Participatory Health Cadre Model to Improve Exclusive Breastfeeding Coverage with King's Conceptual System.

Objective: The purpose of this research is to develop a participatory health cadre model to enhance exclusive breastfeeding coverage through initial stages using the Imogene King model. Methods: This study employs a mixed-methods approach with sequential exploratory designs. Qualitative research utilized in-depth interviews with informants including the head of the community health center, nutrition officers from the health center, the coordinator of Maternal and Child Health (MCH) midwives, village midwives, breastfeeding mothers, families of breastfeeding mothers, and health cadres. Quantitative research respondents consist of health cadres. The quantitative study utilizes a quasi-experimental method with a design paradigm known as the one-group pre and post-test design to measure health cadre perception on exclusive breastfeeding. Results: This study yields elements from Imogene King that form a participatory health cadre model to enhance exclusive breastfeeding coverage, consisting of interaction, perception, communication, transaction, role, growth and development, time, and space. Transactions represent the objective integration of the health cadre participation model, as demonstrated by the behavioral shifts observed in mothers regarding breastfeeding their infants. The t-test results indicate that exclusive breastfeeding monitoring training is effective and successful in enhancing exclusive breastfeeding coverage (Sig. value = 0.000 < 0.05). In addition, the effectiveness of exclusive breastfeeding monitoring training falls within the category of good or high. Conclusion: The research findings indicate the success of the participatory health cadre model in improving exclusive breastfeeding coverage.

Epidemiology of cleft lip and palate charity mission surgery at Bandung Cleft Lip and Palate Center, Indonesia: a 14-year institutional review.

BACKGROUND: The management of cleft lip and palate aims at improving the patient's aesthetic and functional outcomes. Delaying primary repair can disrupt the patient's functional status. Long-term follow-up is essential to evaluate the need for secondary repair or revision surgery. This article presents the epidemiology of cleft lip and palate, including comprehensive patient characteristics, the extent of delay, and secondary repair at our institutional center, the Bandung Cleft Lip and Palate Center, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia. METHODS: This retrospective study aimed to determine the epidemiology and recurrence rates of cleft lip and palate at the Bandung Cleft Lip and Palate Center, Indonesia, from January 2007 to December 2021. The inclusion criteria were patients diagnosed with cleft lip and/or palate. Procedures such as labioplasty, palatoplasty, secondary lip and nasal repair, and alveolar bone grafting were performed, and data on recurrence were available. RESULTS: In total, there were 3,618 patients with cleft lip and palate, with an age range of 12 months to 67 years. The mean age was 4.33 years, and the median age was 1.35 years. Males predominated over females in all cleft types (60.4%), and the cleft lip was on the left side in 1,677 patients (46.4%). Most cases were unilateral (2,531; 70.0%) and complete (2,349; 64.9%), and involved a diagnosis of cleft lip and palate (1,981; 54.8%). CONCLUSION: Delayed primary labioplasty can affect daily functioning. Primary repair for patients with cleft lip and palate may be postponed due to limited awareness, socioeconomic factors, inadequate facilities, and varying adherence to treatment guidelines. Despite variations in the timing of primary cleft lip repair (not adhering to the recommended protocol), only 10% of these patients undergo reoperation. Healthcare providers should prioritize the importance of the ideal timing for primary repair in order to optimize physiological function without compromising the aesthetic results.

Efficacy and Safety Profile of Tuberculin Protein Purified Derivative Injection As Immunotherapy For the Treatment of Cutaneous and Anogenital Warts: A Review Article.

Introduction: Various treatments available today for anogenital and cutaneous warts have limitations, including time-consuming, challenging to perform, and the risk of scarring. A new treatment using tuberculin purified protein derivative (PPD) has been developed, which is expected to generate cellular immunity against HPV. Objective: To assess the evidence for the efficacy and safety of PPD treatment for cutaneous and anogenital warts. Materials and methods: A literature search was performed with the keyword-based search on digital libraries, including the National Library of Medicine, Cochrane Controlled Register of Trial, and Google Scholar, using the following terms: anogenital warts, condyloma acuminata, cutaneous warts, human papillomavirus, immunotherapy, and tuberculin purified protein derivative. Original studies on treating cutaneous or anogenital warts with PPD were included. The results were 47 clinical trials and 4 case reports. Most of the research was done in countries with common Mycobacterium tuberculosis infection. The treatment showed good efficacy. Comparative studies showed that the treatment has similar efficacy with other immunotherapies. No significant side effects were reported, with evidence of the safety use on the pregnant population. Conclusion: Based on good efficacy and safety, PPD can be considered an alternative therapy, especially in countries where tuberculosis is frequent.

Effect of Executive Function on Health-Related Quality of Life in Children with Chronic Kidney Disease.

Introduction: As the highest function in the brain that regulates our daily activity, executive dysfunction might affect someone's health-related quality of life (HRQoL), especially in those with chronic diseases, including chronic kidney disease (CKD). Neurocognitive functions, including intelligence quotient (IQ) and executive function can be affected through various mechanisms in CKD. However, there was still no specific study regarding how IQ and executive function might affect HRQoL in children with CKD. Purpose: To assess Executive Function's impact on HRQoL and to find association between treatment modalities and CKD stages with HRQoL in children with CKD. Methods: A cross sectional study was conducted at Pediatric Nephrology Clinic at Hasan Sadikin General Hospital, Bandung, Indonesia from September 2022 to April 2023. We included 38 children whose age range were 6-16 years 11 months old with CKD stage III - V. Assessment tools used were: BRIEF questionnaire for executive function; WISC III tool for IQ; PedsQLTM questionnaire generic module for HRQoL. Data was analyzed using SPSS ver. 26.0. Results: Total number of samples was 38. Complete examinations were done on 30 patients. Eight other patients did not undergo the IQ test. There was a negative correlation between executive function components scores (GEC, BRI, MI) with HRQoL scores on parents' proxy in all domains. We found no correlation between HRQoL and IQ scores, but we found a correlation between IQ and CKD stage. There was a significant difference in HRQoL from the children's perspective among the three modalities; children who underwent conservative treatment were having the best HRQoL scores. Conclusion: Interventions to improve executive function of children with CKD should be done to improve their HRQoL in the future. Early diagnosis and treatment of CKD should be done at the earliest to improve neurocognitive function and HRQoL.

Refining macrostomia correction: Case series applying square flap technique and Z/W-plasty skin closure for enhanced aesthetic and functional outcome.

INTRODUCTION AND IMPORTANCE: Macrostomia is a congenital deformity found in Tessier no. 7 facial clefts defined as an enlargement of the mouth at the oral commissure. Several techniques are described in literature to achieve optimal functional and aesthetic results, with varying results and surgeon preferences. In this case series we report surgical repair of macrostomia with a vermillion square flap method for the oral commissure combined with either Z-plasty or W-plasty closure for the skin. CASES PRESENTATION: A retrospective case analysis of 12 patients with macrostomia operated over the past 7 years at our plastic surgery division was performed (by two different operators; 11 cases by A.S. and 1 case by R.S.). Clinical features of the patients were analyzed through photography documentation, and patient description such as age of operation, operation technique, and complications were obtained through patient records. Macrostomia was corrected with a vermillion square flap method for commissure, overlapping muscle closure, along with either Z-plasty or W-plasty closure for the skin. Quality of lip commissure position, symmetry, thickness of vermillion, and scar result were recorded. CLINICAL DISCUSSION: In all twelve patients repaired with the overlapping muscle closure and square flap, the lip commissures were formed with satisfactory shape, position, and thickness with no commissure contracture during the follow up period. The Z-plasty was a simpler method compared to the W-plasty, and resulted in comparable scars. One patient (adult with hemifacial macrostomia and W-plasty skin closure) underwent revision surgery for more accurate symmetry and position of the oral commissure. CONCLUSION: There are many varieties of surgical repair for macrostomia, and each method should be adjusted and combined according to each patient. Overall, macrostomia repair with this technique combination produced satisfactory aesthetic and functional results in all twelve patients. Z-plasty for skin closure after muscle and vermillion closure was a simpler technique and resulted in comparable scars than W-pasty closure in this case series.

Evaluation of Process Indicators and Challenges of the Elimination of Mother-to-Child Transmission of HIV, Syphilis, and Hepatitis B in Bali Province, Indonesia (2019-2022): A Mixed Methods Study.

BACKGROUND: This study was conducted to describe the prevalence of and evaluate the processes and challenges in implementing the elimination of HIV, syphilis, and hepatitis B transmission from mother to child in Bali Province, Indonesia. METHODS: The research method used is a descriptive approach using indicators and a set of processes by the WHO, quantitative methods using descriptive analysis, and qualitative methods using phenomenological paradigms through in-depth interviews and FGD with healthcare professionals involved in the elimination of mother-to-child transmission (EMTCT) program. RESULTS: The indicators that have successfully met the target for 4 years are antiretroviral therapy (ART) coverage in Badung District (≥95%) and ANC coverage (at least one visit) in Buleleng District (≥95%). The study found low prevalence rates of HIV, syphilis, and hepatitis B among pregnant women in the three districts. There are some indicators that show improvement from 2019 to 2022, namely, syphilis (60.44% to 86.98%) and hepatitis B (29.03% to 95.35%) screening coverage showed improvements, with increasing screening rates observed in Buleleng District. However, adequate treatment coverage for pregnant women with syphilis decreased in Denpasar City in 2022 compared to 2019 (100% to 71.28%). Despite data on hepatitis B treatment being unavailable, hepatitis B vaccination coverage exceeded the WHO target in all three districts. The utilization of the information system is not yet optimal, and there is a lack of ability to track cases. Furthermore, there is insufficient involvement of the private sector, particularly in screening, and a lack of standardized procedures in the management of referrals for pregnant women with hepatitis B. CONCLUSION: The prevalence of HIV, syphilis, and hepatitis B among pregnant women has consistently remained below the Ministry of Health's target for four years. Despite this, there are a lot of targets, and the indicator EMTCT process has yet to reach the WHO target. The challenges for each district in reaching the WHO target include providing syphilis and hepatitis B reagents and benzatine penicillin; increasing private sector involvement; and strengthening information systems, policies, and guidelines for the management of hepatitis B among pregnant women in line with WHO recommendations to achieve EMTCT.

Cleft lip and palate surgery during COVID-19 pandemic in Indonesia: a 36-month experience at the Bandung Cleft Lip and Palate Center.

BACKGROUND: In Indonesia, the prevalence of cleft lip and palate increased from 0.08% to 0.12% between 2013 and 2018. Children with cleft deformities typically undergo staged surgery. However, the coronavirus disease 2019 (COVID-19) pandemic has had negative impacts on the healthcare sector, including the suspension of elective procedures; this has raised concerns about the safety of performing surgery and the functional consequences of delaying treatment, the latter of which is associated with poor prognosis. The purpose of this study was to report the characteristics of clefts treated by the Bandung Cleft Lip and Palate Center team during the pandemic period. METHODS: This brief comparative study based on a chart review was conducted at the Bandung Cleft Lip and Palate Center. We statistically evaluated data from all patients treated between September 2018 and August 2021. Frequency analysis was performed to analyze the average number of each procedure by age before and during the COVID-19 pandemic. RESULTS: Data from 18-month periods before (n = 460) and during (n = 423) the pandemic were compared. Cheiloplasty procedures were examined (pre-pandemic, n = 230; pandemic, n = 248); before the pandemic, 86.1% were performed according to the treatment protocol (patient < 1 year old), and this proportion non-significantly dropped to 80.6% during the pandemic (p = 0.904). Palatoplasty procedures were also compared (pre-pandemic, n = 160; pandemic, n = 139); the treatment protocol (patient 0.5-2 years old) was followed for 65.5% of procedures before the pandemic and 75.5% during the pandemic (p = 0.509). Additionally, 70 (mean age, 7.94 years) revision and other procedures were performed before the pandemic and 36 (mean age, 8.52 years) during the pandemic. CONCLUSION: The cleft procedures performed at the Bandung Cleft Lip and Palate Center did not significantly change during the COVID-19 pandemic.

Hearing Screening Alternative Using a Website-Based Application.

BACKGROUND AND OBJECTIVES: Indonesians encounter several barriers to regular functional hearing assessment. Hearing loss screening is only provided by tertiary-care hospitals that are not reachable by people in remote regions. This study aimed to develop a website-based hearing screening application that is accessible and inexpensive. Subjects and. METHODS: This comparative study was conducted between July and August 2022 in the Otolaryngology Clinic of Muhammadiyah Bandung Hospital with noise levels below 50 dB. The hearing screening was conducted using a website-based application (www.Screenout.id) and audiogram as the gold standard method. On ScreenOut, patients heard sounds with frequencies at 500, 1,000, 2,000, 4,000, and 8,000 Hz and sound intensity of each frequency at 35, 55, and 75 dB using earphones. RESULTS: A total of 133 participants were enrolled in our study. ScreenOut showed high sensitivity, specificity, accuracy, positive predictive value, and negative predictive value (90.9%, 98.9%, 93.6%, 99.4%, and 84.8%, respectively). Regarding hearing threshold, a very strong correlation was found between ScreenOut and audiogram, ranging between r=0.843 and r=0.899. Aside from that, there was no significant difference in hearing threshold values between ScreenOut and audiogram. CONCLUSIONS: Many advantages of the ScreenOut were found, including low-cost, accessibility, and easy-to-use interface, making it favorably used in low-middle-income countries such as Indonesia.

Association between spinal muscular atrophy type and delayed diagnosis and the risk of spinal deformity in Indonesian patients.

BACKGROUND: Spinal muscular atrophy (SMA) is a genetic disease that causes muscle weakness and atrophy. Delayed diagnosis can lead to loss of motoric functions, which may then progress to deformities such as thoracolumbar scoliosis, pelvic obliquity, and hip subluxation/dislocation. The lack of information or limited experience among healthcare providers and costly genetic tests can cause delayed diagnosis. The current study aimed to assess the characteristics of patients with SMA. Moreover, the association between SMA type and delayed diagnosis and the risk of spinal deformity in the Indonesian SMA Community was evaluated. METHODS: This was a cross-sectional study performed on 53 patients diagnosed with SMA. Data about patients' characteristics were obtained from the Indonesian SMA Community using a questionnaire in August 2019. The information included age, sex, SMA type, age at suspicion and definite diagnosis of SMA, and presence of spinal deformities. Then, descriptive analysis and logistic regression analysis were performed, and the Kruskal-Wallis test and the Chi-square test were utilized. RESULTS: The median age of patients suspected of SMA was 24 months. A definitive diagnosis of SMA was obtained at 36 months. Further, 43% of patients presented with SMA type 2 and 58% with spinal deformities. Results showed a positive correlation between time interval between suspicion and definite diagnosis of SMA and the risk of spinal deformities (B = 0,07; p > 0.05). Delayed diagnosis was more common in SMA type 3 than in SMA types 1 and 2, and SMA type 2 was correlated with a twofold risk of spinal deformities (p = 0.03; prevalence ratio = 2.09). CONCLUSIONS: SMA type 2 is associated with a twofold risk of spinal deformities. Delayed diagnosis is more common in SMA type 3 than in SMA types 1 and 2. Moreover, there was an association between the time interval between suspicion and definite diagnosis of SMA and the risk of spinal deformities in patients with SMA.

The IRF6 AP-2α binding site polymorphism relate to the severity of non-syndromic orofacial cleft of Indonesian patients.

BACKGROUND: IRF6 AP-2α binding site polymorphism is known as IRF6 rs642961. It has been associated with a nonsyndromic orofacial cleft (NS OFC). This study aimed to determine the IRF6 rs642961 as a risk factor associated with NS OFC and its phenotypes. METHODS: The case-control design used for 264 subjects consists of 158 NS CLP subjects (42 CU CLP, 34 CB CLP, 33 CLO, 49 CPOs) and 106 healthy controls. The DNA is extracted from venous blood. The segment of IRF6 rs642961 amplified by polymerase chain reaction (PCR) followed by restriction fragment length of polymorphisms (RFLPs) used the MspI digestion enzyme. The qPCR method to identify the mRNA expression levels of the IRF6 gene rs642961 was analyzed by the Livak method. RESULTS: The study results show that in NS CB CLP phenotype as the most severe phenotype of NS OFC, the Odds Ratio (OR) of A mutant allele was 5.094 (CI=1.456-17.820; P=0.011) and the OR of AA homozygous mutant genotype was 13.481 (CI=2.648-68.635; P=0.001). There are different levels of mRNA expression changes from NS OFC and its phenotypes. It is substantial among the 2-ΔΔCt and the group of AA, GA, and GG genotypes (P<0.05); in the NS CPO phenotype, it shows IRF6 mRNA under-expression in GA, AA genotypes while in other phenotypes it shows IRF6 mRNA overexpression. CONCLUSIONS: The IRF6 AP-2α binding site polymorphism is strongly associated with the severity of NS OFC, and this polymorphism has a functional role in affecting IRF6 mRNA expression that is variable in each phenotype.

How do elderly people with malnutrition and their families perceive collaborative practice in primary care? A phenomenological study.

As a frequent and serious problem in elderly people, malnutrition is a complex health issue. It requires comprehensive care through interprofessional collaborative practice (IPCP) engaging five health professionals in primary care consisting of a physician, dentist, nurse, dietitian and pharmacist. In Indonesia, the usual care involves monthly health screening in community programmes named Posyandu. The current study aimed to explore perceptions of elderly people with malnutrition and their families' experiences with interprofessional teams compared with usual care in primary care. This qualitative study used the phenomenological approach based on Creswell. Interviews were conducted with fourteen elderly people and their families in the intervention group and fourteen elderly people with their families in the control group. Data were analysed using the four steps of descriptive qualitative analysis described by Giorgi, including comparing the experiences of both groups. Elderly people with malnutrition in the intervention group had more valued experiences regarding two-way communication with the IPCP team and felt it involved more comprehensive care for malnutrition management. Participants in the control group experienced communication between the health care providers and elderly people; however, it was not clear enough. There were overlapping roles among health care providers in the usual care. However, both groups shared the experience that family members are partners in nutritional management. Elderly people and their families in the intervention group have more valuable experiences related to two-way communication and comprehensive care. Family as partners was experienced in both the intervention and control groups.

FITRI's four steps in developing primary health cares' interprofessional collaborative: an intervention for fostering IPCP competencies.

It is important to fill the gaps in collaborative practice due to the lack of the healthcare professionals' ability to work in collaboration with other disciplines. However, the current team training does not routinely address this important issue. This study aimed to identify how interactive interprofessional collaborative practice (IPCP) learning materials in a virtual course and community implementation called FITRI's four steps in developing primary health cares' interprofessional collaborative practice can be used in primary healthcare settings to address IPCP competencies of healthcare providers. This research was a quasi-experimental study with an untreated control group design using a dependent pretest and posttest sample. A purposive sample of 50 primary healthcare providers consisting of general physicians, dentists, nurses, dietitians, and pharmacists were nonrandomly divided into the control and intervention groups. This study showed that IPCP competencies measured by the Interprofessional Collaborator Assessment Rubric (ICAR) in the intervention group were significantly higher after the training and implementation than before. The Mann-Whitney tests indicated that IPCP competencies were better in the intervention group than the control group. Based on effect size analysis, the intervention had a very strong impact and could significantly improve the participants' competencies, especially in the collaborative patient/client-family centered approach domain. The FITRI's four steps in developing primary health cares' interprofessional collaborative practice can be implemented and provide positive impacts in primary healthcare settings to improve and foster competencies of IPCP in primary healthcare.

Workplace wellness programs for working mothers: A systematic review.

BACKGROUND: This systematic review aimed to uncover the evidence and benefits of employers' commitment to delivering workplace wellness programs for working mothers. METHODS: The articles published in PubMed, Embase, Scopus, and AgeLine-Medline databases between 2012 and 2021 were searched to evaluate the workplace wellness programs for working mothers with at least one resultant wellness or wellbeing (e.g., physical health, less stress, mental health, burnout, depression, smoking, bullying, alcohol consumption, overweight), work-life balance outcome, or job satisfaction. RESULTS: Eight studies that met the criteria were retrieved from databases. They showed some effective workplace wellness programs that can reduce depression, stress, and burnout, improve mental health, healthy behaviors, work-family balance and work-life balance. Working mothers participating in a workplace wellness program generally gain some benefits; one of which is reduced stress typically related to childcare, economic, and personal health issues. CONCLUSIONS: The implementation of workplace wellness programs for working mothers showed positive effects on their health problems and health costs. These eight studies revealed that workplace wellness programs specifically designed for working mothers can lead to time efficiency by holding the programs in or near the workplace and implementing them during the workdays. This greatly suits the conditions of many working mothers whose limited time and energy to balance the household, family and work tasks.

Factors Affecting Neurocognitive Function in Children with Chronic Kidney Disease: A Systematic Review.

Purpose: In children, chronic kidney disease (CKD) has been known to affect neurocognitive function which can impair the quality of life. This study aims to determine the factors and treatment modalities which might affect neurocognitive function in pediatric population with CKD. Patients and Methods: A systematic review was done using 3 electronic databases: PubMed, ScienceDirect, SpringerLink, and carried out based on PRISMA guidelines. Our review included articles published in the last 10 years (2011-2021) in English, on children aged 0-18 years with CKD. Factors affecting the children's neurocognitive function were assessed. Results: Eight articles were included in this study. Three articles reported that parent's education, especially maternal education affect the neurocognitive function of children with CKD. In relation with modalities, in general, children with CKD who had kidney transplant had a better neurocognitive outcome. A longer duration of hemodialysis (HD) was associated with poorer neurocognitive outcomes. Other factors that can affect the neurocognitive function included depression, a history of abnormal births, seizures, and hypertension. Conclusion: In children, CKD might cause neurocognitive function disorders through various complex and interconnected mechanisms. Further studies are needed to determine the mechanism and prevention of neurocognitive disorders, as well as the best choice of therapeutic modality to improve both kidney function and neurocognitive function in children with CKD.

Fundamental Aspects of the Development of a Model of an Integrated Health Care System for the Prevention of Iron Deficiency Anemia among Adolescent Girls: A Qualitative Study.

Iron deficiency anemia (IDA) in adolescent girls is a problem that has not been resolved. This study aimed to explore the critical aspects of an integrated health care system model for preventing IDA in adolescent girls in a rural area of Indonesia. This qualitative research employed a grounded theory approach in order to build a substantive theory. This study used in-depth interviews with adolescents, parents, teachers, health workers, and persons in charge of adolescent programs at the health office, education office, and ministry of religion. Purposive sampling was performed until data saturation was achieved. Codes, categories, and themes were generated through thematic data analysis to develop a substantive theory. Data analysis was performed using MAXQDA 2022 software. A total of 41 people participated in this study. This investigation generated twenty-two categories and seven themes. These themes relate to policymaker commitments, stakeholder governance, quality, adolescents' lifestyles, adolescents' self-factors, adolescents' access to health services, and social support. The themes identified become fundamental aspects of the integrated health care system model for preventing IDA in adolescent girls. The model of the integrated health care system consists of several essential points, which include awareness and efforts from policymakers and adolescent girls, supported by parents, teachers, and the community.

The Effect of Mobile Health (m-Health) Education Based on WANTER Application on Knowledge, Attitude, and Practice (KAP) Regarding Anemia among Female Students in a Rural Area of Indonesia.

Female students, as adolescent girls, are more at risk of anemia because of high nutritional requirements. Health education through mobile applications influences the knowledge, attitude, and practice (KAP) of anemia in adolescent girls. Based on our previous study, several adolescents experienced anemia. This study aims to analyze the effect of health education through mobile applications, namely the WANTER application, on increasing KAP. This study was quasi-experimental with a pretest−posttest design; the sample was divided into an intervention (WANTER application) and a control group (booklet). The study was conducted in a rural area of Indonesia. There were 162 adolescent girls included in the intervention group and as many as 115 adolescent girls in the control group. Our study showed that adolescents' knowledge and attitude increased significantly in three months after the intervention of WANTER and booklets toward preventing anemia with p < 0.001; however, there was no significant difference in KAP between the control and intervention groups. In addition, there was no improvement in practice, either in the control or intervention groups. Knowledge, attitudes, and practices to prevent anemia need to be continuously improved. Health education through appropriate media for adolescents is very important to make interventions more effective.

Anemia among Adolescent Girls in West Java, Indonesia: Related Factors and Consequences on the Quality of Life.

Anemia in adolescent girls is still a problem in Indonesia. The impact of anemia is quite significant for adolescent health. This study aims to analyze related factors of anemia among adolescent girls, and the effect of anemia on the quality of life. The study was conducted in the Soreang District, West Java, Indonesia. This cross-sectional study involved 286 female students (15−19 years). A 24-h recall questionnaire was used to collect the nutrient intake. We use the WHOQOL-BREF to analyze the quality of life. The study assessed height, weight, body mass index (BMI), mid-upper arm circumference (MUAC), and a capillary blood sample to determine hemoglobin levels. Bivariate and multiple logistic regression tests were measured to find the factors most influencing anemia. The prevalence of anemia was 14.3%. Related factors of anemia in this study were: duration of blood show per menses, iron consumption, weight, height, and MUAC. From bivariate analyses, anemia influenced the social relationships domain with p < 0.05. Multivariate logistic regression showed that the most influencing factors for anemia were MUAC and duration of blood per menses. Anemia impacted the social relationships domain. In this study, the two main factors that affected anemia were MUAC and duration of blood each menstrual cycle.

The Study of Nutrient Intake and Adolescent Girls' Quality of Life in a Rural Area of Indonesia.

An inadequate nutrient intake correlates with malnutrition, a problem affecting many adolescents worldwide. Nutrient intake is associated with quality of life (QoL). Our study analyzed the relationship between nutrient intake and adolescents' QoL. We conducted a cross-sectional study. Through simple random sampling, 157 adolescent girls were selected. Nutrition status was assessed using anthropometric measurements. Nutrient intake was collected using the food frequency questionnaire (FFQ). WHOQOL BREF was used to explore adolescent girls' quality of life. The median of nutrient intake: energy (908.25 kcal); protein (24.16 g); carbohydrate (128.89 g); fat (21.89 g); vitamin A (77.10 mg); vitamin E (1.40 mg); vitamin B1 (0.19 mg); vitamin B2 (0.29 mg); vitamin B6 (0.45 mg); folic acid (35.13 mg); vitamin C (12.60 mg); calcium (197.46 mg); magnesium (93.72 mg); iron (2.64 mg); and zinc (2.09 mg). The adolescents' QoL scores were physical health 44 (25-81), psychological domain 56 (19-94), social relationships 56 (19-94), and environmental domain 56 (31-100). The strongest correlations were between (1) physical health with carbohydrates, vitamin C, and fat; (2) psychological domain with calcium; (3) social relationships with carbohydrates and vitamin C; and (4) environmental domain with BMI and zinc. There was a significant positive correlation between the intake of some nutrients and adolescents' QoL, despite the observation of some significant negative correlations. The findings of this study indicate that more attention should be focused on adolescents' nutrient intake in order to improve their QoL.

Iron Deficiency Anemia and Associated Factors Among Adolescent Girls and Women in a Rural Area of Jatinangor, Indonesia.

Background: Iron deficiency anemia is a common problem among adolescent girls and women, with significant consequences on personal health. One of the causes of iron deficiency anemia is inadequate nutritional intake. This study explores iron-deficiency anemia and associated factors among adolescent girls and women in a rural area of Jatinangor, Indonesia. Methods: A cross-sectional study was conducted with 95 adolescent girls and 85 women between April and November 2018. Cluster random sampling was used to select the participants from seven villages in the Jatinangor district. After obtaining informed consent, we collected sociodemographic data, menstrual histories, and related data, including nutritional intake using 24-hour dietary recall. Anthropometrics were gathered to determine the body mass Index (BMI), and venous blood samples were analyzed for complete blood count and hemoglobin levels. Descriptive statistics followed by bivariate and multivariable logistic regression were used to identify anemia-associated factors. Results: The prevalence of iron deficiency anemia among the girls was 21.1% and 9.4% among women, with an average hemoglobin level in adolescents of 10.75 g/dL (± 0.79) and in adults 11.20 g/dL (± 0.61), whereas MCV was 74.49±8.22 fL in adolescents and 7.61±8.62 fL in adults. The majority of our samples were not stunted in growth and were also within a normal weight range. Multivariate logistic regression analysis showed that protein intake (OR=0.25; 95% CI 0.11-0.58) was a positively associated factor with anemia. Conclusion: The prevalence of iron-deficiency anemia in this study represents a mild public health problem in the study sample. Based on the hemoglobin level, anemia, can be classified as moderate in adolescents and mild in adults. Low levels of MCH indicate iron-deficiency anemia. Sufficient protein intake did not prevent anemia due to macronutrient and micronutrient intake.

An evaluation of kidney dysfunction as a common symptom of typhoid infection in an endemic country: A rare case study.

Nephrotic syndrome and encephalopathy are uncommon complications that occurred in typhoid fever. The diagnosis is based on proteinuria finding with nephrotic range value, edema, and hypoalbuminemia. In this study, a 10-year-old boy was diagnosed with encephalopathy typhoid and nephrotic syndrome. The physical examination and urinalysis were conducted with methylprednisolone 60 mg/body surface area and captopril to reduce proteinuria.