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Abstract : Indonesia falls into the category of developing countries with healthcare inequalities. One of the main factors is the limitation of human resources for health, infrastructure facilities, and medical devices. This study aims to identify the needs of e-patients in internal medicine and surgical clinics at the Regional General Hospital of West Sulawesi Province. The research uses the qualitative method. Data were collected through in-depth interviews and focus group discussions. All interview was conducted in Indonesian and converted into a verbatim transcript afterward. Data were analyzed using the NVivo application. E-patient application is necessary for both patients and the doctors and other health workers involved to decrease patient waiting times and improve the effectiveness and efficiency of their work. As a recommendation, the West Sulawesi Regional General Hospital should keep improving e-patient features and e-patient applications while maintaining patient data security through the e-patient application. The study concluded that an e-patient development is considered important and necessary because it makes it easier for patients and reduces waiting time, resulting in more effective and efficient hospital services.

Abstract : Dynamic, uncertain, and ambiguous environments currently influence organizations worldwide, including the hospital industry. Hospital problems, both internal and external disruptions, such as the Covid-19 pandemic, have affected hospital performance. In line with those conditions, excellent meta-leaders beyond clinical entities are urgently needed. Meta leadership has important implications for individual, team, and organizational performance. There are three dimensions of meta-leadership (the person, connectivity, and the situation). As a person or individual, a hospital leader must have strong meta-leadership competencies to handle crises. However, the implementation of the meta-leadership in-person approach, especially in healthcare-based settings, has not yet been reviewed. This study aimed to determine the person-focused-meta leadership capabilities of hospital managers through an analytical cross-sectional study. Research was conducted in six different types of hospitals where all hospital managers were involved. Furthermore, data was analyzed by the R Chi test that showed meta-leadership capabilities were still under the mean (<90), although analysis for each detailed variable indicator was relatively high. This means that the capabilities of self-management of hospital managers were still weak. The results have implications for proposing a capacity-building program of meta-leadership training to hospital managers—especially the self-management component. Three categories of the person could describe the integral and comprehensive description of meta-leadership capabilities that would be more emphasized in handling crises of health services and achieve the highest performance of effective meta-leadership in the future.

Abstract : Post-anesthesia complications, including shivering, pain, nausea and vomiting are among the most common complaints of patients undergoing general anesthesia. Dexmedetomidine (DMET) is an agent abundantly applied to reduce these complications; however, the best dosage remained a question. The current study aims to investigate different doses of DMET for management of postoperative shivering, pain, nausea and vomiting in laparoscopic cholecystectomy. The current randomized clinical-trial (RCT) has been conducted on 76 patients undergoing laparoscopic cholecystectomy who were randomly assigned into three groups of low-dose DMET (0.3 µ/kg) (n=25), high-dose DEMT (0.5 µ/kg) (n=25) or normal saline (control group) (n=26). The patients’ vital signs and postoperative complications were assessed every 15 minutes during and after the surgery, within 6, 12, 18 and 24 hours after it. The assessments of shivering showed that high dose DEMT led to statistically lower scores than the other two groups (P-value<0.05). Significant pain improvement was noted in all the groups (P-value<0.05), while treated patients with high dose DMET represented lower pain scores (P-value<0.05). Significant improvement in postoperative nausea and vomiting was noted in the control group only (P-value<0.05). The pain scores were remarkably higher in the control group (P-value<0.05) compared to the others; however, low versus high dose DMET did not differ (P-value>0.05). DMET administration was accompanied by significant postoperative shivering, pain, nausea and vomiting control. Besides, superior outcomes with negligible adverse effects were generally, achieved by the application of 0.5 μg/kg than 0.3 μg/kg.

Abstract : Peri-implant health is defined as the absence of signs of inflammation, bleeding, and suppuration around dental implants. The presence of adequate KT around dental implants is considered to be beneficial for maintaining peri-implant health and preventing peri-implant diseases, such as peri-implant mucositis and peri-implantitis. A comparative clinical study was conducted on a series of 18 patients with 30 alveolar ridge defects suffering from a horizontal bone defect that will result in the exposure of 2 to 3 mm of the implant threads after the implant placement in the anterior region of the maxilla. The patients were divided into three equal groups: The xenograft bone ring, EthOss® bone graft, and β-TCP bone graft. All of which were used to augment the alveolar ridge simultaneously with implant placement. The keratinized tissue width around the dental implants in each group was evaluated and compared before the surgery and at six, 12, and 24 months postoperatively. The exposure of the graft material during the pre-prosthetic phase was assessed in all of the three groups after six months of the surgical procedure. Xenograft bone ring had the lowest keratinized tissue width among the groups, but the differences were not significant. Graft exposure occurred only in the xenograft bone ring group, showing significant differences between the groups. Within the confines of our study, we observed no difference in the keratinized tissue width among the xenograft bone ring, the EthOss®, and the β-TCP bone graft groups.

Abstract : Carcinoid tumors mimicking acute appendicitis are rare (0.43% of patients), and the prognosis is excellent in the non-perforating appendix. The treatment depends on the site, size, and degree of mesoappendix and lymphovascular invasion. The level of Ki67 and mitotic activation rate are vital. Thus, it is important to follow the pathology report. We presented a case of tubular carcinoid mimicking acute appendicitis.