DSpace Collection: 61 - 132

Flaps or flat: a case report of double free flap survival after a prolonged cardiac arrest

Sat, 01 Jun 2024 00:00:00 GMT

Title: Flaps or flat: a case report of double free flap survival after a prolonged cardiac arrest Authors: Atmodiwirjo, Parintosa; Ramadan, Mohamad Rachadian; Djohan, Michael; Amanda, Nadira Fildza Abstract: This case addressed patient and free flap survival after cardiac arrest with the contentious use of vasopressors amid concerns about potential vasoconstrictive effects on flap vitality. A 59-year-old male with mucoepidermoid carcinoma underwent post-total maxillectomy and double free flap reconstruction (free fibular flap and anterolateral thigh free flap). Intraoperatively, he experienced cardiac arrest after anastomosis due to hypovolemia or hypoxia, requiring external cardiac massage and vasopressor administration. Despite the initial restoration of circulation, subsequent cardiac arrest ensued, necessitating further resuscitation. Postoperatively, vasopressors were also administered due to hemodynamic instability. Contrary to concerns, both flaps demonstrated sustained vitality, challenging prevailing apprehensions about vasopressor-induced vasoconstriction compromising flap viability. This observation suggests that vasopressors may not significantly threaten flap viability, prompting reconsideration of hesitations and encouraging further investigation. The study advocates for a judicious evaluation of vasopressor administration in free flap procedures, enriching clinical considerations for optimal patient care.

Obesity in urban Indonesia: evidence from the 2007 and 2018 Basic Health Research

Sat, 01 Jun 2024 00:00:00 GMT

Title: Obesity in urban Indonesia: evidence from the 2007 and 2018 Basic Health Research Authors: Ferdina, Ayunina Rizky; Arfines, Prisca Petty; Aryastami, Ni Ketut Abstract: BACKGROUND The prevalence of obesity in urbanizing Indonesia is rising, where the double burden of malnutrition poses a significant challenge. This study aimed to examine the prevalence and increment of obesity-related noncommunicable diseases (NCDs) of diabetes and hypertension. METHODS Secondary data from the latest 2018 Basic Health Research (RISKESDAS) were used to analyze the obesity rate and its associations with lifestyle, sociodemographics, and certain comorbidities among urban Indonesians. This study included non-pregnant adults aged ≥18 years who lived in the urban area and whose blood pressure and glucose levels were measured in the survey. Results were compared to a similar study using data from 2007. RESULTS The proportion of obesity among Indonesia’s urban population was more than doubled from 23.0% in 2007 to 50.1% in 2018 for obesity and 28.0% to 57.2% for central obesity. Additionally, females, individuals with higher socioeconomic status, and higher education levels exhibited a higher obesity prevalence. CONCLUSIONS Urban Indonesia has witnessed a dramatic rise in obesity prevalence. Our findings highlighted the urgent need for policymakers to consider the escalating prevalence of NCDs associated with obesity. Strengthening and concretizing health promotion and prevention policies at the community level are crucial to combat this alarming public health challenge.

Changes in body weight and healthy lifestyle perception of Indonesian adults during COVID-19 pandemic

Sat, 01 Jun 2024 00:00:00 GMT

Title: Changes in body weight and healthy lifestyle perception of Indonesian adults during COVID-19 pandemic Authors: Septiyana, Sorra Milwayani; Aji, Arif Sabta; Paratmanitya, Yhona Abstract: BACKGROUND Social restrictions during the COVID-19 pandemic have impacted eating patterns and psychological status, leading to changes in body weight and perceptions of a healthy lifestyle in society. This study aimed to investigate the effect of social restrictions on weight changes and perceptions of a healthy lifestyle in adults during the COVID-19 pandemic in Indonesia. METHODS This cross-sectional study was conducted using convenience sampling on 287 Indonesian adults from June to August 2020. The data were collected using a selfadministered online questionnaire using Google Forms. Data were analyzed using the chi-square test and logistic regression analysis. RESULTS There was no effect of social restrictions on weight changes and perceptions of lifestyle in adults (p = 0.900 and 0.748, respectively). However, 112 respondents (78.3%) had positive perceptions or supported adopting a healthy lifestyle under largescale social restrictions. Multivariable logistic regression demonstrated that adults aged 36–45 years had a 3.6 times higher risk of weight changes than young adults aged 25–35 years (p = 0.004, OR = 3.65, 95% CI = 1.51–8.85). CONCLUSIONS Social restrictions did not affect weight changes and perceptions of a healthy lifestyle in adults during the COVID-19 pandemic in Indonesia. However, older adults might have a higher risk of body weight changes. Controlling body weight is important to prevent further weight gain and the risk of noncommunicable diseases that can aggravate COVID-19.

Diabetic foot score: a predictive model for leg amputation in patients with diabetic foot disease

Sat, 01 Jun 2024 00:00:00 GMT

Title: Diabetic foot score: a predictive model for leg amputation in patients with diabetic foot disease Authors: Vincent, Agustinus; Soelistijo, Soebagijo Adi; Ardiany, Deasy; Pranoto, Agung; Lusida, Michael Austin Pradipta; Pradhevi, Lukita; Saefudin, Rendra Prasetya Abstract: BACKGROUND Patients with diabetes mellitus are at a higher risk for peripheral artery disease (PAD) and diabetic foot disease (DFD), which can ultimately result in leg amputation. This study aimed to develop a novel scoring system to predict the risk of leg amputation using widely available modalities, including demographic characteristics and various laboratory data. METHODS This study was conducted at Dr. Soetomo General Hospital and analyzed risk factors for leg amputation in 99 patients with DFD who underwent leg amputation compared with 80 control patients. This study presented a predictive model for leg amputation in patients with DFD, using odds ratio (OR) analysis and logistic regression approach with confidence intervals (CIs) set at 95%. The data analysis was conducted using SPSS software version 25.0. RESULTS PAD (OR 6.52, 95% CI = 2.19–19.37, p = 0.001), high low-density lipoprotein cholesterol (OR 5.97, 95% CI = 2.31–15.43, p<0.001), type of DFD (OR 4.58, 95% CI = 2.14–9.79, p<0.001), poor glycemic control (OR 4.48, 95% CI = 1.78–11.28, p = 0.001), and neutrophil-to-lymphocyte ratio level (OR 1.04, 95% CI = 1.00–1.07, p = 0.025) were the independent predictors for leg amputation. The predictive model, developed using multivariate analysis with an area under the curve of 89%, optimum threshold of 0.5 (score 6), sensitivity of 84.8%, and specificity of 78.8%, indicating a promising approach for predicting leg amputation outcomes. CONCLUSIONS The newly developed diabetic foot score may assist in making decisions regarding therapeutic options for patients with DFD.