Green Medical Journal
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Factors Length of Intensive Stay in Patients Post Gastro Intestinal Tract Operation
Full text linkIntroduction: Intensive care after gastrointestinal surgery is one of the factors that play an important role in caring patients with gastrointestinal disorders. Long treatment will have an impact on mortality and high treatment costs. The length of treatment can be caused by several factors, namely external factors and internal factors. External factors are nutritional status, type of surgery, and type of anesthesia. Meanwhile, internal factors are age, gender, amount of bleeding, incidence of infection and underlying disease.
Objective: Determine the factors associated with the length of intensive care in post-lower gastrointestinal tract surgery patients at Ibnu Sina YW UMI Makassar Hospital.
Method: Observational analysis with a cross-sectional method uses secondary data from the medical records data of patients treated in 2021 and 2022.
Results: From the data of 60 patients who met the inclusion criteria with patient descriptions: 56.6% adult age, 66.6% male gender, 83.3% type of operation found to be elective, 56.6% type of anesthesia without epidural, amount of bleeding <30% EBV was 83.3%, the incidence of infection was found to be 75%, good nutrition was 51.6%, the underlying disease was found to be malignant in 31.6%. Factors that influence the length of hospitalization are the amount of bleeding >30% EBV (p <0.001) and malnutrition nutritional status (p = 0.037).
Conclusion: Factors associated with the length of intensive care in post-lower gastrointestinal tract surgery patients at Ibnu Sina YW UMI Makassar Hospital are the amount of bleeding >30% EBV and malnutrition nutritional status
Characteristics of Tonsilitis Disease
Full text linkIntroduction: Tonsillitis is an inflammation of the palatine tonsils that are part of Waldeyer's ring, and is caused by microorganisms such as viruses, bacteria, and fungi that enter the body through the air or food. The spread of tonsillitis infection can also be through kisses that contain microorganisms. Acute tonsillitis is caused by streptococcus beta hemolyticus, streptococcus viridans and streptococcus pyogenes, can also be caused by viruses. Chronic tonsillitis isgenerally caused by complications of acute tonsillitis, especially those that are not treated properly. In addition to improper treatment, other risk factors for the onset of chronic tonsillitis include poor oral hygiene, physical fatigue and certain types of food.
Methods: Descriptive observational with a retrospective approach and the research design used is Cross Sectional Study.
Result: The results of the distribution of patients with tonsillitis based on age, the most at the age of 5 - 11 years, as many as 20 people (50%). Based on gender, the highest number was female as many as 23 people (58%). Based on the size of the tonsils, the largest size was T2- T2 as many as 17 patients (43%). Based on the diagnosis, there were 23 patients (58%) with acute tonsillitis.
Conclusion: Acute tonsillitis was the most common diagnosis with a patient age range of 5 - 11 years, where most were female and tonsil size was T2-T2.Introduction: Tonsillitis is an inflammation of the palatine tonsils that are part of Waldeyer's ring, and is caused by microorganisms such as viruses, bacteria, and fungi that enter the body through the air or food. The spread of tonsillitis infection can also be through kisses that contain microorganisms. Acute tonsillitis is caused by streptococcus beta hemolyticus, streptococcus viridans and streptococcus pyogenes, can also be caused by viruses. Chronic tonsillitis isgenerally caused by complications of acute tonsillitis, especially those that are not treated properly. In addition to improper treatment, other risk factors for the onset of chronic tonsillitis include poor oral hygiene, physical fatigue and certain types of food.
Methods: Descriptive observational with a retrospective approach and the research design used is Cross Sectional Study.
Result: The results of the distribution of patients with tonsillitis based on age, the most at the age of 5 - 11 years, as many as 20 people (50%). Based on gender, the highest number was female as many as 23 people (58%). Based on the size of the tonsils, the largest size was T2- T2 as many as 17 patients (43%). Based on the diagnosis, there were 23 patients (58%) with acute tonsillitis.
Conclusion: Acute tonsillitis was the most common diagnosis with a patient age range of 5 - 11 years, where most were female and tonsil size was T2-T2
Relationship between Diet using Food Frequency Questionnaire and The Incidence of Dysmenorrhea
Full text linkIntroduction: Students’ eating habits are strongly shaped by their busy schedules and active social lives, which often encourage a preference for fast food and reduce the consumption of fiber-rich foods.
Methods: This study uses a cross-sectional methodology and is an analytical observational study.
Methods: Descriptive observational with a retrospective approach and the research design used is Cross Sectional Study.
Result: The results of the distribution of patients with tonsillitis based on age, the most at the age of 5 - 11 years, as many as 20 people (50%). Based on gender, the highest number was female as many as 23 people (58%). Based on the size of the tonsils, the largest size was T2- T2 as many as 17 patients (43%). Based on the diagnosis, there were 23 patients (58%) with acute tonsillitis.
Conclusion: Acute tonsillitis was the most common diagnosis with a patient age range of 5 - 11 years, where most were female and tonsil size was T2-T2
Primary Dysmenorrhea and Sleep Quality: A Study in Tarumanagara University Medical Students
Full text linkIntroduction: Primary dysmenorrhea is a common menstrual pain experienced by young women, characterized by lower abdominal quadrant pain without any underlying pelvic pathology. The intensity of menstrual pain can significantly impact daily activities, and it can also influence various factors, including sleep quality.
Objective: This study aimed to determine the association between sleep quality and dysmenorrhea severity.
Methods: This study used a cross-sectional design in 214 female medical students at Tarumanagara University aged between 18 to 25 years. Sleep Quality was measured using the Pittsburgh Sleep Quality Index (PSQI) and the severity of primary dysmenorrhea was measured using a questionnaire adapted from a previously developed instrument. It was validated and tested for reliability by the authors in this study (Cronbach’s α = 0.767). Data were analyze using the Chi-square and multivariable logistic regression, adjusting for BMI and age at menarche.
Result: The study found that 49.1% students have poor sleep quality, and 47.2% experienced severe primary dysmenorrhea. Poor sleep quality was significantly associated with higher dysmenorrhea severity (OR = 3.07; 95% CI: 1.76–5.37). Good sleep quality was independently associated with lower odds of severe dysmenorrhea (OR = 0.309; 95% CI: 0.174–0.548; p < 0.001), while BMI and menarche age were not significant.
Conclusion: Good sleep quality is independently associated with reduced severity of primary dysmenorrhea and may reduce the risk of experiencing severe dysmenorrhea
Helicopter Parenting: Effects on Medical Students’ Adaptation and Academic Achievement
Full text linkIntroduction: Helicopter parenting has many negative impacts on higher education, including how it affects students’ college adjustment and academic achievement. Although a wide range of articles explore helicopter parenting and its influence on higher education, the research on medical education still scarce.
Methods: The aims of this study provide a brief explanation of helicopter parenting and its impact on medical education. Articles were collected by assessing SpringerLink, ScienceDirect, Taylor & Francis, and Google Scholar databases.
Result: Overcontrol and overprotective manners from helicopter parents may reduce children’s sense of autonomy and competence. Hence, it significantly reduces students’ self-efficacy, self-directed learning, and has low intrinsic motivation in learning. The children of helicopter parents are vulnerable to stress, anxiety, and depression, and tend to have difficulties adjusting to college life.
Conclusion: Considering the negative impacts of helicopter parenting, faculty and medical teachers need to develop strategies to address the issue and prevent further impacts
Sickle Cell Trait and Protection Against Malaria: Review Literature
Full text linkIntroduction: Malaria is an infectious illness caused by various Plasmodium parasites transmitted by Anopheles mosquitoes. Currently, malaria is still a health problem with a significant incidence globally and has high morbidity and mortality. This makes researchers continue to seek solutions for malaria eradication. One of the things that is known to be protective against severe malaria infection is the sickle cell trait or HbAS.
Content: Sickle cell trait is a condition in which an individual is a carrier or has a single gene that causes sickle cell disease. The way sickle cell trait protects against malaria has been suggested for a long time. Along with the development of science and technology, various mechanisms of how the sickle cell trait protects against severe malaria are becoming known. Several mechanisms include sickling, miRNA, decreased cytoadherence, and immunological mechanisms.
Conclusion: Malaria is most often caused by Plasmodium falciparum. Indonesia is still an endemic country with the most frequent cases of malaria in children. One thing that is known to be protective against severe malaria, both symptomatic and asymptomatic malaria, is the sickle cell trait with various underlying mechanisms
Prevalence of Computer Vision Syndrome Among Medical Students at Universitas Muslim Indonesia
Full text linkIntroduction: Computers are something that is needed nowadays. Computers are not only used to make work easier but also for entertainment. The use of computers in various ways will cause health problems for computer users. Computer Vision Syndrome (CVS) is a group of eye symptoms caused by prolonged use of computers or other electronic devices.
Objective: Determine the frequency of CVS incidents in medical faculty students at the Indonesian Muslim University in the Class of 2020.
Method: This study employed a descriptive design with a cross-sectional approach. Primary data were collected using the Computer Vision Syndrome Questionnaire (CVS-Q), which was distributed to medical students at Universitas Muslim Indonesia via Google Forms. The data were analyzed using Microsoft Excel and SPSS software.
Results: The CVS incidence rate was 116 people (50.9%). Based on gender, the largest number was women, 95 people (91.9%). Based on the use of glasses, CVS was higher among students who did not use glasses, 66 respondents (56.9%). Based on the duration of computer, the highest duration of heavy use was found by 62 people (53.4%). Based on the frequency of rest, <10 minutes more often experienced CVS, namely 89 people (76.7%). Based on viewing distance, there were more respondents with a distance of <50 cm, with 78 people (67.2%).
Conclusion: The most common gender who experienced CVS was female, CVS was more prevalent students who did not use glasses with a heavy duration with a rest frequency of <10 minutes and a viewing distance of <50 cm
Comparison of Students Score between Progress Test and Final Test; Pilot Project
Full text linkIntroduction: The implementation of diverse assessment methods has facilitated the collection of both quantitative and qualitative data, providing students with valuable feedback. Most programs reported that their assessment strategies were aligned with a competency framework, emphasizing constructive alignment and assessments structured according to Miller’s pyramid. Many programs highlighted the significance of multiple low-stakes workplace-based assessments for evaluating real-world competencies, alongside the use of the final test, including progress testing in the knowledge domain to decrease student load. The aim of this study is to compare student final score between the progress test and the final test.
Methods: This is a mixed-method research. A quantitative of 506 students participated in the growth and development & geriatrics block, divided into two groups. Group A (progress test), comprising 253 students, underwent a progress test conducted over four exam sessions in 2024, as a pilot project. Meanwhile, Group B (final test), also with 253 students, completed a final test in 2023. The data from both groups were collected and analyzed using the T-independent test. Also, qualitative data was taken by student interviews.
Result: Group A, assessed in 2024, achieved a higher average score (69.33 ± 11.22) compared to Group B (54.92 ± 11.49). The T-independent test yielded a P value of <0.0001, indicating a statistically significant difference. This suggests that the progress test method is more effective than the final test in enhancing students' final scores, as progress tests help alleviate cognitive load.
Conclusion: As a pilot initiative, the progress test has proven effective in improving students' final scores. It is recommended that this approach be extended to other educational blocks that have similar characteristics to the interventional blocks to enhance overall educational quality.
 
Predictive Role of Non-Invasive Laboratory Markers in Hepatic Fibrosis among Hepatitis B Patients
Full text linkIntroduction: Chronic hepatitis B (CHB) is a major cause of liver fibrosis, which may progress to cirrhosis if undetected. Non-invasive biomarkers such as Gamma-glutamyl Transferase to Albumin Ratio (GAR), Alkaline Phosphatase to Platelet Ratio (APPR), and Alkaline Phosphatase plus Gamma-glutamyl Transferase to Platelet Ratio (AGPR) have shown promise in predicting fibrosis severity, potentially outperforming traditional markers like APRI.
Methods: We conducted a cross-sectional study involving 34 CHB patients at Dr. Sardjito General Hospital, Yogyakarta (October 2022–February 2023). Liver stiffness was assessed using shear wave elastography (SWE) and staged according to the Metavir system (F0–F4). GAR, APPR, and AGPR were calculated from laboratory data. Spearman correlation and linear regression analyses were used to evaluate their association with fibrosis severity.
Result: AGPR showed the strongest correlation with fibrosis stage (ρ = 0.611, p < 0.001), followed by GAR (ρ = 0.450, p = 0.008) and APPR (ρ = 0.384, p = 0.026). All three indices were significant in univariate regression, while the combined model demonstrated improved predictive performance (R² = 0.389, p = 0.003) despite lack of independent significance in multivariate analysis.
Conclusion: GAR, APPR, and AGPR are promising non-invasive biomarkers for assessing liver fibrosis in CHB patients. Their combined use enhances diagnostic accuracy and offers practical benefits, particularly in settings where biopsy is not available.
Abstrak
Pendahuluan: Hepatitis B kronis (CHB) merupakan penyebab utama fibrosis hati, dimana komplikasi berupa sirosis hepatis sering terjadi pada pasien yang terlambat terdiagnosis. Biomarker noninvasif seperti Gamma-glutamyl Transferase to Albumin Ratio (GAR), Alkaline Phosphatase to Platelet Ratio (APPR), dan Alkaline Phosphatase plus Gamma-glutamyl Transferase to Platelet Ratio (AGPR) memiliki potensi dalam memprediksi tingkat keparahan fibrosis serta menunjukkan akurasi yang lebih baik dibandingkan penanda tradisional seperti APRI.
Metode: Peneliti melakukan penelitian cross sectional terhadap tiga puluh empat pasien CHB di RSUP Dr. Sardjito Yogyakarta pada Oktober 2022 hingga Februari 2023. Liver stiffness diukur menggunakan shear wave elastography (SWE) dan diklasifikasikan berdasarkan sistem Metavir (F0–F4). Peneliti menghitung indeks GAR, APPR, dan AGPR dari data laboratorium. Analisis korelasi Spearman dan regresi linier dilakukan untuk mengevaluasi hubungan ketiga indeks tersebut dengan tingkat keparahan fibrosis.
Hasil: Indeks AGPR menunjukkan korelasi paling kuat dengan stadium fibrosis (ρ = 0,611; p < 0,001), diikuti oleh GAR (ρ = 0,450; p = 0,008) dan APPR (ρ = 0,384; p = 0,026). Ketiga indeks signifikan pada analisis regresi univariat. Model gabungan memberikan kinerja prediktif yang lebih baik dengan nilai R² sebesar 0,389 (p = 0,003) walaupun tidak menunjukkan signifikansi independen pada analisis multivariat.
Kesimpulan: Indeks GAR, APPR, dan AGPR merupakan biomarker noninvasif yang berpotensi untuk menilai tingkat keparahan fibrosis hati pada pasien CHB. Penggunaan ketiga indeks secara bersamaan meningkatkan akurasi diagnostik dan memberikan manfaat praktis pada fasilitas pelayanan kesehatan dengan keterbatasan akses biopsi hati.
Kata kunci: Hepatitis B kronis; Fibrosis hati; Biomarker noninvasif; GAR; APPR; AGP
Correlation of Myopia Degree with Central Corneal Thickness and Corneal Endothelial Density
Full text linkIntroduction: The anterior segment characteristics that may contribute to myopia are central corneal thickness and corneal endothelial cell density. The purpose of this study is to ascertain whether corneal endothelial density and central corneal thickness are associated with the degree of myopia.
Methods: This cross-sectional observational analytical study was conducted from October to November 2018 at the Hasanuddin University Hospital in Makassar, Indonesia. Levior myopia (< -3.00 D) 61 eyes, moderate myopia (-3.00 D - -6.00 D) 30 eyes, and gravior myopia (> 6.00 D) 11 eyes comprised the 102 eyes of 65 myopic patients who participated in the study. The Snellen chart projector and trial lens set are used to test the refractive state of myopia. In contrast, the Nidek-CEM 530 specular microscope is used to measure the central corneal thickness and corneal endothelial cell density.
Results: The high myopia group had the lowest CCT mean (521.3um; p: 0.199). The group with high myopia had the lowest mean ECD, 2777.6 (p<0.05). In cases of moderate myopia, a correlation between corneal ECD and CCT was found (p<0.05).
Conclusion: The degrees of myopia and the CCT do not correlate. Reductions in corneal ECD are associated with myopia gravior. In moderate myopia, there is a strong positive relationship between corneal endothelial cell density and central corneal thickness