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Abstract : Platelet indices correlated with cardiovascular risk factors and mortality in children with congenital heart disease (CHD). Cyanotic CHD usually had a low platelet count with a high level of other platelet indices. This study evaluated the difference in platelet indices between cyanotic and acyanotic CHD undergoing cardiac catheterization. A retrospective study evaluated children with CHD, age 1 month until 18 years, hospitalized at Dr. Soetomo General Academic Hospital, Surabaya. Children were classified into acyanotic and cyanotic CHD based on echocardiography result and cyanotic signs. They undergo diagnostic or therapeutic catheterization procedures from January 2020 to December 2021. Platelet count, mean platelet volume (MPV), platelet crit (P-PCT), platelet large cell ratio (P-LCR), and platelet distribution width (PDW) were markers of platelet indices, examined by Hematology Analyzer SYSMEX XN 1000 from peripheral blood sampling. We used the independent sample t test to differentiate the mean of platelet indices between acyanotic and cyanotic CHD with a significance level of p<0.05 (two-tail test). There were 208 from 258 children had complete data. About 61(29.3%) were cyanotic CHD, and 147(70.7%) were acyanotic CHD. Boys in cyanotic CHD was more prevalent than in acyanotic CHD (65.6% vs 39.5; p=0.001). Diagnostic catheterization was performed in 94(45.2) % of children, and therapeutic catheterization was in 114 (54.8%) children. Platelet count was similar between cyanotic and acyanotic CHD (p=0.434). Thrombocytosis with a platelet count above 450.000/mm3 occurred in 16.4% cyanotic CHD and 8.8% acyanotic CHD. The P-PCT had no significant differences between cyanotic and acyanotic CHD. The mean PDW, MPV and P-LCR in acyanotic CHD were lower than in cyanotic CHD; 9.5(SD=1.57) fL and 10.9(SD=2.41) fL with p<0.001; 9.3(SD=0.79) and 9.8(SD=1.4) fL with p=0.007; 19.1(SD=6.11) and 23.0(SD=8.52) with p=0.002; respectively. Platelet indices in cyanotic CHD were higher in cyanotic CHD than acyanotic CHD, especially for PDW, MPV and P-LCR.

Abstract : Schistosomiasis is a neglected tropical disease that is transmitted by freshwater and snails, The intermediate snail that transmits schistosomiasis in Indonesia is O.h. lindoensis. The snail is amphibian. The survival of the O.h. lindoensis snail is supported by the appropriate climate and environmental habitat. Climate change towards schistosomiasis infection has important implications for the production, survival and fertility of schistosomiasis snails. This paper aims to describe the condition of the physical environment and the infection rate of Sistosoma japonicum cercariae in schistosomiasis intermediate snails in Dodolo Village, Poso Regency. The survey results from 25 habitats showed that the water temperature was between 200C-300C, 84% pH of the water was at a neutral acidity level (7), the soil pH of the snail habitat varied from 4.0 - 7, and 60% of the habitat type was found in the cacao plantation waterways. inhabitant. Cercarial infection rates range from 0-50%. Physical environmental factors such as water temperature, water pH, soil pH and habitat type support the breeding of the O.h. lindoensis snail. The level of cercarial infection in O.h. lindoensis snails differed between each habitat.

Abstract : Separated Instruments have become a common problem nowadays during root canal treatment. Some previous studies have shown that olive oil has special properties to be used as a lubricant agent. No study has evaluated the effect of olive oil as a lubricant agent compared to EDTA in the removal of the separated instrument using ultrasonic tips. (2) Referred patients to the Department of Endodontics with the complication of separated instruments in the root canals of their lower first molars were screened. Two groups of patients (n=60) with separated instruments were included with equal numbers of straight and curved roots. Each group was exposed to the EDTA 17% or the olive oil during the application of ultrasonic tips according to the 'Terushi' technique with a 1:1 allocation ratio. The failure rate and the time required for removal of the separated instruments was calculated. Chi-square and student t tests were used to detect differences. In the curved canals groups, there were no significant differences between the EDTA and the olive oil in terms of the failure rate (13.4% and 7%, respectively; P≈1.000) and the mean removal time (2.50 and 2.22, respectively; P=0.665). In the straight canals groups, there were significant differences between the EDTA and the olive oil in terms of the failure rate (0% and 33.4%, respectively; P=0.028) and the mean operating time (1.40 and 2.10, respectively; P=0.042). The olive oil can be used as a lubricant agent in the removal of the separated instrument in the curved canals with a high success rate and an appropriate operating time. However, the EDTA performed better in the straight canals with higher success rate and shorter operating time compared to the olive oil.

Abstract : In patients with total atrioventricular block that is not reversible or not caused by physiological causes, permanent pacing is indicated regardless of symptoms. His bundle pacing can avoid electrical and mechanical dyssynchrony induced by myocardial pacing because it uses the intrinsic pathway of myocardial activation. This case discusses the approach of implanting permanent non-selective His bundle pacing with stylet-driven lead technique in a 62-year-old female patient with total atrioventricular block and vascular anomaly in the left brachiocephalic vein. We modified the implant technique to place the lead in the His bundle area and successfully confirmed non-selective His bundle pacing from intracardiac electrogram and surface ECG.

Abstract : According to the World Health Organization (WHO), chronic disease is a disease with a long duration that generally develops slowly and results from genetic, physiological, environmental, and behavioral factors. Globally, regionally and nationally. In 2030, there will be an epidemiological transition from communicable diseases to non-communicable diseases. This study aims to determine factors related to the use of chronic disease programs in Sorong City. This research is an analytic observational study with a cross-sectional study design. The number of samples is 197 samples. The sampling technique uses Proportional Random Sampling. Data analysis used SPSS version 26 with chi-square and multiple logistic regression. The results showed that significant factors for the utilization of chronic disease programs (prolanis) were age (p=0.028), knowledge (p=0.007), family support (p=0.049), and support from health workers (p=0.007). The results of the Multivariate analysis that were most related were knowledge (p=0.003) and health worker support (p=0.005). The most dominant factor is the Knowledge variable. Health center staff can provide clear and accurate information related to the diseases suffered by prolanis participants by giving prolanis participants a longer consultation time.