Prenatal Secondhand Smoke Exposure: Correlation Between Nicotine in Umbilical Cord Blood and Neonatal Anthropometry

Mery Ramadani,Budi Utomo,Hartono Gunardi,Endang L Achadi 질병관리본부 2019 Osong Public Health and Research Persptectives Vol.10 No.4

Objectives: Nicotine narrows uterine blood vessels reducing the flow of oxygen and nutrients to the developing fetus. This study examined the effects of fetal exposure to secondhand smoke on neonatal anthropometry. Methods: This cross sectional study recruited 128 pregnant women in the third trimester of single pregnancies who had no chronic illness, were not active or ex-smokers, and who were willing to participate in the study. Pregnant women who were exposed to secondhand smoke had umbilical cord blood nicotine concentrations of ≥ 1 ng/mL. Neonatal anthropometry was assessed according to the newborn birth weight and length. The independent t-test was used to determine the neonatal difference in mean birth weight and length between the women who were exposed to secondhand smoke, and those who were not exposed. A multiple linear regression analysis was employed to assess the effect of secondhand smoke exposure on birth weight and birth length, controlling for potential confounding variables (weight gain during pregnancy, body mass index, parity, maternal age, and maternal hemoglobin). Results: There were 35 women exposed to secondhand smoke (nicotine ≥ 1 ng/mL). Neonate birth weight and birth length were lower among mothers who were exposed to secondhand smoke. However, only neonate birth weight was significantly reduced by exposure to secondhand smoke (p = 0.005). The mean birth weight of these neonates was 2,916.5 g ± 327.3 g which was 205.6 g less than in unexposed fetuses. Conclusion: Exposure of mothers to secondhand smoke during pregnancy reduces fetal development and neonatal weight.

Obstetrics and gynecology residents’ satisfaction and selfconfidence after an anal sphincter injury simulation-based workshop in Indonesia: a pre- and post-intervention comparison study

Riska Wahyuningtyas,Eighty Mardiyan Kurniawati,Budi Utomo,Gatut Hardianto,Hari Paraton,Tri Hastono,Djoko Kuswanto 한국보건의료인국가시험원 2022 보건의료교육평가 Vol.19 No.-

Purpose: Obstetric anal sphincter injury is one of the most common complications during delivery. Simulation models with manikinscan be used as an effective medical learning method to improve students’ abilities before encountering patients. The present studyaimed to describe the development of an anal sphincter injury model and to assess residents’ satisfaction and self-confidence after a perineal repair workshop with an anal sphincter injury simulator in Indonesia. Methods: This was a cross-sectional study with evaluation of outcomes before and after the workshop. We created a silicone-latex simulation anal sphincter injury model. Then, we validated this simulation and used it as a simulation model for the workshop. We askedresidents about their satisfaction with repairing anal sphincter injuries using a simulation model and residents’ self-confidence whenpracticing anal sphincter injury repair. Results: All residents felt the simulation-based workshop was valuable (100%). Most of the scores for the similarity of the simulationmodel were good (about 8 out of maximum 10). The self-assessment of confidence was measured before and after the workshop. Overall self-confidence increased significantly after the workshop in identifying the external sphincter ani (EAS) (P=0.031), suturing theanal mucosa (P=0.001), suturing the internal sphincter ani (P=0.001), suturing the EAS (P<0.001), and evaluating the sphincter anitone (P=0.016). Conclusion: The anal sphincter injury simulator improved residents’ self-confidence in identifying the EAS, suturing the anal mucosa,suturing the internal sphincter ani, suturing the EAS, and evaluating sphincter ani tone.

Perceptions of Contraception and Patterns of Switching Contraceptive Methods Among Family-planning Acceptors in West Nusa Tenggara, Indonesia

Amran, Yuli,Nasir, Narila Mutia,Dachlia, Dini,Yelda, Fitra,Utomo, Budi,Ariawan, Iwan,Damayanti, Rita The Korean Society for Preventive Medicine 2019 예방의학회지 Vol.52 No.4

Objectives: The perceptions of family-planning (FP) acceptors regarding contraception influence the reasons for which they choose to switch their method of contraception. The objective of this study was to analyze the perceptions of contraception and rationales for switching contraceptive methods among female FP acceptors in West Nusa Tenggara, Indonesia. Methods: This study involved the analysis of secondary data from the Improve Contraceptive Method Mix study, which was conducted in 2013 by the Center for Health Research, University of Indonesia. The design of the study was cross-sectional. We performed 3 stages of sampling using the cluster technique and selected 4819 women who were FP acceptors in West Nusa Tenggara Province, Indonesia as the subjects of this study. The data were analyzed using multiple logistic regression. Results: The predominant pattern of switching contraceptive methods was switching from one non-long-term method of contraception to another. Only 31.0% of the acceptors reported a rational pattern of switching contraceptive methods given their age, number of children, and FP motivations. Perceptions of the side effects of contraceptive methods, the ease of contraceptive use, and the cost of the contraceptives were significantly associated (at the level of ${\alpha}=0.05$) with rational patterns of switching contraceptive methods. Conclusions: Perceptions among FP-accepting women were found to play an important role in their patterns of switching contraceptive methods. Hence, fostering a better understanding of contraception through high-quality counseling is needed to improve perceptions and thereby to encourage rational, effective, and efficient contraceptive use.

Perceptions of Contraception and Patterns of Switching Contraceptive Methods Among Family-planning Acceptors in West Nusa Tenggara, Indonesia

Yuli Amran,Narila Mutia Nasir,Dini Dachlia,Fitra Yelda,Budi Utomo,Iwan Ariawan,Rita Damayanti 대한예방의학회 2019 Journal of Preventive Medicine and Public Health Vol.52 No.4

Objectives: The perceptions of family-planning (FP) acceptors regarding contraception influence the reasons for which they choose to switch their method of contraception. The objective of this study was to analyze the perceptions of contraception and rationales for switching contraceptive methods among female FP acceptors in West Nusa Tenggara, Indonesia. Methods: This study involved the analysis of secondary data from the Improve Contraceptive Method Mix study, which was conducted in 2013 by the Center for Health Research, University of Indonesia. The design of the study was cross-sectional. We performed 3 stages of sampling using the cluster technique and selected 4819 women who were FP acceptors in West Nusa Tenggara Province, Indonesia as the subjects of this study. The data were analyzed using multiple logistic regression. Results: The predominant pattern of switching contraceptive methods was switching from one non-long-term method of contraception to another. Only 31.0% of the acceptors reported a rational pattern of switching contraceptive methods given their age, number of children, and FP motivations. Perceptions of the side effects of contraceptive methods, the ease of contraceptive use, and the cost of the contraceptives were significantly associated (at the level of α=0.05) with rational patterns of switching contraceptive methods. Conclusions: Perceptions among FP-accepting women were found to play an important role in their patterns of switching contraceptive methods. Hence, fostering a better understanding of contraception through high-quality counseling is needed to improve perceptions and thereby to encourage rational, effective, and efficient contraceptive use.

Simulation-based training using a novel Surabaya hysterectomy mannequin following video demonstration to improve abdominal hysterectomy skills of obstetrics and gynecology residents during the COVID-19 pandemic in Indonesia: a pre- and post-intervention

Dara Dasawulansari Syamsuri,Brahmana Askandar Tjokroprawiro,Eighty Mardiyan Kurniawati,Budi Utomo,Djoko Kuswanto 한국보건의료인국가시험원 2022 보건의료교육평가 Vol.19 No.-

Purpose: During the coronavirus disease 2019 (COVID-19) pandemic, the number of abdominal hysterectomy procedures decreasedin Indonesia. The existing commercial abdominal hysterectomy simulation model is expensive and difficult to reuse. This study compared residents’ abdominal hysterectomy skills after simulation-based training using the Surabaya hysterectomy mannequin following avideo demonstration. Methods: We randomized 3rd- and 4th-year obstetrics and gynecology residents to a video-based group (group 1), a simulation-basedgroup (group 2), and a combination group (group 3). Abdominal hysterectomy skills were compared between before and after the educational intervention. The pre- and post-tests were scored by blinded experts using the validated Objective Structured Assessment ofTechnical Skills (OSATS) and Global Rating Scale (GRS). Results: A total of 33 residents were included in the pre- and post-tests. The OSATS and GRS mean differences after the interventionwere higher in group 3 than in groups 1 and 2 (OSATS: 4.64 [95% confidence interval [CI], 2.90–6.37] vs. 2.55 [95% CI, 2.19–2.90]vs. 3.82 [95% CI, 2.41–5.22], P=0.047; GRS: 10.00 [95% CI, 7.01–12.99] vs. 5.18 [95% CI, 3.99–6.38] vs. 7.18 [95% CI, 6.11–8.26],P=0.006). The 3rd-year residents in group 3 had greater mean differences in OSATS and GRS scores than the 4th-year residents(OSATS: 5.67 [95% CI, 2.88–8.46]; GRS: 12.83 [95% CI, 8.61–17.05] vs. OSATS: 3.40 [95% CI, 0.83–5.97]; GRS: 5.67 [95% CI,2.80–8.54]). Conclusion: Simulation-based training using the Surabaya hysterectomy mannequin following video demonstration can be a bridge tolearning about abdominal hysterectomy for residents who had less surgical experience during the COVID-19 pandemic.

Effects of dietary flavonoids on performance, blood constituents, carcass composition and small intestinal morphology of broilers: a meta-analysis

Prihambodo Tri Rachmanto,Sholikin Muhammad Miftakhus,Qomariyah Novia,Jayanegara Anuraga,Batubara Irmanida,Utomo Desianto Budi,Nahrowi Nahrowi 아세아·태평양축산학회 2021 Animal Bioscience Vol.34 No.3

Objective: This study aims to evaluate the influence of dietary flavonoids on the growth performance, blood and intestinal profiles, and carcass characteristics of broilers by employing a meta-analysis method. Methods: A database was built from published studies which have reported on the addition of various levels of flavonoids from herbs into broiler diets and then monitored growth performance, blood constituents, carcass proportion and small intestinal morphology. A total of 42 articles were integrated into the database. Several forms of flavonoids in herbs were applied in the form of unextracted and crude extracts. The database compiled was statistically analyzed using mixed model methodology. Different studies were considered as random effects, and the doses of flavonoids were treated as fixed effects. The model statistics used were the p-values and the Akaike information criterion. The significance of an effect was stated when its p-value was <0.05. Results: Dietary flavonoids increased (quadratic pattern; p<0.05) the average daily gain of broilers in the finisher phase. There was a reduction (p<0.01) in the feed conversion ratio of the broilers both in the starter (linear pattern) and finisher phases (quadratic pattern). The mortality rate tended to decrease linearly (p<0.1) with the addition of flavonoids, while the carcass parameter was generally not influenced. A reduction (p<0.001) in cholesterol and malondialdehyde concentrations (both linearly) was observed, while super oxide dismutase activity increased linearly (p<0.001). Increasing the dose of flavonoids increased (p<0.01) the villus height (VH) and villus height and crypt depth (VH:CD) ratio (p<0.05) in the duodenum. Similarly, the VH:CD ratio was elevated (p<0.001) in the jejunum following flavonoid supplementation. Conclusion: Increasing levels of flavonoids in broilers diet leads to an improvement in growth performance, blood constituents, carcass composition and small intestinal morphology. Objective: This study aims to evaluate the influence of dietary flavonoids on the growth performance, blood and intestinal profiles, and carcass characteristics of broilers by employing a meta-analysis method.Methods: A database was built from published studies which have reported on the addition of various levels of flavonoids from herbs into broiler diets and then monitored growth performance, blood constituents, carcass proportion and small intestinal morphology. A total of 42 articles were integrated into the database. Several forms of flavonoids in herbs were applied in the form of unextracted and crude extracts. The database compiled was statistically analyzed using mixed model methodology. Different studies were considered as random effects, and the doses of flavonoids were treated as fixed effects. The model statistics used were the p-values and the Akaike information criterion. The significance of an effect was stated when its p-value was <0.05.Results: Dietary flavonoids increased (quadratic pattern; p<0.05) the average daily gain of broilers in the finisher phase. There was a reduction (p<0.01) in the feed conversion ratio of the broilers both in the starter (linear pattern) and finisher phases (quadratic pattern). The mortality rate tended to decrease linearly (p<0.1) with the addition of flavonoids, while the carcass parameter was generally not influenced. A reduction (p<0.001) in cholesterol and malondialdehyde concentrations (both linearly) was observed, while super oxide dismutase activity increased linearly (p<0.001). Increasing the dose of flavonoids increased (p<0.01) the villus height (VH) and villus height and crypt depth (VH:CD) ratio (p<0.05) in the duodenum. Similarly, the VH:CD ratio was elevated (p<0.001) in the jejunum following flavonoid supplementation.Conclusion: Increasing levels of flavonoids in broilers diet leads to an improvement in growth performance, blood constituents, carcass composition and small intestinal morphology.

Evidence of Placental Villous Inflammation and Apoptosis in Third-Trimester Symptomatic SARS-CoV-2 Maternal Infection

Erry Gumilar Dachlan,Manggala Pasca Wardhana,Kuntaman Kuntaman,Budi Utomo,Rozi Aditya Aryananda,Salsabila Nabilah Rifdah,Ifan Ali Wafa,Almira Aulia Shahnaz,Dahlia Ningrum,Nareswari Imanadha Cininta Ma 연세대학교의과대학 2024 Yonsei medical journal Vol.65 No.4

Purpose: In view of conflicting reports on the ability of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) to infect placental tissue, this study aimed to further evaluate the impact of inflammation and placental damage from symptomatic third trimester maternal COVID-19 infection. Materials and Methods: This case-control study included 32 placenta samples each from symptomatic COVID-19 pregnancy and normal non-COVID-19 pregnancy. The villous placental area’s inflammatory expression [angiotensin converting enzyme-2 (ACE-2), transmembrane protease serine-2 (TMPRSS2), interferon-γ (IFN-γ), interleukin-6 (IL-6), and SARS-CoV-2 spike protein] and apoptotic rate were examined using immunohistochemistry and Terminal deoxynucleotidyl transferase dUTP Nick- End La beling (TUNEL) assay. Comparison and correlation analysis were used based on COVID-19 infection, placental SARS-CoV-2 spike protein evidence, and maternal severity status. Results: Higher expressions of TMPRSS2, IFN-γ, and trophoblast apoptotic rate were observed in the COVID-19 group (p<0.001), whereas ACE-2 and IL-6 expressions were not significantly different from the control group (p>0.05). Additionally, SARS-CoV-2 spike protein was detected in 8 (25%) placental samples of COVID-19 pregnancy. COVID-19 subgroup analysis revealed in creased IFN-γ, trophoblast, and stromal apoptosis (p<0.01). Moreover, the results of the current study revealed no correlation be tween maternal COVID-19 severity and placental inflammation as well as the apoptotic process. Conclusion: The presence of SARS-CoV-2 spike protein as well as altered inflammatory and apoptotic processes may indicate the presence of placental disturbance in third-trimester maternal COVID-19 infection. The lack of correlation between placental dis ruption and maternal severity status suggests the need for more research to understand the infection process and any potential long-term impacts on all offsprings born to COVID-19-infected pregnant women.