Purpose: Obstetric anal sphincter injury is one of the most common complications during delivery. Simulation models with manikins can be used as an effective medical learning method to improve students’ abilities before encountering patients. The present study aimed to describe the development of an anal sphincter injury model and to assess residents’ satisfaction and self-confidence after a perineal repair workshop with an anal sphincter injury simulator in Indonesia.Methods: This was a cross-sectional study with evaluation of outcomes before and after the workshop. We created a silicone-latex simulation anal sphincter injury model. Then, we validated this simulation and used it as a simulation model for the workshop. We asked residents about their satisfaction with repairing anal sphincter injuries using a simulation model and residents’ self-confidence when practicing anal sphincter injury repair.Results: All residents felt the simulation-based workshop was valuable (100%). Most of the scores for the similarity of the simulation model were good (about 8 out of maximum 10). The self-assessment of confidence was measured before and after the workshop. Overall self-confidence increased significantly after the workshop in identifying the external sphincter ani (EAS) (P=0.031), suturing the anal mucosa (P=0.001), suturing the internal sphincter ani (P=0.001), suturing the EAS (P<0.001), and evaluating the sphincter ani tone (P=0.016).Conclusion: The anal sphincter injury simulator improved residents’ self-confidence in identifying the EAS, suturing the anal mucosa, suturing the internal sphincter ani, suturing the EAS, and evaluating sphincter ani tone.

Background: Cinnamon is a herbal medicine that is supposed to improve the metabolic disorder polycystic ovary syndrome (PCOS), but there is still no data about the effectiveness and efficacy of this herbal medicine for the metabolic parameters of PCOS. This study aims to systematically evaluate the effects of cinnamon extract on improving insulin resistance, lipid profile and regularity of menstruation in PCOS women. Methods: This is a systematic review and meta-analysis of randomized controlled trials (RCTs) studies. We searched the MEDLINE, Cochrane, Google Scholar, and PubMed databases to identify relevant studies using cinnamon extract effects on insulin resistance, metabolic factors, and menstrual cyclicity of PCOS women. Results: Five RCTs consisting of 206 women were included in the meta-analysis. Significant differences were found in fasting blood glucose (FBG) (mean difference (MD)= -4.8 mg/dL, 95% CI: -8.04 to -1.57, p=0.004; 143 participants), High-Density Lipoprotein (HDL-cholesterol, HDL-C) (MD= -27.24 mg/dL, 95% CI: -32.62 to -21.85, p< 0.00001; 143 participants, Insulin level (MD = -2.20 mIU/dL, 95% CI: -4.17 to -0.23, p=0.03; 143 participants), and menstrual cyclicity in six months (MD= 2.28, 95% CI: 1.83 to 2.73, p< 0.00001; 33 participants) were obtained. Conclusion: Cinnamon can be a potential supplementary therapy agent for PCOS women as it improves fasting blood glucose, insulin level, HDL–cholesterol and menstrual cyclicity in PCOS women.

Cesarean delivery is associated with complications in pregnant women, including pelvic floor disorders. Kegel exercises can help maintain pelvic floor health and support normal delivery. This community service activity aimed to provide education on pelvic floor health and Kegel exercises to empower pregnant women at Pucang Sewu Public Health Center, Surabaya, in 2024. The program was conducted in three stages: preparation, implementation, and evaluation. Preparation involved coordination, planning, and developing a physical activity book for pregnant women. The implementation phase included education sessions and Kegel exercise training using a two-way communication method. Evaluation was conducted through pretest–posttest and observation of participants’ practice skills. The activity was attended by 27 pregnant women and 10 healthcare workers. The results showed increased knowledge and skills among participants after the training, indicated by higher posttest scores and active participation during practice. More than half of the participants had never exercised regularly before. This program effectively improved participants’ understanding and ability to perform Kegel exercises. The health center is expected to continue providing education to encourage pregnant women to practice Kegel exercises independently at home.

HIGHLIGHTS ABSTRACT Objective: This study aimed to evaluate the effectiveness of the "TAMENG" flipchart as an educational tool to improve knowledge about anemia prevention among pregnant women in Sumber, Kabupaten Probolinggo, Indonesia, and to explore associated risk factors for anemia, including nutritional status and supplementation practices. Materials and Methods: A community-based cross-sectional study was conducted in August 2024 as part of Universitas Airlangga’s Community Service Program. Pregnant women attending antenatal care in Sumber, Kabupaten Probolinggo were recruited based on ANC attendance and availability of hemoglobin test results. The "TAMENG" flipchart, designed with culturally relevant visuals and content on anemia prevention, was implemented during interactive education sessions. Demographic data, obstetric histories, and pre- and post-test knowledge assessments were collected. Statistical analysis was performed using chi-square tests to identify significant associations between variables. Results: Among 65 participants, 35.38% were anemic. Significant factors associated with anemia included nutritional status (60.9% of anemic women had mid-upper arm circumference <23.5 cm; p = 0.019) and history of anemia (30.4% vs. 9.5%; p = 0.032). Knowledge scores significantly improved post-intervention for 90.5% of non-anemic women and 100% of anemic women. Employment status and supplementation practices showed notable trends but were not statistically significant. Conclusion: The "TAMENG" flipchart effectively increased knowledge and awareness about anemia prevention. Tailored interventions addressing nutritional deficiencies, supplementation adherence, and family involvement can enhance maternal health outcomes in rural communities.