SEMA3 rs12707682 and rs1583147 variants are not common risk factors for HSCR in Indonesia. The rarity of the SEMA3 rs11766001 polymorphism in Indonesian population might be due to a founder effect.
Background The residency program as a part of the clinical services itself has been influenced by the COVID-19 outbreak. Several reports have been published regarding the impact of COVID-19 on the residency programs; however, all studies were performed in developed countries or did not comprehensively analyze what residents think about the COVID-19 impact on their residency program. We investigated the impact of the COVID-19 pandemic on the pediatric surgery residency program in our institution as an important part of hospital medical services. Methods We developed and distributed a questionnaire to pediatric surgery residents in our institution who were registered from January 2015 – July 2020. The questionnaire was consisting of 24 questions: a) the perspectives of residents about COVID-19 infection during their residency program; b) the learning process; c) academic evaluations; and d) residents' suggestions to improve the quality of their residency program during the outbreak. Results Most (82.6%) pediatric surgery residents agreed that elective surgeries should be postponed during the pandemic. Before the outbreak, almost all (82.6%) residents used textbooks and journals as their primary sources of learning, while during the outbreak, 69.5% of residents shifted to use online lectures either from the school or Association of Pediatric Surgeons. Interestingly, 91.3% of participants agreed that they had more time to complete their academic assignments during the pandemic. Conclusions The pandemic has had a significant impact on the development of pediatric surgery residency programs. Moreover, the responses to the questionnaire are affected by the seniority and sex of the residents. A comprehensive approach is needed to maintain the high standard of competence of pediatric surgery without compromising our safety from the COVID-19 infection risk.
Background: Breast cancer remains a global health issue, including in Indonesia, which has a relatively high incidence of breast cancer. Several theories have proved the role of estrogen in breast cancer carcinogenesis, but there is yet to be a preventive measure against breast cancer. Chemotherapy is one of the therapeutic modalities for breast cancer that disturbs ovarian function in producing estrogen due to damaged ovarian granulosa cells. Chemotherapy becomes an alternative option to decreasing circulating estradiol levels through interventions in ovarian functions, either by surgery, such as oophorectomy, or medications that disturb the ovarian functions. This study aimed to observe the estradiol levels in breast cancer patients before and after chemotherapy. Methods:This was a prospective cohort study. We observed the estradiol levels before and after adjuvant chemotherapy in breast cancer patients. Subjects' characteristics are presented in mean ± standard deviation, distribution frequency, and percentage. Subjects' characteristics based on chemotherapy were tested using an independent ttest, Mann-Whitney U, and Chi-square/Fisher exact test. Effects of chemotherapy on estrogen levels were tested using the Wilcoxon rank test and Kruskal-Wallis test.Results: A total of 194 research subjects were included. There were changes in estradiol levels before and after therapy. The decrease of estradiol levels in patients who did not receive chemotherapy was -6.9% (P > 0.05). Patients who received anthracycline cyclophosphamide (AC) regimen, paclitaxel and anthracycline (TA) regimen, paclitaxel, anthracycline and trastuzumab (TA + H) regimen, and platinum regimen experienced a significant decrease in estradiol levels (-21.4% (P < 0.05), -20.2% (P < 0.001), -31.7% (P < 0.01), and -23.7% (P < 0.05), respectively). Among chemotherapy groups, the estradiol levels before and after chemotherapy did not have significant differences (P = 0.937 and P = 0.730, respectively). Conclusion:There are no significant differences in estradiol levels between chemotherapy and hormonal therapy groups. Patients in both groups have decreased estradiol levels after therapy, although patients in hormonal therapy do not experience as much decrease as those in chemotherapy.
Background Esophageal atresia, with or without fistula, is a congenital defect that causes high morbidity and mortality in newborns. Risk factors of mortality need to be identified to establish the best approach for treating this condition in order to decrease morbidity and mortality.Objective To identify factors associated with mortality in newborns with oesophageal atresia.Methods We reviewed all newborns with esophageal atresia using data from their medical records at Sardjito General Hospital from January 2007 to December 2012. Potential risk factors were analyzed using Chi-square test, with a level of significance of P<0.05.Results Of 31 newborns that met our criteria, only 5 survived, and all 5 had one-stage surgery (primary anastomosis with fistula ligation). Thrombocytopenia and sepsis increased the risk of death with OR 10.857 (95%CI 1.029 to 114.578) and OR 13.333 (95% CI 1.242 to 143.151), respectively. However, anemia had a protective effect against mortality with OR 0.688 (95%CI 0.494 to 0.957).Conclusion Thrombocytopenia and sepsis are the risk factors associated with mortality in newborns with esophageal atresia at our institution. Anemia has a protective effect against mortality.
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