Introduction: Thalassemia is a highly prevalent hemoglobinopathy that causes anemia. Transfusion-dependent thalassemia patients require regular blood transfusions, leading to iron overload and the deposition of iron in various organs, including the liver. Accumulation of iron in the liver causes liver fibrosis, which increases the mortality of thalassemia patients. Serum ferritin levels are an indicator of iron overload that correlates with liver iron levels. Ultrasound-based shear wave elastography is a non-invasive modality with good accuracy for assessing the degree of liver fibrosis. The aim of this study is to determine the correlation between serum ferritin levels and the degree of liver fibrosis in thalassemia major patients using ultrasound-based shear wave elastography. Methods: This research is an observational- analytical study with a cross-sectional approach. The data used is secondary data taken from laboratory results and prospective data from ultrasound-based shear wave elastography examinations at Dr. Hasan Sadikin Hospital Bandung from January 2024 to March 2024. The Spearman’s Rank correlation test was carried out to assess the correlation between serum ferritin levels and the degree of liver fibrosis with a confidence level of 95%. Results: The number of subjects who met the inclusion criteria was 60, consisting of 21 (35%) men and 39 (65%) women with an average age of 25 ± 6 years. The mean value of serum ferritin levels was found to be 6894.0 ± 4774.7 ng/ml. A consultant radiologists conduct the ultrasound-based shearwave elastography. The average median value of liver stiffness using shear wave elastography was 12.3 ± 3.6 kPa, and 95% of subjects had significant liver fibrosis. There is a strong positive correlation between serum ferritin levels and the degree of liver fibrosis. (r=0.734, p<0.001) Conclusion: There is a strong correlation between serum ferritin levels and the degree of liver fibrosis in thalassemia major patients using ultrasound-based shear wave elastography at Dr. Hasan Sadikin Hospital Bandung.

Objective: Oxazolidinone antibiotics are mainly used for skin and soft tissue infections,sepsis,bone marrow inflammation and other diseases caused by Gram-positive bacteria. Despite the emergence of oxazolidinones as a preferred treatment for drug-resistant Gram-positive bacterial infections, there remains a scarcity of large-scale, real-world studies assessing their safety profiles. The purpose of this study is to determine the adverse events of oxazolidinone antibiotics in the real world environment by analyzing the data of oxazolidinone antibiotics. Method: A retrospective analysis was conducted using reports of adverse drug events (ADEs) extracted from the WHO-VigiAccess database. The significant associations between oxazolidone antibacterial agents and ADEs were evaluated using an imbalance analysis that incorporated reported odds ratios (ROR) and proportional reporting rates (PRR). Result: The investigation unveiled 35,750 linezolid-related adverse event (AE) reports and 608 tedizolid-related AE from the WHO-VigiAccess database.The analysis of the top 30 reported preferred terms (PTs) involving both drugs revealed several key adverse reactions, including thrombocytopenia, anemia, pancytopenia, decreased platelet count, neutropenia, peripheral neuropathy, serotonin syndrome, blurred vision, pruritus, dyspnea, nausea, vomiting, rash, diarrhea, dizziness, and headache. These findings are consistent with reports on adverse reactions associated with drugs used in the treatment of mitochondrial diseases, as detailed in recent studies.These adverse reactions encompassed 27 system organ classifications (SoCs), with a primary focus on blood and lymphatic system disorders, nervous system disorders, and general disorders or administration site conditions. Conclusion: This study provides a detailed report on the levels of SOC and specific PT associated with oxazolidinone antibiotics, highlighting the need for vigilance regarding serious adverse events caused by these drugs. Furthermore, attention should be paid to the hematological and nervous system toxicity associated with oxazolidinone drugs. Our findings offer valuable insights into optimizing the use of oxazolidinone antibacterial drugs and minimizing potential side effects. It is expected to promote the safe use of oxazolidinone antibacterial drugs in the clinical environment.

Link Video Abstract: https://youtu.be/BI914kzH1pw The most common gastrointestinal symptoms in hemodialysis patients are dyspepsia, anorexia, nausea, abdominal pain, bloating, diarrhea, and constipation. This review aimed to outline current attitudes regarding complications of the upper digestive tract in patients undergoing chronic hemodialysis. A systematic review was conducted using the PubMed, MEDLINE, and Google Scholar databases, which were searched using the keywords: Complications, Upper Parts, Digestive Tract, and Hemodialysis. Hemodialysis patients have a reduced risk of Helicobacter pylori infection because studies have determined its protective effect on preventing the occurrence of gastroesophageal reflux disease. Likewise, a positive correlation was found between Helicobacter pylori infection and extra-gastrointestinal symptoms. Disorders of the upper part of the gastrointestinal tract in patients with chronic kidney disease can be seen as gastroesophageal dysmotility and mucosal lesions, with an increased tendency towards bleeding from the gastrointestinal tract.

Cervical cancer has continued to pose a substantial global health burden, ranking as the fourth most prevalent malignancy among women worldwide. Although preventable through human papillomavirus (HPV) vaccination and early detection strategies, over 342,000 deaths were attributed to the disease in 2020, with more than 90% occurring in low- and middle-income countries (LMICs). The oncogenesis has been primarily driven by high-risk HPV types—particularly HPV16 and HPV18—via the actions of E6 and E7 oncoproteins, which inactivate key tumor suppressors, p53 and pRB, leading to malignant transformation. In this review, recent advancements in cervical cancer prevention, screening, and treatment have been systematically evaluated to support global elimination efforts. A literature search covering the years 2018 to 2023 was performed using PubMed, Embase, and Cochrane databases. The findings highlighted that while liquid-based cytology and HPV DNA testing remain the current gold standard for screening, novel biomarkers such as DNA methylation markers (e.g., FAM19A4/miR124-2) and dual-staining techniques (e.g., p16/Ki-67) have demonstrated improved sensitivity in detecting precancerous lesions. Prophylactic HPV vaccines, including Gardasil-9 and Cervarix, were shown to be over 90% effective in preventing HPV-associated neoplasia. However, coverage remained disproportionately low in LMICs, with vaccination rates under 15% in regions such as Africa. Therapeutically, immune checkpoint inhibitors like pembrolizumab and cemiplimab yielded objective response rates ranging from 14% to 26% in advanced or recurrent disease, while combination regimens are under active investigation. Despite these advances, significant barriers persisted in LMICs, including limited healthcare infrastructure, suboptimal screening uptake, and frequent late-stage diagnoses. The introduction of point-of-care HPV testing platforms, such as careHPV, and the WHO's endorsement of a single-dose vaccination regimen in 2022 have been recognized as potentially transformative strategies for expanding access. It has been concluded that a coordinated, multipronged approach is essential to achieve cervical cancer elimination. Priorities must include universal HPV vaccination, tiered screening strategies enhanced by AI technologies, and equitable access to advanced therapeutics. Through strengthened global partnerships and policy integration, the goal of eliminating cervical cancer by 2030 may be realistically attained.

Video Abstract: https://youtu.be/Vw8nboaiUa4 Abstract: Objective: This study provides a comprehensive overview of Urology Oncology Nursing, exploring its scope, roles, significance, and challenges, while highlighting opportunities for professional growth and future trends in the field. Through literature review and expert insights, it examines the evolving role of Urology Oncology Nurses in cancer care and innovative approaches to patient needs. Subjects and Methods: A systematic analysis of scholarly literature, including studies, guidelines, and expert opinions, was conducted. Key focus areas included patient care models, assessment and diagnosis, monitoring and management strategies, patient education, support systems, and interdisciplinary collaboration. Results: Urology Oncology Nursing is pivotal in holistic urologic cancer care, emphasizing patient-centered approaches amid challenges and opportunities. The study identifies emerging trends, interdisciplinary collaboration, and the growing recognition of nurses' roles in optimizing outcomes. It underscores the need for adaptive strategies to address evolving healthcare demands. Conclusions: Urology Oncology Nursing is essential for improving patient outcomes, requiring sustained investment, professional development, and interdisciplinary partnerships. Integrating evidence-based practices and innovative technologies is critical to advancing care quality and meeting patient needs. The study advocates for continued focus on this specialty to drive transformative change in cancer care.

Background: administration of long-acting injectable antipsychotics (LAIs) can overcome medication non-adherence and improve the outcome in people with schizophrenia. However, the prescription of LAIs by psychiatrists in Jakarta, Indonesia, remains lacking. This study aims to identify several factors that influence the prescribing practices around LAIs by psychiatrists. Methods: This is a qualitative study involving psychiatrists in Jakarta, Indonesia, from March 2020 to March 2021. Subjects were selected through purposive sampling. Data were collected through in-depth interviews. The validity of the data in this study was assessed through the triangulation of sources, theories, and researchers. Results: the knowledge and experience related to LAIs, attitudes and perceptions towards LAIs, prescribing patterns, persuasion methods, availability, price, effectiveness, and side effects of LAIs, health insurance, and factors related to patients and their families were found to influence the prescription of LAIs. Conclusion: factors related to healthcare providers, healthcare systems, patients, and drugs are interrelated in influencing the prescription of LAIs. Psychiatrists need education and training related to LAIs. To clarify the findings in the study, further research is needed regarding the relationship between attitudes, perceptions, knowledge, and experience with the prescribing practices around LAIs by psychiatrists.

Link of Video Abstract: https://youtu.be/IyRnt5R0zR8 Background: Coronary artery bypass grafting surgery (CABG) is one surgical management for coronary artery disease (CAD). Hyperlactataemia in CABG is associated with poor postoperative outcomes. This study aimed to correlate cardiopulmonary bypass (CPB) time and serum lactate levels to the length of stay (LOS) in the intensive care unit (ICU) in patients with post-CABG. Methods: This was a cohort study of 358 patients with post-CABG from January 2016 until December 2021 in Dr. Kariadi Hospital Semarang, Indonesia. Subjects were selected by consecutive sampling. The correlation between CPB time and serum lactate levels, between CPB time and LOS in ICU, and between serum lactate levels and LOS in ICU were analyzed by non-parametric Spearman correlation test. Subjects were then divided into 2 groups, i.e. groups with lactate levels <4.0 mmol/L and≥4.0 mmol/L. The differences in LOS in the ICU were analyzed between both groups using the non-parametric Mann-Whitney test. Results: There was a correlation between CPB time and serum lactate levels in ICU (r=0.302, p=0.000), between serum lactate levels and LOS in ICU (r=0.194, p=0.003), and between CPB time and LOS in ICU (r=0.373, p=0.005). There was a longer CPB time in the group with lactate levels ≥4 mmol/L compared to that with lactate levels <4 mmol/L (70.7 ± 5.12 versus 66.9 ± 7.28, p=0.006). There was a longer LOS in ICU (3.8 ± 3.17 versus 3.1 ± 1.21, p=0.143) in a group with lactate levels ≥4 mmol/L compared to that with lactate levels <4 mmol/L, although it was not significant. Conclusion: There was a correlation between CPB time and LOS, and between serum lactate levels and LOS in ICU in patients after CABG. If confirmed by further findings, lactate levels might be a predictor for the outcome for patients after CABG including a longer LOS in ICU.

Link of Video Abstract: https://youtu.be/3rkgy4KqfOA Background: ST-elevation mimicking ST-segment elevation myocardial infarction (STEMI), myocarditis, or takotsubo cardiomyopathy may occur in patients with hypertrophic cardiomyopathy. Echocardiography may also show a rounded apex with ballooning/aneurysm, thus mimicking takotsubo. Therefore, this case study aims to evaluate the dramatic ECG changes of hypertrophic obstructive cardiomyopathy mimicking Takotsubo cardiomyopathy. Case Presentation: A 78-year-old female presented to the emergency department with shortness of breath, palpitations, and back pain radiating to both arms. She was hypotensive, with ST elevation, R wave, and T wave inversion in the anteroinferior leads, a normal T wave in aVR, and a wide P wave on the admission ECG. Her NTpro-BNP and hs-TnT levels were elevated. Coronary angiography revealed a non-significant lesion. The echocardiogram showed a dilated LV with rounded apical LV, suggesting Takotsubo syndrome. ECGs from days 3 to 5 before discharge showed normalization of the ST segment. A CMR performed 2 weeks later demonstrated asymmetrical hypertrophic cardiomyopathy with sigmoid hypertrophy of the septal ventricular wall and hypertrophy of the anterolateral and posteromedial papillary muscles, causing narrowing of the left ventricular outflow tract (LVOT) during systole, with turbulence at the LVOT. Conclusion: HCM can cause dramatic changes in ECG features, especially during the acute dynamic phase of LVOT obstruction. Additionally, the upright T wave in aVR, a valuable clinical tool and simple visual criterion in ECG, may provide useful information regarding the unfavorable prognosis of patients with HCM.

Introduction: The application of artificial intelligence (AI) to nutritional screening and management for instance has great possibilities especially in the developing nations like Indonesia where malnutrition prevails. This review aims to explore the potential of AI in nutritional screening methods and its potential and challenges of implementation to reduce the high prevalence of malnutrition in Indonesia. Methods: This literature search was conducted through PubMed (Medline Database) and Cochrane with determined search term. Articles were selected based on predefined inclusion and exclusion criteria, and data were subsequently extracted from these selected articles according to specified criteria Results: This article focuses on the use of artificial intelligence in the areas of dietary evaluation, nutrition, and health promotion as applicable in public health. This has been reinforced by several studies through an extensive review of literature that have proven that there is ready availability of accurate dietary evaluation, targeted nutrition and health education as well as behavior change communication within a very short time. However, despite the optimistic picture of the adoption of AI technologies in the medical field, their implementation in Indonesia is severely limited by many challenges including lack of digital networks, challenges in data collection and shortage of qualified personnel. It is necessary to overcome these challenges before AI can be applied to enhance nutritional intervention in Indonesia. Conclusion: In this regard, the results of this review validate the importance of AI in the field of nutrition and public health, while clearly stating how important it is to develop mechanisms to ensure its use.

The global percentage of adults aged 65 and older is expected to increase rapidly. This demographic transition raises considerable health issues, especially related to cognition, representing skills like memory, thinking, and executive performance. The aging process naturally modifies brain structure and biochemistry through oxidative stress, inflammation, and metabolic disturbances, resulting in minor to severe deficits, such as dementia, leading to both individual and societal constraints. Nutrition is a crucial modifiable element affecting cognitive health in older adults, with dietary quality significantly impacting metabolic, biochemical, and neurophysiological functioning. This review discusses the relationship between nutrition and cognitive health, emphasizing balanced dietary patterns and critical nutrients for cognitive preservation in aging populations. Macronutrients, including complex carbohydrates, proteins, and unsaturated fats, in conjunction with micronutrients such as vitamins and minerals, jointly impact brain function. Omega-3 polyunsaturated fatty acids, vitamins B, C, and E, and polyphenols exhibit protective effects against cognitive decline via their antioxidant and anti-inflammatory properties, although several inconsistencies have been found across the existing research. Specific dietary patterns, such as the Mediterranean, DASH, and MIND diets, may provide advantages in postponing cognitive decline by their anti-inflammation and antioxidant content. Challenges in sustaining healthy nutrition for older persons, including alterations in appetite, social isolation, and gastrointestinal complications, necessitate tailored approaches, family support, public health programs, and governmental initiatives. Advocating for a personalized balanced diet not only aids cognitive maintenance but also improves general health and alleviates societal challenges linked to aging demographics. Holistic strategies that prioritize dietary treatments show potential for promoting healthy aging and reducing cognitive decline.