“Saliva acts as an antibacterial agent. When saliva production decreases, bacteria thrive, causing unpleasant breath,” Dr. Risya explained.

Although bad breath is a natural occurrence while fasting, several effective strategies can help maintain fresh breath throughout the day.

1. Stay Hydrated with the 3-2-3 Rule

Hydration is essential in preventing dry mouth, which contributes to bad breath. Dr. Risya suggests following the 3-2-3 hydration rule:

• Three glasses of water at iftar (breaking the fast)
• Two glasses before bedtime
• Three glasses at suhoor (pre-dawn meal)

This practice keeps the mouth moist and promotes saliva production, reducing the risk of bad breath during fasting.

2. Maintain Good Oral Hygiene

Proper oral care is key to preventing bad breath. Dr. Risya recommends brushing your teeth twice a day, especially before bed and after suhoor. Additionally, flossing helps remove trapped food particles that can cause bacterial growth.

“Food debris left between teeth fosters bacteria, leading to bad breath. Brushing and flossing effectively prevent this issue,” she added.

3. Choose the Right Foods and Avoid Smoking

Diet plays a significant role in maintaining fresh breath while fasting. Dr. Risya advises consuming fiber-rich foods and fresh fruits, which help clean the mouth naturally. She also recommends avoiding foods that cause bad breath, such as onions, garlic, and petai (stink beans).

Smoking worsens bad breath by drying out the mouth. Therefore, quitting or reducing smoking during Ramadan is highly beneficial.

4. Seek Medical Help If Bad Breath Persists

If bad breath continues despite good oral hygiene and a healthy diet, Dr. Risya advises seeking medical attention. Persistent bad breath could indicate underlying health issues, such as GERD (gastroesophageal reflux disease).

“If the problem persists, consult an internal medicine specialist to check for possible digestive disorders,” she explained.

Final Thoughts

By following these practical tips, you can minimize bad breath during fasting and enjoy a more comfortable Ramadan. Maintaining oral hygiene not only enhances confidence but also contributes to overall well-being. Hopefully, these expert tips will help make your fasting experience fresher and more enjoyable!

Humas UNS

The post Fresh Breath During Ramadan: UNS Expert Shares Tips to Prevent Bad Breath While Fasting appeared first on Universitas Sebelas Maret.

This invitation was delivered in the Talkshow held by RS UNS to commemorate the world TBC Day under the topic of ‘Investment to Eliminate TBC, Save the Nation,’ on Tuesday (22/3/2022) through UNS Hospital’s official Instagram @rumahsakituns and YouTube live streaming.

Prof. Reviono stated that the world target in 2030 is to reduce the TBC cases by 80% to 20% of the current cases and to reduce 90% of the mortality rate to 10%. “To achieve this elimination target is not an easy task because many problems still require support from all community members. Such as reducing the risk factors that cause failure in TBC treatment. Because it needs funding, energy, and efforts, therefore, the investment is to strengthen the factors that could prevent the failure of TBC treatment,” he stated.

TBC is an illness caused by mycobacterium tuberculosis that often affects lung tissue, although it is not limited to the lung tissues. The illness could affect the brain membrane or brain itself, and even the intestines. TBC infection remains dangerous no matter what organ it affects, and it is one of the old illnesses that is hard to eliminate. Many patients often received late diagnoses and had infected others because of it. “Chronic illness has slow symptoms; thus, people infected with TBC often adapt to their symptoms,” Prof. Reviono stated.

TBC is an endemic illness and is widespread evenly in all provinces in Indonesia. The risk factors that affect one’s immunity to this illness are diabetes, renal failure, malnutrition, and densely populated area with a lack of ventilation and sunlight. During the Covid-19 pandemic, TBC cases tended to decrease worldwide, and Indonesia contributed to the significant decline in this number. The stay-at-home policy is suspected to be the cause of this decrease. However, Prof. Reviono stated that the cases do not decline per se, but instead, the infection is not detected until later on.

The Difference between TBC and Other Lung Infections

TBC was considered suspect, with two weeks (minimum) as its special symptom. Chronic TBC is marked with systemic symptoms such as fever, low appetite, and declined weight. TBC is different from other lung illnesses such as asthma and pneumonia in terms of its causes, time, and onset, with pneumonia tends to be rapid and acute. TBC is treated using TBC medicines, while pneumonia is treated according to its cause. TBC treatment is also harder because of its rapid multiplication and thick cell membrane.

TBC Prevention and Treatment

The existing research showed that six months of treatment is the standard for TBC. After such treatment, the level of bacteria usually decreases and does not affect one’s health. However, lung tissues damages could vary from mild, medium, and severe. “So, if the damage was mild, usually the recovery or lung tissue revolution could return to its initial state. But if (the damage) was medium or severe, there is a cavity (hole in the lung) that could cause residual symptoms, such as coughs. If it is (residual symptom) only cough without other systemic symptoms, without fever, or decreased appetite, I think it could be treated using common cough medicine; it is just symptomatic. But if there is a continuation of these symptoms, you have to be careful. Doctors will investigate if there is recurrence or there may be comorbid or accompanying disease, then that will be considered,” Prof. Reviono stated.

TBC has four populations, extra-cellular, which could be eliminated easily using antibiotic drugs; intracellular, acidic condition, and dormant, which is impossible to eliminate but manageable so that the bacteria do not cause clinical symptoms. Therefore, people with a good immune system do not need treatment unless they start to show symptoms. “This could lead to latent TB. Once they show immune responses, we usually took two methods, Mantoux and interferon-gamma tests. Treatment is provided once the immune responses are higher than the normal score. But it is preventive in the form of TB preventive therapy,” Prof. Reviono stated.

People recovering from TB could get reinfected if they have close contact with infected people. The current TBC diagnostic is conducted using Molecular Rapid Test (TCM) as the most sensitive test. Although this test is not available in community health centers, samples could be sent to health facilities that run such tests. As a preventive measure, there is also the Bacillus Calmette–Guérin (BCG) vaccine for TBC that, even though it is not yet effective, could prevent severe TBC infection.

TBC in Children

Children generally show different conditions from adults infected with TBC. TBC infection in children is primarily complex or closed TB without the involvement of the respiratory tract. Children also can’t infect others with their symptoms, and the main concern once a child is infected is to find out where the infection came from. “In children, the first infection could not infect other children. In conclusion, children can be infected but cannot infect others,” Prof. Reviono concluded.

TBC symptoms in children are different from adults. In adults, the symptoms are dominated by a cough with phlegm that is not found in children, who usually have a cough with a chronic fever that occurs each day, although it is not high. Children also show decreased appetite or low weights compared to their fellows (below normal) and usually are not diagnosed using TCM. Humas UNS

Reporter: Erliska Yuniar Purbayani
Editor: Dwi Hastuti

The post Commemorating World TBC Day, UNS Hospital Physician Invited the Community to Prevent TBC Cases in Indonesia appeared first on Universitas Sebelas Maret.

The launching ceremony was held in UNS Hospital Auditorium and was attended by the President Director of BPJS Kesehatan, Prof. Ali Ghufron Mukti, Rector of UNS, Prof. Jamal Wiwoho, UNS Hospital Director, Prof. Hartono, and Information Technology Director BPJS Kesehatan, Ir. Edwin Aristiawan.

The online queue system is an innovation and collaboration between BPJS Kesehatan and UNS Hospital to cut the waiting time for patients and provide the best services for JKN-KIS members. UNS Hospital was included as a hospital that could apply the Development of Internal Referral Features on V-Claim Application Version 1.17 since 2020. The hospital also passed the bridging queue process with Mobile JKN, and it is considered feasible to apply Online Queue Version 1. On 12 March 2021, Prof. Ali Ghufrom Mukti visited the hospital and trusted UNS Hospital to be the Pilot Project for Online Queue Program Version 1 and V-Claim Version 2.0. JKN-KIS members can access the online queue system through the Mobile JKN app.

With this app, patient registers themselves through the app and will not need to wait for the queue to access healthcare services. Prof. Ali Ghufron Mukti hoped that the launching of this program could improve UNS Hospital services. He added that the new system could prevent the spread of the Covid-19 Omicron variant because it reduces the queue in JKN-KIS services, especially considering the increasing number of patients in the hospital. “Thus, the online queue could improve services,” he stated.

The Rector of UNS, Prof. Jamal Wiwoho, was grateful because the new system could reduce patients’ fatigue from queuing for the JKN-KIS program. According to the Rector, the new queue system could reduce patients’ queues and provide better services, especially for patients with old age. “Therefore, UNS, especially its hospital is proud to be selected to test this online queue system because there was an impression that BPJS services queue could take a day and the queue was very long,” Prof. Jamal stated.

UNS Hospital Director, Prof. Hartono, stated that the trial for the online queue system ran smoothly, but many people have not understood the use of Mobile JKN. He noted that UNS Hospital received between 400 to 600 patients in a day, and between 10-20% have used the JKN-KIS online queue. “In the past, the queue could be over six hours. Now it is improved, three hours and we targeted to reduce the queue into under one hour. We also hoped that patients could register for the queue from home in the future,” Prof. Hartono stated.

Accessing Online Queue

The online queue system eases the JKN-KIS members to register online from home. Patients could select the polyclinic and physician they wanted and monitor the queue through the system. Following are the method to access the online queue in UNS Hospital:

1. Download Mobile JKN from playstore or appstore, open the app

2. Click registration for service

3. Ensure the referral from the first level health facility is valid

4. Click the advanced referral health facilities

5. Select participant and referral number

6. Select visit plan and preferred physician

7. Click register, and the app will show the queue

8. Check-in or confirm your visit when you are around a 1 km radius of the hospital through mobile JKN

9. Report to the employee to print SEP

10. Patient could receive care directly from the policlinic

11. After the check-up, the patient could receive automatic registration for follow-up check-up in the target clinic and schedule through a check-up letter with QR Code

12. If patients have prescribed medicines, they could buy them in an outpatient pharmacy

13. In the following check-up, the patient only needs to scan their QR Code on APM to perform check-in and generate SEP, and they could go to the polyclinic directly. Humas UNS

Reporter: Y.C.A. Sanjaya

Editor: Dwi Hastuti

The post UNS Hospital-BPJS Kesehatan Launched JKN Mobile-Connected Online Queue System appeared first on Universitas Sebelas Maret.

This award was granted because UNS Hospital was committed to applying digital transformation in providing health care to ensure excellent, timely, and reliable services for the community. This effort is in line with the BPJS Kesehatan program that aims to create innovation to provide ease of access for the members of the National Health Insurance Program – Kartu Indonesia Sehat (JKN-KIS).

Under Prof. Ali Ghufron Mukti’s leadership as the President Director, BPJS Kesehatan created an online queue system at the First Level Healthcare Facility (FKTP) and Advanced Referral Health Facilities (FKRTL). UNS Hospital is also a teaching hospital as a pilot project for the online JKN-KIS queue system that aims to reduce waiting time for JKN-KIS members and improve healthcare service for the patient.

The award for UNS Hospital was granted directly by Prof. Ali Ghufron Mukti and the Director of Information Technology BPJS Kesehatan, Ir. Edwin Aristiawan to the Rector of UNS, Prof. Jamal Wiwoho, and the Director of UNS Hospital, Prof. Hartono. Prof. Jamal stated that he was grateful for the award and mentioned that the online queue system had been tested and implemented in UNS Hospital. The system is expected to ease the JKN-KIS members because before implementing the system, they needed long queue time that created a bottleneck in the hospital.

“Therefore, UNS Hospital was proud to be selected to test this online queue system,” Prof. Jamal stated.

A similar statement was provided by the Director of UNS Hospital, Prof. Hartono, who stated that this implementation is UNS Hospital’s contribution in providing benefits and best services for the community. Prof. Hartono added that the online queue system helped UNS Hospital that see an increase in the number of patients in the last few years.

“Because to this day, the patient queue becomes an issue that is hard to solve from year to year. Even amid the pandemic, the patient number increased, especially for hospitalization. The community also needs time to access BPJS services,” he shared. Humas UNS

Reporter: Y.C.A. Sanjaya

Editor: Dwi Hastuti

The post UNS Hospital Received Award from BPJS Kesehatan appeared first on Universitas Sebelas Maret.

dr. Tonang explained that the government had accelerated the vaccination program for Indonesians; however, vaccinated people still have the probability of getting infected by Covid-19. The proportion of this possibility is 3% at the national level and 10% for Jakarta, according to the simple simulation that dr. Tonang performed.

“Thus, to answer the question regarding people receiving boosters but infected with Covid-19, it was because when the vaccine was administered on our arm, it will form antibody in lungs. However, antibody formation in the respiratory tract is relatively low. Therefore, there is a risk of Covid-19 infection. Thus, what needs to be done is maintain health to prevent viral infection. If Covid-19 re-infection occurs, the symptoms will be mild because of the strong antibody formed in lungs,” dr. Tonang explained in an interview on Metro TV on Sunday (6/2/2022),

“Once again need to be emphasized that vaccine is to prevent symptoms not infection,” dr. Tonang added.

Responding to the hospitals that see increases in Covid-19 infection, dr. Tonang suggested home quarantine for people with mild symptoms and those under close supervision by the local government. dr. Tonang explained that people who experience Covid-19 symptoms need to get checked, and the healthcare professionals will determine the appropriate isolation method. “Or you could measure the breath rate, if it is below 20 per minute, then it is considered normal, but when it gets closer to 25-30 per minute, then (people) need to be alert,” he added.

dr. Tonang also explained that people’s worries of catching the infection from people going through self-quarantine have decreased, and community members should not worry about their catching infection from their neighbors who are self-quarantining. Ironically, many people still ignore the importance of health protocol under an argument of developing herd immunity; however, according to dr. Tonang, herd immunity is an animal husbandry term that cannot be implemented for humans. “Simply said, by not obeying the health protocols, it does not mean that herd immunity will be formed automatically. We need to be careful because even mild symptoms have a possibility of deterioration,” dr. Tonang explained.

dr. Tonang also added that the UK eases the health protocols in the country based on a clear calculation over the impact and solutions for the future probability. However, considering that only 48% of Indonesians had received the full shots, health protocols are still needed in daily life. He also reminded that community members should not ease their health protocols.

“With accelerated vaccination, strict health protocols, it is possible that Covid-19 infection in Indonesia will decrease and pandemic will soon be over,” he concluded. Humas UNS

Reporter: Lina Khoirun Nisa
Editor: Dwi Hastuti

The post Why We Need Booster if Infection Risk still there? Explanation from UNS Hospital Physician appeared first on Universitas Sebelas Maret.

This concern raises skepticism and speculation over the effectiveness of the vaccination and when the pandemic will end. According to the Clinical Pathology Specialist Universitas Sebelas Maret (UNS) Surakarta Hospital, dr. Tonang Dwi Ardyanto, Sp.PK(K), Ph.D., FISQua, vaccines are still beneficial in preventing Covid-19 infection. Although the possibility of infection in people with full vaccination is never zero, vaccination is proved to reduce the severity and death rate.

“In the clinical test, the target was to prevent symptoms. It was not tested whether it could prevent infection. After one year or more, there will be data to be analyzed,” dr. Tonang wrote on Sunday (6/2/2022).

dr. Tonang, who often shared information around Covid-19 through social media, created a simple simulation on the percentage of infection on vaccinated and unvaccinated people. The uns.ac.id received a permit to upload this simulation that dr. Tonang separated into three parts.

Covid-19 Vaccination in Indonesia

The Indonesian government keeps boosting the vaccination process using the existing vaccines amid the spread of the Omicron variant. President Joko Widodo also issued the booster vaccination policy on 12 January 2022 for 18 years old and older who have received full vaccination at least in the last six months.

The data from 1 January to 4 February 2022 recorded cumulative new cases of 183,974. dr. Tonang simulated that the real number of new cases is around ten times the recorded cases, therefore reaching a total cumulative case of 1,839,740. The number of people receiving full vaccination (48% or 130,462,639 people) and those who received the first shot (68% or 186,205,028 people) was included in the simulation. Breakthrough Infection or B-Infection rate is used to reflect the infection that occurred in vaccinated people.

“The first simulation is all new cases are in vaccinated people with at least first shot; then the B-infection rate is 0.99 percent,” dr. Tonang explained.

In the second simulation, if the new cases are proportional, 68%, or 13 out of 18 infections occurred in vaccinated people and 32%, or 5 out of 18 cases occurred in unvaccinated people. The B-Infection rate for the second simulation is 0.68%. “The third simulation, if the cases are equally distributed, each nine of 18 cases in vaccinated and unvaccinated people, then the B-Infection rate is 0.49%,” he explained. In contrast, the report from other countries identified more cases in unvaccinated groups. “If that also occurs in Indonesia, then the B-Infection rate will be even lower,” he added.

Through the three simulations, in the most pessimistic condition, around 99% of vaccinated people could avoid Covid-19 infection. Therefore, reducing all negative impacts of Covid-19 infection and the spread of the new Coronavirus disease. “Thus, it meets the objective of vaccination, to protect oneself and others,” dr. Tonang stated.

From the first simulation, dr. Tonang stated that the B-Infection rate is normal and appropriate to be concluded that vaccination has a good ability in preventing Covid-19 infection. Even if the real cases are 30 times larger than the recorded cases, the B-infection rate will still stand around 2.96%. It is true that there is a concern over the representativeness of the national reports because there is a gap in testing capacity all over Indonesia regions. For example, a simulation on data from Jakarta will generate a B-Infection rate of 10.01% in the first simulation alone.

“If 90% or higher is considered insignificant, that would be incorrect. There are many factors that complement one another, especially implementing health protocols and vaccinations. But there are times when we did the protocols less strict. That is when vaccination takes a role in the long-term,” dr. Tonang explained.

dr. Tonang stated that we need to be grateful if the vaccinated people are prevented from new infections. For the small number of people who got infected after vaccination, he reminded them to continue to be aware even after receiving vaccines.

“The requirement stays the same, strict protocols, accelerate vaccination until we are sure that we could control the pandemic,” he concluded. Humas UNS

Reporter: Y.C.A. Sanjaya
Editor: Dwi Hastuti

The post Simple Simulation from UNS Hospital Physician on Vaccine’s Ability in Preventing Covid-19 Infection appeared first on Universitas Sebelas Maret.

Moreover, the central government also requests the Regional Government to increase tracing and facilitate the doctors and medical staff when conducting contact tracing on Covid-19 patients. Furthermore, the President of the Republic of Indonesia, Joko Widodo (Jokowi), specifically stressed that PCR test must be increased and adopting the special requirement for the community to have a Covid-19 vaccine certificate before entering shopping center or antigen swab test for those who wish to use long-range mass transportation. 

Responding to the policy, the UNS Hospital Covid-19 Task Force spokesperson, Universitas Sebelas Maret (UNS) Surakarta, dr. Tonang Dwi Ardyanto, Ph.D., reminded us to implement health protocol, which is more crucial than swab testing and Covid-19 vaccination. Specifically, he highlights certain people’s attitudes, who feel safe and ‘free’ after taking antigen swab test. While the result of the test is not the only determining factor or assurance. “Actually, how important is taking an antigen swab test before going on a train (for traveling)? If it was me, I always prefer to implement health protocol compared to just taking an antigen swab test. Because a one-time antigen swab test is not a guarantee,” said dr. Tonang.

In the Virtual Talkshow “Freedom in Transportation” hosted by Solopos, on Wednesday (18/8/2021) evening available through Solopos official Youtube, dr. Tonang, as a clinical pathology specialist in UNS Hospital, states that the policy implemented by the government to reduce Covid-19 spread must be clear and assertive. Additionally, the vaccination rate in Indonesia remains insufficient to guarantee the nation to be free from the health crisis. In front of the Indonesia Minister of Transportation (Menhub) Budi Karya and the President Director of PT KAI Didiek Hartantyo, dr. Tonang explains the effect of vaccination, which is only effective after the recipients get the complete dosage and after passing fortnight since the second dosage. 

“We need to assert that the first dosage of the Covid-19 vaccine does not have the expected result, thus the current regulation must clear up this matter. Do not take the risk; the provision must require that vaccination must be completed and passed fourteen days after the second shot,” dr. Tonang explains. Hence, if the public wishes to do long-range travel using mass transportation, he considers that the most important thing is to implement health protocol supported with passenger screening consistently.

dr. Tonang also requests PT KAI as a train transportation operator to ensure that the passengers entering the wagon are not having colds or high fever. Regarding herd immunity, dr. Tonang explains such a situation can only be realized when the vaccine is given to a community in a certain region without mobility. However, considering the Indonesian situation, he considers that herd immunity is still not possible, as the government still allows cross-regional travel.

“Even if we want to consider herd immunity, this is actually too idealistic. We are still far away from it (herd immunity). The President of Indonesia frequently states that the focus is in the health sector, thus, the economy sector will follow suit (improving),” he concluded. Humas UNS

Reporter: Yefta Christopherus AS
Editor: Dwi Hastuti

The post RS UNS Covid-19 Task Force Spokesperson: We Should not Just Rely on Antigen Swab Tests appeared first on Universitas Sebelas Maret.