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31	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-46
THE EFFECTS OF TOXOPLASMA GONDII INFECTION ON MALONDIALDEHYDE AND C-REACTIVE PROTEIN LEVELS IN PREGNANT RATS Hafi Nurinasari(a), Sajidan(a), Bambang Purwanto(a), Dono Indarto(a), Didik T Subekti(b,c) a.Doctorate Program of Medical Sciences, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia Biology Study Program, Faculty of Education, Universitas Sebelas Maret, Surakarta, Indonesia Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia Department of Physiology and Biomedical Laboratory, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia b.The Center of Veterinary Research (BBALITVET) Bogor c. Biomedical Research Center, National Research and Innovation Center (BRIN) Abstract Introduction: Toxoplasmosis is a human disease due to intracellular infection of Toxoplasma gondii, which induces oxidative stress and inflammation. These defense mechanisms often result in massive cell damage, which is characterized by increases of malondialdehyde (MDA) and proinflammatory cytokine productions. Interleukin 6 as an example of proinflammatory cytokine will stimulate the hepatocytes to release a soluble mediator of the innate immune system, C reactive protein (CRP), in order to inhibit the parasite infection. Objective: The purpose of this study was to investigate the effects of T.gondii infection on serum MDA and CRP levels in pregnant rats. Materials and Methods: This laboratory experiment with posttest only group design used 20 female Wistar rats (Rattus novergicus), which aged 6 until 8 weeks and weighed 150 until 200 g. Selected female rats were randomly divided into four groups, named control group that was not given any Toxoplasma isolate, and the other three groups were differentiated based on the dose of Toxoplasma isolate given (10 tachyzoites, 100 tachyzoites, and 1000 tachyzoites respectively). On the day 12 of pregnancy, all rats in the treatment groups were intraperitoneally injected with 2 ml of Toxoplasma isolates. Blood samples were then collected in the end of pregnancy for measurement of serum MDA and CRP levels. Results: Serum MDA and CRP levels increased significantly in all pregnant rats of T groups, compared to that of control group (p < 0.001). Furthermore, serum MDA and CRP levels in all four groups were dose dependent manner. Sequentially from the control group to the third treatment group mean difference in MDA levels was (1,68 nmol/ml- 5,375 nmol/ml- 8,737 nmol/ml- and 10,8 nmol/ml) and in CRP levels was (2,975 mg/L- 4,382 mg/L- 15,727 mg/L- and 17,970 mg/L). Conclusion: Toxoplasma infection increases serum MDA and CRP levels in dose dependent manner in pregnant rats. Keywords: Toxoplasma gondii, MDA, CRP, Pregnant rat Share Link | Plain Format | Corresponding Author (Hafi Nurinasari)

32	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-47
zinc supplementation reduces myeloperoxidase level in chronic suppurative otitis media without cholesteatoma Sudrajad HADI1*, Pratiwi DEWI1, Primadewi NOVI1, Nurhidayah1 Othorhinolaryngology Deparment, Sebelas Maret Universty Surakarta Indonesia Abstract Background: Chronic suppurative otitis media (CSOM) is a chronic infection and inflammation of the middle ear and mastoid cavities characterized by the presence of otorrhoea through perforation of the tympanic membrane. Myeloperoxidase (MPO) is an oxidative enzyme with antimicrobial activity, which utilizes H2O2 to produce hypochlorous acid and other toxic substances in neutrophil phagolysosomes. It has been reported that MPO plays an important role in chronic processes such as CSOM. Zinc is believed to provide benefits as a modulator effect in the inflammatory cascade that can reduce the hyperinflammatory response to infectious agents so that it is expected to reduce MPO levels. Objectives: To analyze the effect of Zinc on MPO in CSOM without cholesteatoma patient. Methods: This research was conducted at the ENT Clinic Dr. Moewardi Hospital Surakarta, Indonesia from July - Augustus 2022 with the pretest-posttest control group design. Results: The mean level of MPO was decrease significantly from 3.17 +- 1.47 ng/mL to 0.65+- 0.48 ng/mL (p=0.001) after intervention with zinc supplementation in the study group, compared to the control group fom 3.08+- 1.05 ng/mL to 2.45+- 0.78 ng/mL (p=0.082). There was also significant difference in MPO level changes in the study group compares to the control group (0.63 +- 1.13 ng/mL vs 2.51 +- 1.24 ng/mL) (p=0.001) Conclusion: Zinc has modulator effect in inflammation cascade that can decrease MOP levels in CSOM. Therefore, the zinc supplementation is recomended in patients with CSOM without cholesteatoma. Keywords: Chronic suppurative otitis media, myeloperoxidase, zinc Share Link | Plain Format | Corresponding Author (Hadi Sudrajad)

33	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-49
An Overview on Beta Vulgaris: Its Functions as Antidyslipidemia Yulia Rohman (a*), Arief Nurudhin (b), Lusi Oka Wardhani (b) a) Department of Nutrition Science Universitas Sebelas Maret, Surakarta, Indonesia b) Internal Medicine Department Faculty of Medicine Universitas Sebelas Maret, Surakarta, Indonesia Abstract Dyslipidemia is a dysfuntion of lipoprotein metabolism indicated by elevated total cholesterol, low density lipoprotein cholesterol and triglyceride as well as lowering high density lipoprotein cholesterol in serum. Beta vulgaris is a rich source of nutrients such as vitamins, minerals, proteins, and a variety of bioactive phenolic substances that are primarily composed of betalains, and other components with antioxidant activity including flavonoids (viteixin, rutin, apigenin, quercetin, orientin), coumarins, carotenoids, and triterpenes. In order for Beta vulgaris to be effective in treating dyslipidemia, it must be able to upregulate antioxidant, inhibit LDL mediated oxidative effect on endothelial cells, and minimiza metabolic abnormalities in rats fed a dyslipidemia diet. A systematic review of research was conducted covering Scopus, PubMed, Cochrane Database and Google scholar in English. The purpose of this review is to focus on nutraceutical facts of Beta vulgaris by focusing on the alternative treatment to future dyslipidemia. Keywords: Beta vulgaris- Dyslipidemia- Treatment Share Link | Plain Format | Corresponding Author (Yulia Rohman)

34	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-52
Comparison of Administration of Lipopolysaccharide (LPS) with Isoproterenol on Fibrosis Area in Sprague Dawley Rat: A Study of Acute Myocardial Infarct Induction in Rat Model Saugi Abduh (a,b*), Purwanto Bambang (c), Dirgahayu Paramasari (d), Soetrisno (e) a)Student of Medical Science, Medical Faculty, Universitas Sebelas Maret, Surakarta, INDONESIA. b)Division of Cardiology, Department of Internal Medicine Science, Sultan Agung Islamic University, Semarang, INDONESIA. *drsaugiabduh01[at]gmail.com c)Division of Kidney and Hypertension, Department of Internal Medicine Science, Universitas Sebelas Maret, Surakarta, INDONESIA. d)Department of Parasitology, Universitas Sebelas Maret, Surakarta, INDONESIA. e)Department of Obstetrics and Gynecology, Universitas Sebelas Maret, Surakarta, INDONESIA. Abstract Background: Myocardial infarct induction in rat model with isoproterenol is a standard in a cardioprotective research on various test substances. The other myocardial infarct induction model uses Lipopolysaccharide (LPS). LPS and isoproterenol show the same mechanism of induction of myocardial damage, that is disturbed balance in free radical formation and antioxidative resistance system. Objective: This research aims to examine the difference between LPS and Isoproterenol injections on rat model based on fibrosis area. Method: This research used a posttest only control group design with 15 sprague dawley rats as samples which were divided into 4 groups: NaCl control group, LPS 10 mg/mL group, LPS 15 mg/mL group, and isoproterenol group. The LPS and isoproterenol groups were respectively given intraperitoneal injection with LPS and isoproterenol for 14 days, while the control group was left without any treatment. On day 15 they were terminated and measured for fibrosis area histopathologically using micrometer. Result: This research shows that the infarct area of LPS 10mg/mL and 15mg/mL groups was 51.910&#956-m2 and 102.512&#956-m2, while that of the isoproterenol group was narrower of 21.190 &#956-m2. Conclusion: LPS 15mg/mL induction causes wider myocardial fibrosis than LPS 10mg/mL induction and even than isoproterenol induction. Keywords: Acute Myocardial Infarct, Lipopolysaccharide, Isoproterenol Share Link | Plain Format | Corresponding Author (Muhammad Saugi Abduh)

35	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-53
Systematic Review: Theurapeutic Response of Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitors in Dyslipidaemia Ariq Ratya Satwika (a), Nur Hafidha Hikmayani (b), Ratih Puspita Febrinasari (b) a) Student of the Faculty of Medicine Universitas Sebelas Maret Surakarta b) Departement of Pharmacology Faculty of Medicine Universitas Sebelas Maret Surakarta Abstract Dyslipidaemia is associated with cardiovascular disease. Statins remain the first choice for dyslipidaemia, however, certain patients will have to consider alternative therapies due to resistance and intolerance. Proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors are some of the newer non-statin medications. This systematic review aimed to understand the effects of PCSK9 inhibitors on LDL-C and other lipid parameters in dyslipidaemia management. A comprehensive search was conducted in PubMed, ScienceDirect, and Cochrane Library for original articles, in English, phase 3 randomized clinical trials, designed to assess the effects of PCSK9 inhibitors on LDL-C and other lipid parameters, published in 2012-2022. The systematic review was performed based on PRISMA guidelines. Jadad score was used for critical appraisal. Data were extracted manually and results were presented in a tabulation format as well as descriptive graphs, to summarize into a conclusion Nine studies included in this review reported PCSK9 inhibitors improved LDL-C and other lipid parameters. Evolocumab treatment led to 55-67% LDL-C reduction from baseline, while alirocumab led to 45-54% LDL-C reduction from baseline. Both with 41-73% LDL-C achievement <70 mg/dl. Results also showed favourable effects on other lipid parameters. PCSK9 inhibitors treatment leads to the improvement of LDL-C and other lipid parameters. Keywords: dyslipidaemia- PCSK9 inhibitors- evolocumab- alirocumab- LDL-C Share Link | Plain Format | Corresponding Author (Ariq Satwika)

36	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-54
The usage of acupuncture for labor pain: a report from primary clinic health in Indonesia Selfi Handayani- M. Nur Dewi Kartikasari- Endang Listyaningsih S- Annang Giri Moelyo- Ita Kusumawati Department of Anatomy and Embryology Faculty of medicine Universitas Sebelas Maret Surakarta Diploma3 Midwifery UNS Vocational School Departement of Histology, Faculty of Medicine, Universitas Sebelas Maret Surakarta, Indonesia Department of Paediatric Dr Moewardi Hospital/ Faculty of Medicine Universitas Sebelas Maret Surakarta Griya Husada 2 Primary Haelth Clinic, Karanganyar Abstract Some parturition women need additional therapy for reducing labor pain. Electroacupuncture is a modern variation of acupuncture that uses electrical energy. This study aims to observe the usage of electroacupuncture to reduce pain labor in the primary health clinic. We report childbirth from July to August 2022 in the primary clinic. There were 13 patients who agreed to be treated by acupuncture, but 2 patients did not fulfill the indication. The general points LI4, ST36, and SP6 and segmental points were used. The segmental points selection is based on the location of the uterus innervation. EA was used at an alternating frequency of 2/100 Hz and intensity of 0.1-0.3 mA, which was adjusted for 20 minutes. The Numbering analog scale (NAS) score, amount of labor pain, duration and intensity of uterine contractions, and duration of phase II of delivery were calculated and it was monitored by Partograph for each woman. After delivery, APGAR scores were recorded for the babies. Acupuncture therapy is effective for reducing labor pain, strengthening uterine contractions, and speeding up phase II of delivery. Acupuncture had no side effects on mothers or babies, and it is recommended for practice in primary care clinics. Keywords: acupuncture- labor pain Share Link | Plain Format | Corresponding Author (Selfi Handayani)

37	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-55
The potential of Cinnamomum cassia in lowering blood sugar levels in patients with type 2 diabetes mellitus Dwi Wulandari Aaas Hamka (a*), Dhani Redhono (b). Ratih Puspita Febrinasari (b) a. Clinical Nutrition Department Universitas Sebelas Maret, Jl. Sutami No.36, Surakarta, Indonesia b. Department of Internal Medicine, Universitas Sebelas Maret and Moewardi General Hospital, Surakartan, Indonesia b. Department of Pharmacology, Universitas Sebelas Maret, Surakartan, Indonesia Abstract Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia that occurs due to defects in insulin secretion, insulin action, or both. People with diabetes mellitus in the world at the age of 20-79 years reached 463 million people or 9.3% of the total population of the same age. The prevalence of diabetes mellitus is estimated to increase until in 2030 it will reach 578 million and in 2045 it is predicted to reach 700 million. Spices such as Cinnamomum cassia have been of interest due to their phytochemical composition that exerts hypoglycemic effects with the potential for the management of type 2 diabetes mellitus. the aim is to determine Cinnamomum cassia as an alternative treatment for patients with type 2 diabetes mellitus. The method is a systematic review of many journals. Cinnamon has several active ingredients, namely cinnamate, cinnamaldehyde, polyphenols, and flavonoids. cinnamaldehyde can increase glucose transport by GLUT 4 in adipose cells and skeletal muscle so that it can significantly reduce blood glucose. Keywords: Cinnamomum cassia- Treatment- Type 2 diabetes mellitus Share Link | Plain Format | Corresponding Author (Dwi.Wulandari.Aaas Hamka)

38	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-56
The Antidiabetic Effects of Konjac Glucomannan from Porang on The Clinical Outcomes of Patients with T2DM: Systematic Review Puan Nur Rizqia Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia Abstract Background: Diabetes Mellitus Type-2 (DMT2) is a group of complex metabolic disorders that cause insulin resistance in the body. Konjac Glucomannan is known to have potential as an alternative therapy for T2DM patients with OAD or insulin therapy. Administration of glucomannan in T2DM patients significantly reduced HbA1C and postprandial glucose. KGM can also reduce insulin resistance which is one of the main factors in the pathogenesis of T2DM and increase insulin sensitivity of body cells. Research Methods: A systematic study was carried out by synthesizing studies on patients with T2DM and compiled based on the PRISMA 2020 Systematic Review protocol. The scientific databases used were Science Direct, Pubmed, Cochrane Library, ProQuest. The main outcomes determined were HbA1C, PPG, HOMA-IR as a standard for assessing insulin resistance, and fasting insulin levels (FSI). The screening and extraction process is carried out by examining the identified titles and abstracts, then the full-text articles are evaluated to obtain articles that meet the eligibility criteria. A risk analysis of bias was carried out by two reviewers based on the 2020 PRISMA protocol and Jadad^s score. Results: Of the total, there were 6 RCT articles that met the criteria, with a total of participants. Based on the results of the risk of bias analysis, 2 articles with low risk of bias and 4 others with high risk of bias were calculated by the Jadad score. 4 studies showed significant reductions in HbA1c and FBG, while two showed no signficant change with KGM. There is significant decrease in HOMA-IR but not in FSI. In general, glucomannan has a general role in preventing the progression of complications in T2DM, especially CVD, namely by regulating postprandial plasma glucose, regulating food absorption, and decreasing insulin resistance. Differences in the effectiveness of glucomannan on glycemic control and decrease insulin resistance may be influenced by the dose and duration of administration. Conclusion: Giving KGM can reduce postprandial blood glucose, FBG, and HbA1C in T2DM patients with OAD and < 3 complications, there is an increase in serum fructosamine, ghrelin, and leptin as well as a significant decrease in HOMA-IR. However, the decrease in fasting insulin levels was found to be insignificant. Further research is needed to investigate the effect of KGM on insulin resistance and the development of KGM as a treatment for T2DM in humans. Keywords: DMT2, HbA1C, HOMA-IR, Insulin resistance, Konjac Glucomannan Share Link | Plain Format | Corresponding Author (Puan Nur Rizqia)

39	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-58
MORINGA OLEIFERA EXTRACT REDUCES DISEASE ACTIVITY IN RHEUMATOID ARTHRITIS PATIENTS Nurhasan Agung Prabowo*, Arief Nurudhin, Yulyani Werdiningsih, Wachid Putranto, Tri Kusumo, Hartono, and Desy Puspa Putri 1 Doctoral Program of Medical Sciences, Faculty of Medicine, Universitas Sebelas Maret, Ir Sutami Street No 36A, Kentingan, Jebres, Surakarta, 57126 2 Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Ir Sutami Street No 36A, Kentingan, Jebres, Surakarta, 57126 3 Department of Internal Medicine, Universitas Sebelas Maret Hospital, Universitas Sebelas Maret, Ahmad Yani Street No 200, Makam Haji, Sukoharjo, Surakarta, 57161 Abstract Rheumatoid arthritis (RA) is a systemic autoimmune disease targeting joints. Remission in Indonesia on RA treatment is 62.3%, with a record of the many side effects of RA therapy. Therefore, new drugs that are effective and safe for managing RA are needed. Moringa oleifera has been shown to have anti-inflammatory, anti-arthritis, and immunosuppressant effects for treating rheumatoid arthritis. This study aimed to prove the effect of moringa oliefera extract on the DAS28-hsCRP score of RA patients. This study was in the form of a Randomized Controlled Trial (RCT) with a sample of 33 people who were divided into two groups, namely the treatment group (n=15, Moringa oleifera extract 40.50 mg/kg BW/day) and the control group (n=18, placebo). This study lasted for 30 days. Disease activity levels (DAS28-CRP, DAS28-LED) were assessed before and before intervention. Analysis of the data used using paired t-test and independent t-test. The number of significance was p <0.05. The results showed the improvement of DAS28-hsCRP before and after administration of Moringa Leaf Extract (MO) in the treatment group (p=0.001). The Delta-DAS28-hsCRP difference was more significant in the treatment group than in the control group (p=0.013). Moringa leaf extract administration reduced DAS28-hsCRP scores in RA. Patients. Keywords: DAS28-hsCRP, Disease Activity, Moringa oleifera, Rheumatoid Arthritis Share Link | Plain Format | Corresponding Author (Nurhasan Agung Prabowo)

40	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-59
COMPREHENSIVE REVIEW IN PSYCHOSIS OF PARKINSON DISEASE: PATHOPHYSIOLOGY, BEST THERAPY, AND PROGNOSIS Ervina Arta Jayanti Hutabarat1*, Suroto1, Diah Kurnia Mirawati1, Subandi1, Rivan Danuaji1, Pepi Budianto1, Yetty Hambarsari1, Baarid Luqman Hamidi1, Hanindia Riani P1, Ira Ristinawati1, Teddy Tejomukti1, Andi Ario Tedjo1, and Fabian Jeremy Prasetyo2 1 Department of Neurology, Faculty of Medicine, Sebelas Maret University, Indonesia 2 Faculty of Medicine, Sebelas Maret University, Indonesia Abstract ABSTRACT Among the non-motor symptoms of Parkinson disease, psychosis is one of the most common, complex, and disabling non-motor symptoms, with an estimated prevalence of up to 43-63% in the advanced stages of Parkinson disease. The prevalence of psychosis in Parkinson disease increases as the disease progresses and is associated with poorer quality of life, disability, and increased caregiver stress, as well as increased cognitive decline, hospitalization rates, morbidity, and mortality. Psychosis not only occurs naturally in the disease progression but is also caused by Parkinson disease medication itself, dopamine-related therapy. Our group reviewed literature specifically about psychosis in Parkinson disease. Key topics include the pathophysiology of psychosis in Parkinson disease, the causal mechanism of psychosis by Parkinson disease medication, and also the best principle of therapy in patients with psychosis in Parkinson disease. Numerous literary works discuss the fundamentals of treating psychosis in Parkinson disease, which also includes using anti-psychotic drugs such as pimavanserin, clozapine, and quetiapine. Psychosis in Parkinson disease has become a unique challenge for clinicians to overcome how Parkinson disease medication can become the cause of psychosis, so this raises questions and directions for future research to come. Keywords: Parkinson disease, psychosis, dopamine, dopamine-related therapy Share Link | Plain Format | Corresponding Author (Fabian Jeremy Prasetyo)

41	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-60
THE CORRELATION BETWEEN MDS UPDRS III WITH DEPRESSION, ANXIETY, AND FATIGUE SYMPTOMS IN PARKINSON DISEASE Ervina Arta Jayanti1, Suroto1, Diah Kurnia Mirawati1, Subandi1, Rivan Danuaji1, Pepi Budianto1, Yetty Hambarsari1, Baarid Luqman Hamidi1, Hanindia Riani P1, Ira Ristinawati1, Teddy Tejomukti1, Andi Ario Tedjo1, Ardisa Permata Putri2, Andry Nurwahyu Putra2 1Neurology Staff, Faculty of Medicine, Sebelas Maret University/RSUD dr. Moewardi Surakarta, Indonesia 2Resident of Neurology, Faculty of Medicine, Sebelas Maret University/RSUD dr. Moewardi Surakarta, Indonesia Abstract ABSTRACT Parkinson is one of the most common neurodegenerative diseases among people aged 40-70. One of Parkinson non-motor symptoms is depression, anxiety, and fatigue. Those symptoms significantly worsen the quality of life of people with Parkinson. This study aims to determine and analyze the relationship between MDS UPDRS III on symptoms of depression, anxiety, and fatigue in Parkinson. This research is an observational analytic quantitative with a cross-sectional study approach. The subjects were all Parkinson patients assessed with MDS UPDRS III (motoric scale) in the Neurology department RSUD Dr Moewardi from July 2022-September 2022. The severity of depression, anxiety, fatigue was assessed using Hamilton Depression Scale, Hamilton Anxiety Scale, and Fatigue Severity Scale. The Spearman correlation test was conducted to determine the correlation between MDS UPDRS III scores and the severity of depression, fatigue and anxiety in Parkinson patients. A statistically significant result was obtained between MDS UPDRS III scores with depression scale (p<0.05- 0.000), anxiety scale (p<0.05- 0.000) and fatigue scale (p<0.05-0.380). From the result of correlation, there is a solid and positive relationship between the degree of UPDDRS III and depression, anxiety and fatigue symptoms. The higher the UPDRS III value, the more likely the patient is to experience depression, anxiety and fatigue. Keywords: Parkinson, Depression, Anxiety, Fatigue, UPDRS III Share Link | Plain Format | Corresponding Author (Fabian Jeremy Prasetyo)

42	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-63
TREND AND VISUALIZATION IN HONEY AND DIABETES MELLITUS: RESEARCH FROM 1953 TO 2022 Siti Munawaroh1,2*, Nanang Wiyono1, Yunia Hastami1,2 1Department Anatomy, Faculty of Medicine, Universitas Sebelas Maret, Indonesia 1Medical Education Unit, Faculty of Medicine, Universitas Sebelas Maret, Indonesia Abstract Diabetes mellitus (DM) is a globally emerging health issue, one of the top five global causes of mortality and morbidity. Many researchers have tried to find an effective treatment for DM. One of the natural ingredients used as an alternative in anti-diabetic therapy is honey. This study aims to find research trends related to honey and diabetes mellitus. Bibliometric analysis in this study uses the Scopus database. A bibliometric analysis tool to visualize countries, journals, and keywords use VOSviewer software. The research carried out on September 28, 2022, found a total of 586 documents in the period 1953 to 2022. The search used the keywords honey AND diabetes* with restrictions on the source type of journals. The results show that publications on honey and diabetes mellitus have grown significantly in the last ten years. United States is a leading country in honey and DM research, accounting for the most significant number of publications worldwide, with lead authors and research institutes involved. Nutrient journal stands out as a major periodical. Keyword analysis shows that studies on honey and DM have focused on themes related to humans, glucose blood levels, and wound healing. The bibliometric analysis provides relevant information on the main themes studied about honey and DM Keywords: diabetes mellitus, honey, bibliometric, trend research, VOSviewer Share Link | Plain Format | Corresponding Author (Siti Munawaroh)

43	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-65
THE EFFECTIVENESS OF USING ANIMATION IN STUNTING EDUCATIONAL VIDEOS Deny Tri Ardianto, Sayid Mataram, Jotika Purnama Yuda Universitas Sebelas Maret Abstract Indonesia is a country that still has a high number of stunting cases. Based on the 2018 Global Nutrition Report (GPR) data, the prevalence of stunting in Indonesia is ranked 108th out of 132 countries. According to data from the Ministry of Health (Kemenkes) in 2019, the national stunting cases reached 27.7%. This means that 1 in 4 children under five year old in Indonesia is stunted. To prevent stunting in children, the government and various private institutions provide information related to early prevention of stunting. This study seeks to analyze the effectiveness of using animation in educational videos. The data of this study are educational videos about stunting on YouTube that have more than 10 thousand views for the period of 2021-2022. Using qualitative content analysis methods, the YouTube videos that convey information related to stunting are classified into several groups, namely videos that use animation, videos that use live shots only without animation, and videos that use both animation and live shots. From the analysis results, the most effective and communicative video model in delivering information related to stunting to the wider community is obtained. Keywords: Stunting, educational video, animation Share Link | Plain Format | Corresponding Author (Deny Tri Ardianto)

44	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-66
Mesenchymal Stem Cell Secretome Decrease Inflammation in Sepsis Model Arifin1,2), Bambang Purwanto1,2), Dono Indarto1,3), Brian Wasita1,4), Tatar Sumanjar1,2), Eti Poncorini1,5), Soetrisno1,6) 1 Doctoral Program of Medical Sciences, Faculty of Medicine, Universitas Sebelas Maret, Jl. Ir Sutami No 36A, Kentingan, Jebres, Surakarta, 57126 2 Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Jl. Ir Sutami No 36A, Kentingan, Jebres, Surakarta, 57126 3 Department of Physiology, Faculty of Medicine, Universitas Sebelas Maret, Jl. Ir Sutami No 36A, Kentingan, Jebres, Surakarta, 57126 4 Department of Anatomic Pathology, Faculty of Medicine, Universitas Sebelas Maret, Jl. Ir Sutami No 36A, Kentingan, Jebres, Surakarta, 57126 5 Department of Public Health, Faculty of Medicine, Universitas Sebelas Maret, Jl. Ir Sutami No 36A, Kentingan, Jebres, Surakarta, 57126 6 Department of Obstetrics and Gynaecology, Faculty of Medicine, Universitas Sebelas Maret, Jl. Ir Sutami No 36A, Kentingan, Jebres, Surakarta, 57126 Abstract Inflammation plays an essential role in sepsis by activating Nf-K&#946- (nuclear factor-kappa Beta). Mesenchymal stem cell secretome (MSC) is one of the breakthroughs in sepsis. The secretion of mesenchymal stem cells consists of cytokines, microRNA (miRNA), exosomes, and microvesicles, which can cause a therapeutic effect. The mechanisms of MSC secretion include antiapoptotic, anti-inflammatory, antifibrotic, angiogenic, and the development of tissue regeneration. This study aims to determine the impact of MSC secretomes on Nf-K&#946- expression in the liver and kidney. This research is a posttest-only control design group experimental study. This experiment used 40 rats. There were eight mice per group, and the animals were randomized, the control group, the sepsis model group, the sepsis model group receiving MSC Secretome 150 l/20 gr, the sepsis model group receiving MSC Secretome 300 l/20 gr, and the sepsis model group receiving secretome. MSC 600 l/20 gr. After four days, they were killed, and their liver and kidneys were removed for examination. Data were analyzed using the Shapiro-Wilk, Anova, and Post-Hoc tests. Significance using p<0.05. MSC secretion decreases Nf-K&#7838- expression in the liver and kidney. MSC secretome 600 l / 20 gr is the best dose for fighting sepsis models. MSC secretion decreased Nf-K&#7838- expression in a mouse model of liver and kidney sepsis. Keywords: kidney, liver, MSC secretome, Nf-KB, sepsis mice model. Share Link | Plain Format | Corresponding Author (Arifin Arifin)

45	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-67
THE EFFECT OF NITRIC OXIDE AND HbA1c ON MUSCLE MASS IN ELDERLY WITH DIABETES MELLITUS Desy Puspa Putri1), Nurhasan Agung Prabowo1), Fatichati Budiningsih2), Agung Susanto3) 1) Internal Medicine Department, Faculty of Medicine, Sebelas Maret University, Indonesia 2)Geriatric Division, Internal Medicine Department, Faculty of Medicine, Sebelas Maret University/ Dr. Moewardi Hospital Surakarta, Indonesia 3)Nephrology Division, Internal Medicine Department, Faculty of Medicine, Sebelas Maret University/ Dr. Moewardi Hospital Surakarta, Indonesia Abstract Background. Diabetes Mellitus (DM) in the elderly is followed by the incidence of sarcopenia, one of which is a decrease in muscle mass. Hyperglycemia and decreased Nitric Oxide (NO) levels in the elderly will affect the degradation and regeneration of skeletal muscle, thereby affecting muscle mass. Aim. To determine the effect of NO and HbA1c levels on muscle mass in elderly with DM. Methods. This is a cross-sectional study on 30 elderly with DM who visited the Geriatric Clinic. We take the serum for NO and HbA1c assays, and muscle mass measurement by DXA. We used SPSS 22 for statistical analysis using Shapiro Wilk test for data normality and correlation analysis and multiple linear regression with a significance value at p &#8804- 0.05. Results. We found the BMI of subjects varied, with low average handgrip strength and fairly normal TUG results. NO levels have a positive and significant effect on muscle mass with a significant degree of 5 percent (p = 0.003). HbA1c has a negative and significant effect on muscle mass (p = 0.04). The multiple correlation test results showed that NO and HbA1c together had a significant effect on muscle mass (p = 0.001) Conclusion. NO levels were shown to have a positive and significant effect on muscle mass and HbA1c levels were shown to have a negative effect on muscle mass in elderly with DM. NO and HbA1c levels also simultaneously affect muscle mass and contribute as predictor factors for muscle mass in elderly with DM. Keywords: NO, HbA1c, muscle mass, elderly, DM Share Link | Plain Format | Corresponding Author (Desy Puspa Putri)

46	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-68
HUMORAL IMMUNE RESPONSE AND CELLULAR IMMUNE RESPONSE OF CORONAVAC VACCINE FOLLOWING COVID19 VACCINATION Luhut Suryanugraha, B. Rina A. Sidharta Department of Clinical Pathology, Faculty of Medicine/Dr. Moewardi Hospital at Surakarta, Sebelas Maret University, Indonesia Abstract Inactivated coronavirus disease (COVID19) vaccine, CoronaVac (Sinovac Biotech) has constraint in stimulating cellular immune response compared to humoral immune response leading to inability to produce antibody against severe acute respiratory syndrome coronavirus 2 (SARSCoV2) which plays role in providing neutralization and protection from SARSCoV2. Humoral and cellular immune responses can be evaluated by examining CD4 and CD8 percentages, respectively. This study analyzed the potentiality of inactivated COVID19 vaccine in inducing humoral and cellular immune responses by evaluating its correlation with SARSCoV2 antibody. A cross sectional study was performed in 50 healthcare workers who met our inclusion criteria. The CD4 and CD8 T cells were examined with BD FACSCanto II using flowcytometry. ROCHE Cobas E411 with electrochemiluminescence immunoassay (ECLIA) was employed for examining SARSCoV2 antibody. Spearman Correlation test was used for analysing the data statistically and the significance was determined with p value less than 0.05. This study obtained the mean values of CD4 percentages, CD8 percentages and SARSCoV2 antibody were 32.98+-7.74%, 27.72+-8.58%, and 87.18+-142.95 Uml-1, respectively. The correlation test yielded statistically significant positive weak correlation of CD4 with SARSCoV2 antibody (r=0.322 p=0.023) and significant negative weak correlation of CD8 with SARSCoV2 antibody (r= -0.297 p=0.036). To sum up, there are positive correlation of CD4 percentage and negative correlation of CD8 percentage with SARSCoV2 antibody. This evidences that inactivated COVID19 vaccine can produce humoral immune response. However, the finding of negative correlation indicates that the ability of this vaccine to induce cellular immune response has not been able to be proven. Keywords: COVID-19, CD4 percentage, CD8 percentage, SARS CoV 2 antibody, CoronaVac inactivated vaccine. Share Link | Plain Format | Corresponding Author (Luhut Suryanugraha)

47	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-69
The Shrimp Skin Extract (Litopenaeus vannamei) as an adjunct Therapy of Hemostasis in Open Fractures Ratna Indriawati1*, Alifia Ichsan Nabila 2 Universitas Muhammadiyah Yogyakarta Abstract Shrimp is the main export commodity of Indonesian fisheries. The majority of shipments are in the form of fresh frozen shellless shrimp, which results in increased shrimp shell waste. The utilization of waste is still lacking even though shrimp shells have many important ingredients, one of which is chitosan. Chitosan has been shown to be able to accelerate hemostasis. This study aimed to examine the shrimp skin extract as adjunct therapy of hemostasis in hemostasis through a clotting time (CT) test in open fractures. This study was an experimental study with 18 samples of white rats (Rattus norvegicus) induced by fracture, divided into 3 groups, control, oral chitosan, and topical chitosan. The control group did not receive chitosan therapy, but all groups received levofloxacin injections and splint dressing. The clotting time test using the Lee-White method was held on days 1, 3, and 5 by taking venous blood through the orbital sinus, for each clotting time test, 2 samples were taken from each group and euthanized immediately after blood collection. The data obtained were analyzed using Kruskal-Wallis. The results showed that there was a decrease in CT time although it was not statistically significant in the CT test on day 1 (p 0.156), day 3 (p=0.102), and day 5 (p=0.368). There was a significant improvement in swelling found in the topical chitosan group. The shrimp skin extract as an adjunct therapy did not significantly accelerate clotting time in open fractures. Keywords: Shrimp shell, hemostasis, clotting time, chitosan, fracture Share Link | Plain Format | Corresponding Author (Ratna Indriawati)

48	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-70
A Bibliometric Analysis of 10 years of Publications on L-Citrulline Dhoni Akbar Ghozali (a,b*), Muchsin Doewes M (c), Soetrisno (d), Dono Indarto (e) and Muhana Fawwazy Ilyas MF (f) a) Doctoral Program of Medical Sciences, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia b) Departement of Anatomy, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia, Indonesia *dhoniakbar[at]staff.uns.ac.id c) Lecturer of Doctoral Program of Medical Sciences, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia d) Departement of Obstetrics and Gynecology, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia, Indonesia e) Department of Physiology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia f) Department of Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia Abstract Publication of L-citrulline has increased since it has been deemed advantageous in the health and wellness field, but it has not yet reached the level of maturity. It contributes to the recent increase in the quantity of research published. However, only a few or none bibliometric analyses have been undertaken in the past ten years. The objective of this research is to establish bibliometric analysis as a comprehensive review of l-citrulline literature. This study^s methodology consists: defining search keywords, initializing search results, refining search results, generating preliminary data statistics, and assessing data. The Scopus database was chosen since it is regarded as optimal for bibliometric analysis. The software VOSviewer has been used as a bibliometric analysis tool in order to show the networks of authors, countries, journals, and keywords. The analysis carried out on 9 September 2022 retrieved a total of 563 documents in the period 2013 to 2022. In the recent decade, the number of L-citrulline-related publications has increased dramatically. The United States is the leading nation in the field of L-citrulline research, providing the greatest number of publications in the world and involving the world^s leading writers and research organizations. Nutrients stands out as the main publishing periodical. In recent decades, L-citrulline research has primarily concentrated on nitric oxide synthase, ergogenic aid, and exercise performance, as indicated by a keyword analysis. On the basis of the analysis of keywords with less frequent occurrence, the bibliometric analysis also identified possible themes for future investigation. Keywords: L-citrulline- bibliometric analysis- VOSviewer Share Link | Plain Format | Corresponding Author (Dhoni Akbar Ghozali)

49	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-73
The Influence of Integrated Learning Environment on Pre-service Medical Doctors Career Options Kayyis Hawari1, Muchtar Hanafi1,2, Siti Munawaroh3 1Universitas Sebelas Maret Hospital / Faculty of Medicine, Universitas Sebelas Maret 2Radiology Department, Faculty of Medicine, Universitas Sebelas Maret 3Anatomy Department, Faculty of Medicine, Universitas Sebelas Maret Abstract Background: Pre-service general practitioners have several career choices once they graduate from the faculty of medicine. Their choices may be influenced by several factors, including the learning environment. This current study aims to seek correlation between the medical students^ perceptions on integrated learning environment and career choices. Method: This cross-sectional study was conducted at one of Indonesian Red Cross offices involving 160 medical students by using consecutive sampling technique. This study employed Postgraduate Hospital Educational Environment Measure (PHEEM) questionnaire which is valid and reliable by values of 0.89 (&#945-=0.826) and r&#8805-0.30 (r=0.442). The data were analysed using the Wilcoxon Theta Correlation test for nominal and ordinal measurement scales. Results: The result of career choice shows that most of the students choose a non-primary service doctor career. There is a weak correlation between the integrated learning environment at the Indonesian Red Cross and the choice of a career as a primary care doctor for students with a value of &#952- = 0.0084 (&#952- < 0.2). Conclusion: There is a weak correlation between the integrated station learning environment at the Indonesian Red Cross (PMI) and career choices as primary care doctor. Keywords: Learning Environment, PHEEM, Career Choice Share Link | Plain Format | Corresponding Author (Muchtar Hanafi)

50	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-75
Conservative management of grade III penile injury using topical mupirocin: a case report M. Ghilman Nurizzan, Rizki Abri Laksono FK UNS Abstract External genital trauma cases account for 33-66% of all urogenital trauma cases, which is more prevalent in men than in women These cases are uncommon in the pediatric population, with numerous etiology and trauma mechanisms. We present a case of a 3-years-old boy with a complaint of penile pain after the patient fell forward in the prone position. The patient was diagnosed with grade III penile injury and given conservative management of wound care. After three days in the hospital, the patient was discharged. An examination one week later showed that the wound had improved without any complications. Keywords: Penile injury, penile trauma, conservative management, mupirocin Share Link | Plain Format | Corresponding Author (M. Ghilman Nurizzan)

51	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-76
EFFECT OF ERYTHROPOIETIN ON PREVENTION OF CEREBRAL PALSY IN HYPOXIC ISCHEMIC ENCEPHALOPATHY Study of hemoglobin, C-reactive protein, Caspase-3 and Tumor Necrosing Factor-&#61537- levels Fadhilah Tia Nur1*, Harsono Salimo1, Hardiono D Pusponegoro2, Ari Natalia Probandari3, Bambang Purwanto4, and Soetrisno5 1Department of Child Health, Medical Faculty, Sebelas Maret University, Indonesia 2Department of Child Health, Medical Faculty, University of Indonesia, Indonesia 3Department of Public Health, Medical Faculty, Sebelas Maret University, Indonesia 4Department of Internal Medicine, Medical Faculty, Sebelas Maret University, Indonesia 5Department of Obstetric and Gynecology, Medical Faculty, Sebelas Maret University, Indonesia *fadhilah.harris[at]gmail.com Abstract ABSTRACT Hypoxic ischemic encephalopathy (HIE) is one of the leading causes of cerebral palsy (CP) and neonatal mortality in developing countries. Erythropetin (Epo) is one of the newest neuroprotective therapies to prevent cerebral palsy. In order to analyze the effect of Epo as neuroprotective agent to prevent CP, a double-blind, randomized, placebo-controlled trial was conducted between January-October 2022 in neonatology ward, at a tertiary hospital in Surakarta, Indonesia. We assigned 25 infants borned at 32 weeks or more of gestation with HIE based on Thompson^s criteria to receive Epo or placebo. Epo (1000 IU per kilogram of body weight) or saline placebo was administered intravenously within 24 hours after birth, as well as at 2, 3, 4, and 5 days of age. Before and after treatment, hemoglobin, c-reactive protein (CRP), caspase-3 and tumor necrosing factor-&#61537- (TNF-&#61537-) levels were checked. Neurological examination was performed at 2, 4, and 6 months of age to assess the occurrence of CP. There was an effect of Epo administration on hemoglobin and caspase-3 levels, but there was no difference in erythropetin administration on CRP and TNF-&#61537- levels. There was no significant difference in the occurrence of cerebral palsy in the treatment group. Epo has significant neuroprotective effects on caspase-3 levels, but this is not enough to prevent CP. Keywords: erythropoietin, cerebral palsy, hypoxic ischemic encephalopathy Share Link | Plain Format | Corresponding Author (Fadhilah Tia Nur)

52	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-81
EFFECT OF NFK&#914-, CASPASE-3, AND E-SELECTIN ON PREGNANT RATS TOXOPLASMOSIS MODEL Hafi Nurinasari1, Sajidan1, Bambang Purwanto1, Dono Indarto1, Didik T Subekti,23 1Doctorate Program of Medical Sciences, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia Biology Study Program, Faculty of Education, Universitas Sebelas Maret, Surakarta, Indonesia Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia Department of Physiology and Biomedical Laboratory, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia 2The Center of Veterinary Research (BBALITVET) Bogor 3 Biomedical Research Center, National Research and Innovation Center (BRIN) Abstract Introduction: Toxoplasmosis is a zoonotic disease caused by the obligate intracellular Toxoplasma gondii that can infect humans and warm-blooded animals. The prevalence of toxoplasmosis occurs in most areas of the world and about one third is estimated to be chronically exposed to toxoplasmosis. T. gondii infection causes oxidative stress that causes an imbalance between the free radical-producing system and the cellular defense system, namely an increase in free radical production or a decrease in antioxidant defense activity or both. Oxidative stress and infection will cause inflammation there by increasing levels of Nuclear Factor Kappa beta, caspaae 3 and E-Selectin resulting in inflammation and cell death. Objective: The purpose of this study was to to determine the effect of NFK&#914-, caspase-3 and E-Selectin on pregnant rats model of toxoplasmosis. Materials and Methods: This research is a laboratory experimental study using Randomized Control Trial (RCT) with posttest only with control group design. This study used female rats (Rattus novergicus) aged 6-8 weeks, weighing 150-200 grams. In this study, female rats that had gone through the pregnancy process were divided into four groups, namely one control group which was not given Toxoplasma isolate, and the other three groups were differentiated based on the dose of Toxoplasma isolate given, namely 10, 100, and 1000 tachyzoites. Each group consisted of four rats. Toxoplasma isolate was administered intraperitoneally as much as 2 ml on the 12th day of pregnancy and then measured levels of NFK&#914-, caspase-3 and E-Selectin through rat blood samples on the 17th day of gestation. Results: There were significant differences in the levels of NFK&#914- (p < 0.001), caspase-3 (p < 0.001 and E-Selectin (p < 0.001) in the four groups. The data mean difference in levels of NFK&#914-, caspase-3 and E-Selectin in the four groups showed the increase corresponds to an increase in the dose of Toxoplasma tachyzoite injected in mice. Conclusion: There was a significant difference in the increase in levels of NFK&#914-, caspase-3 and E-Selectin in pregnant toxoplasmosis model rats along with an increase in the dose of toxoplasma tachyzoites compared to normal pregnant rats. Keywords: Toxoplasma gondii, NFK&#914- , caspase- 3, E- Selectin,, Pregnant rats Keywords: PleaToxoplasma gondii, NFK&#914- , caspase- 3, E- Selectin,, Pregnant ratsse Just Try to Submit This Sample Abstract Share Link | Plain Format | Corresponding Author (Hafi Nurinasari)

53	Medical : basic science, clinical, translational research, medical education, and miscellaneous	ABS-82
Increased level of TNF-&#945- in serum and peritoneal fluid of endometriosis women-related infertility Nanda Yuli Rahmawati1, Fadhil Ahsan2, Budi Santoso2, Alfin Firasy Mufid1, Ashon Sa^adi2, Sri Ratna Dwiningsih2, Arif Tunjungseto1,2, M. Y. Ardianta Widyanugraha1,2 1Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia. 2Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia. Abstract Objective: TNF-&#945- has been implicated in developing endometriosis- however, TNF-&#945- is largely unexplored in women with infertility cases. We aimed to evaluate serum and the peritoneal fluid level of TNF-&#945- in endometriosis patients and correlates its level to the severity of endometriosis. Study design: Peripheral blood and peritoneal fluid samples were obtained from 87 infertility cases who underwent laparoscopy, consisting of 44 endometriosis women and 43 non-endometriosis women. We assessed serum and peritoneal fluid levels of TNF-&#945- using enzyme-linked immunosorbent assay. Results: Serum and peritoneal fluid TNF-&#945- levels were significantly increased in the endometriosis group compared to the control group (p-value = 0.0278- p-value = 0.0271). Serum and peritoneal TNF-&#945- levels were significantly different between late-endometriosis and the control group (p-value = 0.026, p-value = 0.004). Conclusions: Our results show increased levels of TNF-&#945- level in endometriosis women related to infertility cases that correlate with the severity of endometriosis. Keywords: endometriosis, infertility, the severity of endometriosis, TNF-&#945- Share Link | Plain Format | Corresponding Author (Nurul jannatul Wahidah)

54	Nursing and Midwifery	ABS-21
PROTECTIVE EFFECTS OF AJWA EXTRACT ON SUPEROXIDE DISMUTASE, ESTROGEN RECEPTOR ALPHA, AND OVARIAN CELLS APOPTOSIS IN FEMALE RATS EXPOSED TO ARSENIC Herdhika Ayu Retno Kusumasari (a*), Harwin H Desyanti (b) and Mahanutabah H Qurniatillah (c) a) Department of Physical Education, Health and Recreation, Faculty of Sport Science, State University of Malang, Indonesia *herdhika.ayu.fik[at]um.ac.id b) Midwifery Program, Faculty of Health, Nurul Jadid University, Probolinggo, Indonesia c) Harapan Kita Women and Children Hospital, Jakarta, Indonesia Abstract Context: Inorganic arsenic exposure in the environment can cause homestatic disturbances and reproductive disorders that have an impact on infertility. Oxidative damage caused by arsenic is due to the accumulation of reactive oxygen species (ROS) which inhibit endogenous antioxidant activity and cause organ damage. Ajwa dates contain strong antioxidants that can break the chain reaction of oxidative stress and inhibit lipid peroxidation caused by arsenic exposure. Objectives: To determinate the protective effect of Ajwa date fruit extract on Superoxide dismutase (SOD) activity, ER-&#945- expression and apoptosis of granulosa ovarian cells in female wistar rats exposed to arsenic Methods: The laboratory experimental studies with five groups, namely a negative control group, a positive control group was administered with arsenic 3 mg/kg body weight, Treatment Group 1 was administered with arsenic 3 mg/kg body weight and date extract 2 ml/kg body weight, Treatment Group 2 with arsenic 3 mg/kg body weight and date extract 4 ml/kg body weight, and Treatment Group 3 was administered with arsenic 3 mg/kg body weight and date extract 8 ml/kg body weight, and further observed for 30 days. The rats were terminated in the proestrus phase then ovarian tissue were examined for SOD activity with colorimetric method and apoptosis of ovarian follicle granulosa cell using the immunofluorescence method, and endometrial tissue were examined for ER-&#945- expression using immunohistochemicals method. Results: There were significant changes in SOD activity, ER-&#945- expression and apoptosis of ovarian follicle granulosa cell in female rats exposed to arsenic. Conclusions: Ajwa date fruit extract significantly provide a protective effect on female rats exposed to arsenic. Keywords: arsenic, apoptosis, estrogen receptor alpha, reactive oxygen species, superoxide dismutase Share Link | Plain Format | Corresponding Author (Herdhika Ayu Retno Kusumasari)

55	Nursing and Midwifery	ABS-22
The effect of the SPIRIT program on anxiety of elderly in nursing homes: a pilot study Cahyanto, EB 1, Subijanto, AA 2, Kristiyanto, A 3, Sumardiyono4, Suratih, K5 1Student of Doctorate Degree Program in Public Health, Sebelas Maret University, Surakarta, Indonesia 2Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia 3Department of Sport Science, Sebelas Maret University, Surakarta, Indonesia 4,5Shool of Vocation, Sebelas Maret University, Surakarta, Indonesia Abstract Anxiety is one of the most common mental health disorders. The most widely used non-pharmacological intervention to overcome anxiety in the elderly in nursing homes is physical activity. Physical activity alone is not always able to overcome anxiety. Expert recommendations say physical activity should be combined with meditation relaxation. This study aims to determine the effect of comprehensive physical and mental activity on reducing anxiety. The design is quasi experiment one group pre test post test. A comprehensive program called SPIRIT consists of elderly gymnastics, pedaling a stationary bicycle, walking, muscle strength training, flexibility, balance, as well as breathing relaxation, and gratitude were carried out three times a week for four weeks. Seven elderly who meet the criteria are willing to become participants. The results measured included the presence or absence of side effects, mean attendance, dropout rates, and anxiety scores. No unexpected events occurred during the intervention. Average attendance is 86 percent. The mean anxiety score at baseline was 14 (5.13) and 11 (3.55) at follow up. There was a significant decrease in anxiety with p less than 0,05. The SPIRIT program is effective in reducing anxiety and deserves to be used for further research. This is a pilot study to test the feasibility of the SPIRIT program, which is part of the comprehensive program to enhance the quality of life of elderly people in nursing homes, with registration number IRSCTN 13989556. Keywords: SPIRIT program, anxiety, elderly, nursing home, pilot study Share Link | Plain Format | Corresponding Author (erindra budi cahyanto)

56	Nursing and Midwifery	ABS-38
THE EFFECT OF SPIRITUAL HYPNOSIS INTERVENTION ON THE LEVEL OF COMFORT, PAIN, AND ENDORPHINS IN POST-OPERATIVE FEMUR FRACTURE PATIENTSSample Abstract eko mulyadi Faculty Of Health Science, Universitas Wiraraja, Indonesia Abstract This study proposes a model of spiritual hypnosis. It investigates its effect on comfort, pain, and Endorphin levels in post-operative femur fracture patients in four east java hospitals. This study used a Pre-posttest quasi-experiment with a control group design. This study used 34 samples of Post-operative femur fracture patients divided into two groups, 17 patients in the control group and 17 in the treatment group. The level of comfort, pain, and Endorphin were measured before and after the treatment using questionnaires and blood samples. The control group received the standard intervention, while the treatment group received spiritual hypnosis. The findings indicated that spiritual hypnosis decreased pain and improved comfort level but did not affect Endorphin level- path analysis demonstrated that spiritual hypnosis reduces pain through enhanced comfort without mediation by Endorphin. Previous research found that endorphins were not involved in hypnotic analgesia. Hypnosis is not primarily mediated by opiate endorphin. At the same time, plasma Endorphin levels were not significantly affected by hypnosis future research needs to consider environmental and patient conditions, as they may affect pain levels when applying spiritual hypnosis. Keywords: hypnosis, spiritual, pain, comfort, surgery Share Link | Plain Format | Corresponding Author (eko mulyadi)

57	Nursing and Midwifery	ABS-41
THE EFFECT OF HEALTH BELIEF MODEL EDUCATION ON THE PREVENTION OF ACUTE RESPIRATORY INFECTION IN TODDLERS DURING COVID-19 PANDEMIC Naya Ernawati, Fitriana Kurniasari Solikhah, Erlina Suci Astuti Politeknik Kesehatan Kemenkes Malang Abstract Acute respiratory infection (ARI) is one of the health problems that still occurs today. Rural communities in areas near factories at risk of suffering from ARI during the Covid-19 pandemic. Limited public knowledge and wrong perception of ARI are the underlying factors. The purpose of thisAcute respiratory infection (ARI) is one of the health problems that still occurs today. Rural communities in areas near factories in the Wagir area Malang Regency are at risk of suffering from ARI during the Covid-19 pandemic. The purpose of this study was to determine the effect of health belief model education on the prevention of recurrent non-pneumonia ARI in toddler. The research design used in this study was a quasi-experimental quantitative research with a control group approach of pre-test-post-test design. The number of samples in this study were 30 respondents in the control group and 30 respondents in the treatment group using purposive sampling technique. Data analysis was performed univariately, bivariately with the Wilcoxon signed rank test. The results showed (p < 0.05) which means that there is a significant influence between the provision of health belief model education and efforts to prevent non-pneumonia ARI in toddler. Providing health education based on the Health Belief Model increases the knowledge and attitudes of mothers in preventing ARI. Therefore, the government, non-governmental organizations, health educators, and other health services must incorporate the construction of the Health Belief Model into the Health Education program as an effort to prevent ARI in toddler Keywords: Health belief model- Acute Respiratory Infection- Toddler Share Link | Plain Format | Corresponding Author (Naya Ernawati Ernawati)

58	Nursing and Midwifery	ABS-45
THE EFFECT OF TELEMEDICINE PLUS APPLICATION ON THE COVID 19 PATIENTS QUALITY OF LIFE Megasari A.L., Masbahah, Riatma D.L., and Fatsena R.A Universitas Sebelas Maret Abstract Covid-19 pandemic affects human^s life quality. The consultations between patients and health workers are being carried out online using telemedicine to stop the transmission. This research aimed to assign the effect of the Telemedicine Plus application on the Covid-19 patients^ quality of life. The method of the study is quasi-experimental with the pretest-posttest nonequivalent control group design. The participants were 60 patients who was confirmed positive for Covid-19 in the Ngoresan Region, Surakarta City. The sampling technique using purposive sampling. There were two types of subject criteria: the intervention group- given the Telemedicine Plus application and the control group- given a standard therapy. The life quality of the Covid-19 patients was rated using the Short-Form 36 questionnaire. Participants who applied Telemedicine Plus experienced an increasing number of the average life quality scores from 39.70 to 50.93, while respondents who were given a standard therapy also experienced an increase from 39.93 to 41.67. The independent t-test indicated 0.000 (<0.05) for a p-value. This points out that there is a difference in life quality between the intervention group and the control group significantly. The Telemedicine Plus application improves the Covid-19 patients^ life quality more than patients which receive the standard therapy Keywords: Telemedicine, Application, Covid-19, Life Quality Share Link | Plain Format | Corresponding Author (Anis Laela Megasari)

59	Nursing and Midwifery	ABS-62
The Effect of Peer Counseling on Knowledge and Motivation of Pregnant Women in Stunting Prevention Ropitasari, Fresthy Astrika Yunita, M.Nur Dewi Kartikasari, Cahyaning Setyo Hutomo, Sri Anggarini Parwatiningsih, Hardiningsih, M.Kes, Rizka Adela Fatsena Vocational School D3 Midwifery, Universitas Sebelas Maret, Surakarta Abstract ABSTRACT: Stunting is a chronic malnutrition problem characterized by short body posture and influenced by nutritional intake from the womb period. The low knowledge and motivation of pregnant women regarding stunting can be improved through Peer Counseling. This study aims to determine the effect of Peer Counseling on the knowledge and motivation of pregnant women in preventing stunting. This study used a Quasi Experiment one-group pretest-posttest design. Purposive sampling with 50 respondents. The level of knowledge and motivation was measured using a questionnaire at the pretest-posttest. Peer Counseling has been done with the lecture method through mentoring using leaflets. The test of differences in respondents^ knowledge level before Peer Counseling was carried out was moderate (37.4%). After being assisted, the category increased (80.8%). The test for the difference in the level of motivation of respondents in stunting prevention before (pre-test) peer counseling was carried out in the medium (50.4%) and after (post-test) high category (92.8%). The analysis using a t-test showed an increase in knowledge and motivation regarding stunting prevention before and after peer counseling (p=0.000). It is concluded that Peer Counseling can increase the knowledge and motivation of pregnant women to prevent stunting. Keywords: Effect of Peer Counseling, Knowledge and Motivation, Stunting Prevention Share Link | Plain Format | Corresponding Author (Ropitasari Ropitasari)

60	Nursing and Midwifery	ABS-64
OCCUPATIONAL AND ART THERAPY REDUCING DEPRESSION, ANXIETY AND STRESS LEVELS OF ELDERLY IN NURSING HOME Ika Subekti Wulandari, Anis Laela Megasari, Wiwin Winarni, Sri Mulyani, Kanthi Suratih, Erindra Budi Cahyanto, Mujahidatul Musfiroh Sebelas Maret University Abstract The elderly are vulnerable group to health, social and economic problems. Decreased physical activity, frequent illness, unfriendly environment and lack of self-confidence cause the elderly to become anxious, stressed and even depressed. The purpose of this study was to determine the effectiveness of Occupational Art therapy on depression, stress and anxiety among elderly in nursing home. This study used a quasi-experimental pre and post test design with control group design. The sample used was 60 respondents divided into intervention and control groups by purposive sampling technique. Data were collected using short version (21 item) of Depression Anxiety Stress Scale and analyzed using dependent t-test. The results showed that occupational arts therapy can reduce depression scores with a mean difference of 8.63, 5.54 for anxiety scores and 3.59 for stress scores. Data analysis showed occupational arts therapy significantly reduced anxiety, depression and stress scores (p value 0.000). Occupational and art therapy can be used as complementary therapy in nursing homes to reduce depression, anxiety and stress among elderly Keywords: Occupational Therapy, Art Therapy, Depression, Anxiety, Stress, Elderly. Share Link | Plain Format | Corresponding Author (Ika Subekti Wulandari)

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