Allergic rhinitis (AR) remains a prevalent inflammatory disorder for which long-term pharmacological management is often constrained by adverse effects. This study investigated the impact of red apple peel extract (Malus domestica 'Rome Beauty'), a quercetin-rich by-product sourced from Malang–Batu, on serum histamine concentrations in an established AR rat model. Employing a true-experimental, post-test-only control group design, 25 male Wistar rats were randomized into five groups: negative control, positive control (OVA-induced AR), and three treatment arms receiving 10, 25, or 80 mg/kg body weight of extract over 16 days. Serum histamine was quantified via ELISA, and data were subjected to Kruskal-Wallis analysis with subsequent Dunn-Holm corrected Mann-Whitney tests; dose-response was further evaluated using the Jonckheere-Terpstra test. Statistically significant intergroup differences were observed (H = 22.347; p < 0.001), with the positive control group exhibiting the highest histamine levels (33.0 ng/mL). Treatment groups demonstrated a progressive reduction in histamine (29.4, 25.4, and 19.0 ng/mL), with the 80 mg/kg dose yielding a 42.4% decrease relative to control (p = 0.011). The presence of a significant dose-dependent trend (p = 0.031) underscores the potential of red apple peel extract as a cost-effective adjunctive strategy in AR management.
Accurate assessment of endotracheal tube (ETT) position is essential after intubation because displacement may lead to clinically relevant pulmonary complications, while local real-world data from Indonesian referral hospitals remain limited. This study aimed to identify chest radiographic characteristics and complications associated with displaced ETT in patients at Dr. Saiful Anwar General Hospital, Malang. This descriptive cross-sectional study reviewed electronic medical records and post-intubation chest radiograph archives from September 2023 to September 2024. Among 4,000 patients who underwent ETT placement, 60 patients (1.50%) had displaced ETT. Pulmonary complications were identified in 48 of these patients (80.00%). Pneumonia was the most frequent complication, occurring in 25 patients (52.08%), followed by combined pneumonia and atelectasis in 12 patients (25.00%) and isolated atelectasis in 11 patients (22.92%). Follow-up chest radiography after ETT repositioning was performed in 43 patients, of whom 18 (41.86%) showed radiographic improvement. Although displaced ETT occurred in a relatively small proportion of patients, pulmonary complications were frequent once displacement occurred. These findings highlight the importance of post-intubation chest radiographic evaluation for early detection of displaced ETT and its complications in routine referral hospital practice.
Background: Stunting is the cause of death and morbidity among children 0-59 months. Stunting can be associated with some factors such as child factors, maternal factors, and feeding patterns, especially exclusive breastfeeding. Objectives: Determine the effects of exclusive breastfeeding and demographic factors (gender, mother age and education) associated with stunting incidence among 0-59 months child in Public Health Center. Method: This was an observational analytic study with a case-control design involving 132 children under five in the Ngletih Health Center area. Data were analyzed using univariate analysis to describe variables, Chi-square tests to assess associations, and logistic regression to estimate the magnitude of effects. Result: Chi-square analysis showed a significant association between exclusive breastfeeding and stunting (p=0.005), while no significant associations were found for child gender (p=0.601), maternal age (p=0.367), and maternal education (p=0.052). Logistic regression indicated that children without exclusive breastfeeding had a higher risk of stunting (OR=3.009). The proportion of stunting was 59% among children of mothers with junior high school education and 55% among those with senior high school education. Conclusion: Lack of exclusive breastfeeding is significantly associated with stunting (p=0.004; OR=3.009; 95%CI=1.434–6.312). Strengthening maternal nutrition education programs is essential to reduce stunting risk
Background: Medical records are crucial for healthcare management during disasters. However, the World Health Organization’s Emergency Medical Team Minimum Data Set (EMT-MDS) is a relatively new standard and remains unfamiliar to many practitioners. In Indonesia, its implementation is further challenged by language barriers, making evaluation against locally adapted documentation formats necessary. Objectives: This study compares the effectiveness of EMT-MDS with a conventional medical record prototype adapted from Indonesian Ministry of Health guidelines. Methods: A quantitative comparative study was conducted using a Table Top Exercise (TTX) simulation. Two simulation teams acting as Type 1 EMT managed 64 randomized cases using either the EMT-MDS or the conventional format. Results: Statistical analysis using Mann-Whitney, McNemar, and Kappa tests showed no significant differences in completion time (p = 0.642) or data completeness (p = 0.980). Wilcoxon One-Sample tests indicated that both systems performed below ideal reference standards. However, EMT-MDS demonstrated better decision-making quality, with higher agreement with scenario keys for patient outcomes (Kappa = 0.848) and coordination assessments (Kappa = 0.968). Conclusion: EMT-MDS better supports accurate decision-making. Therefore, it is recommended for adaptation into the Indonesian EMT documentation system, accompanied by language adjustments and enhanced training for medical personnel.
Thyroid nodules are a common clinical finding, although only a minority are malignant. Thyroid stimulating hormone (TSH) and free thyroxine (FT4) have been investigated as potential biomarkers for predicting thyroid malignancy, yet previous studies have shown inconsistent results. This study aimed to analyse the association between TSHs and FT4 levels and histopathological outcomes in patients with thyroid nodules undergoing surgery. This analytical observational study used a cross-sectional design with retrospective medical record data from patients who underwent thyroid surgery at Wangaya Regional General Hospital during 2021–2025. Total sampling was applied based on the inclusion criteria, resulting in 121 patients with complete histopathological, TSHs, and FT4 data. The association between histopathological findings and hormone levels was analysed using chi-square test and logistic regression. Most patients were female (84.3%), and benign lesions predominated (71.1%). Higher TSHs levels were more frequent in borderline (66.7%) and malignant (56.3%) groups than in benign lesions (46.5%), but the association was not statistically significant (p=0.535). Lower FT4 levels were also more common in borderline (66.7%) and malignant groups (62.5%) than in benign lesions (48.8%), without significant association (p=0.367). TSHs and FT4 levels were not significantly associated with histopathological outcomes in patients undergoing thyroid surgery. These parameters should not be used as single predictors of thyroid malignancy.
