitalized in the Indonesian mother and child hospital. Data were extracted from the BPJS health insurance e-claim database from January 1 to December 31, 2019 and from January 1 to June 30, 2020. A descriptive and bivariate analysis were used to examine total patients and hospital admissions; INACBGs diagnoses, procedures by severity; types of inpatient wards; length of stay; discharge status; hospital costs; and 30-day readmissions. Results: Total inpatient unit admissions were 2870 in 2019 and 1533 in 2020. From total hospital admissions in 2019 and 2020, over 50% were admitted to the 3rd class of inpatient units, less than 10% had length of stays more than 5 days, and over 98% were discharged based on physician approval. However, hospital readmissions were also found for about 20.1% in 2019 and 2.9% in 2020 and about 42.9% in 2019 and 61.3% in 2020 were found causing hospital financial losses. Older patients, longer hospital stays, inpatient ward class 1 & 2, high hospital tariff, inadequate clinical pathway implementation, lack of interprofessional collaboration, and ineffective nurse manager supervision were identified as contributing factors to the hospital financial losses. Conclusion: Integrated clinical pathways with interprofessional collaboration that are implemented through professional nursing practice model are suggested for health care quality improvement. (AU)

The rise of circulatory endothelin (ET)-1 and endothelin receptors (ETA, ETB) expression in kidney of obese wistar rat.

BACKGROUND: Endothelin (ET)-1, a circulatory protein, and its receptors (ETA and ETB) in various organs were reported to play a pivotal role in many diseases, including obesity. However, the changes of ETA and ETB expression in ventricle and kidney in obesity was less reported. The study is designed to observe the level of circulatory ET-1 and expression of ETA/ETB in ventricle and kidney of obese, as compared to non-obese, Wistar rats. METHODS: Groups of obese 14 and 34 weeks Wistar rats were compared to non-obese controls at similar ages. The obesity status was achieved by feeding the with high calories protein diet CP 551 + milk powder, while the control group was fed with a standard calorie protein AD II diet. The concentration of circulatory ET-1, ETA and ETB of ventricle and kidney were measured by Enzyme Linked Immunosorbent Assay (ELISA) technique after the termination of both groups at 14th and 24th weeks. RESULTS: The level of circulatory ET-1, expression of ETA and ETB in kidney, and LDL of obese rats were significantly higher than control rats (T-Test, P<0.05) in the elder groups, while no differences of the ETA and ETB were found in the ventricle. No differences of the levels of circulatory ET-1, ETA and ETB expression were found between obese and control groups of younger rats (P>0.05). HDL levels were under normal value for both groups. CONCLUSION: Obesity in elder obese rats leads to dysregulation of kidney vessels through activity of ET-1 and ETA/ETB.

Effects of antibacterial nanostructured composite films on vascular stents: hemodynamic behaviors, microstructural characteristics, and biomechanical properties.

The purpose of this research was to investigate stresses resulting from different thicknesses and compositions of hydrogenated Cu-incorporated diamond-like carbon (a-C:H/Cu) films at the interface between vascular stent and the artery using three-dimensional reversed finite element models (FEMs). Blood flow velocity variation in vessels with plaques was examined by angiography, and the a-C:H/Cu films were characterized by transmission electron microscopy to analyze surface morphology. FEMs were constructed using a computer-aided reverse design system, and the effects of antibacterial nanostructured composite films in the stress field were investigated. The maximum stress in the vascular stent occurred at the intersections of net-like structures. Data analysis indicated that the stress decreased by 15% in vascular stents with antibacterial nanostructured composite films compared to the control group, and the stress decreased with increasing film thickness. The present results confirmed that antibacterial nanostructured composite films improve the biomechanical properties of vascular stents and release abnormal stress to prevent restenosis. The results of the present study offer the clinical benefit of inducing superior biomechanical behavior in vascular stents.

Follow-up study of dental implants with bioactive oxide films on bone tissue healing and osseointegration: clinical radiography and bone quality analysis.

OBJECTIVE: The purpose of this study was to investigate osseointegration and bone stress resulted during the first 3 months after the installation of functional implants modified with bioactive oxide. METHODS: Several studies have investigated finite element models for dental implants; however, only a few have examined a model for the implants during different stages of osseointegration. In this study, mandible models were reconstructed using computer tomographic data, and bone qualities and stress distributions were investigated as well. RESULTS: Bone quality increased rapidly within the 3-month bone healing time. Data analysis indicated that the bone stresses increased with the progress of osseointegration, and the maximum stresses were obtained at the position around the first screw. CONCLUSION: The results confirmed that functional films could improve the biomechanical properties of the implants and promote the initial bone stability. Furthermore, potential clinical benefit can be obtained due to the inducing superior biomechanical behavior in dental implants.