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Background: Medical students are a population that is considered vulnerable to experience stress during the COVID-19 pandemic, especially with the heavy learning load and changes in the learning system that were initially carried out face-to-face. Currently, there are limited data regarding the stress of studying online in medical students and their effect on learning achievement. This study aimed to determine the stress effect of studying online in medical students on their academic achievement.Methods: This study was an analytic observational study with a cross-sectional approach. 112 samples were obtained from students of Bachelor of Medicine and Medical Doctor in one of the universities in Bali with the instruments that were distributed via Google Form. Primary data collection was carried out using the Medical Student Stressor Questionnaire (MSSQ) questionnaire, while secondary data collection was obtained from the average score of three-block exams done online during the COVID-19 pandemic.Results: The stress level of medical students in online learning was dominated by high stress (55.4%) with the majority cause due to Academic Related Stressor (ARS). There is a significant relationship (p = 0.021) between the incidence of stress and learning achievement in students (-0.217, 95% CI -0.39 to -0.03). The learning system preference that was chosen by the students is dominated by a 50% online learning system and 50% offline as much as 27.7%.Conclusion: The results indicated that there is a high level of stress among medical students. There is a correlation between stress events and medical student’s achievement during online learning.

The multidrug-resistant tuberculosis (MDR-TB) remains a significant public health burden in term of the successful TB treatment because of the lack awareness of TB drugs administration. Patients infected with MDR-TB are resistant to isoniazid (INH) and rifampicin (RMP) due to genotypic mutation, thus could not adequately treated by the first-line regimen standards. The management of MDR-TB using Short-Term Regimen (STR) is a crucial topic to be discussed due to low success rate of conventional therapy and its long duration. This systematic review aims to further examine the effectiveness and safety of STR to manage MDR-TB. In this systematic review, various cohort studies were searched using standardized Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA). The keywords were arranged based on Problem, Intervention, Comparison, and Outcome (PICO). Key terms consisted of multidrug-resistant tuberculosis and short regimen therapy. Seven cohort studies were selected from 314 studies. STR has better therapeutic efficacy and shorter duration than the 2011 WHO regimen for MDR-TB with therapy success rates for each study above 50%. The most effective regimen according to studies in this review is kanamycin-high dose isoniazid-clofazimine-ethambutol-prothionamide- pyrazinamidegatifloxacin (KM-INH-CFZ-EMB-PTH-PZA-GFX) in the intensive phase for 4 months and clofazimine-ethambutol-pyrazinamide-gatifloxacin-prothionamide (CFZ-EMBPZA-GFX-PTH) in the continuation phase for 8 months. The four most reported side effects were gastrointestinal problems, ototoxicity, dysglycemia, and liver problems. In conclusion, STR provides good effectiveness in MDR-TB treatment, in terms of treatment success rate and short therapy duration. Therapy with STR is relatively safe, with minimal side effects that can be tolerated in the majority of individuals.

Background: In the globalization era, the high number of obesities is happened to the teenagers because of the unhealthy life-style. Obesity in the teenagers or pediatric obesity is important to be handled because it can trigger another complication that happened in the early age. This study aims to collect and analyze any source related to anthocyanin (ASN) from purple sweet potato (Ipomoea batatas L) as modality of obesity that is packaged as dry jelly.Methods: A literature search strategy was conducted to obtained eligible source of study such as books and journals from Google Scholar, Research Gate, and PubMed. The criteria of eligible literature used in this study were articles published on 1981-2019 from different type of study. About 73 literature were used as references regarding the potency of ASN from purple sweet potato (Ipomoea batatas L) as the modality for obese people.Results: ASN in the purple sweet potato has anti-obesity effect by decreasing the a-glucosidase enzyme and a-amylase, increasing glucagon-like-peptide-1 and peptide YY, changing the size of adipose cell, decreasing the lipogenic activity and inflammation, increasing the lipolysis and β-oxyanion adipose cell, as well as increasing the concentrate of brain-derived neutrophil factor in a brain. To increase the bioavailability of ASN, it has to be done the encapsulation with liposome base.  Modality is packaged in the dry jelly form with pectin base as a formulation in powder form taken orally. The modality consumption is 24 mg/kg of weight, however, after eating, the obese people tend to give the weight decreasing effect and cross section attractive to target modalities.Conclusion: According to the studies, the ASN from purple sweet potato and package in Pectin-Based Dry Jelly could be used as a novel strategy in managing the pediatric obesity.

Nyeri muskuloskeletal menjadi masalah kesehatan utama yang menyerang para petani maupun profesi lainnya akibat beban fisik dan durasi kerja yang tinggi. Dengan keterbatasan modalitas terapi saat ini, Transcutaneous Electrical Nerve Stimulation (TENS) dapat menjadi terapi fisik yang potensial. Systematic review ini bertujuan untuk mengkaji efikasi TENS pada nyeri muskuloskeletal dengan penyebab non-spesifik di dua lokasi tubuh tersering, yaitu punggung dan lutut berdasarkan hasil Visual Analogue Scale (VAS). Pencarian studi Randomized Controlled Trial (RCT) dilakukan dengan menggunakan standardisasi Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Dari 1734 studi, diperoleh 16 studi RCT yang menilai efikasi TENS ditinjau dari nilai VAS dengan rincian 8 studi (181 pasien) pada regio lutut dan 8 studi (278 pasien) pada regio punggung. Rata-rata penurunan VAS pada regio lutut sebesar 46,50% dan regio punggung sebesar 49,81%. Penggunaan terapi TENS selama 30 menit dengan frekuensi rendah (<50 Hz) ataupun tinggi (>50 Hz) sudah dapat memberikan repons terapi. Lamanya durasi, tingginya frekuensi terapi, dan penggunaan TENS dalam bentuk kombinasi tidak sejalan dengan efikasi TENS. TENS memberikan efikasi yang baik terhadap nyeri punggung dan lutut dan memiliki keunggulan karena sifatnya yang portabel, mudah digunakan, dan murah.