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Correlation between complications during delivery and neonatal mortality: Data analysis of Indonesia Demographic and Health Survey (IDHS) 2017 分娩并发症与新生儿死亡率的相关性:2017年印度尼西亚人口与健康调查(IDHS)的数据分析
Pub Date : 2022-08-31 DOI: 10.20885/jkki.vol13.iss2.art5
Noor Anisa, A. Astuti, M. Hakimi
Background: Neonatal mortality is a death that occurs during the first twenty-eight days of life after a baby is born. Based on Indonesia Demographic and Health Survey (IDHS data) in 2017, there was a decrease in neonatal mortality between 2012 – 2017, but this has not yet reached the SDG's target of 12 deaths per 1,000 live births. Complications during childbirth are one of maternal factors that directly cause pain and death to a mother and her or newborn due to some disorders resulting from childbirth. One of the factors that can influence neonatal mortality is complications during delivery.Objective: This study aims to observe correlation between complications during childbirth and neonatal mortality. Also, this is to reveal the neonatal mortality rate in children born from 2012-2017 in Indonesia after controlling for all confounding.Methods: This was a cross-sectional study with an analytical observational approach using secondary data from the IDHS 2017. Its samples were women of childbearing age (15-49 years) who have been married and gave birth, with the last birth data of 5 years prior to the survey. Its inclusion criteria were children who were born in 2012-2017 and were not twin-birth as big as 15.357. The sample selection used total sampling, and the obtained data were analysed by univariate, bivariate, and multivariate analysis using multiple logistic regression.Results: The final model indicated that there was a significant relationship between the complications during delivery and neonatal mortality after controlling by variables of age, ANC visits, baby's birth weight, and baby's gender on neonatal mortality. PR 3,90 (95% C.I; 2.467 – 6.187).Conclusion: The results revealed that there was an influence of childbirth complications, maternal age, ANC visits, baby's birth weight, and baby's gender on neonatal mortality.
背景:新生儿死亡率是指婴儿出生后28天内发生的死亡。根据2017年印度尼西亚人口与健康调查(IDHS数据),2012-2017年间新生儿死亡率有所下降,但尚未达到可持续发展目标中每1000名活产死亡12人的目标。分娩期间的并发症是直接导致母亲及其新生儿因分娩引起的某些疾病而疼痛和死亡的母体因素之一。影响新生儿死亡率的因素之一是分娩期间的并发症。目的:观察分娩并发症与新生儿死亡率的相关性。此外,这是为了揭示印度尼西亚2012-2017年出生的儿童在控制所有混杂因素后的新生儿死亡率。方法:这是一项横断面研究,采用分析观察性方法,使用2017年IDHS的二次数据。其样本是已婚并生育的育龄妇女(15-49岁),调查前5年的最后一次生育数据。它的纳入标准是2012-2017年出生的儿童,他们不是15.357岁的双胞胎。样本选择使用总抽样,并使用多元逻辑回归通过单变量、双变量和多变量分析对获得的数据进行分析。结果:最终模型表明,在通过年龄、ANC访视、婴儿出生体重和性别等变量控制新生儿死亡率后,分娩并发症与新生儿死亡率之间存在显著关系。PR 3,90(95%C.I;2.467-6.187)。结论:结果显示,分娩并发症、产妇年龄、ANC访视、婴儿出生体重和性别对新生儿死亡率有影响。
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引用次数: 1
Integrative psychotherapy in stress management of cervical cancer patients at RSUD Dr. Moewardi Surakarta: A case study 综合心理疗法在RSUD宫颈癌患者压力管理中的应用:个案研究
Pub Date : 2022-08-31 DOI: 10.20885/jkki.vol13.iss2.art8
Jhonny Prambudi Batong, Gusti Ayu Maharatih, Debree Septiawan, Teguh Prakosa
Background: Worldwide, cervical cancer is the second highest cause of death after breast cancer. In Indonesia, cervical cancer is ranked second among all types of cancer. Psychological distress negatively affects the mortality rate of cancer patients, and there is no stress management treatment of standard integrative psychotherapy to be carried out in the process of individual therapy in cervical cancer.Objective: To treat psychological distress in cases of cervical cancer using an integrative psychotherapy approach, create a model of factors that influence psychopathology related to psychological distress, and an integrative psychotherapy model as the basis for making modules and standard operation procedures of stress management in cervical cancer patients.Methods: This is an integrated case study with descriptive, exploratory, and exploratory qualitative approaches in two women with cervical cancer who were given integrative psychotherapy (integrative psychoeducation combined with integrative guided imagery and music), data analysis using the constant comparative method. Presentation of data using tables and graphs.Results: Two models were illustrated, a model of factors that influence psychopathology related to psychological distress and an integrative psychotherapy model in stress management of cervical cancer patients. Evaluation of decreased distress and improved related physical symptoms (pain and sleep quality).Conclusion: A model of factors that influence psychopathology related to psychological distress and an integrative psychotherapy model that can be implemented in stress management of cervical cancer patients were obtained, with sessions and types tailored to the patient’s needs.
背景:在全球范围内,宫颈癌症是仅次于癌症的第二大死亡原因。在印度尼西亚,癌症在所有癌症类型中排名第二。心理困扰对癌症患者的死亡率有负面影响,且在癌症个体治疗过程中没有标准的综合心理治疗的压力管理治疗。目的:采用综合心理治疗方法治疗癌症患者的心理困扰,建立与心理困扰相关的心理病理影响因素模型,建立综合心理治疗模型,为制定癌症患者压力管理模块和标准操作程序提供依据。方法:采用描述性、探索性和探索性定性方法,对两名癌症宫颈癌患者进行综合心理治疗(综合心理教育结合综合图像和音乐指导),并采用恒定比较法进行数据分析。使用表格和图表表示数据。结果:阐明了两个模型,一个是与心理困扰相关的影响精神病理学的因素模型,另一个是癌症患者压力管理的综合心理治疗模型。减轻痛苦和改善相关身体症状(疼痛和睡眠质量)的评估。结论:获得了一个与心理痛苦相关的影响精神病理学的因素模型和一个可用于癌症宫颈癌患者压力管理的综合心理治疗模型,其疗程和类型适合患者的需求。
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引用次数: 0
Testosterone undecanoate treatment for muscle weakness in a male with hypogonadotropic hypogonadism delayed puberty: A case report 十一酸睾酮治疗青春期延迟性促性腺功能减退症男性肌无力1例
Pub Date : 2022-08-31 DOI: 10.20885/jkki.vol13.iss2.art14
D. M. Rizal, Nandia Septiyorini
Puberty is a series of physical development and sexual maturation that aims to achieved reproductive capacity. The hypothalamic-pituitary-gonadal (HPG) axis has an important role in the normal process of puberty. Disruption in the HPG axis causes hormonal disturbances, one of which is hypogonadotropic hypogonadism, which is associated with delayed puberty. Hormonal disorders can also cause various problems besides the reproductive system, such as muscle weakness, lack of energy, and an increased risk of bone fractures. We report the case of a male patient who complained of predominant muscle weakness, did not show signs and symptoms of puberty, and had an idiopathic hypogonadotropic hypogonadism who unresponsive to human chorionic gonadotropin (hCG) therapy. We decided to administered Testosterone Undecanoate (TU) therapy to overcome the problem of delayed puberty and complaints of muscle weakness experienced by the patient. TU therapy has shown beneficial effects in these patients by increasing testosterone levels, increasing penis length, and eliminating complaints of muscle weakness.
青春期是一系列旨在达到生殖能力的身体发育和性成熟。下丘脑-垂体-性腺(HPG)轴在青春期的正常过程中起着重要作用。HPG轴的破坏会导致激素紊乱,其中之一是促性腺功能减退症,与青春期延迟有关。激素紊乱也会导致生殖系统以外的各种问题,如肌肉无力、能量不足和骨折风险增加。我们报告了一例男性患者,他抱怨主要的肌肉无力,没有表现出青春期的体征和症状,患有特发性促性腺功能减退症,对人绒毛膜促性腺激素(hCG)治疗没有反应。我们决定给予十一酸睾酮(TU)治疗,以克服患者青春期延迟和肌肉无力的问题。TU疗法通过提高睾酮水平、增加阴茎长度和消除肌肉无力的抱怨,对这些患者显示出有益的效果。
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引用次数: 0
The relationship between anxiety and sleep quality among medical students during Covid-19 pandemic 新冠肺炎疫情期间医学生焦虑与睡眠质量的关系
Pub Date : 2022-08-31 DOI: 10.20885/jkki.vol13.iss2.art9
Yolanda Salim, Surilena, N. T. Widjaja, Fransisca Tjhay
Background: Coronavirus disease 2019 (COVID-19) pandemic causes individuals at risk of anxiety and sleep disorders. Anxiety can cause a person’s sleep quality to be poor.Objective: To investigate the association between anxiety and sleep quality among students in the Faculty of Medicine and Health Sciences UNIKA Atma Jaya during the COVID-19 pandemic.Methods: This cross-sectional study involved 635 preclinical and clinical students at FKIK UNIKA Atma Jaya. Measuring instruments used were the Generalised Anxiety Disorder 7 (GAD-7) and the Pittsburgh Sleep Quality Index (PSQI). Both instruments were distributed using Google Forms. Data analysis was performed descriptively and bivariate (Mann Whitney U Test).Results: There were 62% of respondents with anxiety; among them, 37% were mild anxiety; 16.9% were moderate anxious; 8.2% were severe anxiety. This study finds that 66.28% of women with anxiety and 62.8% with poor sleep quality. In 2020, 73.81% of preclinical respondents experienced anxiety and 69.84% experienced poor sleep quality. The bivariate analysis demonstrated a significant association between anxiety and sleep quality among preclinical and clinical students at FKIK UNIKA Atma Jaya during the COVID-19 pandemic (p<0.05).Conclusion: There is an association between anxiety and sleep quality in preclinical and clinical students in FKIK UNIKA Atma Jaya During the COVID-19 Pandemic.
背景:2019冠状病毒病(新冠肺炎)大流行导致个人有焦虑和睡眠障碍的风险。焦虑会导致一个人的睡眠质量变差。目的:调查新冠肺炎大流行期间医学与健康科学学院学生焦虑与睡眠质量之间的关系。方法:这项横断面研究涉及FKIK UNIKA Atma Jaya的635名临床前和临床学生。所用的测量仪器是广义焦虑症7(GAD-7)和匹兹堡睡眠质量指数(PSQI)。这两种工具都是使用谷歌表格分发的。数据分析采用描述性和双变量(Mann-Whitney U检验)。结果:62%的受访者存在焦虑;其中轻度焦虑占37%;16.9%为中度焦虑;8.2%为严重焦虑。这项研究发现,66.28%的女性患有焦虑症,62.8%的女性睡眠质量较差。2020年,73.81%的临床前受访者经历了焦虑,69.84%的人经历了睡眠质量差。双变量分析表明,在新冠肺炎大流行期间,FKIK UNIKA Atma Jaya的临床前和临床学生的焦虑与睡眠质量之间存在显著关联(p<0.05)。
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引用次数: 0
The influence of demography, travel history and comorbidity toward the mortality incidence due to Covid-19 in Semarang 人口统计学、旅行史和合并症对三宝垄市新冠肺炎死亡率的影响
Pub Date : 2022-08-31 DOI: 10.20885/jkki.vol13.iss2.art7
Rita Laila Wulandari, Cahya Tri Purnami, F. Agushybana, A. Mawarni
Background: Semarang is one of the cities in Central Java with the highest positive number and mortality rate of Covid-19. It became the largest contributor to daily cases in Central Java. In general, the severity of Covid-19 in Semarang is 5.3% and increased to 24% in the elderly. Mortality Covid-19 was caused by various factors such as demographic and non-demographic factors.Objective: This study aims to determine the impact of several risk factors of COVID-19 mortality in Semarang.Methods: This is an analytical cross-sectional study. Data analysis was carried out analytically with a binary logistic regression test. The sample used was the total population of 32.555 confirmed positive from March 2020 to March 2021 registered in Semarang Health Office.Results: The results demonstrated that mortality due to Covid-19 in Semarang was frequent in the elderly (27.3%), males (9.4%), had comorbidities such as diabetes mellitus (28.6%), kidney disease (43.5%), neuromuscular (36.4%), and cancer (29.3%), and accompanied by symptoms such as Dyspnea (18.1%), weakness/lethargy (19.9%), and fever (14.6%).Conclusion: Age, gender, travel history, comorbidities (kidney, neuromuscular, cancer, and diabetes mellitus), and symptoms (fever, shortness of breath, and weakness/lethargy) are risk factors for mortality Covid-19 in Semarang.
背景:三宝朗是中爪哇省新冠肺炎阳性人数和死亡率最高的城市之一。它成为中爪哇每日病例的最大贡献者。总体而言,三宝朗新冠肺炎的严重程度为5.3%,老年人的严重程度增至24%。新冠肺炎死亡率是由多种因素造成的,如人口统计学和非人口统计学因素。目的:本研究旨在确定新冠肺炎死亡的几个危险因素对三宝朗的影响。方法:这是一项分析性的横断面研究。数据分析采用二元逻辑回归检验进行分析。所用样本为2020年3月至2021年3月在三宝朗卫生办公室登记的确诊阳性总人口32.555人。结果:结果表明,三宝朗新冠肺炎导致的死亡率在老年人(27.3%)、男性(9.4%)中很常见,患有糖尿病(28.6%)、肾病(43.5%)、神经肌肉(36.4%)和癌症(29.3%)等合并症,并伴有呼吸困难(18.1%)、虚弱/嗜睡(19.9%)和发烧(14.6%)等症状。结论:年龄、性别、旅行史、合并症(肾脏、神经肌肉、癌症和糖尿病)和症状(发烧、气短和虚弱/嗜睡)是三宝朗新冠肺炎死亡的危险因素。
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引用次数: 0
Hypokalemic periodic paralysis in subclinical hyperthyroidism: A case report 亚临床甲状腺功能亢进症的低钾周期性麻痹1例
Pub Date : 2022-08-31 DOI: 10.20885/jkki.vol13.iss2.art13
E. V. Christabel, Onggo Williyanto
Hypokalemia is a common electrolyte abnormality often encountered in daily practice. While mild hypokalemia often asymptomatic, moderate-to-severe hypokalemia usually manifested as significant symptoms such as muscle weakness. In this paper, we presented a case of 23-years-old male coming to our emergency department because of muscle weakness in all his four limbs when he woke up in the morning. Physical examinations were all within normal limit, except that his muscle strength decreased in all four extremities. Laboratory measures showed severe hypokalemia (1.9 mmol/L), hence patient was treated with potassium infusions. During hospitalization, thyroid function tests revealed hyperthyroidism. Therefore, in patient with paralysis, in which laboratory finding showed hypokalemia, hyperthyroidism should be considered as one of the potential diagnosis especially in younger patient, even in patient without previous history of hyperthyroidism. Merely treating hypokalemia in patient with underlying hyperthyroidism could be a dangerous boomerang.
低钾血症是一种常见的电解质异常,在日常生活中经常遇到。轻度低钾血症通常无症状,而中度至重度低钾血症则通常表现为肌肉无力等显著症状。在这篇论文中,我们介绍了一个23岁的男性来我们的急诊室,因为他早上醒来时四肢肌肉无力。身体检查都在正常范围内,只是他的四肢肌肉力量都有所下降。实验室检查显示患者出现严重的低钾血症(1.9 mmol/L),因此患者接受了钾离子输注治疗。住院期间,甲状腺功能检查显示甲状腺功能亢进。因此,在实验室检查结果显示低钾血症的瘫痪患者中,甲状腺功能亢进应被视为潜在的诊断之一,尤其是在年轻患者中,甚至在没有甲状腺功能亢进病史的患者中。单纯治疗甲状腺功能亢进患者的低钾血症可能是一个危险的回旋镖。
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引用次数: 0
The effect of interactive online learning on knowledge, attitude, and practice related to diabetes mellitus of productive-age population 交互式在线学习对生产年龄人群糖尿病相关知识、态度和行为的影响
Pub Date : 2022-08-31 DOI: 10.20885/jkki.vol13.iss2.art4
Bendix Samarta Witarto, V. Visuddho, Teddy Yusuf, Rizqi Apsari Fairuz Kamila, Ghifar Akbar Iftinan, Clonia Milla, Salma Firdaus, Muhammad Wildan Nabalah Hartawan, Aisha Fairuz Zahira, Lintang Cahyaning Ratri, Amara Destania Armyne, S. Sulistiawati, Rimbun Rimbun
Background: Diabetes mellitus still becomes a significant population health problem. In achieving sufficient awareness, face-to-face public education methods may serve as an effective measure. However, in the amid of pandemic, their implementation is restricted, which leads to the use of virtual platforms for learning activities. In addition, the applicability of the online learning method has yet to be explored.Objective: To evaluate its impact on the knowledge, attitude, and lifestyle practices of the productive-age population related to diabetes.Methods: A pre-test and post-test quasi-experimental study involving a single group was conducted among the productive-age population (aged 15 to 64 years) selected using consecutive sampling in two sub-districts in Surabaya, Indonesia. Baseline and endline levels of participants’ knowledge, attitude, and practice regarding diabetes assessed using a self-developed questionnaire were compared after receiving an educational intervention.Results: A total of 19 participants meeting the eligibility criteria were selected as the study subjects. A statistically significant increase in the participants’ knowledge score from pre- to post-test (p=0.038) was observed. There was no significant change between the pre-test and post-test scores of attitude (p=0.938) and practice (p=0.087) after the intervention.Conclusion: Online learning method improved the population’s knowledge regarding diabetes mellitus. However, it appears to have a limited role in providing better modification for attitude and practice. Further research comparing online and traditional face-to-face education methods are required to establish this approach as an alternative.
背景:糖尿病仍然是一个重要的人群健康问题。为了获得足够的认识,面对面的公共教育方法可以作为一种有效措施。然而,在疫情期间,它们的实施受到限制,这导致使用虚拟平台进行学习活动。此外,在线学习方法的适用性还有待探索。目的:评估其对糖尿病相关生产年龄人群的知识、态度和生活方式实践的影响。方法:在印度尼西亚泗水的两个分区,采用连续抽样的方法,在生产年龄人群(15至64岁)中进行了一项涉及单个群体的测试前和测试后准实验研究。在接受教育干预后,使用自行开发的问卷对参与者关于糖尿病的知识、态度和实践的基线和终点水平进行了比较。结果:共有19名符合资格标准的参与者被选为研究对象。从测试前到测试后,参与者的知识得分在统计学上显著增加(p=0.038)。干预后,态度(p=0.938)和实践(p=0.087)的测试前和测试后得分之间没有显著变化。结论:网络学习方法提高了人群对糖尿病的认识。然而,它在更好地改变态度和实践方面的作用似乎有限。需要对在线教育和传统的面对面教育方法进行进一步的比较研究,以确定这种方法是一种替代方法。
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引用次数: 0
The harada-mori technique: Revisited 原田森技术:重访
Pub Date : 2022-08-31 DOI: 10.20885/jkki.vol13.iss2.art11
A. I. Toemon, Handinata Indrawan, S. S. Surja
More sensitive diagnostic methods for detecting worms’ eggs are needed in areas with low soil-transmitted helminth (STH) prevalence. The Harada-Mori technique was first introduced by Mr. Harada and Mr. Mori. This technique is easy, simple, and does not require sophisticated equipment. The Harada-Mori technique is based on larvae tropism nature in the water to concentrate the larvae of hookworms and Strongyloides stercoralis. Since its first application in 1955, this technique has undergone several modifications. The Harada-Mori could complement the Kato-Katz technique for faeces examination in areas with low STH infection intensity.
在土壤传播蠕虫(STH)流行率较低的地区,需要更灵敏的诊断方法来检测蠕虫卵。原田森技术最早由原田先生和森先生介绍。这种技术简单易行,不需要复杂的设备。Harada Mori技术是基于幼虫在水中的嗜性性质,以浓缩钩虫和斯特科类圆线虫的幼虫。自1955年首次应用以来,这项技术经历了几次修改。Harada Mori可以补充Kato Katz技术,在STH感染强度低的地区进行粪便检查。
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引用次数: 0
Description of clean and healthy lifestyle behaviour implementation in MI Ma’arif Gandrungmanis Cilacap students during the pandemic time Covid-19 描述在Covid-19大流行期间MI Ma 'arif Gandrungmanis Cilacap学生的清洁和健康生活方式行为实施情况
Pub Date : 2022-08-31 DOI: 10.20885/jkki.vol13.iss2.art6
Cahya Rahma Miftah, S. Sunarto
Background: Clean and healthy living behaviour (PHBS) in elementary school (SD) children, in the age range of about 10 years, is often discussed because it is associated with active physical activity.Objective: To describe the developments in PHBS during the COVID-19 pandemic in elementary school childrenMethods: This study used a quantitative descriptive design with a survey method using a questionnaire to determine the description of PHBS implementation in 4th, 5th, and 6th-grade students of MI Ma’arif Gandrungmanis. The data was obtained by identifying students’ behaviour regarding PHBS towards health protocols during the Covid-19 pandemic in schools.Results: The results of this study show an overview of the PHBS of MI Ma’arif Gandrungmanis students during the Covid-19 pandemic with a very good category of 7.8%, good category of 28.4%, fairly good category of 37.1%, less good category of 20.7%, and not good category 6%.Conclusion: The PHBS in 4th, 5th, and 6th-grade of MI Ma’arif Gandrungmanis is mostly in the fairly good category with a percentage of 37.1%.
背景:10岁左右的小学(SD)儿童的清洁和健康生活行为(PHBS)经常被讨论,因为它与积极的身体活动有关。目的:描述2019冠状病毒病(COVID-19)大流行期间小学生PHBS的发展情况。方法:本研究采用定量描述性设计和问卷调查法,确定MI Ma 'arif Gandrungmanis小学四、五、六年级学生PHBS实施情况的描述。这些数据是通过确定学生在2019冠状病毒病大流行期间在学校对PHBS健康协议的行为获得的。结果:本研究结果显示了2019冠状病毒病大流行期间MI Ma’arif Gandrungmanis学生PHBS的概况,非常好为7.8%,良好为28.4%,较好为37.1%,不太好为20.7%,不太好为6%。结论:MI Ma 'arif Gandrungmanis 4、5、6年级PHBS多为较好,占37.1%。
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引用次数: 0
The effectiveness of personal preventive measures against occupational contact dermatitis in healthcare workers: A systematic review 医护人员职业性接触性皮炎个人预防措施的有效性:系统综述
Pub Date : 2022-08-31 DOI: 10.20885/jkki.vol13.iss2art12
Khansa Maria Salsabila, S. Febriana, R. Padmawati, Retno Danarti
Healthcare workers (HCWs) embody the principles of hand hygiene and protective attire to support self- and patient safety, but the materials involved in this process are found to be offending agents. The incidence of occupational contact dermatitis (OCD) among HCWs keeps increasing. This review aimed to evaluate the effectiveness, investigate the outcome and clinical skin condition improvement with the implementation of primary preventive measures (PPM), specifically: barrier cream, emollient, moisturiser, gloves use, and education. All relevant literature about PPM against OCD among HCWs published between 1995 to 2020 was searched. The data search was performed using the PUBMED, Cochrane Library, and ScienceDirect databases. There were 16 studies comprised of 8 randomised controlled trials (RCTs), 7 clinical trials, and one comparative study. The study results showed that using barrier cream, moisturiser or emollient, gloves, and education were effective tools in reducing the number of clinical symptoms in cases of OCD. There was no significant difference in the effect between barrier cream use and moisturiser or emollient. The gloves were advised to be used non-latex gloves or powder-free latex gloves. Education was also observed to improve preventive behaviour among workers. The use of barrier cream, emollient, moisturiser, and gloves is recommended to be educated to ascertain the proper use of preventive measures, increase knowledge and awareness, and promote positive preventive behaviour.
医护人员(HCW)体现了手部卫生和防护服的原则,以支持自身和患者的安全,但这一过程中涉及的材料被发现是违规因素。职业接触性皮炎(OCD)在医务人员中的发病率不断上升。本综述旨在评估主要预防措施(PPM)的有效性,调查结果和临床皮肤状况的改善,特别是:屏障霜、润肤剂、保湿霜、手套使用和教育。检索了1995年至2020年间发表的所有关于HCW中PPM对抗强迫症的相关文献。使用PUBMED、Cochrane Library和ScienceDirect数据库进行数据搜索。共有16项研究,包括8项随机对照试验、7项临床试验和一项比较研究。研究结果表明,使用屏障霜、保湿霜或润肤剂、手套和教育是减少强迫症患者临床症状数量的有效工具。使用屏障霜和保湿霜或润肤剂的效果没有显著差异。建议使用非乳胶手套或无粉末乳胶手套。还观察到了改善工人预防行为的教育。建议对屏障霜、润肤剂、保湿霜和手套的使用进行教育,以确定预防措施的正确使用,增加知识和意识,并促进积极的预防行为。
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引用次数: 0
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JKKI Jurnal Kedokteran dan Kesehatan Indonesia
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