Jarod Wahyu Kristiyanto, Muyassaroh Muyassaroh, D. Antono
{"title":"Facial nerve paralysis in nasopharyngeal carcinoma: a case report","authors":"Jarod Wahyu Kristiyanto, Muyassaroh Muyassaroh, D. Antono","doi":"10.19106/jmedsci005501202309","DOIUrl":"https://doi.org/10.19106/jmedsci005501202309","url":null,"abstract":"Nasopharyngeal carcinoma (NPC) is cancer originating from the mucosal lining of nasopharynx, with the highest predilection in the fossa of Rosenmüller. One-fifth of NPC cases have cranial nerve complications. The location of Rosenmüller's fossa which is adjacent to foramen lacerum and middle base of the cranium allows the tumor to extend directly into the cranium and surrounding cranial nerves. This paper reported a case of facial nerve paralysis in NPC. A 55-year-old man came to the Ear-Nose-Throat (ENT) Clinic at Dr. Kariadi General Hospital, Semarang with complaints of facial pain on the right side, headache, a lump on the left neck, fullness in ears, and nosebleed. However, the patient did not complain of double vision. After a thorough history taking, physical examination, radiology, and histopathology tests, the patient was diagnosed with WHO 3 ECOG I T3N2M0 stage III NPC with House Brackmann III facial nerve paresis at the level of Mastoid segment. The patient was treated using chemotherapy treatment by an ENT specialist with a chemotherapy regimen of paclitaxel-cisplatin for 6 cycles. In conclusion, although rare, NPC can cause facial nerve paralysis. ","PeriodicalId":173108,"journal":{"name":"Journal of the Medical Sciences (Berkala Ilmu Kedokteran)","volume":"13 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114128153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. N. Rohmah, Dwita Dyah Adyarini, P. D. Sattwika, Anastasia-Evi Handayaningsih, Hemi Sinorita, V. Susanti
{"title":"Vitamin D levels of obesity and non-obesity health workers: a cross-sectional study in Dr. Sardjito General Hospital/Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada, Yogyakarta","authors":"S. N. Rohmah, Dwita Dyah Adyarini, P. D. Sattwika, Anastasia-Evi Handayaningsih, Hemi Sinorita, V. Susanti","doi":"10.19106/jmedsci005404202202","DOIUrl":"https://doi.org/10.19106/jmedsci005404202202","url":null,"abstract":"Obesity is one of the causes of chronic diseases, such as diabetes, hypertension, stroke, cancer, dyslipidemia, and heart disease. It is considered a financial burden on national health insurance since it drains the largest health fund. The study aimed to determine the difference in vitamin D levels in obese and non-obese health workers and analyze the factors that influence it. This was a cross-sectional study of the obese and non-obese health workers at Dr. Sardjito General Hospital, Yogyakarta. A total of 50 subjects, including 25 obese and 25 non-obese subjects were involved. Serum vitamin D levels was determined by ELISA. There was no significant difference between the obese and non-obese groups on vitamin D status (p<0.365). Vitamin D deficiency was found in 10% of subjects, whereas insufficient vitamin D levels were found in 46 and 44% of subjects, respectively. Vitamin D deficiency was more common in the obese (12%) than non-obese (8%) group. Contrarily, vitamin D insufficiency was more common in the non-obese (56%) than obese (36%) group. The serum vitamin D levels in the obese [30.08 (14.67-101.71) ng/mL] was not significantly different compare to those non-obese [28.54 (14.38-54.41) ng/mL] (p = 0.691). The multivariate analysis significantly showed that outdoor activities <30 min had a 7.061 times greater risk of having vitamin D deficiency/insufficiency compared to outdoor activities >30 min (OR 7.061; 95% CI: 1.064-46.872; p=0.043). In conclusion, there is no significant difference in vitamin D levels between the obese and non-obese groups. Vitamin D deficiency/insufficiency is more common in non-obese subjects than in obese subjects. Outdoor activity <30 min is a risk factor for vitamin D insufficiency/deficiency despite living in a tropical country with abundant sunlight throughout the year. ","PeriodicalId":173108,"journal":{"name":"Journal of the Medical Sciences (Berkala Ilmu Kedokteran)","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114807465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of clinical pathway implementation and clinical practice guidelines in the management of deep neck abscess (DNA) at Dr. Sardjito, General Hospital Yogyakarta, Indonesia","authors":"Dian Paramita Wulandari, Hesti Dyah Palupi, Feri Trihandoko","doi":"10.19106/jmedsci005404202206","DOIUrl":"https://doi.org/10.19106/jmedsci005404202206","url":null,"abstract":"Deep neck abscess (DNA) is an infectious condition categorized as anemergency case with high mortality and morbidity. The incidence decreasesover time due to extensive use of antibiotics, operative intervention, andimproved awareness of dental hygiene. Management of DNA must be carriedout appropriately and efficiently to prevent complications that may occur,such as jugular vein thrombosis, pericarditis, and pneumonia. Patients withDNA are often categorized as high-cost patients, because of the long durationof hospitalization, the need for special examinations, and complicatedmanagement. Clinical practice guidelines (CPG) and clinical pathways (CP)are a standard created for management, quality, and cost control. The studyaimed to evaluate the implementation of the CPG and CP in DNA patients atDr. Sardjito General Hospital, Yogyakarta. The study used medical recordsdata of DNA patients from January 2018 to December 2020 who met theinclusion and exclusion criteria. A total of 55 subjects were obtained, withcompliance to complete CPG filling of 98.3% and CP filling of 96.2%. There was100% completion in CPG filling categorized as good compliance, whilst thenumber of good compliances for CP was 92.7%. In conclusion, the diagnosisand management of DNA patients at Dr. Sardjito General Hospital has goodcompliance with CPG and CP available.","PeriodicalId":173108,"journal":{"name":"Journal of the Medical Sciences (Berkala Ilmu Kedokteran)","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115375563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dinar Yudistira Firdaus, A. Guyansyah, Umiyanti Thenu, Selvia D. Denggo
{"title":"Comparison of neutrophil lymphocyte ratio (NLR), mean platelet volume (MPV) and platelet lymphocyte ratio (PLR) in preeclampsia and normotensive pregnancies","authors":"Dinar Yudistira Firdaus, A. Guyansyah, Umiyanti Thenu, Selvia D. Denggo","doi":"10.19106/jmedsci005404202204","DOIUrl":"https://doi.org/10.19106/jmedsci005404202204","url":null,"abstract":"The study aimed to compare the NLR (neutrophil lymphocyte ratio), MPV (meanplatelet volume), and PLR (platelet lymphocyte ratio) values in preeclampsiaand normotensive pregnancies. This was a retrospective case-control studyusing medical records of pregnancies between January 1, – December 31, 2019.A total 31 pregnancies with preeclampsia who met the inclusion and exclusioncriteria were involved in the study. As control, 31 normotensive pregnanciesrecruited by simple random sampling were used. The data were presented asmean ± standard deviation (SD) and analyzed by using SPSS program. Receiveroperating characteristic (ROC) curve were used to determine the optimal cutoff point for predicting preeclampsia. The NLR and MPV values of patients withpreeclampsia were significantly higher compare to normotensive pregnancy(p<0.001). Whereas, the PLR value of both groups was not significantlydifferent (p>0.245). The result of AUC analysis showed that the NLR and MPVhave AUC values of 0.758 (95%CI:0.637-0.878; p=0.000) and 0.903 (95%CI:0.816-0.989; p=0.000), respectively. Further analysis showed that the optimal cut-offpoint for NLR was 4.0 (sensitivity of 64.5% and a specificity of 71.0%) and forMPV was 7.55 (sensitivity of 87.1% and specificity of 80.0%). In conclusion, theNLR and MPV values are significantly higher in preeclampsia. However, theMPV value has a better predictive value than NLR for preeclampsia.","PeriodicalId":173108,"journal":{"name":"Journal of the Medical Sciences (Berkala Ilmu Kedokteran)","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126790333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Maternal determinants of average weekly fetal weight gain in Yogyakarta, Indonesia","authors":"Eugenius Phyowai Ganap, Pakartian Ayu Sugmana, Riantina Rizky Amalia, LaksmiIka Hidayati, Aditya Doni Pradana Doni Pradana","doi":"10.19106/jmedsci005404202208","DOIUrl":"https://doi.org/10.19106/jmedsci005404202208","url":null,"abstract":"Average fetal weight gain (AWG) is one of the important parameters usuallyused as an indicator to identify the fetal risk of poor outcomes of intrauterinegrowth restriction (IUGR) or macrosomia. This study aimed to investigate theassociation between AWG and maternal factors such as body weight (BW), bodymass index (BMI), middle-upper arm circumference (MUAC), and economicstatus in Yogyakarta, Indonesia. This community-based cross-sectional studywas conducted in one district in the Yogyakarta Special Province, Indonesia.The study included 50 mother-infant pairs who delivered at term (37-42 weeksof pregnancy). The mother’s BW, height, BMI, and MUAC were recorded usinga case-report form. Questionnaires were also completed to establish therespondents’ economic status. Maternal factors associated with fetal birthweight were determined using univariate and multivariate analyses. Themothers registered in our study mostly had good nutritional status (74.0% hadan optimal MUAC > 23cm). The mean AWG and birth weights were 172.6 ±24.5g/wk and 3.08 ± 0.34kg, respectively. Univariable analysis models wereused to assess the associations between each variable and AWG (with a cut-offvalue of 153.8 g/wk). Our study found no associations between higher MUACand higher AWG (OR=1.03; 95% CI: 0.83-1.27; p=0.77) and energy intakes perday with AWG (OR=1.0; 95% CI: 1.00-1.001; p=0.21). Socioeconomic factors suchas the mother’s educational background also showed no association with AWG(OR=0.38; 95% CI: 0.92-1.57; p=0.18). In conclusion, this finding shows that thereis no association between variables such as MUAC, mother’s age, energy intake,and educational background with the average fetal weight gain achieved.","PeriodicalId":173108,"journal":{"name":"Journal of the Medical Sciences (Berkala Ilmu Kedokteran)","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129518750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effect of hormonal contraceptives on the ocular surface and the tear film","authors":"Muhammad Syauqie","doi":"10.19106/jmedsci005404202205","DOIUrl":"https://doi.org/10.19106/jmedsci005404202205","url":null,"abstract":"Dry eye syndrome (DES) is a common multifactorial disease of the tears andocular surface associated with sex hormones. Hormonal contraception is arisk factor for DES, but its relationship with DES exacerbations in womenof childbearing age is still unclear. This study aimed to evaluate changesof the tear film and ocular surface of young women using the hormonalcontraceptive agent. It was a case-control study involving 56 healthywomen aged 20 to 45 y.o. Subjects was divided into two groups i.e. thehormonal contraceptives group and the control group without hormonalcontraceptive. Subjects were interviewed with the ocular surface diseaseindex (OSDI) questionnaire. Tear secretion and tear stability were measuredusing Schirmer’s I test and fluorescein tear break-up time test (TBUT).Ocular surface impression cytology with cellulose acetate filter paper wastaken from inferonasal bulbar conjunctiva and was stained with periodicacid- Schiff (PAS) and counterstained with hematoxylin and eosin (HE). Nosignificantly decrease in tear secretion and tear stability in the hormonalcontraceptives group compared with the control groups was observed (p >0.05). However, a statistically significant decrease in goblet cell density andconjunctival epithelium metaplasia was observed, where 25% of the hormonalcontraceptives group had an abnormal impression cytology result comparedwith the control group (p<0.05). The hormonal contraceptives group also hada higher OSDI score than the control group, although it was not statisticallysignificant (p> 0.05). The hormonal contraceptives group had a signifificanteffect on the ocular surface in which it induced squamous metaplasia andinflflammation of conjunctival cells and the reduced number of goblet cellsp<0.05). The slightly decreased tear film volume and stability accompaniedby an increase in OSDI score found in the hormonal contraceptives groupsupport the possibility of hormonal contraceptive use as one of the riskfactors in the occurrence of dry eye syndrome.","PeriodicalId":173108,"journal":{"name":"Journal of the Medical Sciences (Berkala Ilmu Kedokteran)","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133820249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Z. M. Sofro, Widya Wasityastuti, Rakhmat Ari Wibowo, Rahmaningsih Mara Sabirin, S. Siswanto, Jajar Setiawan, Denny Agustiningsih
{"title":"Practical tips to adopt active lifestyle for university students during pandemic life: a narrative review","authors":"Z. M. Sofro, Widya Wasityastuti, Rakhmat Ari Wibowo, Rahmaningsih Mara Sabirin, S. Siswanto, Jajar Setiawan, Denny Agustiningsih","doi":"10.19106/jmedsci005404202210","DOIUrl":"https://doi.org/10.19106/jmedsci005404202210","url":null,"abstract":"The Covid-19 pandemic worsened the physical inactivity pandemic and also increased sedentary behavior across the population, including university students. While physical inactivity and sedentary behavior are detrimental to health and academic performance, there is an urgent need to help university students to adopt an active lifestyle during post-pandemic life. This narrative review discussed current physical activity (PA) and sedentary behavior recommendations, practical tips for adopting an active lifestyle by applying PA doses using the frequency, intensity, time, and type (FITT) principle, and behavioral strategies to adopt and maintain an active lifestyle. Finally, several considerations related to the PA-related musculoskeletal injury and cardiovascular events risks were also discussed with examples from interventions during the pandemic in university settings.","PeriodicalId":173108,"journal":{"name":"Journal of the Medical Sciences (Berkala Ilmu Kedokteran)","volume":"174 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124282961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effect of Citrullus lanatus seed oil on xerosis in leprosy patients","authors":"Puteri Wulandari, S. Lubis, D. A. Paramita","doi":"10.19106/jmedsci005404202203","DOIUrl":"https://doi.org/10.19106/jmedsci005404202203","url":null,"abstract":"Xerosis in leprosy patients may result from defects in sweat gland function.Red watermelon (Citrullus lanatus) seed oil a lot of contains linoleic acid,which can hydrate the skin and reduce trans-epidermal water loss (TEWL).This study aimed to evaluate the effect of C. lanatus seed oil administrationin leprosy patients with xerosis. It was a clinical study with one group pretestposttest control group design involving 30 leprosy patients with xerosis at theDepartment of Dermatology and Venereology, Dr. Pirngadi Medan Hospital, thePolyclinic of Dermatology and Venerology, Universitas Sumatera Utara Hospitaland the Department of Dermatology and Venerology, H. Adam Malik GeneralHospital, Medan, Indonesia. Patients were asked to topically administration of2 mL C. lanatus seed oil to the right and left legs for two times daily for 4 weeks.Specified symptom sum score (SRRC) and skin capacitance (SCap) were thenmeasured before the intervention at the first visit (week 0), week 2, and week 4.A significantly different on SRRC and SCap of the leprosy patients was observedon the 2nd and 4th week after C. lanatus oil administration compared to week 0(p<0.001). No side effects of erythema, blistering, and burning were observed.However, a mild degree itching was observed in 2 (6.7%) patients. Majority ofleprosy patients feel good satisfaction (83.4%), followed by a moderate (13.3%)and a low satisfaction (3.3%). In conclusion, topically administration of redwatermelon (C. lanatus) seed oil can reduce the xerosis degree in leprosypatients as indicated by the decrease of SRRC and the increase of SCap. Theseed oil is well tolerated and gives a good satisfaction on the patients.","PeriodicalId":173108,"journal":{"name":"Journal of the Medical Sciences (Berkala Ilmu Kedokteran)","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127608308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Decreasing of hand colonization and sterility of refill antiseptic in Dr. Yap Eye Hospital, Yogyakarta","authors":"Briliana Nur Rohima, Syarah Rysty, Ulupi Rina Hapsari, Palupi Dwi Astuti","doi":"10.19106/jmedsci005404202201","DOIUrl":"https://doi.org/10.19106/jmedsci005404202201","url":null,"abstract":"Dr. Yap Eye Hospital, Yogyakarta uses aseptic gel containing 70% ethyl alcohol to refill antiseptic containers during times of antiseptic scarcity. The study aimed to evaluate the effectiveness and sterility of the refill antiseptics in reducing the number of colonization on the hands of nurses. It was a quasi-experimental using pre- and post-control groups design involving 56 nurses who used antiseptics in a bottle sterilized by plasma device (plasma bottle) compare to those washed using detergent (detergent bottle) before being refilled. Sterility tests were performed every two wk for up to two mo. Colonization pre and post hand hygiene practices were determined as an efficacy test and compared using the Mann-Whitney test in STATA 14. Antiseptic in plasma bottles remains sterile until the week8th since refilled, longer than detergent bottles (6th weeks). The pre-handrub colorizations were 0.04-16.92 CFU/cm2 and decreased significantly post-handrub to 0.00-3.08 CFU/cm2 (p<0.0001). Significant decrease pre- vs post-handrub colonization was observed in usage of detergent bottle (0.04-31.04 vs 0.00-10.48 CFU/cm2, p=0.0007). There was no significant difference in ∆ colonization for two bottles (0.40-15.76 vs 0.04-30.92 CFU/cm2, p=0.8790). In conclusion, antiseptic in the plasma bottle remains sterile longer than in the detergent bottle since refilled. Both of them are equally effective in reducing colonization after handrub activity.","PeriodicalId":173108,"journal":{"name":"Journal of the Medical Sciences (Berkala Ilmu Kedokteran)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114340117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. B. Hartopo, I. A. Arso, A. M. Ambari, B. Dwiputra, B. Radi
{"title":"Exercise-based cardiac rehabilitation adaptation protocol during Covid-19 pandemic achieved similar results as compared to non-pandemic usual practice: a single center experience","authors":"A. B. Hartopo, I. A. Arso, A. M. Ambari, B. Dwiputra, B. Radi","doi":"10.19106/jmedsci005404202207","DOIUrl":"https://doi.org/10.19106/jmedsci005404202207","url":null,"abstract":"During the Covid-19 pandemic, exercise-based cardiac rehabilitation (EBCR) faced challenges. Adaptation protocols were implemented to circumvent these challenges. The study aimed to investigate whether the adaptation protocols of EBCR during Covid-19 period influenced the result of cardiac rehabilitation. This was a retrospective cohort study. The subjects were patients who underwent an EBCR program in Dr. Sardjito General Hospital. Yogyakarta, Indonesia. The registry of cardiac rehabilitation was obtained and divided into two periods: non-Covid-19 period and Covid-19 period. During the non-Covid-19 period, 3 EBCR sessions per wk (10-12 total sessions) were performed. During the Covid-19 period, EBCR was reduced to 2 sessions per wk (10-12 total sessions). The functional capacities were evaluated as metabolic equivalents (METs) and exercise test time (min) by treadmill test. A total of 122 subjects completed the EBCR. There were no significant differences in METs and exercise minute achieved between two time periods. Among subjects with different sessions per wk, namely 2, 3, and 4-5 sessions per wk, there were no significant differences in METs (7.01±1.89; 7.23±1.74; and 7.33±2.13, p=0.813) and minutesachieved (6.72±1.94; 6.96±1.96; and 6.81±1.84, p=0.848) in the end sessions. In conclusion, the adaptation of EBCR protocols during the Covid-19 period by reducing the number of sessions per wk has similar results as compared to the usual regular EBCR practice.","PeriodicalId":173108,"journal":{"name":"Journal of the Medical Sciences (Berkala Ilmu Kedokteran)","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124527591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}