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The Effect of Hypnotherapy on Postpartum Pain and Depression in Women with Post Caesarean Delivery Mahandaru, Araafi Hariza; Respati, Supriyadi Hari; Sulistyowati, Sri; Laqif, Abdurahman; Prasetya, Hanung
Indonesian Journal of Medicine Vol 6, No 2 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Postoperative pain is one of the most common problems in women after cesarean section. Caesarean section is also associated with post-partum depression. Hypnotherapy is one of the complementary therapy options that are effective and efficient in reducing pain symptoms and post-partum depression. This study aimed to analyze the effect of hypnotherapy on the level of pain and post-partum depression in post-cesarean section patients.Subjects and Method: This was an experimental single-blind randomized controlled trial with a post-test group design, which was conducted from January to April 2021, at the Dr. Moewardi and Universitas Sebelas Maret Hospitals, Surakarta. A sample of 80 patients with cesarean section was divided into two groups, namely 40 patients in the hypnotherapy group and 40 patients in the control group. The independent variable was hypnotherapy. The dependent variables were pain and depression. Hypnotherapy was carried out by self-hypnosis using audio recordings of hypnotherapy in 2 sessions before and after the cesarean section procedure. The pain was measured by the Numeric Rating Scale. Post-partum depression was measured by the Edinburgh Postnatal Depression Scale. The data were analyzed by an independent t-test.Results: Post-cesarean section pain in the group of hypnotherapy (Mean= 4.58; SD= 1.20) was lower than without hypnotherapy (Mean= 6.48; SD= 1.01), and it was statistically significant (p<0.001). Postpartum de-pression in the group of hypnotherapy (Mean= 6.08; SD= 1.60) was lower than non-hypnotherapy group (Mean= 8.48; SD= 3.78), and it was statistically significant (p <0.001).Conclusion: Hypnotherapy has a significant effect on reducing pain and post-partum depression in post-cesarean section patients.Keywords: Hypnotherapy, pain levels, post-partum depression, post-cesarean sectionCorrespondence: Araafi Hariza Mahandaru. Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta, Jl. Kolonel Sutarto, Jebres, Surakarta 57126, Central Java. Email: mahandarurafi@gmail.com.Indonesian Journal of Medicine (2021), 06(02): 194-205https://doi.org/10.26911/theijmed.2021.06.02.08

Effectiveness of Mirror Therapy on Post Stroke Functional Ability: A Meta-Analysis
Indonesian Journal of Medicine Vol 8, No 1 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Stroke is the third leading cause of death after heart disease and cancer. One of the impacts of stroke is it causes a decrease in the functional ability to carry out daily activities, therefore mirror therapy is carried out to restore the functional ability. The study aims to determine the effect of mirror therapy on the functional ability of post-stroke patients based on previous primary studies.Subjects and Method: It was a systematic review and meta-analysis study with PICO as follows: P= post-stroke patients, I= mirror therapy, C= conventional therapy, and O= functional ability. Data collection was conducted from databases, namely: Google Scholar and PubMed. The inclusion criteria used were full-text articles in English, with randomized control trial design, published in 2006-2021. The keywords used were "stroke" AND "mirror therapy" AND "functional independence measure" OR "FIM" AND "randomized control trial". The inclusion criteria of the study were articles using a randomized control trial study design, the effect size used was the Mean SD, the subjects of the study were patients with poststroke conditions, the intervention given was mirror therapy, the comparison was conventional therapy, with the outcome was increased functional ability. The articles were analyzed using Review Manager 5.3. application.Results: The meta-analysis was conducted on 9 primary studies from several countries such as Turkey, South Korea, India, and Italy. The results of the study showed that there was an effect of mirror therapy on the functional ability of post-stroke patients. Patients who obtained mirror therapy had a functional ability of 0.92 units higher than conventional therapy. The results were statistically significant (SMD= 0.92; 95% CI= 0.67 to 1.17; p<0.001).Conclusion: mirror therapy can improve the functional ability of post-stroke patients.Keywords: mirror therapy, functional ability, post-strokeCorrespondence: Galang Aji Samudera. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: ghalangsamudera@gmail.com. Mobile: +6287836783209.Indonesian Journal of Medicine (2023), 08(01): 1-11https://doi.org/10.26911/theijmed.2023.08.01.01

Meta-Analysis of Re-perfusion Injury and Ischaemic Conditioning in Limb Surgery
Indonesian Journal of Medicine Vol 6, No 3 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Pneumatic tourniquet commonly used for orthopedic surgery is associated with morbidity related to ischemia-reperfusion injury. Ischaemia conditioning (IC) had shown beneficial effects to attenuate these outcomes. This study aimed to systematically review the evidence of IC effect on outcomes of the patient undergoing orthopedic surgery.Subjects and Method: This was a systematic review and Meta-Analysis conducted through the online database search from PubMed, Central, Clinicaltrials.gov, and Scopus with topics related to IC and all possible orthopedic surgical interventions. Articles were searched with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocols used keywords "Ischemic conditioning," "Reperfusion injury," "Orthopaedic surgery." The data were extracted from the eligible study within inclusion and exclusion criteria. Two independent reviewers collected the study characteristics. Each study was examined for the risk of bias. The pooled data were analyzed using RevMan 5.3 in Standardized Mean Difference (SMD) as a summary measure with 95% Confidence Interval (CI).Results: Out of 12 eligible studies collected for qualitative analysis, eight studies with the same outcomes were analyzed for quantitative analysis. A random-effect model was used for analysis with high heterogeneity. The pooled SMD data for IC compared to control for postoperative pain were -0.50 (95% CI= -0.95 to 0.06; p<0.001). Outcome measures for hemodynamic stability, systemic inflammation, and end-organ injury were pooled with MD= 4.81 (95% CI= 3.19 to 6.44); SMD= -1.33 (95% CI= -2.06 to -0.60); SMD= 0.15 (95% CI= -0.14 to 0.71); respectively.Conclusion: Ischaemic conditioning significantly reduces postoperative pain, inflammation response and maintains hemodynamic stability. A better study design with a higher population number is needed for further study.Keywords: ischaemic conditioning, reperfusion injury, orthopedic surgery, Meta-AnalysisCorrespondence: Pamudji Utomo. Dr. Soeharso Ortopedic Hospital. 157th Ahmad Yani St. Sukoharjo 57162, Central Java, Indonesia. pamudji_utomo@staff.uns.ac.id.Indonesian Journal of Medicine (2021), 06(03): 271-284 https://doi.org/10.26911/theijmed.2021.06.03.04

Meta-Analysis of the Effects of Diet and Physical Activity on HbA1c in Type II Diabetes Mellitus Patients
Indonesian Journal of Medicine Vol 7, No 2 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Type II Diabetes Mellitus is still a global health problem. The prevalence of diabetes has increased over the decades due to the increased incidence of Type II DM. This study aims to analyze the effectiveness of diet therapy and physical activity on HbA1c levels in type II DM patients.Subject and Method: This study is a systematic and meta-analysis study, with the following PICO Population = Patients diagnosed with type II DM. Intervention= High physical activity and diet therapy. Comparison = Low physical activity and no diet. Outcome= HbA1c level. The articles used in this study were obtained from several databases, including PubMed, Science Direct, Scopus, Clinical Key, and Google Scholar. The keywords used were: “tertiary prevention and DM”, “diet”, “physical activity”, “diet and DM” “physical activity and DM”, “diet and tertiary prevention and DM”. The inclusion criteria were full-text articles, experimental study design using randomized controlled trial (RCT). Articles were collected using PRISMA flow diagram. Articles were analyzed using Review Manager 5.3 application.Results: A meta-analysis of 9 articles on the effectiveness of diet therapy on HbA1c levels from Spain, the United States, Japan, the United Kingdom, and Israel concluded that Type II DM patients on diet therapy had an HbA1c level of 0.49 units compared to Type II DM patients without treatment, and the results were statistically significant (SMD= -0.49; 95% CI= -0.56 to -0.42; p < 0.001). A meta-analysis of 9 articles on the effectiveness of physical activity on HbA1c levels from the United States, Australia, Italy, and India concluded that Type II DM patients with high physical activity had HbA1c levels by 0.81 units lower than Type II DM patients with low physical activity, and the results were statistically significant (SMD= -0.81; 95% CI= -1.20 to -0.43; p < 0.001).Conclusion: Diet therapy and high physical activity reduce HbA1c levels in type II DM patients.Keywords: Physical activity, diet, HbA1c, type II DMCorrespondence: Utari Kusumaningrum. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: utariikusuma@gmail.com. Mobile: +6289636061501.Indonesian Journal of Medicine (2022), 07(02): 172-187https://doi.org/10.26911/theijmed.2022.07.02.06

Analysis of the COVID-19 Severity Based on NLR and the Mortality Rate of Pregnant Women with COVID-19 at Dr. Moewardi General Hospital, Surakarta, Central Java, Indonesia
Indonesian Journal of Medicine Vol 7, No 4 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Coronavirus Disease 2019 (COVID-19) is a disease of the human respiratory system. Pregnant women are more susceptible to respiratory infections due to physiological changes in the immune and cardiopulmonary systems. Routine laboratory biomarkers such as lymphocytes, neutrophils, and NLR are considered prognostic in COVID-19. This study aimed to analyzed the severity of COVID-19 based on NLR on the mortality of pregnant women with COVID-19 at Dr. Moewardi, Surakarta.Subjects and Method: This study used analytic observational with a cross-sectional. The study subjects were 82 pregnant women with confirmed COVID-19, aged over 18 years, and being treated at RSUD Dr. Moewardi Surakarta between March 2020 to January 2022. The samples were taken using the consecutive sampling technique. The independent variable is the severity of COVID-19 based on clinical presentation. The dependent variable is the laboratory results in lymphocytes, neutrophils, and NLR. Data were collected from medical records and anlayzed using SPSS software.Results: There was correlation between NLR on the severity of pregnant women with COVID-19 (Mean= 10.11; SD= 4.10; p= 0.026) and there was a significant correlation between NLR on the mortality rate of pregnant women with COVID-19 (Mean= 9.92; SD= 3.94; p<0.001).Conclusion: NLR affected the severity and the mortality rate among pregnant women with COVID-19.Keywords: COVID-19, pregnancy, lymphocytes, neutrophils, NLR, mortalityCorrespondence: Dhea Fitria Rachma. Faculty of Medicine Universitas Sebelas Maret Surakarta. Jl. Ir. Sutami 36A, Surakarta 57126, Indonesia. Email: dheaf1020@student.uns.ac.id. Mobile: 085702594898.Indonesian Journal of Medicine (2022), 07(04): 401-410https://doi.org/10.26911/theijmed.2022.07.04.05

Effect of Garlic Powder Supplementation on Total Cholesterol and Low Density Lipoprotein Level in Patient with Hypercholesterolemia: A Meta-Analysis
Indonesian Journal of Medicine Vol 7, No 1 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Hypercholesterolemia is a risk factor for cardiovascular disease that can cause death and disability, so it must be managed properly. Garlic flour (GP) is one of the dosage forms of garlic that has the potential to reduce cholesterol. This study is a systematic review and meta-analysis that aims to determine the effectiveness of GP in reducing total cholesterol (TC) and low density lipoprotein (LDL).Subjects and Method: Search articles through the Pubmed database, Google scholar, Proquest, Springer link, and Science direct with the appropriate keywords. Population= patients with hypercholesterolemia. Intervention= GP. Comparison= placebo. Outcome= TC and LDL. Inclusion criteria included complete articles in English or Indonesian published from 2010-2022, Randomized Controlled Trial (RCT) design, subjects >18 years old with hypercholesterolemia, the study had a complete fat profile outcome, duration of intervention 2 weeks-12 months. The flow of article selection is based on the PRISMA flow diagram. Meta-analysis using RevMan 5.3 with effect size standardized mean difference (SMD) and Random Effect Model (REM) analysis model.Results: A total of 10 articles were eligible for a meta-analysis. The GP group had TC levels 1.49 units lower than the placebo group (SMD = -1.49; 95% CI = -1.95 to -0.55; p = 0.005) and LDL levels 0.68 units lower than the placebo group (SMD= -0.68; CI95). %= -1.08 to -0.27; p=0.001). Subgroup analysis based on the length of the intervention showed that administration of GP <12 weeks only significantly reduced TC while administration > 12 weeks significantly reduced TC and LDL.Conclusion: GP is effective in lowering TC and LDL especially at 12 weeks or more.Keywords: garlic powder, hypercholesterolemia, RCTCorrespondence: Zuraida Zulkarnain. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java 57126. Mobile: 081393933862. Email: zuraida.zu@gmail.com.Indonesian Journal of Medicine (2022), 07(01): 102-114https://doi.org/10.26911/theijmed.2022.07.01.11

Meta Analysis the Effect of Acupunctur Therapy and Ultrasound Therapy to Reduce Pain Caused by Carpal Tunnel Syndrome
Indonesian Journal of Medicine Vol 6, No 4 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Carpal tunnel syndrome is a condition of health problems in the form of pain, numbness, and tingling that occurs in a person's hands. This sensation can be felt in the thumb, index finger, middle finger, and 1/2 ring finger on the radial side, this occurs when the median nerve that passes through the carpal tunnel at the wrist is compressed or compressed. This study aims to estimate the effect of acupuncture therapy and ultrasound therapy on reducing pain in carpal tunnel syndrome cases.Subjects and Method: This was a systematic review and meta-analysis conducted using PRISMA flow diagrams. Article searches through journal databases include: PubMed, Science Direct, Scopus, Google Scholar, Springer Link, Hindawi, BMC. The PICOs of this study were, Population: carpal tunnel syndrome sufferers, Intervention: acupuncture therapy and ultrasound therapy, Comparison: no acupuncture and ultrasound therapy, Outcome: pain reduction. Using search keywords: (“acupuncture” OR “acupuncture therapy”) AND (“carpal tunnel syndrome” OR “cts”) AND (“ultrasound” OR “ultrasound therapy”) AND (“randomized controlled trial”) AND (“ acupuncture for carpal tunnel syndrome”) AND (“ultrasound for carpal tunnel syndrome”). Inclusion criteria were full paper articles with Randomized Controlled Trial (RCT) research method, the relationship measure used was Mean SD, the intervention given was acupuncture and ultrasound, study subjects were aged 18-85 years. Eligible articles were analyzed using the Revman 5.3 app.Results: Meta-analysis of 16 articles showed acupuncture treatment outcome of -0.34 units compared with other interventions or no intervention (SMD -0.34; 95% CI= -0.83 to 0.16; p=0.180), I2=78%, and treatment outcome. ultrasound as much as -0.76 units compared with other interventions or no intervention, and statistically significant value (SMD -0.76; 95% CI= -1.37 to -0.16; p=0.001), I2= 92%.Conclusion: Acupuncture therapy and ultrasound therapy have an effect on reducing pain in cases of carpal tunnel syndrome.Keywords: Acupuncture, ultrasound, carpal tunnel syndromeCorrespondence: Afifah Noer. Masters Program in Public Health. Universitas Sebelas Maret, Jl.Ir. Sutami 36A, Surakarta 57126, Jawa Tengah, Indonesia. Email: Afifahnoer97@gmail.com. Mobile: 085601564681.Indonesian Journal of Medicine (2021), 06(04): 399-411https://doi.org/10.26911/theijmed.2021.06.04.06

Meta-Analysis: The Effectiveness of Acupucture in Reducing Pain and Improving Quality of Life in Patients with Low Back Pain
Indonesian Journal of Medicine Vol 7, No 3 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: In Indonesia, low back pain is a common health problem that can interfere with a person's productivity in carrying out activities due to the manifestations of the pain it causes. Acupuncture therapy is one of the complementary treatments that is quite effective in reducing the intensity of low back pain. This study aims to estimate the effectiveness of acupuncture therapy to reduce pain and improve quality of life in patients with low back pain.Subjects and Method: This study is a systematic review and meta-analysis with PICO, Population: Low back pain patients, Intervention: Acupuncture therapy, Comparison: No acupuncture therapy, Outcome: Pain reduction and quality of life improvement. It was measured using the Oswestry Disability Index. The article search process was carried out between 2006-2022 using 3 databases, including Google Scholar, PubMed, and Science Direct. The keywords used in the database search were “acupuncture” AND “oswestry disability index” AND “quality of life” AND “low back pain”. The inclusion criteria for full text articles using a Randomized Controlled Trial (RCT) study design by including the results of the study in the form of the number of respondents, the mean and standard deviation (SD) values, for articles using English and Indonesian. Articles that have met the requirements are analyzed using the RevMan 5.3 application.Results: There are 9 articles that meet quantitative requirements and are divided into 2 categories according to independent variables with a Randomized Controlled Trial (RCT) study design originating from Spain, Australia, South Korea, Brazil, Germany and England, which were carried out in a meta-analysis in this study. Meta-analysis of 7 articles showed estimates that acupuncture therapy was effective in reducing pain in LBP patients. Patients experienced a decrease in pain 0.32 units higher than those who were not given acupuncture therapy (SMD = 0.32; 95% CI= -0.46 to -0.17; p <0.001). Meanwhile, a meta-analysis of 9 articles showed the estimation of the effect of effective acupuncture therapy on improving the quality of life in LBP patients. Patients experienced an improvement in quality of life 0.52 units higher than those who were not given acupuncture therapy (SMD = 0.52; 95% CI= 0.22 to 0.81; p= 0.006).Conclusion: Acupuncture therapy is effective in reducing pain and improving the quality of life of LBP patients. Keywords: acupuncture, low back pain, quality of life, oswestry disability index, meta-analysisCorrespondence: Frannesty Estu Winahyu. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: frannestyestuwinahyu@gmail.com. Mobile: +6285228783882.Indonesian Journal of Medicine (2022), 07(03): 313-325https://doi.org/10.26911/theijmed.2022.07.03.08

The Use of Modified Cervical Colar in Reducing Neck Pain
Indonesian Journal of Medicine Vol 6, No 4 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: One of the conditions of pain in the neck area where there is a stiff neck, so sometimes there is pain radiating from the shoulder to the hand, the symptom is often called cervical syndrome. This condition occurs because the vertebral root is compressed for a long time in the use of activities. In the long term, the pain can even radiate to both shoulders and even to the arms of the arch, this situation will result in abnormal and rapid fatigue. According to studies conducted by researchers, this situation may be prevented by giving a special cervical collar design to Tafidz Ouran students. In this study, it will be investigated how effective the special collar model is to overcome the problems/prevention of cervical syndrome for Tafidz Ouran students in Karanganyar. The purpose of this study was to determine how effective a special cervical collar design is to reduce pain in cervical syndrome.Subjects and Method: This research is a Randomized Controll Trial (RCT) where in this study before being randomized in determining the control and treatment groups, matching was done first. In the control group in this study were students who used regular collars (collars sold in the market) and in the intervention group were given special collars. The sample in this study was the students of the Tahfidz boarding school in the Karanganyar area as many as 160 students who experienced cervical syndrome. Each group in this study amounted to 80 students. The sampling technique was simple random sampling. The variables in this study, the dependent variable is the cervical syndrome condition of the Tafidz Quran students and the use of a special cervical collar model as the independent variable. Analysis of the data using the Independent samples t test if the data is normal, and using the Mann Whitney test if the data is not normal.Results: After the intervention, it was shown that pain in the special cervical collar group (mean = 2.51; SD = 0.50) was lower than that in the regular collar group (mean = 5.50; SD = 0.59) and was statistically significant (p value = 0.000).Conclusion: The use of a special cervical collar is better than a regular cervical collar to reduce neck pain.Keywords: cervical syndrome, cervical collar, special cervical collarCorrespondence: Alfan Zubaidi. Department of Orthotic Prosthetic, Ministry of Health Surakarta. Jl. Letjen Sutoyo, Mojosongo, Surakarta, Central Java, Indonesia. Email: drsalfanzubaidi@gmail.com.Indonesian Journal of Medicine (2021), 06(04): 460-464https://doi.org/10.26911/theijmed.2021.06.04.12

Effect of Acupressure on Blood Glucose Level in Diabetes Mellitus Patients: Meta-Analysis
Indonesian Journal of Medicine Vol 8, No 1 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Diabetes Mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia resulting from abnormalities in insulin secretion that affect blood sugar levels. Chronic hyperglycemia in DM is associated with long-term damage to several organs of the body. One of the interventions that can be given to lower blood sugar levels is acupressure therapy. The purpose of this study was to determine the effect of acupressure therapy on blood sugar levels in patients with diabetes mellitus.Subjects and Method: This study is a systematic review and meta-analysis with PICO, P: Diabetes mellitus patients, I: Acupressure, C: No acupressure, O: Blood sugar levels. The process of searching for articles is done through a database of journals including: Pubmed, Google Scholar, Science Direct, Scopus, Spinger Link, CNKI and Hindawi. The keywords used in the literature search were: “acupressure” AND “diabetes” AND “blood sugar” AND “blood glucose” AND “standard controlled trial”, “acupressure for diabetes”, “diabetes standardized controlled trial”, “acupressure randomized controlled trial”. trial”, diabetes acupoint, “diabetes and placebo”, “acupressure” AND “diabetes”. The articles included in the study were full text articles with a randomized controlled trial study design and the results were reported with the effect size, mean standard deviations (SMD). Articles were collected using PRISMA flow diagrams and analyzed using the Review Manager 5.3 application.Results: A meta-analysis of 9 articles reviewed in this study came from Taiwan, China, Indonesia, Egypt and Iran with a sample size of 451. The study results showed that acupressure therapy was able to reduce blood sugar levels in diabetes mellitus patients with SMD blood sugar values. acupressure was 0.56 units lower than no acupressure and was statistically significant with a significance value of (SMD=-0.56; 95% CI= -0.76 to -0.37; p<0.001).Conclusion: Acupressure therapy has the effect of lowering blood sugar levels in diabetes mellitus patients.Keywords: acupressure, blood sugar, diabetes mellitus.Correspondence: Muslihatin Khuril Rosyida. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Jawa Tengah, Indonesia. Email: khurilrosyida@gmail.com. Mobile: 08564713149.Indonesian Journal of Medicine (2023), 08(01): 68-78https://doi.org/10.26911/theijmed.2023.08.01.07

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