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Is gluten free and casein free (GFCF) diet effective for individuals with autism? Widyahening, Indah S.; Ismail, Raden I.
Medical Journal of Indonesia Vol 20, No 2 (2011): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (44.354 KB) | DOI: 10.13181/mji.v20i2.440

Abstract

Background: Even though the etiology of autistic spectrum disorder (ASD) has not been clearly known, various types of therapies have been offered. One of the most popular therapies is Gluten Free and Casein Free Diet – GFCF diet.Methods: A structured internet literature search was conducted using Pubmed and Cochrane library. Titles and abstracts were screened using predetermined selection criteria. Critical appraisal was conducted based on standard criteria for relevance, validity, and levels of evidence.Results: Based on relevance, only four out of twelve selected articles can be used; one is a systematic review and three randomized controlled trials (RCTs). Several methodological problems which could lead to over-estimation of the effect were found in the studies including poor randomization and selective drop-out. Risk of under-estimation of report due to small number of participants and in-adequate duration of intervention was also found. Small to moderate improvement were found in some outcome measured including overall autistic traits, social isolation, and the ability in communication and interaction. However, insignificant differences also found in some area such as individual’s behavior, cognitive and motor function.Conclusion: Available studies fail to provide sufficiently credible and strong evidence to recommend the practice of GFCF diet in treating autism. (Med J Indones 2011; 20:114-8)Keywords: autism, gluten free and casein free diet
High level of work stressors increase the risk of mental-emotional disturbances among airline pilots Widyahening, Indah S.
Medical Journal of Indonesia Vol 16, No 2 (2007): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (115.209 KB) | DOI: 10.13181/mji.v16i2.267

Abstract

Civilian airline pilots have one of the most stressful occupations. The aim of this study was to identify the effect of work stressors and other factors on mental-emotional disturbances among airline pilots. A cross-sectional study was done by interviewing selected pilots of an airline using appropriate questionnaires, during their routine medical examination from May to July 1999 in Jakarta. Five aspects of work stressor were assessed: working conditions, physical conditions of working environment, career development, organization and interpersonal relationship. Mental-emotional disturbances were determined by using the Symptom Checklist 90 (SCL 90) questionnaire. Data analysis was carried out using relative risk by Cox regression with constant time. From 128 subjects interviewed, 109 could be analyzed. Most of the subjects were married (73.4%) and college graduates (91.7%). The number of captains and first officers were almost equal. The prevalence of mental-emotional disturbances was 39.4%. Mental-emotional disturbances were significantly related to work stressors and moderately related to household tension (P = 0.184). Compared to pilots with low levels of work stressors, those with high or very high levels of work stressors had a risk of 4.6 times of mental-emotional disturbances [adjusted relative risk (RRa) = 4.64; 95% confidence interval (CI) = 1.01 – 19.65]. Adequate guides to cope work stressors and household tension which related to mental-emotional disturbance is recommended. (Med J Indones 2007; 16:117-21)Keywords: mental-emotional disturbance, work stressors, household tension, airline pilots
Does the establishment of universal health coverage drive the foundation of postgraduate education for primary care physicians? Widyahening, Indah S.; Tanoto, Rodri; Rinawan, Fedri; Setiawati, Elsa P.; Leopando, Zorayda E.
Medical Journal of Indonesia Vol 26, No 2 (2017): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (486.652 KB) | DOI: 10.13181/mji.v26i2.1857

Abstract

Background: Studying the formation of postgraduate training in primary care within countries which has attained Universal Health Coverage (UHC) is important to support the development of similar training in low-and middle-income countries aiming to achieve UHC by 2030. This review aims to describe the state of postgraduate training for primary care physicians in UHC-attaining countries.Methods: A literature review of published literature and official documents from the websites of regional and global health/primary care organizations or societies such as World Health Organization (WHO), World Organization of Family Doctors (WONCA), European Forum for Primary Care, European Union of General Practitioners (GP)/Family Physicians (FP), European Academy of Teachers in GP/Family Medicine (FM), as well as the websites of GP/FP organizations in each of the respective countries. The list of UHC attained countries were identified through WHO and International Labor Organization databases.Results: A total number of 72 UHC-attained countries were identified. Postgraduate education for primary care physicians exists in 62 countries (86%). Explicit statements that establish primary care postgraduate training were corresponded with the policy on UHC is found in 11 countries (18%). The naming of the program varies, general practice and family medicine were the commonest. In 33 countries (53%), physicians are required to undertake training to practice in primary level. The program duration ranged from 2–6 years with 3 years for the majority.Conclusion: Although UHC is not the principal driving force for the establishment of postgraduate training for primary care physicians in many countries, most UHC-attaining countries make substantial endeavor to ensure its formation as a part of their health care reform to improve national health.
EPIDEMIOLOGY OF MICROORGANISMS IN INTRAABDOMINAL INFECTION/COMPLICATED INTRAABDOMINAL INFECTIONS IN SIX CENTERS OF SURGICAL CARE IN INDONESIA: A PRELIMINARY STUDY Moenadjat, Yefta; Lalisang, Toar JM.; Saunar, Rofy S.; Usman, Nurhayat; Handaya, Adeodatus Y.; Iswanto, J.; Nasution, Safruddin; Karuniawati, Anis; Loho, Tony; Widyahening, Indah S.
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. Data of complicated intraabdominal infections (cIAI) and the epidemiology of causative microorganisms which is Indonesian characteristics is required to develop a guideline. Thus, a preliminary study run to find out such characteristics. Method. Data of subjects with cIAI managed in six centers of teaching hospital in Indonesia in period of 2015?2016 were collected. Those data of source of infection, the epidemiology of microorganism and susceptibility of antibiotics were descriptively provided. Results. Source of infection were perforated appendicitis (26.64%), perforated gastric and duodenal ulcer (22.70%), small bowel perforation (11.84%), large bowel perforation (13.16%), postoperative (9.54%), and others (16.2%). Escherichia coli and Klebsiella pneumonia were the most microorganisms found in the pus specimen. The sensitivity of Escherichia coli and Klebsiella pneumonia to cephalosporins were in range of 14.1? 42% and 28.7?35.6%, respectively. Conclusion. Perforated appendicitis, perforated gastric and duodenal ulcer, small bowel perforation, large bowel perforation, and postoperative in sequent are the main causal of cIAIin Indonesia. The epidemiology predominated by Gram negative, particularly Escherichia coli and Klebsiella pneumonia.