Introduction: Ventilator Associated pneumonia (VAP) is pneumonia that occurs in patients who have been mechanically ventilated for a duration of more than 48 hours. The duration of ventilator use was identified as a risk factor which is trigger of VAP. Objective: This study aimed to determine the association between the duration of ventilator use and the incidence of VAP in patients in the Intensive Care Unit of Dr. Mohammad Hoesin General Hospital, Palembang. Method and Material:This study was an observational analytic study using cross sectional design. The samples were all patients who use a ventilator for more than 48 hours at the ICU room periode of July 1, 2014 to June 30, 2015. Data were obtained from patient's medical records of total 146 patients, but the number of patients who comply the criteria was 106 patients. Result and Discussion: Out of the 106 samples, 41 patients (38.7%) developed VAP and 65 patients (61.3%) did not develop VAP. The analysis using Chi Square test showed that patients who used ventilator for >5 days had an OR = 3.273 compared to patients using ventilator 2-5 days (p value = 0.016; 95% CI = 1.223 to 8.754). Conclusion: There is a significant association between the duration of ventilator use and the incidence of VAP in patients at the ICU of Dr. Mohammad Hoesin General Hospital, Palembang. Patients using ventilators for more than 5 days 3,386 times more at risk of developing VAP compared to patients using ventilators 2-5 days. The most risky time for patient using ventilator was more than 5 days of usage. And, the mortality rate of VAP patients was 63.4% from 41 patients while the mortality rate of whole ICU patients was 50.9%.

A preliminary study showed that most health workers in primary health care (PHC) claimed that they need a refreshing course because of their lack of updated knowledge and skill. This study enrolled 27 primary healthcare workers recruited from the PHC. The intervention used were classic lectures and workshops. The knowledge was evaluated using a paper-based test and practice, while the skill was evaluated using a practice test. Multiple questions (pre-test and post-test) based on current emergency management for pediatric were used for paper-based evaluation. Semi-structured interviews were conducted to confirm the subject's perspective on the intervention. A paired t-test was used for evaluating the pre- and post-test results, which was confirmed by a triangulation approach. There was a significant difference between the pre- and post-test results (p<0.001), and 8 of 10 subjects can demonstrate the procedure learned correctly after the intervention. A total of 14 interviewed subjects stated great effectiveness of the intervention, with several limitations on applicability in daily clinical practice. Classic lecture and workshop as an intervention in health education effectively increase health workers' knowledge and skill in PHC. This study might help other rural areas PHC apply the same method so the professionalism and quality of health workers in PHC providers can be maintained.Keywords                : primary health care, classic lecture; workshop; knowledge; skillCorrespondence     : rickyindraalfaray@gmail.com

BackgroundSocial media had eased communication among people in the last twenty years. However, the ease of being constantly connected also lead to problems, including social media addiction and social media bullying. Association between these two problems has not been researched extensively in Indonesia. Indonesia is the fourth most populous country in the world and said to be the most social media-addicted nation. Approximately 50% of the population is categorized as Youth Generation (Generation Y and Z) who consider social media as a necessity in their daily lives. We conducted this nation-wide study to examine the correlation between social media addiction and the experience of being bullied in a social media platform in Indonesian youth.MethodsAn observational analytic study with a cross sectional design was conducted with a total of 1403 respondents. The samples were collected via consecutive sampling on Instagram. To determine social media addiction, the standard Social Media Disorder (SMD) Scale was used and the experience of being bullied is evaluated using a self-made questionnaire. Chi-square and Coefficient contingency analysis is used to determine the correlation.ResultsAlmost half of the respondents (n = 671, 47.9%) are classified as addicted to social media. More than half of the respondents claimed to have experienced bullying when interacting with people via social media (n = 923, 66%). Analyzing the two nominal independent variables results in a weak yet significant correlation (r = 0.097, p = 0.032).ConclusionThere is a significant correlation between social media addiction and the experience of being bullied in a social media platform in Indonesian youth. Future research are needed to help government prevents social media addiction that proved has correlation with bullying.

Infectious diseases are common problems in most countries. Streptococcus pyogenes is the infectious agent that causes diseases such as pharyngitis, impetigo, toxic shock syndrome, and necrotizing fasciitis. Tembelek (Lantana camara) is a wild plant that can easily be found in every ecosystem in Indonesia whether in nature or settlements and known as a plant that has an antibacterial effect but the knowledge about its potential against Streptococcus pyogenes in this past five years remain scant. The aim of this study was to determine the potentiality of Lantana camara leaves and flowers extract against Streptococcus pyogenes. In this experimental study, in vitro using Post-test Only Control Group Designed, has been done and confirmed by the Indonesian Institute of Sciences. Lantana camara leaves and flowers extracts were obtained by maceration using ethanol. The extracts were diluted into eight concentrations and their antibacterial activity against Streptococcus pyogenes was tested using the Kirby-Bauer disc then proceeded Minimum Inhibitory Concentration (MIC) test and phytochemical assay. The data processed using SPSS software version 22. The results showed that flowers extract had the most significant inhibition zone (11.85 ± 0.119 mm) compared with the leaves extract (9.54 ± 0.07 mm) at the highest tested concentration was 640 mg/ml. The MIC of both extracts was 250 mg/ml. Flavonoids, phenolic, steroids, and saponins were found in both extracts whereas, alkaloid was found only in flowers extract. In conclusion, the Tembelek plant has an antibacterial effect against Streptococcus pyogenes. Future study is needed related to its mechanism of antibacterial effect. Keywords                : Antibacterial potential, Lantana camara; Streptococcus pyogenes