
Relationship of gallbladder histopathology towards types of stones in cholelithiasis patients at Universitas Sumatera Utara Hospital, Medan, Indonesia
Adi Muradi Muhar, Denny Rifsal Siregar, Doddy Prabisma Online First: January 25, 2021Relationship of gallbladder histopathology towards types of stones in cholelithiasis patients at Universitas Sumatera Utara Hospital, Medan, Indonesia
Adi Muradi Muhar, Denny Rifsal Siregar, Doddy PrabismaBackground: Cholelithiasis is a common disease of the gall bladder. It is estimated that around 10-15% of the population in western countries suffer from cholelithiasis. Types of gall bladder stones can be classified into cholesterol stones (containing cholesterol> 50%), mixed stones (containing 20-50% cholesterol), and pigment stones (containing cholesterol <20%). Cholelithiasis causes various histopathological changes in the gallbladder mucosa such as acute and chronic inflammation, Cholelithiasis, hyperplasia and carcinoma. The general objective of this study was to determine the histopathological relationship of the gallbladder to the type of stone in cholelithiasis patients at USU Hospital.
Method: The design in this study was cross-sectional. The sample of this study was 49 samples of patients with cholelithiasis who underwent cholecystectomy either by open cholecystectomy or per-laparoscopic cholecystectomy at Universitas Sumatera Utara (USU) Hospital. Gallstones and gall bladder will be examined in the laboratory. Data analysis will use the chi-square test.
Result: From 49 research samples found the most types of stones were mixed stones with 24 (49%) and histopathological results showed 18 examples (36.7%) were chronic inflammation. Based on the Chi-Square test found a significant relationship between the types of stones with histopathology of the gallbladder with a p-value of 0.001.
Conclusion: There is a significant relationship between the type of stone with histopathology in patients with cholelithiasis.
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Study of neutrophil-lymphocyte ratio (NLR) in recent onset type 2 diabetes mellitus
Sharmila Dudani, Sanjiti Poodury, Sridhar Mangalesh Online First: February 13, 2021Study of neutrophil-lymphocyte ratio (NLR) in recent onset type 2 diabetes mellitus
Sharmila Dudani, Sanjiti Poodury, Sridhar MangaleshIntroduction: The prevalence of type 2 diabetes mellitus (T2DM) is increasing steadily, assuming an epidemic proportion throughout the world. Most of this increased burden will come from developing countries. Studies show an increasing role of inflammation in the pathophysiology of diabetes. Estimation of neutrophil-lymphocyte ratio (NLR) could be a simple, inexpensive marker to stratify at-risk diabetes patients. This study aimed to estimate the NLR and CRP levels as a measure of systemic inflammation in diabetics compared to healthy controls. We also investigated if NLR was lower in diabetics with good glycemic control.
Methods: A cross-sectional comparative study, conducted in a tertiary hospital on 60 patients with T2DM and 69 healthy controls after voluntary informed consent. Anthropometric parameters, fasting plasma glucose, Lipid profile, CBC, CRP, and HbA1c were measured for all participants.
Results: The diabetic group showed significantly higher waist circumference(p=0.007) mean TG (p=0.003), VLDL-c (p=0.001), LDL-c (p=0.010), TG/HDL-c (p=0.001), HbA1c (p=0.00001), MPV (p=0.002), NLR (p=0.006), and CRP (p=0.004) values and lower HDL-c values (p=0.039) as compared to the control group. No significant difference was seen in BMI, Waist -Hip ratio, total cholesterol, and total cholesterol/HDL-c values between the two groups. Among the diabetics, only HDL-c (p=0.018) and TG/HDL-c ratio (p=0.049) differed significantly with glycemic control.
Conclusion: Diabetics had higher inflammatory markers (NLR, CRP) as compared to controls. Dyslipidemia (high TG, low HDL-c with high TG/HDL-c) and a higher waist circumference were seen in diabetics. Diabetics with fair control of glycemia (HbA1c < 7%) did not demonstrate lower NLR levels indicating that meticulous glycemic control may not ameliorate the chronic inflammation seen in diabetics until dyslipidemia is corrected.
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Mean pulmonary artery diameter in chest CT scan in the Thai population
Sitang Nirattisaikul, Nuttapat Sunpech, Keerati Hongsakul Online First: February 20, 2021Mean pulmonary artery diameter in chest CT scan in the Thai population
Sitang Nirattisaikul, Nuttapat Sunpech, Keerati HongsakulIntroduction: Pulmonary hypertension has been associated with a significant increase in morbidity and mortality. The pulmonary artery diameter measurement from a CT scan is routinely used to predict possible evidence of pulmonary hypertension. However, no data available as a reference for the normal range, especially in the Thai Population. The primary purpose of this study was to determine the normal diameter of the main pulmonary artery (MPA) and ascending aorta (AAo) and the ratio between MPA and AAo diameter in the Thai population.
Methods: Patients who met the inclusion criteria and had a chest CT performed in Songklanagarind hospital between 1 January 2014 and 14 July 2014 were enrolled. Measurement of the MPA diameter at the level of its bifurcation and the AAo from an axial-view contrast-enhanced CT chest (venous phase) image was done. The ratio between the diameter of MPA and AAo was then calculated.
Results: 2395 patients were included in this study (male = 1271 patients, female = 1124 patients, aged between 20-96 years; mean = 57 years old). The mean diameter of the MPA was 25.21 mm, and the mean diameter of the AAo was 30.78 mm. The mean MPA/ AAo ratio was 0.83. The sex-specific mean diameters of the MPA were 25.4 mm in men and 25.0 mm in women. The mean diameters of the AAo in men and women were 31 mm and 30 mm, respectively.
Conclusion: The mean MPA diameter obtained from chest CT scans in this study was about 25.4 mm in men and 25.0 mm in women. These values are easily obtained from chest CT scans and are highly reproducible. Therefore, it may be used as a reference value for a healthy Thai population.
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Vitamin D Receptor (VDR) Apa1 gene polymorphism increasing the risk of breast cancer women in Bali, Indonesia
I Putu Gede Fajar Mahayasa, I Ketut Widiana, Putu Anda Tusta Adiputra, I Wayan Sudarsa Online First: February 19, 2021Vitamin D Receptor (VDR) Apa1 gene polymorphism increasing the risk of breast cancer women in Bali, Indonesia
I Putu Gede Fajar Mahayasa, I Ketut Widiana, Putu Anda Tusta Adiputra, I Wayan SudarsaBackground: Breast cancer is the most common cancer diagnosed in women. It basically caused by a progressive accumulation of genetic disorders. Vitamin D and its receptor (VDR) have been shown to have an effect on the carcinogenesis of breast cancer. Several studies have shown VDR Apa1 polymorphisms became the most prevalent polymorphism of other polymorphism variants of breast cancer. There are still lack of studies that review the relationship of VDR gene polymorphisms, especially Apa1 on breast cancer risk among Balinese woman.
Method: This study was a case-control design- analytic study to see the relationship between Vitamin D receptor Apa1 gene polymorphism and breast cancer risk in Balinese women. There were 42 venous blood samples from breast cancer women and healthy women in Bali. This study was carried out at the Faculty of Medicine Integrated Biomedical Laboratory. DNA isolation was done for sequencing to determine the sequence of gene bases. Then the data were analyzed using SPSS 16.
Results: Univariate analysis showed the characteristics of the subject and research variables. Bivariate analysis showed that the presence of VDR Apa1 polymorphism in Balinese women increased the risk of breast cancer by 5,846-fold higher compared to women without polymorphism (CI95%:1.065- 32.082; P = 0.03). Multivariate analysis confirmed that the VDR Apa1 polymorphism independently influence and increase the risk of breast cancer without being influenced by other variables (95% CI: 1.065-32.082; P = 0.042).
Conclusion: In this study has shown VDR Apa1 polymorphism significantly associated and increased the risk of breast cancer in women in Bali.
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Functional assessment of operative and non-operative management in major pelvic fracture at Dr. Moewardi Hospital, Surakarta, Indonesia
Udi Heru Nefihancoro, Muhamad Muamar, Muhammad David Perdana Putra Online First: February 21, 2021Functional assessment of operative and non-operative management in major pelvic fracture at Dr. Moewardi Hospital, Surakarta, Indonesia
Udi Heru Nefihancoro, Muhamad Muamar, Muhammad David Perdana PutraIntroduction: Pelvic fractures are responsible for skeletal injuries and soft tissue-related injuries. Pelvic fracture is a disorder of the pelvis bones' structure, including the hip bone, sacrum, and coccyx. The condition will result in stable status if the pelvis can resist weight-bearing loads without the incidence of any displacement. This study aims to determine pelvic fracture outcome, in which operative and non-operative management used the Majeed score to evaluate the functional results.
Method: A retrospective case-control study was performed to retrieve data from medical records of patients with pelvic fractures at Dr. Moewardi Hospital Surakarta for the period from January 1st, 2017, until December 31st, 2019. The evaluation of reduction quality was conducted following the scores put forward by Majeed to evaluate the clinical outcomes. Data analyzing used SPSS V.24.0 (IBM Corp). P-value of <0.05 was determined as the statistical significance.
Results: In this study, there were 40 samples of pelvic fracture cases; 60% were male, 55% were aged 19 – 40 y.o, motor crash caused 67%, 37.5% were cases of pubic rami fractures. Besides, operative management was 52,5%, while non-operative was 47,5%. Further, operative management's functional outcome was excellent at 66%, good at 19%, fair at 9%, and poor at 8% of the patients. Patients treated with operative management had significantly fewer severe injuries, as rated using the Majeed score than the non-operative group.
Conclusion: The results suggest that operative treatment may be a viable option in treating major pelvic fracture as it provides better functional results than non-operative treatment.
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Liver resection profile in Prof. dr. R.D. Kandou General Hospital: 1-year experience
Michael Tendean, Toar Deliezer Bram Mambu, Ferdinand Tjandra, Jimmy Panelewen, Michael Iskandar, Celine Martino Online First: February 21, 2021Liver resection profile in Prof. dr. R.D. Kandou General Hospital: 1-year experience
Michael Tendean, Toar Deliezer Bram Mambu, Ferdinand Tjandra, Jimmy Panelewen, Michael Iskandar, Celine MartinoBackground: The role of liver surgery is increasing for primary and secondary liver tumors. One of the most feared complications of liver surgery is Post-Hepatectomy Liver Failure (PHLF). The authors would like to present their experience in a year for liver surgery with morbidity and mortality, including PHLF as evaluation parameters.
Methods: This is a prospective study from July 2019-2020 in a single-center, in which patients with pre-existing liver pathology were assigned to receive liver resection. Types and duration of liver resection, duration of Pringle maneuver, and blood loss were measured. PHLF was evaluated using the ISGLS classification, and morbidity was evaluated using Clavien-Dindo and FABIB classification. The energy device used varies from the harmonic scalpel, ligature, and Thulium-doped fiber laser (TDFL). Data were processed descriptively with IBM SPSS 25 (SPSS Inc., Chicago, USA). Data are presented in descriptive frequency tables as medians and means.
Results: A total of 17 procedures were performed, including minor hepatectomies (58.82 %) and major hepatectomies (41.18%). The mean duration of operation 5.3 hours, the duration of parenchymal transection 91.5 minutes, and the estimated blood loss 1638.2 cc. Vascular occlusion method using Pringle maneuver with mean duration of 31.67 minutes. PHLF incidence found were grade B (5.88 %) and grade C (11.7%), while morbidities by Clavien-Dindo mostly are grade 2 (38.2%) and FABIB classification mostly are Bleeding (45%). The mean postoperative ICU is 3.06days, and the mortality rate is as high as 23.52%.
Conclusion: Liver resection in our center is quite fair judging from the low incidence of PHLF, although the mortality rate is at 23.52%. Due to that, surgical technique and teamwork between units involved need to be improved even further.
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Sexual satisfaction of Indonesian women with breast cancer in Central Java, Indonesia
Yan Wisnu Prajoko, Tommy Supit Online First: February 21, 2021Sexual satisfaction of Indonesian women with breast cancer in Central Java, Indonesia
Yan Wisnu Prajoko, Tommy SupitBackground: The negative impact of breast cancer diagnosis on the sexuality of women patients is well-known. Sexual dissatisfaction arises from the disruption of physical appearance by the tumor or as a result of both operative or non-operative treatments. This study aimed to describe the perception of sexuality and its quality of breast cancer in Indonesian women.
Methods: This descriptive study recruited women diagnosed with breast cancer that have undergone chemotherapy, radiotherapy, and surgery, either in singular, combination, or no treatment at all. The sexuality was assessed using the Indonesian version of the Sexual Satisfaction Questionnaire (SEXSAT-Q).
Results: A total of 113 female breast cancer patients ranging from 20 to 71 years old participated in the study. The majority of respondents were clinically diagnosed with stage II (36.2%) or higher (54.9%). Most patients underwent surgery (91.1%) and chemotherapy (85.8%). Before the diagnosis of cancer, the level of sexual satisfaction was good on average, which remained stagnant for 64 (56.6%) participants during cancer treatment. Significant anxiety and distress were reported by 35 patients (31.0%), depression by 21 patients (18.6%), and tiredness by 48 patients (42.5%).
Conclusion: The sexual satisfaction of women with breast cancer patients in our study group is average on general, prior or after cancer diagnosis. However, the treatment's negative psychological impact is quite profound, affecting almost half of the study participants.
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Fractional erbium: YSGG laser compared to the combination of fractional erbium: YSGG laser and topical autologous platelet-rich plasma for treatment of atrophic acne scars: a case report
Prasetyadi Mawardi, Adniana Nareswari Online First: March 10, 2021Fractional erbium: YSGG laser compared to the combination of fractional erbium: YSGG laser and topical autologous platelet-rich plasma for treatment of atrophic acne scars: a case report
Prasetyadi Mawardi, Adniana NareswariBackground: Acne scar is the most common complication in acne that occurs in about 49% of acne individuals. Fractional resurfacing lasers such as CO2 laser and erbium-doped yttrium aluminum garnet (Er: YAG) have been widely used for acne scar treatment and give satisfying results have complications such as pain, hyperpigmentation, infection, prolonged erythema, and scarring. Fractional erbium: yttrium scandium gallium garnet (Er: YSGG) laser solves previous laser techniques' disadvantages. It has an ideal wavelength of 2790 nm, which balances the epidermis layer's vaporization and thermal damage in the dermis's superficial layer. Platelet Rich Plasma (PRP) is an autologous concentration of human platelets in a small plasma volume that secreted various growth factors that can speed up the scar healing process.
Case report: A-24 years old male student came with a chief complaint of acne scars on his face four years before the examination. The patient's condition is classified as moderate-severe acne scarring based on Goodman and Baron's criteria (qualitative global acne scarring system). Acne scars treatment plan was single fractional erbium: YSGG laser for the left side of the face and combined fractional Er: YSGG laser with topical autologous PRP on the right side. This procedure was performed in 2 sessions with an interval of 4 weeks, the final evaluation at 12 weeks after the first procedure. Clinical improvement of acne scars was assessed using qualitative and quantitative scales based on Goodman and Baron's, patient and observer scar assessment scale (POSAS), quartile grading scale, and patient satisfaction level.
Conclusion: In the final evaluation, there was an improvement on the entire grading scale on the right side of the face (Er: YSGG laser + PRP) and the face's left side (Er: YSGG laser only). Post-treatment erythema was found on both sides of the patient's face but disappeared within three days on the face's right side and five days on the face's left side.
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The role of cholelithiasis risk factors in stone types in cholelithiasis patients at Universitas Sumatera Utara Hospital
Denny Rifsal Siregar, Adi Muradi Muhar, Doddy Prabisma Pohan Online First: April 01, 2021The role of cholelithiasis risk factors in stone types in cholelithiasis patients at Universitas Sumatera Utara Hospital
Denny Rifsal Siregar, Adi Muradi Muhar, Doddy Prabisma PohanIntroduction: Cholelithiasis is the most common disease in the biliary tract. Several risk factors have been known as risk factors of cholelithiasis, such as obesity and female gender. Meanwhile, only few studies evaluate correlation between clinical characteristics and stone type in cholelithiasis. The study aims to evaluate correlation between clinical characteristics and stone type in cholelithiasis patients at Universitas Sumatera Utara Hospital.
Method: The study design was cross sectional. The sample of this study was 35 people with cholelithiasis patients who underwent cholecystectomy either by open or laparoscopic cholecystectomy at Universitas Sumatera Utara Hospital. Gallstones will be examined by a laboratory. Risk factors assessed were age, gender, body mass index, hemoglobin bilirubin, cholesterol levels. Data analysis will use the Kruskal Wallis test.
Result: From 35 study samples was found the most types of stones were mixed stones with 17 (48.6%). Based on the Kruskal Wallis test found a significant relationship between the type of stone with gender, body mass index, total bilirubin, total cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C).
Conclusion: Factors related to the type of cholelithiasis stone are gender, body mass index, bilirubin levels, total cholesterol levels, HDL-C, and LDL-C.
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Characteristics of non-genital warts in the dermato-venereology department of Mangusada Badung General Hospital during in 2019
Efbri Chauresia Dalitan, Anak Agung Ari Agung Kayika Silayukti Online First: April 01, 2021Characteristics of non-genital warts in the dermato-venereology department of Mangusada Badung General Hospital during in 2019
Efbri Chauresia Dalitan, Anak Agung Ari Agung Kayika SilayuktiBackground: Non-genital warts are a very common and benign skin disease caused by low-risk Human Papilloma Virus (HPV) infection. Common warts, flat warts, and plantar warts are common clinical manifestations of non-genital warts and are caused by many different types of HPV. Data on the prevalence or incidence of non-genital warts in Bali is still very limited. Therefore, it is important to identify the incidence and prevalence as a reference for conducting further studies on non-genital warts cases. This research studied the incidence, distribution, and characteristics of non-genital warts at Mangusada Badung General Hospital.
Methods: Descriptive cross-sectional retrospective study, using secondary data from outpatient clinic's patient register book and medical records in a period of 1 year, from January 1 - December 31 2019. Variables that included are types of non-genital warts, age and sex. Data were analyzed with SPSS 18 for Windows.
Results: The number of patients in this research was 3086. The incidence of non-genital warts was 88 cases (2.85%). Common wart was the most frequent findings, with 82 cases (93.2%) and flat wart with 6 cases (6.8%). Non-genital warts frequency was highest among age 11-20, with 31 cases (35.2%). Based on sex, non-genital warts are more frequent in males than females (56.8% vs. 43.2%). The most frequent non-genital warts cases in the male population occur at age 11-20 (20 cases), while in female populations, 11-20 and 21-30 share the same incidence of non-genital warts (11 cases).
Conclusion: Non-genital warts most likely to affect a male compare to the female population. It tends to occur more frequently in children and young adults. The common wart is the most frequent findings in non-genital warts.
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Intracranial stenosis in patients with post-ischemic stroke: a case-control study Rizaldy Pinzon1, Andre Dharmawan Wijono1
Rizaldy Pinzon, Andre Dharmawan Wijono Online First: April 01, 2021Intracranial stenosis in patients with post-ischemic stroke: a case-control study Rizaldy Pinzon1, Andre Dharmawan Wijono1
Rizaldy Pinzon, Andre Dharmawan WijonoBackground: Despite its remained position as the main culprit of stroke worldwide, studies on intracranial stenosis in Indonesia are still very limited. It is necessary to research to measure the prevalence and risk factors of intracranial stenosis in post-ischemic stroke.
Method: We conducted case-control research with participants of 234 ischemic stroke patients. Each patient was listed for their risk factors and analyzed for their association with intracranial stenosis. Intracranial circulation was determined by transcranial doppler (TCD) sonography TD-DOP 9000 with a 2-MHz probe. A peak systolic velocity (PSV) of >140cm/s or mean systolic velocity of (MSV) >80cm/s were used as criteria for middle cerebral artery (MCA) stenosis. In contrast, PSV>90 cm/s or MSV>60cm/s were used to determine the posterior circulation stenosis. Statistical analysis used SPSS 18.0 software which The Independent t-test and chi-square test were used to assess significant differences in correlation to intracranial stenosis. P-value <0.05 was statistically significant.
Result: Intracranial stenosis cases were 38%, with the anterior circulation being the most common stenosis location. Hypertension, diabetes mellitus and dyslipidemia were the most often risk factors. Only hypertension with OR=2.97 (95%CI=1.76-4.98) and diabetes mellitus with OR=1.48 (95%CI=1.12-2.43) were positively correlated with increased risk intracranial stenosis.
Conclusion: The occurrence of intracranial stenosis in ischemic stroke patients was high and increased with the presence of hypertension or diabetes mellitus.
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DNA barcoding in molecular identification and phylogenetic relationship of beneficial wild Balinese red algae, Bulung sangu (Gracilaria sp.)
I Gede Putu Wirawan, Maria Malida Vernandes Sasadara, I Nyoman Wijaya, Anak Agung Keswari Krinandika Online First: April 01, 2021DNA barcoding in molecular identification and phylogenetic relationship of beneficial wild Balinese red algae, Bulung sangu (Gracilaria sp.)
I Gede Putu Wirawan, Maria Malida Vernandes Sasadara, I Nyoman Wijaya, Anak Agung Keswari KrinandikaBackground: Bulung sangu (Gracilaria sp). is wildly widespread Rhodophyta in Bali and usually consumed as vegetable. Bulung sangu is reported for its bioactive compound scientifically proven as antioxidant, anti-inflammatory, and anti-hypercholesterolemia. Likewise, Bulung sangu as Rhodophyta is a potential source for food, fertilizer, cosmetic and pharmaceutical industry. Bulung sangu production is highly fluctuating and unable to meet its demands. Proper and correct cultivation methods based on molecular information are expected to increase the availability of Bulung sangu in Bali. Complete taxonomy is required to design the proper cultivation method. Meanwhile, Bulung sangu taxonomy is limited to the genus level. More information on Bulung sangu strain is needed, either does its relatedness.
Methods: Fresh Bulung sangu was collected from Serangan coastal area, Bali. DNA extraction was applied followed by PCR amplification using six combinations of COI primer sequence. DNA sequences obtained was evaluated to determine pairwise distance, percent of similarity and phylogenetic relationship compared to Gracilaria species registered in GenBank.
Results: PCR amplification produced 730 base pairs amplicons. Genetic distance and percentage of similarity obtained exhibit relatedness to Gracilaria gracilis with 0.487 of pairwise distance and 49.04% of similarity. The phylogenetic tree produced seven clades in which Bulung sangu and Gracilaria gracilis were in the same clade.
Conclusion: Bulung sangu showed closest relatedness to Gracilaria gracilis.
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Correlation of CD44 and CD24 expression with the positive response after neoadjuvant chemotherapy in stage IIIB breast cancer patient at Dr. Saiful Anwar Hospital, Malang, Indonesia
Muhammad Bachtiar Budianto, Artono Isharanto, Andry Haris Online First: April 01, 2021Correlation of CD44 and CD24 expression with the positive response after neoadjuvant chemotherapy in stage IIIB breast cancer patient at Dr. Saiful Anwar Hospital, Malang, Indonesia
Muhammad Bachtiar Budianto, Artono Isharanto, Andry HarisBackground: Breast cancer is a type of cancer due to abnormal cell growth of breast tissue. CD44 and CD24 is a potential target in breast cancer therapy. This study aims to evaluate the responsiveness of stage 3 breast cancer to chemotherapy by measuring the expression levels of CD44 and CD24 molecules
Methods: We conducted an observational study with pre-and –post-intervention or test research types. This study was performed on 49 Luminal Stadium IIIB subtype breast cancer patients who received 3 series of neoadjuvant chemotherapy at RSUD dr. Saiful Anwar Malang, immunohistochemical examination, and painting of tissue specimens from the biopsy results. Data were analyzed using SPSS version 20 for Windows.
Results: Based on the Paired t-test and discriminant analysis, there were no significant differences between CD44 and CD24 expression before and after chemotherapy (p=0.501 and p=0.097, respectively). Therefore, the results of the study prompt that the expression of CD44 and CD24 could not be a predictor of the chemotherapy response.
Conclusion: There are different expressions of CD44 and CD44 in primary breast cancer before and after chemotherapy, but no significant difference was found.
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Patients’ characteristics following reoperation after Modified Blalock-Taussig Shunt (MBTS) in Cardiac Centre National General Hospital Cipto Mangunkusumo from 2018-2020
Suprayitno Wardoyo, Joshua Parsaoran Partogi Pardede, Hari Agung Asari Online First: April 01, 2021Patients’ characteristics following reoperation after Modified Blalock-Taussig Shunt (MBTS) in Cardiac Centre National General Hospital Cipto Mangunkusumo from 2018-2020
Suprayitno Wardoyo, Joshua Parsaoran Partogi Pardede, Hari Agung AsariBackground: Modified Blalock-Taussig shunt (MBTS) is a common palliative procedure for congenital heart defect to connect the systemic to the pulmonary circulation via a synthetic shunt from a subclavian artery to a pulmonary artery. However, certain postoperative complications do exist, such as blockage. Early identification of modifiable risk factors is important to prompt early intervention for better outcomes.
Material: This article is a descriptive narrative retrospective study. We gather data from the Cipto Mangunkusumo Hospital Cardiovascular Center medical report of 8 patients having undergone reoperation post-MBTS surgery as their first operation between January 2018 and October 2020. Data were analyzed using SPSS version 20 for Windows.
Results: The patient’s age ranged from 3 months to 30 years old. Seven of them suffered from shunt occlusion complications, while the other suffered from the bleeding problem. The laboratory results showed that preoperative hemoglobin (18.9±4.1 g/dL vs. 16.90 (10.80-19.20) g/dL), hematocrit (58.8±12.40% vs. 42.9±14.30%), platelet counts (284.487±147.003 vs. 210.625±104.688) 103/uL, and oxygen saturation (86.00 (75.00-89.00) vs. 70.00±17.00) levels were higher than the pre-reoperative. The coagulation markers showed that PT value has increasing trend (1.10 (0.90-2.30) vs. 1.30±0.20) while aPTT (5.90 (2.90-6.30) vs. 2.30 (1.60-5.30)) seconds and activated clotting time (ACT) (205.00±86.00 vs. 165.00 (114.00-255.00)) showed the opposite.
Conclusion: MBTS remains the first-choice bridging palliation surgery to increase the pulmonary blood flow in congenital heart defects. The cause of shunt failure remains inconclusive in this study. Other studies suggest that graft material choice, S/PA ratio, S/W ratio, operative approach, thrombus formation, and aPTT value contribute to shunt failure, thus needing a reoperation.
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The effects of cyclophosphamide, adriamycin and 5-fluorouracil chemotherapy on blood cells and cardiac hemodynamics in breast carcinoma patients: a case study at Dr. Kariadi General Hospital, Semarang, Indonesia
Sibin Chandra, Djoko Handojo Online First: April 01, 2021The effects of cyclophosphamide, adriamycin and 5-fluorouracil chemotherapy on blood cells and cardiac hemodynamics in breast carcinoma patients: a case study at Dr. Kariadi General Hospital, Semarang, Indonesia
Sibin Chandra, Djoko HandojoBackground: One of the treatment modalities for breast malignancy is chemotherapy. Chemotherapy could kill cancer cells as well as normal cells, including blood cells and cardiac cells. Early detection of adverse events includes myelosuppression and cardiotoxicity could reduce morbidity and mortality rates. This study aims to determine a decrease in blood cells and cardiac hemodynamics in breast carcinoma patients who underwent Cyclophosphamide, Adriamycin, and 5-Fluorouracil (CAF) chemotherapy.
Methods: Analytical prospective observational study with breast carcinoma. The measurements were Haemoglobin (Hb), Hematocrit (Ht), Erythrocyte (Ery), Leukocyte (Leu), Platelet (Plt), Left Ventricle Ejection Fraction (LVEF), Stroke Volume (SV), and Cardiac Output (CO) until 3rd cycles of chemotherapy. Data were analyzed using SPSS version 17 for Windows.
Results: There were 35 subjects enrolled in this study. Decreases in Hb, Ht, Ery, Leu, and Plt after the 1st, 2nd, and 3rd cycles of chemotherapy were statistically significant (p<0.05). There was a statistically significant decrease in LVEF, SV, and CO after the 1st, 2rd and 3rd cycles of chemotherapy (p<0.05). Besides, the SV and CO after the 2nd and 3rd cycles of chemotherapy were also decreased significantly (p<0.05).
Conclusions: There is a decrease in blood cells (Hb, Ht, Ery, Leu, Plt) and cardiac hemodynamics (LVEF, SV, and CO) in breast carcinoma patients who underwent CAF chemotherapy.
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The correlation TNF-α gene promoter region -238G, -308G, -857, and -1031 polymorphism with psoriasis vulgaris
Cashtri Meher, R. Lia Kusumawati Iswara, Irma D Roesyanto-Mahadi Online First: March 19, 2021The correlation TNF-α gene promoter region -238G, -308G, -857, and -1031 polymorphism with psoriasis vulgaris
Cashtri Meher, R. Lia Kusumawati Iswara, Irma D Roesyanto-MahadiBackground: Psoriasis vulgaris is a recurrent chronic skin disorder signed by hyperproliferation and epidermal inflammation. One of the etiology of psoriasis is genetic factors related to genetic polymorphism as disease susceptibility markers. This study was aimed to analyze the correlation of TNF-α gene promoter region polymorphism with psoriasis vulgaris.
Methods: An analytical observational study with cross-sectional design to identify correlation TNF-region promoter polymorphisms with psoriasis vulgaris. This study included 45 psoriasis vulgaris patients and 45 non-psoriasis vulgaris patients from April to October 2016 at Immuno-dermatology Polyclinic of Dermatology and Venereology/Haji Adam Malik Hospital, Medan. We isolated DNA from the blood sample then ran into the PCR process with specific primers. PCR results were examined by electrophoresis with 2% agarose. Chi-Square test was used to test the hypothesis of a relationship between the TNF-α promoter region and psoriasis vulgaris at a significance of P <0.05.
Result: Analysis by Chi-Square test found a significant correlation of polymorphism in TNF-α gene promoter region with psoriasis vulgaris in -308G (p=0,001) and 1031 (p=0,002) loci.
Conclusion: TNF-α gene promoter region polymorphism TNF-α gene -1031 was more frequent in the case group, -308G was commonly found in the control group. Both of them were significantly correlated with psoriasis vulgaris.
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The role of psychosocial stressors, carbohydrate and protein intake on serum serotonin and cortisol levels in patients with depression: a preliminary evaluation
Alifiati Fitrikasari, Natalia Dewi Wardani, Tanjung Ayu Sumekar, Fanti Saktini, Hang Gunawan Asikin, Mohamad Sulchan Online First: April 01, 2021The role of psychosocial stressors, carbohydrate and protein intake on serum serotonin and cortisol levels in patients with depression: a preliminary evaluation
Alifiati Fitrikasari, Natalia Dewi Wardani, Tanjung Ayu Sumekar, Fanti Saktini, Hang Gunawan Asikin, Mohamad SulchanIntroduction: Depression is a mental disorder associated with biological, environmental and psychological factors. Depression is estimated to be a disease that requires the second largest expense on treatment. Chronic stress will reduce serotonin activity and storage and also stimulate the adrenal cortex to release cortisol and other glucocorticoid hormones. Nutritional intake such as carbohydrates and protein also plays a role in depression with various mechanisms. The study aims to investigate the role of psychosocial stressors, carbohydrate and protein intake on serum cortisol and serotonin levels in patients with depression
Methods: The study used an analytic observational approach with a cross sectional design. Subjects were selected by consecutive sampling and were asked to fill out the general characteristics questionnaire, Beck Depression Inventory (BDI) - II to determine depression levels, Holmes Rahe scale to measure psychosocial stressors, food frequency questionnaires to measure carbohydrate and protein intake. Subjects who met the inclusion criteria were taken blood samples to measure the cortisol and serotonin levels.
Result: Of the 79 subjects, 57 (72%) women and 22 (28%) men with an average age of 43 ± 3 years. A total of 64 (81%) subjects were with mild psychosocial stressors and 5 (6%) were severe. Psychosocial stressor were not significantly correlated with either serotonin (p=0.479), nor cortisol level (p=0.625) Carbohydrate were not significantly correlated with serotonin level (p=0.628) and cortisol level (p=0.252). Protein was not significantly correlated with serotonin level (p=0.688) and cortisol level (p=0.110).
Conclusion: There was no correlation between psychosocial stressors, carbohydrate and protein intake with serum cortisol and serotonin levels in depressed patients.
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Ergonomic workstation reduces electrical activity of upper trapezius muscles, erector spinae muscles, and musculoskeletal complaints in agel fiber twisting process
Chandra Dewi Kurnianingtyas, I Putu Gede Adiatmika, Ketut Tirtayasa, I Wayan Surata Online First: April 01, 2021Ergonomic workstation reduces electrical activity of upper trapezius muscles, erector spinae muscles, and musculoskeletal complaints in agel fiber twisting process
Chandra Dewi Kurnianingtyas, I Putu Gede Adiatmika, Ketut Tirtayasa, I Wayan SurataBackground: Humans' role in small industries as a source of labor is still dominant, mostly manual work. The research was conducted on manual workers in small agel fiber industries in Yogyakarta. Manual work is related to human strength and endurance. Ergonomic problems often arise in manual labor, including neck pain, back pain, and leg pain called musculoskeletal disorders. Non-ergonomic working conditions also increase the electrical activity of muscles. This study aims to reduce electrical muscle activity and musculoskeletal complaints by repairing an ergonomic workstation in the agel fiber twisting process.
Methods: This research is an experimental study with 15 female subjects. The electrical activity of muscles is measured when working under conventional conditions (Period 1) and repairing an ergonomic work station (Period 2). The electrical activity of the muscles was measured using surface electromyography. Musculoskeletal complaints were measured before and after intervention with conventional conditions (Period 1) and ergonomic work station repair (Period 2). Musculoskeletal complaints were measured using the Nordic Body Map Questionnaire. The measurement data between the two periods were analyzed by using the paired samples t-test and the Wilcoxon signed-rank test.
Results: The results showed a decrease in the upper trapezius muscles' electrical activity by 35.46% and the erector spinae muscles' electrical activity by 22.43%. The average of musculoskeletal complaints decreased by 23.77%, measured after working in period 1 and period 2.
Conclusion: Ergonomic work station can reduce the electrical activity of the upper trapezius muscles, electrical activity of the erector spinae muscles, and musculoskeletal complaints in workers twisting the agel fiber rope.
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The ethanol extract of Garcinia mangostana L peel reduces the isoniazid-induced liver damage in rats
Triyanta Yuli Pramana, Brian Wasita, Vitri Widyaningsih, Risya Cilmiaty, Suroto Suroto, Ambar Mudigdo, Bambang Purwanto Online First: April 01, 2021The ethanol extract of Garcinia mangostana L peel reduces the isoniazid-induced liver damage in rats
Triyanta Yuli Pramana, Brian Wasita, Vitri Widyaningsih, Risya Cilmiaty, Suroto Suroto, Ambar Mudigdo, Bambang PurwantoBackground: The long-term use of Isoniazid (INH) as the Tuberculosis (TB) treatment increases the risk of possible liver damage. The peel from Garcinia Mangostana L. has been shown to reduce hepatotoxicity in the rat model. However, the molecular mechanism of this effect is not well-understood
Objective: This study aims to investigate the effect of the ethanol extract of the peel of Garcinia Mangostana L or mangosteen in preventing INH-induced liver damage at the cellular and molecular levels.
Methods: A total of 32 male Wistar rats (Rattus Norvegicus) three to four months old with bodyweight between 170 and 200 grams are randomly enrolled into the negative control (NC), Positive control (PC), Treatment 1, and treatment 2 groups. The rats in the positive control (PC) and the treatment groups (T1, T2) were injected with 80 mg INH per kilogram body weight to induce liver fibrosis at the beginning of the study. The rats in the negative control group (NC) are injected with normal saline. The T1 and T2 groups are given 250 mg and 500 mg per kilogram body weight of mangosteen peel ethanol extract, respectively. After 35-days of treatment, blood samples were drawn from the rats, and the SGPT level was measured. Following the sacrifice, the liver tissues were prepared into slides and immunohistochemically stained and the TGF-β1 expression and fibrosis level were examined.
Results: The expression of TGF-β1 is significantly higher in the PC and T1 groups than in the NC group (p-value <0.05). Compared with the NC groups, the SGPT level is significantly higher in the PC, T1, and T2 groups with a p-value less than 0.05. The fibrosis scoring in the T2 group is statistically lower than the PC group. (p-value <0.05)
Conclusion: The ethanol extract of Garcinia mangostana L peel at a dose of 500 mg/kg of body weight shows a significant difference in the fibrosis score between the treatment group and the positive control group.
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The future of three-dimensional skin graft: a mini-review
Zendio Abednego Santoso Online First: April 01, 2021The future of three-dimensional skin graft: a mini-review
Zendio Abednego SantosoOver the last few years, the development of three-dimensional (3D) skin bioprinting has increased rapidly. The concept of bioprinting involves a computer in designing using conventional 3D printing. 3D bioprinting can produce tissue structures such as skin and have the opportunity to substitute autografts, which are still the gold standard today. Network construction in bioprinting requires stages in the network structure design, selection of cell and biomaterial raw materials, and the molding process. The use of keratinocytes and fibroblasts is used as the main raw material in the manufacture of the dermis and epidermis layers. The biomimetic technique will combine these raw materials with other biomaterials (hydrogel, collagen, fibrin, gelatin, alginate, chitosan, and chitin) and growth factors (hydrocortisone, thrombin, and FGF-2) so that the physiological condition of the skin can be created. Currently, 3D bioprinting research continues to develop in response to the various shortcomings and challenges faced. The purpose of this review is to discuss the current use of 3D bioprinting technology, the principles of this technology and the prospects for 3D skin bioprinting in the future.
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COVID-19 vaccination in patients with cancer: Position paper from the Indonesian Society of Hematology and Medical Oncology (ISHMO) of Semarang
Eko Adhi Pangarsa, Budi Setiawan, Santosa Santosa, Ridho Monotoc Naibaho, Daniel Rizky, Suyono Suyono, Mika Lumban Tobing, Muchlis Achsan Udji Sofro, Catharina Suharti Online First: April 01, 2021COVID-19 vaccination in patients with cancer: Position paper from the Indonesian Society of Hematology and Medical Oncology (ISHMO) of Semarang
Eko Adhi Pangarsa, Budi Setiawan, Santosa Santosa, Ridho Monotoc Naibaho, Daniel Rizky, Suyono Suyono, Mika Lumban Tobing, Muchlis Achsan Udji Sofro, Catharina SuhartiPatients with active cancer (cancer on treatment, those planning to start treatment, and those immediately post-treatment) consider getting the COVID-19 vaccine, like the other vulnerable populations, to reduce the severe risk of SARS-CoV-2 infection. We suggest patients with cancer should be vaccinated with a non-lived COVID-19 vaccine. Specific consideration belongs to the type of cancer, current treatment, phase of disease along the cancer continuum, and optimal timing for vaccination; they should talk to their hematologist-medical oncologist. Vaccination with the live-attenuated and replicating-vector vaccine is strongly discouraged in patients with active cancer receiving chemotherapy and during other immunocompromising therapies. For patients those receiving intensive chemotherapy (e.g., induction or consolidation therapy in acute leukemia), anti-B-cell antibodies, hematopoietic stem cell transplantation (HSCT), and other immunocompromised conditions, we suggest postponing SARS-CoV-2 vaccination until reaching stable lymphocyte counts due to the risk of vaccine infectivity. Cancer survivors are considered to have the same risk as other persons with matched aged and other risk factors. They also should be vaccinated as early as possible. There are various other risk factors for cancer patients which must consider related to complications of COVID-19, such as age, other comorbid diseases, demographic and social factors. All of these factors should be judged as a comprehensive evaluation of an individual patient. The use of masks, physical distancing, hygienic activities such as washing hands with soap and hand sanitizers are still needed during this pandemic. Caregivers and households should certainly be included in the vaccination strategies.
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A 3-days old infant with neonatal soft tissue sarcoma: a case report
Dwi Feris Sidabutar, Agung Aji Prasetyo Online First: February 21, 2021A 3-days old infant with neonatal soft tissue sarcoma: a case report
Dwi Feris Sidabutar, Agung Aji PrasetyoBackground :The incidence of sarcomas occurs in less than 1% of all malignant tumors but sarcoma is the cause of 2% of total cancer deaths. Based on the National Registry the incidence of neonatal sarcomas is 2.6 per million live births.
Case Description : A baby girl aged 3 days, complaining of a mass on the patient's left thigh since birth. the mass was large from birth and there was only one on the left thigh. In the prenatal history, the mother and baby with routine ANC history to the midwife, and never having a control with an obstetrician, the mother was not sick during pregnancy and took medication during pregnancy outside of a doctor's prescription. In the perinatal history, the baby was born to mother G1P1A0, gestational age at term, was born by cesarean section, with birth weight 2800 grams, was born crying, active movement, reddish color, vomiting (-) genitalia (+) anus (+)
Conclusion : Soft tissue sarcomas (STS) require proper diagnosis and management. The results of rhomboid flap in the tumor resection area are better than skin grafts of similar shape and location and provide cosmetic advantages with very few complications.
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Successful total correction of Transposition of Great Artery in Surabaya’s rural area experience: serial cases
Heroe Soebroto, Farhan Danisa, Arief Rakhman Hakim Online First: January 25, 2021Successful total correction of Transposition of Great Artery in Surabaya’s rural area experience: serial cases
Heroe Soebroto, Farhan Danisa, Arief Rakhman HakimBackground: Transposition of the great arteries (TGA) is a cyanotic heart disorder characterized by the aorta being positioned to the pulmonary artery's right-anterior. Arterial switch operation (ASO) is the main surgical procedure for TGA correction that has favorable outcomes. This case report aims to explain the findings of TGA cases that were performed successfully by ASO surgery at Dr. Soetomo Hospital in Surabaya.
Case Presentation: We reported two cases of dextro-TGA, which were confirmed from anamnesis, physical examination and echocardiographic. Both cases have been successfully carried out with an arterial switch operation (ASO) procedure with a post-operative length of 14-15 days with stable hemodynamics.
Conclusion: TGA is a congenital heart defect with a rapid worsening of clinical signs if not detected early. The early correction will improve post-correction outcomes in patients.
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Single Umbilical Artery (SUA) - prenatal sonography diagnosis and vascular imaging features postnatal cord: a case report
I Nyoman Hariyasa Sanjaya, Cokorda Istri Mirayani Pemayun, Ni Wayan Dewi Purwanti, Made Diah Vendita Sakuntari, Ni Putu Nining Gianni, Ni Luh Made Diah Mas Cahyani Putri, Ni Komang Anik Pirgantari, Ni Luh Md Dwi Laxmi Satriani, Firsta Sesarina Mintariani, Ni Luh Putu Yulia Padmawati, Anak Agung Wahyu Putri Online First: January 25, 2021Single Umbilical Artery (SUA) - prenatal sonography diagnosis and vascular imaging features postnatal cord: a case report
I Nyoman Hariyasa Sanjaya, Cokorda Istri Mirayani Pemayun, Ni Wayan Dewi Purwanti, Made Diah Vendita Sakuntari, Ni Putu Nining Gianni, Ni Luh Made Diah Mas Cahyani Putri, Ni Komang Anik Pirgantari, Ni Luh Md Dwi Laxmi Satriani, Firsta Sesarina Mintariani, Ni Luh Putu Yulia Padmawati, Anak Agung Wahyu PutriBackground: Single umbilical artery (SUA) is a rare presentation in obstetrics practice, yet it comprises most of the umbilical anomaly. Despite its rare occurrence, a proper prenatal diagnosis needs to be established timely in order to prevent morbidity and mortality from commonly coexisting abnormalities. This case report presents a delayed diagnosis of SUA by prenatal sonography diagnosis and vascular imaging features postnatal cord at the third trimester of pregnancy and discusses the proper diagnosis and management of such cases.
Case Presentation: We reported a case of a 37 year old pregnant woman who found to have one artery one vein in her umbilical cord on ultrasound. This is very rare case and precise concern for us. Unfortunately we found this case in the third trimester of pregnancy (37w5d), therefore we have slightly to evaluate. Female baby was born by elective C-section. The baby cried immediately, with an Apgar score of 8-9. We didn’t find major abnormalities in the baby. Birth weight 3700 grams. There were not sign of heart diseases and kidney’s abnormality. Baby was monitoring for one weeks and the baby has good growth and development.
Conclusion: This report is expected to increase the awareness of this disease entity as a fundamental basis for developing its screening and management protocols.
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Right hepatic artery pseudoaneurysm after choledocoduodenostomy: a case report
Erik Prabowo, Ahmad Fathi Fuadi, Antonius Gunawan Santoso Online First: February 21, 2021Right hepatic artery pseudoaneurysm after choledocoduodenostomy: a case report
Erik Prabowo, Ahmad Fathi Fuadi, Antonius Gunawan SantosoBackground: Pseudoaneurysm of right hepatic artery is a rare complication after bile duct injury (BDI) repair. An unidentified rupture of pseudoanuerysm will lead to mismanagement of this fatal complication. Massive haemorrhage can present and causes high mortality
Case Description: We report a 60-year-old female who suffered jaundice and massive upper gastrointestinal bleeding two weeks after cholodocoduodenostomy bypass surgery in rural hospital. That procedure was done because of BDI after laparoscopic cholecystectomy. Embolisation was carried out after identifying an pseudoaneurysm of right hepatic artery to stop bleeding. Bleeding was transiently stopped, and rebleeding occurred several weeks later. Surgery was performed because of repeated bleeding after third embolization in Kariadi hospital. Ruptured pseudoaneurysm to choledocoduodenostomy anastomosis was found. Pseudoaneurysm was resected and right hepatic artery was sutured. Choledocoduodenostomy was closed. Continuity of biliary tract was maintained by re-reconstruction choledoco-jejunostomy roux n Y. Upper gastrointestinal bleeding symptom was disappeared, and bilirubin level was returned to normal at outpatient follow up after operation.
Conclusion: This patient had a hemobilia because of ruptured right hepatic artery pseudoaneurysm. Triad Quincke which consist of right upper quadrant pain, jaundice and upper gastrointestinal bleeding, occurs in 30% of patient with hemobilia. This sign of hemobilia after biliary tract procedure must be managed quickly and accurately. Angiography is main diagnostic procedure. Arterial embolisation is first line intervention to stop the bleeding. Surgery is preserved in case where rebleeding occurs. Good anatomical knowledge can prevent this complication.
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Delayed laparotomy and gastric repair in gastric perforation: a case report in the neonatal patient
Barmadisatrio Barmadisatrio, Ali Sibra Mulluzi Online First: March 21, 2021Delayed laparotomy and gastric repair in gastric perforation: a case report in the neonatal patient
Barmadisatrio Barmadisatrio, Ali Sibra MulluziBackground: The incidence of gastric perforation in neonates is rare but has a high mortality rate of 15-70%. Spontaneous gastric perforation in neonates is estimated to occur in one of 2,900 live births and accounts for approximately 7% of all gastrointestinal perforations in neonates and children.
Case: We present a case of gastric perforation complicated by sepsis, anemia, thrombocytopenia, and hypoalbuminemia in a 3-day-old girl. The patient was brought to the emergency room of Dr. Soetomo Hospital Surabaya with blood vomiting complaints from 1 day. On physical examination, it was found that the general condition was weak, with an axillary temperature of 38.2° C. The abdomen looked distended from inspection of the abdominal region, with the dilated vein and periumbilical hyperemia. Its percussion revealed the loss of liver dullness. The results of laboratory examinations: Hb 10.7 g/dl, Platelet 14,000/mm3, Albumin 2,6 g/dl. Plain thoracoabdominal X-Ray study showed a pneumoperitoneum. Needle decompression was performed because there were signs of Abdominal Compartment Syndrome (ACS). After five days of optimization in the Intensive Care Unit, a laparotomy exploration and primary repair of gastric perforation were conducted.
Conclusion: Gastric perforation in neonates is a rare condition. The management principle for each patient is different depending on the patient's condition. Needle decompression is indicated when ACS is present or the patient's condition is not optimal for surgery. Definitive laparotomy can be done after the patient's condition has been stabilized. Proper selection of treatment can improve the patient's outcome and reduce the risk of morbidity and mortality.
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The change of cell biometric and its nucleus on cervical-squamous-epithelial-cell with GA genotype of Fas-promoter-670 gene, high-risk human papillomavirus and Candida species infection: a case report
Edy Parwanto, Raditya Wratsangka, Assangga Guyansyah, Kirana Anggraeni, Reza Aditya Digambiro, David Tjahyadi, Hanslavina Arkeman, Haryo Ganeca Widyatama, Hosea Jaya Edy, Yosua Jaya Edy Online First: April 01, 2021The change of cell biometric and its nucleus on cervical-squamous-epithelial-cell with GA genotype of Fas-promoter-670 gene, high-risk human papillomavirus and Candida species infection: a case report
Edy Parwanto, Raditya Wratsangka, Assangga Guyansyah, Kirana Anggraeni, Reza Aditya Digambiro, David Tjahyadi, Hanslavina Arkeman, Haryo Ganeca Widyatama, Hosea Jaya Edy, Yosua Jaya EdyBackground: Cervical samples of patients with human papillomavirus (HPV) infections show positive results in HPV DNA testing. HPV infection can alter cervical squamous epithelial cells (CSECs) to be abnormal. Epigenetically, CSECs that change to be abnormal are affected by Fas-promoter-670 gene polymorphism. High-risk HPV (hr-HPV) patients can be infected by other microbes, for example, Candida species (Candida sp.). The present study's purpose was to show CSEC biometrics based on epigenetics of the Fas-promoter-670 gene polymorphism in Indonesian women with hr-HPV and Candida sp. infection. Biometric quantification was performed based on the following analysis of CSECs.
Case report: Indonesian hr-HPV women at the age of 28 years, with Candida sp. infection, underwent a Pap smear examination on April 21st, 2016, using the ThinPrep method, and a blood test was also performed using the cubital vein. Blood and ThinPrep samples were examined for the Fas-promoter-670 gene polymorphism. Epigenetically, the subjects had the GA genotype of the Fas-promoter-670 gene in the blood and ThinPrep samples. Patients with Candida sp. infection in the early stages were characterized by the appearance of polymorphonuclear leukocytes (PMN), whereas those in advanced stages presented without PMN on the hyphae. CSEC biometric measurements were performed quantitatively using mononuclear CSECs (mn-CSECs) and binucleated CSECs (bn-CSECs).
Conclusion: Biometric measurements of the CSECs were performed quantitatively and assessed the length, width, area and perimeter of the cell and its nuclei. Cell length, cell width, nucleus area, nucleus perimeter and nucleus length index were significantly different between the mn-CSECs, the 1st nucleus of bn-CSECs and 2nd nucleus of bn-CSECs (P<0.05).
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Video-assisted thoracoscopic surgery in the treatment of empyema: a case series
Yustinus Rurie Wirawan, Christophoroes Jonathan Tansil Online First: April 01, 2021Video-assisted thoracoscopic surgery in the treatment of empyema: a case series
Yustinus Rurie Wirawan, Christophoroes Jonathan TansilBackground: Empyema is a condition that can be treated depending on the etiology of the empyema and the phase of empyema development. Open thoracotomy surgery is a conventional technique commonly used in empyema that has greater risk and more extended postoperative hospital stay. This case series aims to evaluate Video-Assisted Thoracoscopic Surgery (VATS) to shorten postoperative hospital stay and lower the risk during the surgery.
Case Presentation: We describe a case series of empyema in five patients, each with a different presentation, clinical course, and outcome. All of our patients were performed VATS procedures under General Anesthesia and evaluated for postoperative hospital stays and complications that occur after the surgery. Most of the patients experienced tolerable pain on the site of surgery and only need 3 – 4 days post-operation hospital stays after VATS before being discharged. Only one patient with a poor prognosis after VATS in this case series caused the patient to be admitted to the Intensive Care Unit and using a mechanical ventilator.
Conclusion: In this case series, VATS has a promising result for the patient and can become a choice of treatment for empyema.
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Simultaneous resection on the patient with synchronous colorectal liver metastasis: two cases report
Celine Martino, Michael Tendean, Toar Deliezer Bram Mambu, Ferdinand Tjandra, Michael Iskandar Online First: April 01, 2021Simultaneous resection on the patient with synchronous colorectal liver metastasis: two cases report
Celine Martino, Michael Tendean, Toar Deliezer Bram Mambu, Ferdinand Tjandra, Michael IskandarBackground: Colorectal cancer (CRC) is ranked as the third most common cancer worldwide.One of the leading causes of death in CRC patients is due to its metastasis. The liver is the most common site of metastasis. The best treatment to achieve long-term survival and cure patients with CRC liver metastasis is surgery, whether it’s sequential, delayed, or simultaneous resection.This case study aims to evaluate the simultaneous resection on the patient with synchronous colorectal liver metastasis.
Case Presentation: From January-June 2020, in Prof. Dr. R. D. Kandou General Hospital, Manado, 2 patients were treated with simultaneous resection for CRC with resectable synchronous liver metastasis. Blood loss, bile leak, ascites, and post hepatectomy liver failure (PHLF) were observed as outcome parameters.
Conclusion: Simultaneous resection is safe and exhibits advantages in the long-time survival of patients. However, the incidence of complications and mortality are higher in simultaneous resection than in staged resection.
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Penile gangrene as a priapism sequele due to Chronic Myeloid Leukemia (CML): the first report in Indonesia
Deddy Rasyidan Yulizar, Eka Putri Maulani, Heru Prasetya, Hendra Sutapa, Eka Yudha Rahman Online First: April 01, 2021Penile gangrene as a priapism sequele due to Chronic Myeloid Leukemia (CML): the first report in Indonesia
Deddy Rasyidan Yulizar, Eka Putri Maulani, Heru Prasetya, Hendra Sutapa, Eka Yudha RahmanBackground: Priapism is defined as a prolonged erection of the penis lasting over 6 hours in the absence of sexual stimulation. Priapism is divided into two types, Low-Flow (ischemic priapism) and High-Flow (trauma). This case study aims to evaluate penile gangrene as a priapism sequele due to Chronic Myeloid Leukemia (CML) as the first report in Indonesia.
Case Presentation: A 45-years old male patient admitted at Muara Teweh hospital before referred to Ulin Hospital presented with Fournier gangrene with unconfirmed leukemia as comorbidities used in this case report. In his medical history, “Snake Maneuver Shunting” has been carried out in this patient as an indication for priapism lasting more than 24 hours.
Conclusion: Hyperleukocytosis is thought to be the cause of priapism in patients with leukemia. Leukostasis is the most common medical emergency seen on CML patients in blast crisis.
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Radiofrequency ablation for management of thyroid nodules: a case report
Kristanto Yuli Yarsa, Monica Bellynda Online First: April 01, 2021Radiofrequency ablation for management of thyroid nodules: a case report
Kristanto Yuli Yarsa, Monica BellyndaBackground: Thyroid nodules constitute a frequently seen clinical problem and the incidence of thyroid nodules has increased with the recently increased use of thyroid ultrasonography. Radiofrequency ablation (RFA) is an effective and safe method for treating benign thyroid nodules and recurrent thyroid cancers.
Case Presentation: A 48 years old woman came to the surgical oncology clinic with the presence of a getting bigger, moves when the patient swallows, and painless mass on her neck since 20 years ago. The physical examination measured 5x5 cm mass, mobile on swallowing, no pain on palpation, and the laboratory examination shows a euthyroid state. The ultrasound result has revealed an enlargement of the right and left thyroid with increased echo intensity of parenchyma and increased vascularisation. This mass was concluded as struma nodus bilateral. The FNAB was follicular neoplasm, Bethesda system class 4. The patient underwent a single session RFA. RFA was performed employing transisthmic access using a 7 cm 18 gauge electrode-needle with a 1 cm active needle tip. The patient well tolerated the procedure and no adverse events were noted.
Conclusion: Radiofrequency ablation for thyroid lesions is a safe and effective method for treating benign thyroid nodules and even recurrent thyroid cancers. Therefore, various factors, including serum TSH, clinical risk factor assessment, size of the nodule, ultrasound characteristics, patient preferences, and results of the FNA biopsy, should be considered to manage thyroid nodule.
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The relationship between self-esteem and husband support with body image perception in post-vaginal delivery primiparous mother in independent Delima midwife practice in Denpasar
Ignasius Yulianus Jagkson Bomba, Cok Bagus Jaya Lesmana, Ni Ketut Sri Diniari, Luh Nyoman Alit Aryani, Anak Ayu Sri Wahyuni, Ni Ketut Putri Ariani, Ida Ayu Kusuma Wardani, I Gusti Ayu Indah Ardani Online First: February 23, 2021The relationship between self-esteem and husband support with body image perception in post-vaginal delivery primiparous mother in independent Delima midwife practice in Denpasar
Ignasius Yulianus Jagkson Bomba, Cok Bagus Jaya Lesmana, Ni Ketut Sri Diniari, Luh Nyoman Alit Aryani, Anak Ayu Sri Wahyuni, Ni Ketut Putri Ariani, Ida Ayu Kusuma Wardani, I Gusti Ayu Indah ArdaniBackground: Childbirth is a big, happy event for a mother. In post-partum mothers, physical changes and psychological changes can occur. It is reported that 50% to 70% of post-partum mothers experience psychological disorders, such as a mother can feel uncomfortable with body image perception changes, which result in feelings of lack of husband support. Body image perception itself can cause an effect on self-esteem. This study aimed to analyze the relationship between self-esteem and husband's support with body image perception among primiparous mothers after vaginal delivery.
Methods: An observational analytic study was conducted among 30 post-vaginal delivery primiparous mothers in independent Delima midwife practice in Denpasar. Data regarding respondents’ characteristics, self-esteem, husband’s support and body image perception were obtained using the Rosenberg self-esteem questionnaire, the Revised Dyadic Adjustment Scale (R-DAS) questionnaire Multidimensional Body-Self Relations Questionnaire Appearance Scales (MBSRQ-AS). The relationship between self-esteem and husband's support with body image perception was analyzed using SPSS version 23 for Windows.
Results: The average age of the respondents were 24.73 years old, and most of them were graduated from high school (50%), employed (53.3%) and have no conflict in their marriage (80%), have normal self-esteem (96.6%), didn’t get enough husband’s support (56.7%) and have positive perception regarding the evaluation of physical appearance (96.6%). We found a significant relationship between self-esteem and body image perception (p = 0.001), husband's support and body image perception (p = 0.001) and husband's support and self-esteem (p = 0.010) in post-vaginal delivery primiparous mother in independent Delima midwife practice in Denpasar.
Conclusion: Self-esteem, husband's support and body image perception were essentials factors that contributed to post-partum woman mental health stability that should be understood by family and health workers to avoid psychological disorder in post-partum woman.
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Phytochemical test and identification of active compounds with LC-MS/MS in green meniran leaf (Phyllanthus niruri Linn)
Ni Kadek Eka Widiadnyani, I Nyoman Mantik Astawa, I Wayan Putu Sutirta Yasa, I Dewa Made Sukrama Online First: March 01, 2021Phytochemical test and identification of active compounds with LC-MS/MS in green meniran leaf (Phyllanthus niruri Linn)
Ni Kadek Eka Widiadnyani, I Nyoman Mantik Astawa, I Wayan Putu Sutirta Yasa, I Dewa Made SukramaBackground: Green meniran plant (Phyllanthus niruri Linn) is traditionally believed to treat many diseases, such as reducing fever, diarrhea, cough with phlegm, inflammation, malaria, and acne. This research aims to determine the class of compounds and active compounds in the ethanol extract of green meniran leaf.
Methods: An experimental study was conducted using phytochemical testing includes qualitative and quantitative tests to identify the active compounds in green meniran leaf (Phyllanthus niruri Linn) by Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS). Crude powder packaging of green meniran leaf was conducted at Materia Medika Herbal Laboratory, Malang, Indonesia. The ethanol extraction from green meniran leaf was conducted at Pharmacology Laboratory, Faculty of Mathematics and Natural Sciences, Udayana University.
Results: Based on the results of the phytochemical qualitative test, the green meniran leaf extract was positive for flavonoids, saponins, steroids, terpenoids, alkaloids, phenols, tannins, and glycosides. From quantitative phytochemical tests, we found the levels of phenolic, flavonoid, tannin 5.13%, 3.30%, 5.01%, respectively and 28.212.67 mg/kg chlorophyll. Identification using LC-MS/MS showed the suspected compounds Apigenin-8-C-glucoside from the glycoside group and 5,6,7-trimethoxyflavone from the flavonoid group.
Conclusion: Green meniran leaf contains flavonoids, saponins, steroids, terpenoids, alkaloids, phenols, tannins, and glycosides with the active compounds Apigenin-8-C-glucoside and 5,6,7-trimethoxyflavone.
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The 4th Aceh Surgery Update 2021
Yopie Afriandi Habibie Online First: February 26, 2021The 4th Aceh Surgery Update 2021
Yopie Afriandi HabibieAssalamualaikum Wr.Wb
Praise and gratitude we pray the presence of Allah SWT for all His grace and guidance so we can still work to help in the fields of education and humanity. With greetings and prayers we praise the prophet Rahmatan lil alamin Rasulullah Muhammad SAW who has brought us from the realm of darkness to a realm full of knowledge.
In the fourth year it was held during the Covid 19 pandemic, 4th Aceh Surgery Update International Conference in 2021 will be held virtually on February 26-28, with theme Current Update on Covid 19; Clinical and Surgery. This virtual science event will be attended by international and national speakers who have expertise in the field of surgery and the latest information regarding Covid 19 from the Indonesia government. This scientific event felt very special with the presence of the Bali Medical Journal indexed by SCOPUS and Web of Science in scientific publications for all topics presented, both in symposium and free paper sessions.
I would like to welcome all experts who are willing to attend to be native speaker at this scientific even. I would like to thank all the committees and sponsors who have helped make this scientific webinar a success. Finally, I am also welcome all the participants and delegated, really hope you all get valuable scientific experiences in extra ordinary city of Banda Aceh.
Sincerelly Yours,
Yopie Afriandi Habibie, MD, Sp. BTKV (K)-D, FIHA, FICS, FACS
Chairman
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