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61	COVID-19	ABS-63
SMOKING BEHAVIOUR CHANGES DURING COVID-19 WITHIN THE COMMUNITY OF CIPAGERAN HEALTH CENTER REGION Desy Linasari (a), Naufal Langit (b), Emma Mardliyah (c) (a) 1 Departemen Ilmu Kesehatan Masyarakat, Fakultas Kedokteran Universitas Jenderal Achmad Yani (b)Program Studi Kedokteran Umum, Fakultas Kedokteran Universitas Jenderal Achmad Yani (c) Program Studi Kedokteran Umum, Fakultas Kedokteran Universitas Jenderal Achmad Yani Abstract Covid-19 is an infectious disease caused by SARS-CoV-2. The Indonesian government has implemented several policies to stop the spread of the disease. on the other hand, several government have cause behavioral changes in the community, one of which is smoking habits during the Covid-19 pandemic. This study aims to see changes in smoking habits before and during the Covid-19 pandemic n the community of cipageran health center region. this is an analitycal retrospective cohort study. Data obtained from questionnaires and the sample was collected using the consicutive sampling technique which then obtained 133 respondents and analyzed by Mcnemar test. From the results of the study, there was no significant change in smoking habits (P &gt- 0.05). this result showed that the pandemic is not affecting the smoking habitt on people who have smoked before. the public is advised to reduce and stop smoking in order to avoid diseases caused by substances contained in cigarettes. Keywords: COVID-19, Pandemic, Smoking Share Link | Plain Format | Corresponding Author (Naufal Langit Alwan)

62	COVID-19	ABS-66
The Relationship of Neutrophil-Lymphocyte Ratio Value to the Severity of COVID-19 Patients Silvia Andina Yelsi, Rika Nilapsari Instalasi Laboratorium Patologi Klinik, RSUD Cicalengka, Kab. Bandung, Indonesia silviaandinayelsi[at]gmail.com Abstract At the end of December 2019 in Wuhan, there was a group of patients with respiratory symptoms diagnosed as pneumonia of unknown etiology. After looking for the cause of this virus is SARS-CoV2, a new Coronavirus^s types. This disease was named by WHO as COVID-19. Peripheral hematological changes in severe COVID-19 patients may effect an immune responses, one of which is lymphocytes. Lymphocytes can be detected as a prognosis for the severity of the disease by calculating the neutrophil-lymphocyte ratio (NLR). The measurement of NLR is one of laboratory tests that can be used as a factor to determine the patient^s prognosis in various clinical situations. This study aims to determine the relationship between NLR values and the severity of COVID-19 patients. The method used in this research is Systematic Review by analyzing scientific articles from 3 databases, namely SpringerLink, ProQuest, and ScienceDirect, the last review was carried out using The Joanna Briggs Institute application and PRISMA diagram. Initial search results were 1,652 articles. Based on the criteria obtained 625 articles. Meanwhile, according to the PICOS exclusion criteria, there were 6 articles that matched the inclusion and exclusion criteria. The method of the 6 articles is observational consisting of cohort, cross-sectional, and case control. The neutrophil-lymphocyte ratio can be used as a predictor of the severity of COVID-19, early warning of symptoms that appear and determining treatment actions. The value of neutrophils-lymphocytes in each country can be different. Keywords: COVID-19, Neutrophil-Lymphocyte Ratio, Severity Share Link | Plain Format | Corresponding Author (Silvia Andina Yelsi)

63	COVID-19	ABS-77
GAMBARAN TINGKAT PENGETAHUAN MASYARAKAT KELURAHAN CIPAGERAN KECAMATAN CIMAHI UTARA KOTA CIMAHI TENTANG PROTOKOL TATALAKSANA JENAZAH PASIEN COVID-19 Nurul Aida Fathya1*, Jihan Amalia2, Fahmi Aditya Riza3 1Bagian Ilmu Kedokteran Forensik dan Medikolegal Fakultas Kedokteran Unjani 2Bagian Ilmu Kesehatan Masyarakat Fakultas Kedokteran Unjani 3Program Studi Tahap Sarjana Kedokteran Fakultas Kedokteran Unjani Abstract Coronavirus Disease 2019 (COVID-19) ditetapkan oleh World Health Organization (WHO) sebagai pandemi global. Jumlah kasus dan jumlah kematian akibat COVID-19 terus meningkat dan menimbulkan dampak pada masyarakat seperti rasa takut, khawatir, stigma sosial, perilaku diskriminatif, pengusiran, bahkan penolakan kegiatan pemakaman jenazah pasien COVID-19. Hal ini diakibatkan oleh kurangnya pengetahuan masyarakat tentang pencegahan infeksi dan penularan COVID-19. Masyarakat berisiko terinfeksi COVID-19 dari jenazah apabila tatalaksana jenazah tidak sesuai dengan protokol tatalaksana jenazah pasien COVID-19. Penelitian ini bertujuan untuk mengetahui gambaran tingkat pengetahuan masyarakat tentang protokol tatalaksana jenazah pasien COVID-19 berdasarkan usia, jenis kelamin, tingkat pendidikan, pekerjaan dan sumber informasi. Metode yang digunakan adalah deskriptif observasional dengan menggunakan kuesiner. Kuesioner penelitian terdiri atas 20 pertanyaan yang telah diuji validitas dan realibilitas yang disebar secara daring menggunakan aplikasi google form. Subjek penelitian adalah masyarakat di RT 3 RW 3 Kelurahan Cipageran yang diambil dengan teknik Purposive sampling. Hasil penelitian didapatkan 14 responden (23,3%) memiliki tingkat pengetahuan baik tentang protokol tatalaksana jenazah pasien COVID-19, 24 responden (40%) memiliki tingkat pengetahuan cukup dan 22 responden (36,7%) memiliki tingkat pengetahuan kurang. Karakteristik responden dengan tingkat pengetahuan baik yaitu kelompok usia 31-40 tahun, laki-laki, tingkat pendidikan SMP, Diploma dan Sarjana, Wiraswasta. Media sosial dan elektronik merupakan sumber informasi yang paling banyak digunakan dan diminati oleh masyarakat. Pengetahuan yang tepat dari media elektronik diharapkan dapat meningkatkan tingkat pengetahuan yang nantinya akan menurunkan stigma negatif atas jenazah COVID-19. Keywords: COVID-19, Jenazah, Pengetahuan, Protokol Share Link | Plain Format | Corresponding Author (NURUL AIDA FATHYA)

64	COVID-19	ABS-86
Stemcell,Secretom dan Covid-19 Sandy Qlintang Deputy Director Stemcell and Cancer Institute KALBE Abstract Covid-19 has been a global health emergency and not only induced an unprecedented economic crisis in almost every country, but has led to social and educational crises. With the fast spreading and mutation rate of this virus, human lifestyle has been changed to mitigate the infection of SARS-CoV-2. However, this virus is still able to infect vaccinated people, thus reducing their quality of life for those who have post covid syndrome. In this case report, we report 3 case studies of Mesenchymal Stem Cell Secretome to reduce lung fibrosis post covid in humans. All patients who tested negative after being infected by SARS-CoV-2 have breathing difficulty and weakness as the symptoms of post covid syndrome, then intramuscular Mesenchymal Stem Cell Secretome injections were administered and patients were monitored closely to see it^s effectiveness. After 1 month from the last injection, all patients were able to breathe normally, shown by reduction of lung fibrosis. Keywords: stemcell, secretom, covid-19 Share Link | Plain Format | Corresponding Author (Sandy Qlintang)

65	Emergency Assesment and Magement	ABS-28
Myocardial Infarct with Non Obstructive Coronary Arteries in Young Woman with Peripartum Cardiomyopathy : A Case Report Mohamad Fatichul Huda (a*), Saniy Ghaida (b) Program Studi Sarjana Kedokteran, Fakultas Kedokteran, Universitas Jenderal Achmad Yani, Cimahi Abstract Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA) in young woman is a rare case in daily. It has a five times increase in young woman incident of non atherosclerotic Mi. MINOCA for approximately 17% of coronary thrombosis in pregnancy. We report of 30 years old with Peripartum Cardiomyopathy (PPCM). She was 16 days post partum and came to Emergency Room with acute chest pain. Physical examination was elevated JVP with ronchi at basal pulmo. Electrocardiogram showed ST-segment elevation in the inferior leads while Troponin I level was elevated, suggesting diagnosis STEMI inferior. The patient is known for decreased left ventricular ejection fraction and global hypokinesia at inferior wall left ventricle. Coronary angiography showed normal coronary with thrombus Distal Left Coronary circumflex and coronary slow flow. No subsequent intervention was given. She was treated in ICU with an anticoagulant, ace-inhibitor, beta blocker, mineralocorticoid receptor antagonists, diuretic. Our case further documents thrombus coronary occlusion as a consequence of PPCM. Oxidative stress led to cleavage of the nursing hormone, prolactin. The 16-kDa prolactin fragment had vasculotoxic and pro-apoptotic properties and vascular and myocardial dysfunction. Protein C and protein S can influens hypercoaguable conditions, although infrequent, were more common with MINOCA than MI-CAD. Deficiency of protein C and protein S resulting in unchecked thrombin generation, leading to thromboembolism. Coronary thrombosis may potentially cause coronary occlusion and thus be responsible for MINOCA. Keywords: Young woman, myocardial infarct, peripartum cardiomiopathy Share Link | Plain Format | Corresponding Author (Saniy Ghaida)

66	Emergency Assesment and Magement	ABS-36
TAMPONADE JANTUNG DENGAN EFUSI PERIKARDIAL MASIF BERULANG SUATU KONDISI YANG MENGANCAM JIWA : SEBUAH LAPORAN KASUS Arinta Setyasari Subdepartemen Jantung dan Pembuluh Darah Bagian Penyakit Dalam, Fakultas Kedokteran, Universitas Jendral Ahmad Yani / RS Dustira Cimahi Abstract Tamponade jantung merupakan suatu kondisi yang mengancam jiwa disebabkan oleh kompresi jantung yang berasal dari adanya efusi cairan, darah ataupun udara di ruang perikardium. Laporan kasus : Laki-laki 31 tahun datang ke UGD dengan keluhan sesak nafas dan tanda-tanda syok kardiogenik. Riwayat perawatan 3 bulan sebelumnya disebabkan oleh tamponade jantung dan Meningoencefalitis tuberculosis (TB). Efusi perikardium dikeluarkan dengan baik setelah 2 minggu perawatan dengan jumlah produksi cairan sekitar 40 cc/hari. Pasien pulang perawatan dengan terapi TB. Diagnosa tamponade jantung berdasarkan pada anamnesa, pemeriksaan fisik terutama Trias Beck dan pemeriksaan tambahan berupa foto thoraks, rekam EKG dengan adanya EKG Low voltage dan swinging heart yang tampak pada pemeriksaan ekhokardiografi. Kesimpulan : pasien dengan TB yang berkaitan dengan efusi perkardium dapat menyebabkan terjadinya akumulasi cepat efusi perkardium yang dapat mengakibatkan tamponade jantung yang mengancam jiwa sehingga membutuhkan tindakan emergensi pengambilan cairan perikardial. Keywords: Tamponade jantung, Tuberkulosa, Trias Beck Share Link | Plain Format | Corresponding Author (Arinta Setyasari)

67	Emergency Assesment and Magement	ABS-37
Management of Septic Shock Due to Community-Acquired Pneumonia with Chronic Kidney Disease: A Case Report Arief Kurniawan (a*), Nur Pudyastuti Pratiwi (b) a) Department of Anesthesiology and Intensive Therapy Faculty of Medicine Universitas Jenderal Achmad Yani Cimahi, Indonesia b) Department of Hospital Administration Faculty of Medicine Universitas Jenderal Achmad Yani Cimahi, Indonesia Abstract Community-acquired pneumonia is an infectious disease that can cause local and systemic inflammation that causes dysregulation of the body^s response and results in life-threatening organ dysfunction or commonly known as sepsis. Chronic kidney disease is a common and progressive disease that has become a public health problem. Infection is the leading cause of death in patients with end-stage renal disease and the cause of requiring hospitalization. Among infectious causes, pneumonia is one of the leading causes of infection and is associated with an increased risk of death with a poorer glomerular filtration rate. A 49-year-old woman was diagnosed with uremic encephalopathy, chronic kidney disease with hyperkalemia, and community-acquired pneumonia. The choice of antibiotics was carried out by considering the risk of exposure to Pseudomonas bacteria including the presence of bronchiectasis, corticosteroid treatment >10 mg/day, broad-spectrum antibiotic treatment >7 days in the last month, and the presence of malnutrition. This patient was considered exposed to Pseudomonas bacteria. The antibiotics chosen for this patient were ceftazidime and levofloxacin as recommended by the following Indonesian Intensive Care Doctors Association. Successful management of cases of septic shock caused by community-acquired pneumonia is highly dependent on early diagnosis, optimal resuscitation, administration of antibiotics, and positive ventilation support when needed. Appropriate adjustment of drug dosage in patients with renal failure will result in optimal drug effects and lower side effects. Keywords: Antibiotics, community-acquired pneumonia, chronic kidney disease, septic shock Share Link | Plain Format | Corresponding Author (Arief Kurniawan)

68	Emergency Assesment and Magement	ABS-40
ACUTE ANGLE-CLOSURE GLAUCOMA IN EMERGENCY MEDICINE TREATMENT AND MANAGEMENT Awan Buana Faculty of Medicine Universitas Jenderal Achmad Yani Cimahi, Indonesia Abstract Of the nearly 67 million patients with glaucoma worldwide, it has been estimated that one-half are of Asian descent. The prevalence of angle-closure glaucoma (ACG), much of which is primary angle closure, has been shown to be higher than that of other types of glaucoma among Asian persons. Population studies have determined that the ratio of open-angle glaucoma (OAG) to ACG in Chinese individuals range from 1:1 to 2.6:1. Primary ACG (PACG) is more common than previously recognized and is a leading cause of bilateral blindness worldwide. In primary OAG, while the resistance to aqueous outflow is known to be increased, structures proximal to the trabecular meshwork do not add to the resistance to aqueous outflow and the pathologic resistance to outflow resides in the meshwork itself. Early diagnosis and treatment of most forms of ACG can be invaluable, and sometimes curative. Accordingly, understanding the pathophysiology is essential if proper treatment is to be initiated. Also, screening patients at greatest risk for angle closure can be beneficial in reducing the number of patients who develop these diseases and in reducing the risk of blindness. In primary angle closure, there is no identifiable underlying pathology- there is only an anatomical predisposition to pupillary block. In secondary angle closure, an identifiable pathologic cause, such as an intumescent lens, iris neovascularization, chronic inflammation, corneal endothelial migration, or epithelial ingrowth, initiates the angle closure. Keywords: Angle-Closure Glaucoma Share Link | Plain Format | Corresponding Author (Awan Buana)

69	Emergency Assesment and Magement	ABS-46
CONCOMITANT PRESENTATION OF VOLVULUS OF THE SIGMOID COLON WITH RECTAL CANCER: A CASE REPORT Vina Dwitia General Surgeon of Dustira Army Hospital, West Java, Indonesia Surgery Lecturer of Medical Faculty Jenderal Achmad Yani University, West Java, Indonesia Abstract Sigmoid volvulus is one of the three most common causes of acute colonic obstruction. Predisposing factors to sigmoid volvulus include chronic constipation, megacolon, and an excessively mobile colon. However, concomitant presentation of volvulus of the sigmoid colon and rectal cancer is extremely rare. We report a case of a 38-year-old woman with coexisting volvulus of the sigmoid colon and rectal cancer. The patient presented with abdominal distension, pain, vomiting for 3 days. She had history of abdominal distention several times in the past 1,5 months. On Abdominal X-Ray, the whole colon was dilated with gas . There were multiple air fluid level with gas above ^stepladder pattern^. Exploratory laparotomy was performed. We found extremely dilated both small and large bowel. The sigmoid colon was rotated around its mesentery. The sigmoid colon was redundant. It was severely distended with oedematous, hyperaemic serosa. Stricture mid rectum due to shrinkage tumour was identified in the proximal-rectum. The patient underwent decompression (ileotomy) , sigmoid resection, tumour biopsy and colostomy mucous fistulas. Pathologic findings confirmed adenocarcinoma of the rectum. The postoperative course was good. The patient came home and have been reffered to Digestive Surgeon for chemotherapy and planned for definitive surgery ( Low Anterior Resection). Keywords: Sigmoid volvulus, Tumour, Rectum Share Link | Plain Format | Corresponding Author (Vina Dwitia, SpB., M.Kes)

70	Emergency Assesment and Magement	ABS-80
Singleton Pregnancy Didelphys Uterus With 2 Vaginal Septa Complete : Case Report Danti Nelfa Riza, David Eka Prasetya Departement of obstetrics and gynecology, Dustira Armany Hospital Abstract Abstract Didelphys uterus, is a rare congenital malformation of the Mullerian ducts. This anomaly of the reproductive tract is associated with various clinical reproductive disorders including: increased preterm birth before 37 weeks of gestation, low birth weight less than 2,500 gram, intrauterine fetal growth restriction, abnormal fetal presentation, cesarean delivery, and perinatal death. Keywords: Didelphys, malformation, pregnancy Share Link | Plain Format | Corresponding Author (Danti nelfa riza)

71	Epidemiology and Public Health	ABS-12
HUBUNGAN WAKTU PENGGUNAAN PERSONAL LISTENING DEVICES DENGAN KELUHAN GANGGUAN AUDITORIK DAN NON-AUDITORIK PADA MAHASISWA FAKULTAS KEDOKTERAN UNJANI ANGKATAN 2019 Yanti Nurrokhmawati(a) , Emil Faishal Hanif(b), Yustiani Dikot(c), Sigit Sasongko(d) a) Departemen Ilmu Kesehatan Telinga Hidung Tenggorok - Bedah Kepala dan Leher, Fakultas Kedokteran Universitas Jenderal Achmad Yani, Cimahi. Indonesia, b) Program Studi Sarjana Kedokteran,Fakultas Kedokteran, Universitas Jenderal Achmad Yani, Cimahi. Indonesia, c) Departemen Saraf Fakultas Kedokteran Universitas Jenderal Achmad Yani, Cimahi. Indonesia, d) Program Studi Sarjana Kedokteran, Fakultas Kedokteran, Universitas Jenderal Achmad Yani, Cimahi. Indonesia Abstract Personal Listening Devices (PLDs) are the result of modern technological developments that are currently widely used by the public, especially when calling, playing games, listening to music or watching videos. The current COVID-19 pandemic has led to an increase in the use of PLDs, which in turn can be a risk factor for the occurrence of NIHL in its users. This study aims to determine the relationship between the time of using PLDs with symptoms of auditory and non-auditory disturbances in students of the Faculty of Medicine Unjani Class 2019. This study was an analytical study with a cross-sectional approach. The population of this study were students of the Faculty of Medicine Unjani Class 2019 who used PLDs that met the inclusion criteria and exclusion criteria. The minimum number of respondents in this study was 40 people. Data was collected using simple random sampling. The instrument used in this study was a questionnaire. The characteristics of respondents who used PLDs were dominant in women than men (72.50%) with the average age of 20 years. The results showed that most of the respondents used PLDs for more than 3 hours (47.50%) per day. Based on the results of the Chi Square Test analysis, it shows that there is a significant relationship between the time of using PLDs with symptoms of auditory disturbances (p = 0.007) and symptoms of non-auditory disorders (p = 0.018) in students of the Faculty of Medicine Unjani class 2019. The conclusion of this study is the time of using PLDs has a significant relationship with symptoms of auditory and non-auditory disturbances in students of the Faculty of Medicine Unjani Class 2019. Keywords: Auditory, Noise, Noise Induced Hearing Loss, PLDs Share Link | Plain Format | Corresponding Author (Emil Faishal Hanif)

72	Epidemiology and Public Health	ABS-16
Prevalence and Trigger Factors of Primary Headache Among Medical Students in Jenderal Achmad Yani University Batch 2018 During Online Learning Yustiani Dikot (a*), Jusron Iriawan (b), Anamira Cesaria Nur (c) a) Departemen Penyakit Saraf, Fakultas Kedokteran, Universitas Jenderal Achmad Yani, Cimahi. Indonesia *yustianidikot[at]yahoo.com b) Departemen Penyakit Dalam, Fakultas Kedokteran, Universitas Jenderal Achmad Yani, Cimahi. Indonesia c) Program Studi Sarjana Kedokteran, Fakultas Kedokteran, Universitas Jenderal Achmad Yani, Cimahi. Indonesia Abstract Primary headache is the most common complaint in general population. Several epidemiological studies show the high prevalence of primary headache in medical students due to the large number of stressors both psychologically and physically. This study aims to determine the prevalence of primary headaches in medical students at Jenderal Achmad Yani University batch 2018, and to determine the relationship between the use of electronic media, psychological factors, and sleep patterns with the incidence of primary headaches. Descryptive analytical study of primary headache based on questionnaire adapted to the PERDOSSI 2018 headache diagnostic criteria. The assessment of the factors that influence headache was obtained from DASS 21 questionnaire, PSQI, and several parameters related to the use of electronic media such as duration of computer usage, position of the monitor, and the presence of refractive errors. Bivariate data analysis was done using Chi-square test . Multivariate analysis was done using Binary Logistics Regression test. There were 100 respondents consisting of 37 male respondents and 63 female. Migraine headache percentage is 23%, Tension-type headache 27%, Cluster headache 2%, and unspecified headache 20%. There is no significant corelation between psychological factors and sleep quality with headaches. Significant corelation was found between refractive errors on electronic media users with the incidence of primary headaches. It can be concluded that there is significant corelation between refractory error on electronic media users with with the incidence of primary headaches, but not with psychological factor and sleep disorders. Keywords: Medical students, electronic media user, primary headache Share Link | Plain Format | Corresponding Author (Anamira Cesaria Nur)

73	Epidemiology and Public Health	ABS-25
DESCRIPTION OF INJURY TO THE VICTIMS OF MOTORCYCLE TRAFFIC ACCIDENT (LITERATURE STUDY OF SOUTHEAST ASIA) Andri Andrian Rusman (a*), Livaldi Naufal Aflah (b), Andri Anugerah Kusuma (c) a) Department of Forensic, Faculty of Medicine, Jenderal Achmad Yani University, Cimahi, Indonesia. *andri.andrian[at]lecture.unjani.ac.id b) Bachelor of Medicine Study Program, Faculty of Medicine, Jenderal Achmad Yani University, Cimahi, Indonesia. c) Department of Surgery, Faculty of Medicine, Jenderal Achmad Yani University, Cimahi, Indonesia. Abstract Road accidents are events that can lead to injury or death. The number of fatalities from traffic accidents is the eighth highest in the world. In Southeast Asia, up to 316,000 people die each year in road accidents. Motorcycles are the type of vehicle with the highest number of accidents compared to other types of vehicles. The increase in motorcycle purchases in Indonesia is associated with an increase in road accidents. Road accident injuries can occur on multiple parts of the body and can cause different types of injuries. The purpose of this study is to determine the description of the victims of motorcycle traffic accidents in Southeast Asia. This research is a descriptive study using a literature study method by searching various literatures that uses electronic databases such as Google Scholar, Researchgate, PubMed, NCBI, WHO, Ministry of Health, ScienceDirect, Springer to search related literature. Keywords used when searching for items are injuries, car accidents, motorcycles, and Southeast Asian descriptions. A total of seven articles were selected for analysis using synthetic matrices, and the results showed that working-age and male gender were most frequently involved in motorcycle road accidents. Extremities injuries are the most common site of injury and the majority of injuries obtained are soft tissue injuries. In order to add data on the most common types of injuries to motorcycle traffic accident victims in Indonesia, this study needs to be further conducted in Indonesia on the most common types of injuries to motorcycle traffic accident victims. Keywords: Pattern of injury- traffic accidents- motorcycle- Southeast Asia Share Link | Plain Format | Corresponding Author (Andri Andrian Rusman)

74	Epidemiology and Public Health	ABS-26
The Correlation of Smoking with Hearing Loss Due to Noise in Furniture Factory Workers at PT Chitose Cimahi Haryo Bayu Putranto, Yanti Nurokhmawati ENT Department Dustira Hospital Cimahi Medical Faculty of General Achmad Yani University, West Java Indonesia Abstract Background : Hearing loss due to noise is a disturbance in the form of a decrease function sense of hearing due to exposure noise with excessive continuous noise intensity for a long time. Smoking triggers cochlear ischemia by the mechanism of carboxyhemoglobin production and vasospasm. So that smoking habits and exposure to noise can interfere with the cochlea to carry out its functions. Objective: To determine the correlation between smoking and noice induced hearing loss due to noise in furniture factory workers at PT Chitose Cimahi Methods: Analytical research with cross sectional method and bivariate analysis using chi square. Data collection by total sampling. Results: Of the 66 workers, the proportion of smokers workers was 56.06%, and 56.06% of the workers had noise induced hearing loss. There was no significant correlation between smokers and noise induced hearing loss (p = 0.898). Conclusion: There is an insignificant relationship between smoking habit and noise induced hearing loss in furniture factory workers at PT Chitose Camille Keywords: Cochlea, noise, noise-induced hearing loss, smoking Share Link | Plain Format | Corresponding Author (Haryo Bayu Putranto)

75	Epidemiology and Public Health	ABS-29
The Relationship between the Use of Personal Protective Equipment and Noise Induced Hearing Loss Among Textile Factory Workers at PT Trisulatex Cimahi Siti Zakiaturrahmah, Yanti Nurrokhmawati, Ear, Nose, and Throat - Head and Neck Surgery, Faculty of Medicine University of General Achmad Yani Medical School/Dustira Hospital, Cimahi Abstract Noise Induced Hearing Loss (NIHL) is a decrease in hearing or deafness due to noise that exceeds the hearing threshold value in the work environment. The textile factory industry in which the research is focused specifically in the weaving section of the factory. The average worker in the weaving section is exposed to 94 dB from the noise generated from the weaving machine. This measurement exceeds the normal hearing threshold which is 85dB for a duration of 8 hours a day, which was set by Permenakertrans No. 13 of 2011 about Threshold Values for Physical and Chemical Factors at the workplace. The impact of exposure to noise that exceeds this threshold can cause hearing loss, especially for workers. Therefore, it is very important for this industry and its workers to understand NIHL so they can take preventive and rehabilitative precautions to overcome these problems, such as using ear protective equipment when working. This study aims to compare the relationship between the use of personal protective equipment (PPE) and the incidence of NIHL in PT Trisultex factory workers. The method used for data collection were through questionnaires followed by an audiometric examination. Selection of samples were chosen through total sampling. The results showed that there were 36 people (51.4%) with NIHL with an average employment of 14.7 years. Gender-wise, there were 27 males (75%) and 9 females (25%). A total of 69 workers (98%) used PPE while 25 people (35%) used ear plugs and 45 people (65%) used ear muffs. Out of those who wore earplugs, 13 people (52%) experienced NIHL and of those who wore earmuffs, 23 people (51%) experienced NIHL. Out of the 56 people who always used PPE, 30 people (53%) experienced NIHL and of the 14 people who sometimes use PPE, 6 people (42%) experienced NIHL. In conclusion, these results indicate that there is no significant relationship between using PPE while working with the incidence of NIHL (p-value>0.05). Keywords: Factory Workers, Hearing Loss, Noise, PPE, Textile Factory Share Link | Plain Format | Corresponding Author (Siti Zakiaturrahmah)

76	Epidemiology and Public Health	ABS-34
A Description of BERA Click Test Results at Dustira Hospital Cimahi 2020-2021 Siti Zakiaturrahamah, Evy Shavilla Ear, Nose, and Throat - Head and Neck Surgery, Faculty of Medicine University of General Achmad Yani Medical School/Dustira Hospital, Cimahi Abstract Brainstem Evoked Response Audiometry (BERA) is an auditory electrophysiology that assesses the integrity of the central and the peripheral auditory system objectively. To assesses Brainstem Evoked Response Audiometry profile in people old with normal hearing and to assess BERA profile based on different rate, intensity and stimuly. Study design Cross sectionalstudy. Specimen in this study thirty eight ears with normal hearing in individual age 1-3 years old. Results:Wave latencies differed significanly between click stimuli and tone burst stimuli. There was also difference of average latencyin various rate and intensity. Conclusion: the average profile brainstem evoked response audiometry in normal hearing is difference in every difference stimuli, rate and intensity. Keywords: Brainstem Evoked Response Audiometry (BERA) Share Link | Plain Format | Corresponding Author (Siti Zakiaturrahmah)

77	Epidemiology and Public Health	ABS-35
STRATEGY FOR IMPLEMENTATION OF SCHOOL CHILD IMMUNIZATION MONTH PROGRAM IN COVID-19 PANDEMIC AT BATUJAJAR HEALTH CENTER 1Sri Quintina Indriyana, 2Desy Linasari, 3Enung Masruroh 1,2 Department of Public Health Faculty of Medicine Jenderal Achmad Yani University jl. Terusan Jenderal Sudirman PO BOX 148 Cimahi West Java 3Batujajar Health Center Bandung Barat Abstract The COVID-19 pandemic has hindered one of the government^s health sector programs, the School Child Immunization Month (BIAS). The complete immunization program must still follow the schedule to protect children from immunization-preventable diseases. This study sought strategies, processes, and obstacles in implementing the BIAS program during the COVID-19 pandemic at Batujajar Health Center from December 2020 to January 2021. The study design was a qualitative method by conducting in-depth interviews. The informants were selected through a purposive sampling technique to obtain the information required for the study. The results showed that immunization was only administered in safe zones, and socialization was distributed from the Community Health Centre to schools by WhatsApp (WA) application. The school used WA to deliver the socialization to parents, then recorded the students to immunize, and chose places fulfilling health protocols. The BIAS process during the COVID-19 pandemic was the selection of place, time, and the number of people involved for BIAS with the health protocol, monitoring by the immunization program coordinator through field officers reporting, and evaluations during monthly workshops. Some problems occurring in the BIAS program were there were external obstacles like school^s difficulty applying health protocols during the administration, and some parents^ resistance to children^s immunization, misinformation that it was a vaccine for COVID-19 or the vaccine was expired, children were sick of afraid of the syringe. Better socialization and coordination on the implementation of this program was needed. Keywords: School Child Immunization Month, Pandemic, Community Health Center, Strategy Keywords: Community Health Center, Pandemic, School Children Immunization Month, Strategy Share Link | Plain Format | Corresponding Author (Sri Quintina)

78	Epidemiology and Public Health	ABS-51
THE OVERVIEW OF MICROBIOLOGICAL QUALITY OF THE UPSTREAM OF CIKAPUNDUNG RIVER BASED ON TOTAL COLIFORM AND Escherichia coli Eka Noneng Nawangsih, Ania Kurniawati, dr., M.Kes, Dinyar Supiadi W, Muhammad Azka Fadhlan Qinthara Faculty of medicine, Universitas Jenderal Achmad Yani, Cimahi Abstract Cikapundung River is one of many rivers which its existence used by Bandung citizens for many function. One of the function is main water source for Dago Pakar Water Treatment Plant which is located in Bantar Awi. The social activity as a cow farmer can contaminate the quality of Cikapundung River because of the disposal of the waste that didn^t go through the process. The purpose of this research was to determine the amount of Total Coliform Bacteria and Escherichia coli contained in the upstream of Cikapundung River and to adapt with the regulation of the minister of the health of the Republic of Indonesia Number 32 of 2017. This research is a descriptive study conducted at Microbiology Laboratory, Faculty of Medicine in Jenderal Achmad Yani University. The sample was collected from three spots: upstream, midstream and downstream on three times which are morning, daylight, and afternoon. The method used is Most Probable Number with three steps including Presumptive test using Lactose Broth, Confirmed Test using BGLB (Brillian Green Lactose Broth) and Completed Test using EMBA (Eosin-methylene blue agar). The presumptive test showed all samples are positive except for the first spot which is from the upstream as main water source. The confirmative test showed on second and third spot taken on morning, daylight and afternoon contain very high amount of coliform which is 1101 CFU/100 ml. On completed test, E. coli, Enterobacter and Klebsiella colonies were found. It can be concluded that microbiological quality of Cikapundung River is not yet fullfiled the standard. Keywords: Cikapundung River, coliform, most probable number Share Link | Plain Format | Corresponding Author (Eka Noneng Nawangsih)

79	Epidemiology and Public Health	ABS-61
PREVALENCE AND CHARACTERISTICS OF MASKNE IN CLERKSHIP STUDENTS FACULTY OF MEDICINE UNIVERSITY ACHMAD YANI CIMAHI YEAR 2021 Lina Damayanti1, Athaya Haura Tiza Azizah2, Siska Telly Pratiwi3, Dian Mardianti1 1Bagian Kulit & Kelamin, Fakultas Kedokteran, Universitas Jenderal Achmad Yani, Cimahi. Indonesia 2Program Studi Sarjana Kedokteran, Fakultas Kedokteran, Universitas Jenderal Achmad Yani Cimahi. Indonesia 3Bagian Mikrobiologi, Fakultas Kedokteran, Universitas Jenderal Achmad Yani, Cimahi. Indonesia Abstract Maskne is a term from 2 combines words, namely mask and acne. The clinical symptom of maskne is the appearance of acne vulgaris in the area covered by the mask which is known as the O-zone due to long use of mask. The purpose of this study was to determine the incidence of maskne and it affecting factors due to the use of masks as a protocol during the COVID-19 pandemic. This research was conducted using a descriptive research method with a cross sectional design. Total sample of 77 respondents who had met the inclusion criteria by taking samples using a simple random sampling technique. The data was primary data taken from questionnaires directy to respondents. Characteristics of respondents in this study are gender, age, type of mask, duration of mask use, frequency of changing masks, skin type, and previous history of acne. The results showed that 76.62% of clerkship students at the Faculty of Medicine, Jenderal Achmad Yani University, experienced maskne during the pandemic. As many as 61.02% of students have a history of previous acne vulgaris, 52.54% of students have a frequency of using masks 4-8 hours in a day, 67.8% of students use N95 masks, 64.41% of students change masks once in a day, and 59.32% of students have combination skin type. Maskne occurs in students who have a previous history of acne vulgaris, have 4-8 hours frequency of using masks in a day, using N95 masks, changing masks once a day, and having combination skin type. Keywords: acne vulgaris, COVID-19, clerkship student, maskne, pandemic Share Link | Plain Format | Corresponding Author (Athaya Haura Tiza Azizah)

80	Epidemiology and Public Health	ABS-65
THE RELATIONSHIP OF ANXIETY DEGREES WITH THE COPING MECHANISMS FOR PRE-DUTY SOLDIERS COMBAT ENGINEER BATTALION 9/1 KOSTRAD IN MILITARY OPERATIONS OTHER THAN WAR (DISASTER MANAGEMENT) Arlisa Wulandari, Sutrisno, Siti Annisa, Irwanto Ichlas Fakultas Kedokteran UNJANI Cibeber, Kec. Cimahi Sel., Kota Cimahi, Jawa Barat 40531 email korepodensi: arlisawulandari[at]yahoo.com Abstract The Indonesian National Army (TNI) is a servant of the state who has a challenging task because they must have good physical and mental readiness to protect the Unitary State of the Republic of Indonesia (NKRI). One of the mandatory tasks of the TNI is Military Operations Other than War (MOOTW). The frequent assignments followed cause soldiers to be vulnerable to stress. They have a high risk of anxiety symptoms when they are about to be assigned tasks, especially for soldiers who do not have previous duty experience. One way to reduce anxiety and stress symptoms is by using a coping mechanism strategy. Soldiers^ coping responses can be in the form of adaptive or maladaptive coping responses, so the degree of anxiety in soldiers will affect the coping responses that arise. The purpose of this study was to analyze the relationship between the degree of anxiety and the coping mechanisms of the new Yonzipur 9/1 Kostad soldiers in implementing MOOTW. The research is analytical observational with the subject of new TNI soldiers Yonzipur 9/1 Kostrad, using the Zung Self Anxiety Scale questionnaire and the Jaloweic Coping Scale questionnaire. The results showed that most respondents were not anxious when assigned to OMSP (94.4%) with an adaptive coping mechanism response (86.7%). In comparison, the remaining 4.4% experienced mild anxiety (4.4%) and moderate anxiety. (1.1%). Generally, the age of the respondents is 22 years old, and the majority have never had experience in MOOTW. The Conclusion of the research is that there is a relationship between the degree of anxiety and the coping mechanisms of pre-duty soldiers at Yonzipur 9/1 Kostrad. Keywords: TNI, MOOTW, disaster management, Anxiety, Coping Mechanism Keywords: TNI, MOOTW, disaster management, Anxiety, Coping Mechanism Share Link | Plain Format | Corresponding Author (Siti Annisa)

81	Epidemiology and Public Health	ABS-78
Gambaran Tingkat Pengetahuan Dan Sikap Orang Tua Terhadap Kasus Kekerasan Seksual Pada Anak Di Kelurahan Melong Tahun 2021 Nurul Aida Fathya1*, Yasmar Alfa2, Clara Herdiarti3 1 Bagian Ilmu Kedokteran Forensik dan Medikolegal Fakultas Kedokteran Unjani 2 Bagian Ilmu Kesehatan Anak Fakultas Kedokteran Unjani 3 Program Studi Tahap Sarjana Kedokteran Fakultas Kedokteran Unjani Abstract Kekerasan seksual merupakan salah satu bentuk kekerasan pada anak. Pengetahuan dan sikap orang tua merupakan salah satu faktor yang berhubungan dengan terjadinya kasus kekerasan seksual pada anak. Penelitian ini bertujuan untuk mengetahui gambaran tingkat pengetahuan dan sikap orang tua terhadap kasus kekerasan seksual pada anak di Kelurahan Melong tahun 2021. Metode penelitian ini adalah deskriptif dengan rancangan cross sectional menggunakan kuesioner. Subjek pada penelitian ini adalah orang tua yang memiliki anak dan tinggal menetap di Kelurahan Melong dan diambil dengan teknik cluster random sampling. Sebanyak 155 responden terlibat pada penelitian ini dengan distribusi karakteristik antara lain: jenis kelamin perempuan sebanyak 86,5%- 40% responden berusia lebih dari 40 tahun- 60% responden memiliki 2-3 anak- 31,6% responden berlatar belakang pendidikan hingga SMA- 74,2% responden bekerja sebagai ibu rumah tangga- dan 93,5% berstatus menikah. Gambaran tingkat pengetahuan orang tua mengenai kasus kekerasan seksual didapatkan 65,2% responden memiliki pengetahuan yang baik, 26,5% pengetahuan cukup, dan 8,3% pengetahuan kurang. Gambaran sikap orang tua terhadap kasus kekerasan seksual pada anak didapatkan 85,2% responden menunjukan sikap positif dan 14,8% menunjukan sikap negatif. Tingkat pengetahuan orang tua yang baik sejalan dengan sikap positif, sehingga diharapkan dapat mempengaruhi sikap orang tua dalam pencegahan serta tindak lanjut yang benar perihal kejadian kekerasan seksual terhadap anak. Keywords: Kekerasan seksual pada anak, orang tua, pengetahuan, sikap Share Link | Plain Format | Corresponding Author (NURUL AIDA FATHYA)

82	Medical Education and Bioetic	ABS-72
The learning impact on Online Formative Assessment system (OFAs) for undergraduate medical education in Indonesia Sylvia Mustika Sari, Hindun Saadah Faculty of Medicine Universitas Jenderal A. Yani Abstract Introduction Formative assessment is a continuum process of evaluating students^ performance that facilitates feedback and reflection to enhance students^ learning quality. The shift on full-online learning in pandemics reduces student lectures attachments during formative assessment. Aim of the study: This study aimed to explore the learning impact of OFAs for undergraduate students, such as learning preparation, feedback perception, and self-reflection. Method: We used the mixed method with an exploratory approach. We collected quantitative data from 150 students who experienced OFAs, using 26 questions adapted from AEQ (Assessment Experience Questionnaire) and analyzed by pre-post design (paired-T test). To explore deeper understanding, we conducted 6 FGDs (N=28). Finally, we analyzed the quantitative and qualitative data sequentially. Results We found the difference in students^ preparation (p<0.5), feedback perception (p<0.5) and no difference in self reflection (p>0.5). In Qualitative data, we found three themes as follows: (1) OFA system has been externally driven the students^ preparation (2) Less constructive feedback led to the lack of self-reflection- (3)Student^s learning behavior depends on assessment experience. These findings represent that learning impact is a complex pathway that the assessment systems can externally drive. Conclusion: OFA system has an externally driven learning impact on students^ preparation. However, we found the challenges to improve students^ quality feedback and self-reflection skills. This study brings further exploration on student lectures engagement in online formative assessment. Keywords: Formative, online, learning impact, undergraduate Share Link | Plain Format | Corresponding Author (Sylvia Sari)

83	Medical Education and Bioetic	ABS-74
The sociocultural challenges in the R2C2 framework of feedback in clinical education: An Indonesian context Andri Andrian Rusman, Sylvia Mustika Sari Faculty of Medicine, Universitas Jenderal A. Yani Abstract Introduction Feedback in clinical education is a driving force in developing students^ competence. However, the feedback process in the hierarchical culture, such Asian context, was found to be unidirectional and instructive. Aims of study To explore the feedback communication during the workplace-based assessment was done in Indonesian culture based on the R2C2 framework. Method Based on the ethnomethodology approach, we observed six WBA sessions in Forensic Medicine clinical rotation in 4 weeks and audiotaped six feedback conversations. We used the critical discourse analysis and conducted the thematic analysis. Results We found three sociocultural barriers in R2C2 framework: 1) The power construction influences the student lectures relationships. 2)The unidirectional feedback conversation affects the exploration of students^ responses and coaching processes. 3) The content of feedback focuses on correcting students^ mistakes. Conclusions We identify the sociocultural challenges in implementing the R2C2 framework in feedback during clinical education. This study addresses the need to develop the original model based on cultural context. Keywords: Feedback, communication, clinical education Share Link | Plain Format | Corresponding Author (Sylvia Sari)

84	Medical Education and Bioetic	ABS-79
Values and Ethics on Interprofessional Collaboration Practice in Indonesia: a Qualitative Study Nurul Aida Fathya1, Christantie Effendy2*, Yayi Suryo Prabandari3 1Mahasiswa Program Studi Magister Bioetika Sekolah Pascasarjana Universitas Gadjah Mada, Laboratorium Ilmu Kedokteran Forensik dan Medikolegal Fakultas Kedokteran Universitas Jenderal Achmad Yani - Indonesia 2Program Studi Keperawatan Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan Universitas Gadjah Mada, Yogyakarta - Indonesia 3Program Studi Magister Magister Bioetika Sekolah Pascasarjana Universitas Gadjah Mada, Yogyakarta - Indonesia Abstract Background:The concept of patient center health services encourages interprofessional collaborative practice (IPCP). Although each healthcare professional has their own policy in collaborating, a shared understanding of ethics is needed to strengthen IPCP. Objective:This study aimed to determine how interprofessional ethics is understood by health workers in the hospital. Methods: This study was a qualitative with a phenomenology design using in-depth interviews with health workers at a regional general hospital in West Java province. Subjects were selected from 7 healthcare professions (nurse, general practitioner, specialist doctor, pharmacist, midwife, physiotherapist and nutritionist) with maximum variety. Data^s credibility and reliability obtained by member checking, source triangulation, rich data and analysis triangulation. Obtained data were analyzed thematically. Results: 11 participant interviewed and analysis resulted in 2 themes: perception of healthcare professional about professional ethics and the common ground principles in professional practice. Some respondents had as a etiquette. Perception of professional ethics varies from guidelines for professional practice, code of conduct, promises made during professional oaths and professional ethics as etiquette. Interprofessional ethics is understood as a common guideline that has similar principles, including: beneficence, nonmaleficence, respect for autonomy, justice, mutual respect, mutual understanding, equality, and the golden rule principle. Conclusion: Differences in understanding about professional ethics did not change the practice applied by healthcare professional. Common values when dealing with patients and other professions can encourage IPCP interprofessional ethics collaboration and strengthen IPCP. Keywords: : ethics, value, professional ethics, interprofessional, collaboration Share Link | Plain Format | Corresponding Author (NURUL AIDA FATHYA)

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