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Neurodevelopment and Fetal Growth in Fetuses with Congenital Heart Disease

Sat, 01 Jul 2023 00:00:00 GMT

Title: Neurodevelopment and Fetal Growth in Fetuses with Congenital Heart Disease Authors: Pribadi, Adhi Abstract: Objective: To determine mechanisms underlying fetal growth abnormalities, particularly intrauterine neurodevelopment, in congenital heart defects. Method: Literature Review. Results: Since intrauterine, smart mechanisms have ensured that blood flow to the central nervous system remains smooth to maintain Neurodevelopment. The mechanism fluctuates to keep oxygen flowing to the brain. Blood with the highest oxygen content should always be pumped to upper body and the head via the heart and the aorta. Aortic arch region contains three major blood vessels, a.Brachiocephalic, a.Carotid communis, and a.Subclavia that bleed the upper body and head, including the brain. So, blood flow from the left heart through the aortic arch is critical for fetal brain growth. If the heart cannot drain blood to the head, brain growth will be jeopardized because hypoxia will interfere with brain growth so will be influence to Neurodevelopment. Impaired blood flow can occur as early as intrauterine, particularly if the fetus has congenital heart disease. Blood flow in the Middle Cerebral Artery (MCA) can be used to measure blood flow in the fetus head. The pulsatility index value can be used to measure blood flow in the MCA, and another parameter is the cardioplacental ratio. There is a decrease in flow to the head in congenital heart disease, which results in a decrease in the Pulsatily index of the MCA and a decrease in the cardioplacental ratio. Conclusions: Prolonged reduction in cardiac-derived blood flow leads to compromised neurodevelopment. Consequently, timely correction of postpartum heart defects becomes paramount to prevent protracted impairments in brain growth. Failing to address this promptly could also diminish the overall quality of life for children afflicted by congenital heart disease.

Resolution of Ethical Conflicts between Medical Indications and Patient Preferences in Case of Unmarried Woman with Ovarian Cancer

Sun, 01 Oct 2023 00:00:00 GMT

Title: Resolution of Ethical Conflicts between Medical Indications and Patient Preferences in Case of Unmarried Woman with Ovarian Cancer Authors: Suryadi, Taufik; Irmayani, Putri; Kulsum, Kulsum Abstract: Objectives: To resolve ethical conflicts in medical decision making in unmarried patients with a diagnosis of ovarian cancer. The ethical issue in this case is the main operative management in cases of ovarian cancer, namely removal of the uterus and both ovaries even though the patient is not married and has never been pregnant. The opportunity for patients to get pregnant no longer exists, so there is an ethical conflict between medical indications and patient preferences. Methods: This case report is about an unmarried woman 38- year with a diagnosis of ovarian cancer. This patient initially underwent right salfingooophorectomy surgery. Anatomical pathology results found adenocarcinoma serosum ovarii. The patient underwent chemotherapy for 3 cycles. Then the patient was re-operated with a planned debulking interval laparotomy. Discussion: From the aspect of patient indications, the results of combination treatment between surgery and chemotherapy have shown a marked increase in the survival rate of patients in five years. The choice of performing a debulking interval laparotomy is a difficult choice. The patient's preference to get pregnant will be difficult to accept, but it can be accommodated by improving the quality of life and paying attention to humanism, social and cultural aspects of its contextual features. Conclusion: Clinical ethical considerations related to uterine removal in unmarried patients is a matter of debate. Clinical ethical theory namely quality of life, patient preferences, medical indications, and contextual features are beneficial in medical decision making.

The prevalence of lower urinary tract symptoms in Caesarean section patients’ first and seventh day of postpartum

Sun, 01 Oct 2023 00:00:00 GMT

Title: The prevalence of lower urinary tract symptoms in Caesarean section patients’ first and seventh day of postpartum Authors: Julian, Austin; Prihadi, Johannes C.; Indrajaya, Yuma S. S. Abstract: Objective: To compare the prevalence of Lower Urinary Tract Symptoms (LUTS) on the first day and the seventh day postpartum in Caesarian section patient Method: This cross-sectional study utilized the ICIQ-FLUTS LF (ICIQ-Female Lower Urinary Tract Symptoms-Long Form) and a questionnaire to screen for risk factors among postpartum patients who underwent C-section delivery at Santo Antonius Hospital, Pontianak, West Kalimantan. Data were collected twice, 12 hours after urinary catheter removal and on the seventh day of the postpartum period. The study sample consisted of 95 respondents. Results: Among the 111 total respondents, the majority were under 35 years old, multiparous, classified as obese, had no family history of Lower Urinary Tract Symptoms (LUTS), and had not used diuretics or traditional medicine. Significant differences were observed in the prevalence of LUTS between the first and seventh days of the postpartum period. Most symptoms showed a decrease on the seventh day, except for six symptoms: insensible urinary incontinence, hesitancy, urinary retention, feeling of incomplete emptying, bladder pain, and dysuria, which increased. Conclusion: In conclusion, our study suggests that the duration of the postpartum period affects the prevalence of LUTS following C-section delivery. However, it's important to acknowledge the limitations of this study, which may impact the understanding of LUTS progression during the postpartum period. Conclusion: In conclusion, we concluded that the duration of the postpartum period affects the LUTS after delivery with the method of C-section, but this study has many limitations which may affect the progressivity of LUTS in the Postpartum period.

Optimal Omega-3 Intake: A Natural Way to Ease Primary Dysmenorrhea Severity

Sun, 01 Oct 2023 00:00:00 GMT

Title: Optimal Omega-3 Intake: A Natural Way to Ease Primary Dysmenorrhea Severity Authors: Widyatmoko, Benedicta A.; Mardjuki, Edihan Abstract: Objective: To examine the link between adequate omega-3 intake and degree of primary dysmenorrhea in Atma Jaya preclinical medical students Methods: This cross-sectional study of 126 female students who experienced primary dysmenorrhea started from August to October 2022. Data was collected through the distribution of google forms containing the Working ability, Location, Intensity, Days of pain, Dysmenorrhea (WaLLID) score and Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ). According to Recommended Dietary Allowance (RDA), daily intake of omega-3 fatty acids is sufficient if it is ≥ 1.1 g/day. Data were processed using Microsoft Excel and SPSS and analyzed by a 2x3 Chi-square test. Results: The findings showed that the majority of the respondents who consumed optimal omega-3 fatty acids, 17.5% (22 people), had primary dysmenorrhea with mild pain and also had a low percentage of severe primary dysmenorrhea, 3.2% (4 people). The link between adequate intake of omega-3 fatty acids with the degree of primary dysmenorrhea in female medical students showed significant test results (p=0.046). Conclusion: There is a significant link between optimal intake of omega-3 and degree of primary dysmenorrhea in Atma Jaya preclinical medical students (p<0.005).