The characteristics of neurocognitive function in farmers exposed to chronic pesticides at Banjar Tengah Kelod, Kerambitan, Tabanan, Bali, Indonesia
Dewa Putu Gde Purwa Samatra, Ni Luh Putu Dirasandhi Semedi Putri Online First: December 01, 2019The characteristics of neurocognitive function in farmers exposed to chronic pesticides at Banjar Tengah Kelod, Kerambitan, Tabanan, Bali, Indonesia
Dewa Putu Gde Purwa Samatra, Ni Luh Putu Dirasandhi Semedi PutriPurpose: This study aims to evaluate the characteristics of neurocognitive function in farmers exposed to chronic pesticides.
Material and Methods: This study uses a descriptive cross-sectional design with total sampling methods. The study was conducted from 1st January 2019 until 31st January 2019 located in Banjar Tengah Kelod, Kerambitan sub-district, Tabanan district, Bali, Indonesia.
Results: A total of 60 samples, consisted of 36 samples (60%) were women and 24 samples (40%) were men were obtained. The median age of the study sample was 55 year-old. Most of the samples who experienced neurocognitive impairment used organophosphate pesticides (60%), followed by organochlorine (20%), carbamate (13.3%), and pyrethroid (6.7%). Organophosphate users experienced neurocognitive impairment in both memory domain (mean score of 1.5 what scoring was used?) and visuospatial executive functions (mean score of 1, what scoring system?). The mean memory function score in the organochlorine user group was the highest compared to other groups of pesticide users while the average score of visuospatial function was 1. The samples of the study using carbamate pesticides had the same average score in both domains of neurocognitive function. The mean score of memory function in pyrethroid user was 2.5 and the average score of executive visuospatial function was 1.
Conclusion: Chronic exposure to the four types of pesticides provided a picture of neurocognitive function impairment, including memory, visuospatial and executive functions. This result did not show clinical significance. The addition of sample size and analytic method studies should be considered for further research.
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The effect of tomato juice on the expression of matrix metalloproteinase-2 (MMP-2) and type-1 collagen on the vaginal wall of the menopausal rats
Juminten Saimin, Hendy Hendarto, Soetjipto Soetjipto Online First: December 01, 2019The effect of tomato juice on the expression of matrix metalloproteinase-2 (MMP-2) and type-1 collagen on the vaginal wall of the menopausal rats
Juminten Saimin, Hendy Hendarto, Soetjipto SoetjiptoBackground: Aging is a multifactorial phenomenon that is characterized by a decrease in physiological functions that increases with age. Free radicals cause oxidative stress, which plays a role in the aging process. The accumulation of reactive oxygen compounds increases matrix metalloproteinase-2. Collagen can be directly destroyed by reactive oxygen compounds or through the induction of MPPs. Tomato fruit is an antioxidant, which acts as a binder and damper of free radicals that activate collagen damage. This study aims to assess the effect of tomato juice on the expression of MMP-2 and type-1 collagen on the vaginal wall of the menopausal rat.
Methods: This was a true experimental study, using Sprague-Dawley rats and tomato juice (Solanum lycopersicum). Expression of MMP-2 and type-1 collagen was examined using immunohistochemistry staining. Twenty-four healthy female rats, aged 4 months weighing 150-200 grams, were divided into 4 groups, each group as many as 6 rats. The negative control group (NC) was a group of rats with a sham procedure, given aquades for 28 days. The positive control group (PC) was bilaterally ovariectomized rats, given aquades for 28 days. The first treatment group (P1) was bilaterally ovariectomized rats, given tomato juice with a dose of 11 g / 200 g BW / day. The second treatment group (P2) was bilaterally ovariectomized rats, given tomato juice with a dose of 15 g / 200 g BW / day. Data analysis used the One-way ANOVA statistical test (α = 0.05) and different tests between groups using Games-Howell and Tukey HSD. The association between tomato juice and the expression of MMP-2 and type-1 collagen used regression tests.
Results: This study found that the lowest expression of MMP-2 was NC group (2.07 ± 0.84), and the highest was the PC group (5.72 ± 1.91). The mean MMP-2 expression in the treatment groups was lower than the PC group but still higher than the NC group. There was a significant difference in MMP-2 expression between groups (p = 0,000). There was a negative correlation between tomato juice administration and MMP-2 expression (b = -0.592). The lowest type-1 collagen expression was PC group (3.83 ± 1.44), and the highest was the P2 group (7.27 ± 2.21). The mean type-1 collagen expression in the treatment groups was higher than the PC group. There were significant differences of type-1 collagen expression between groups (p = 0.012). There was a positive correlation between tomato juice administration and type-1 collagen expression (b = 0.682).
Conclusions: Tomato juice administration can reduce the expression of MMP-2 and increase the expression of type-1 collagen on the vaginal wall of the menopausal rat. The higher the dose of tomato juice, the higher the expression of type-1 collagen.
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The effect of intraarterial heparin flushing to autism symptoms when used to treat the concomitant cerebral venous thrombosis: a case series
Erwin Setiawan, Ristaniah Soetikno, Nelly Amalia Risan, Shelly Shelly, Tugas Ratmono, Ardianto Pramono, Rachmanto Heryawan Surya Adiputra, Terawan Agus Putranto Online First: December 01, 2019The effect of intraarterial heparin flushing to autism symptoms when used to treat the concomitant cerebral venous thrombosis: a case series
Erwin Setiawan, Ristaniah Soetikno, Nelly Amalia Risan, Shelly Shelly, Tugas Ratmono, Ardianto Pramono, Rachmanto Heryawan Surya Adiputra, Terawan Agus PutrantoIntroduction. There are still no definite therapeutic strategies for Autism Spectrum Disorder (ASD) other than behavioural interventions and few FDA approved behaviour control drugs. In this study, we found a co-existence medical condition of ASD & Cerebral Vein Thrombosis (CVT) in the paediatric population. Based on these findings, a new therapeutic approach, a catheter-directed anticoagulant therapy termed as IAHF (Intra Arterial Heparin Flushing) was performed on this population of patients.
Methods. This paper aims to describe a series of 10 cases of IAHF procedure performed to treat CVT on children with ASD from 2018 through 2019 at Cerebrovascular Center RSPAD Gatot Soebroto Jakarta-Indonesia. The children diagnosed with ASD by the multidisciplinary team but also had CVT findings on their brain magnetic resonance imaging studies when performed as the series of comprehensive diagnostic examination. IAHF were conducted by delivering heparin through a modified DSA technique into the occluded vessels. Subject Autism status was assessed with the Childhood Autism Rating Scale (CARS) before and one month after IAHF procedures.
Results. The measurement of CARS Score after IAHF shows a relatively positive result. Eight patients showed a decreased in total CARS Score after the procedure, while only two patients had no improvement. One subject shows a decrease of nine points, the most significant changes, and improved the status from moderate to mild autism.
Conclusion. In children who have ASD and also accompanied by CVT findings in their imaging studies, IAHF treatment showed clinical improvement of the autism symptoms.
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Profiles of IgM, IgG and IgE immune responses of mice against p14, p31 and p71 proteins following immunization with crude cystic fluid of Cysticercus bovis
Ida Bagus Made Oka, I Made Dwinata, I Nyoman Sadra Dharmawan, I Made Damriyasa, Nyoman Mantik Astawa Online First: December 01, 2019Profiles of IgM, IgG and IgE immune responses of mice against p14, p31 and p71 proteins following immunization with crude cystic fluid of Cysticercus bovis
Ida Bagus Made Oka, I Made Dwinata, I Nyoman Sadra Dharmawan, I Made Damriyasa, Nyoman Mantik AstawaBackground: The presence of IgM, IgG and IgE antibodies has been widely used as important markers for the differentiation of acute and chronic infection in many infectious diseases, but limited studies reported on Cysticercus bovis infection are available. This study aimed to determine the IgM, IgG and IgE responses of mice against crude cystic fluid, p14, p31 and p71 antigens as the possible diagnosis of acute and chronic cysticercosis in hosts.
Methods: Six mice were immunized four times at 10 days interval with Cysticercus bovis. Individual p14, p31 and p71 proteins were separated by using sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and elution of proteins from gel with elution buffer. The crude cystic fluid, p14, p31 and p71 were used as antigens for enzyme-linked immunosorbent assay (ELISA) to measure the IgM, IgG and IgE antibody titers in mice sera before and after the first, the second, the third and the fourth immunizations.
Results: No IgM, IgG and IgE against crude cystic fluid, p14, p31, and p71 was detected in sera samples collected before the first immunization. Moderate to high titers of IgM antibodies against crude cystic fluid, p14, p31 and p71 were identified following the first, the second, the third and the fourth immunizations. IgG titers against crude cystic fluid, p14, p31 and p71 was still at a low level following the first immunization and started to increase following the second, the third and the fourth immunization. Generally, low titers of IgE antibodies against crude cystic fluid, p14, p31 and p71 were detected after each immunization. IgE responses only increased slightly against crude cystic fluid and p71 antigens after the third and the fourth immunizations. The IgM, IgG and IgE responses of mice against crude cystic fluid and p71 antigens were higher than those against p31 and p14 antigens.
Conclusions: The presence of IgM without IgG and IgE can indicate acute infection, whereas the presence of IgM and IgG with slight increase IgE might indicate a chronic infection of Cysticercus bovis.More ... | PDF
Physical rehabilitation of middle-aged women with vegeto-vascular dystonia in Russia
Svetlana Vasilyevna Shmeleva, Elena Nikolaevna Latushkina, Alexandra Stanislavovna Scheglova, Ekaterina Igorevna Dubrovinskaya, Angela Valerievna Romanova, George Ramazovich Dushevin, Yanina Vasilevna Shimanovskaya Online First: December 01, 2019Physical rehabilitation of middle-aged women with vegeto-vascular dystonia in Russia
Svetlana Vasilyevna Shmeleva, Elena Nikolaevna Latushkina, Alexandra Stanislavovna Scheglova, Ekaterina Igorevna Dubrovinskaya, Angela Valerievna Romanova, George Ramazovich Dushevin, Yanina Vasilevna ShimanovskayaIntroduction: Vegeto-vascular dystonia (VSD) resembles a common condition in women nowadays. Its manifestations exert a weakening effects constellation on the central nervous system (CNS) and the bodily process. With insufficient effect from medical efforts in VSD, the level of viability of the organism inevitably decreases. The purpose of the study was to assess the possibilities of the author's version of physiological rehabilitation of women with VSD.
Materials and methods: The study involved 2 groups of women aged 27-35 years (mean age 30.8 ± 2.1 years). Each group consisted of 25 women with a diagnosis confirmed at least 3 years ago by the VSD. In the first group of women, rehabilitation was carried out according to the author's method, whereas the traditional scheme of rehabilitation is applied in second group. Rehabilitation activities lasted for 6 months, evaluated by functional tests using Student's t-test.
Results: The author's complex of rehabilitation measures proved to be very effective in first group, including a rational diet, therapeutic gymnastics, electrostimulation, massage and hydrotherapy. The complex of rehabilitation measures developed by the authors was able to provide the most complete restoration of the physical condition of women with VSD by achieving a balance between the activator and inhibitory processes in CNS also the optimal tone of their vessels.
Conclusion: The study proved that the author's version of rehabilitation of women with VSD was capable of completely eliminating somatic manifestations accompanying vegetative vascular dystonia and increasing the adaptive capabilities of the body in daily life.
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Association between expression of ALDH1 and TGFb2 genes, histological and clinical findings in breast cancer
Yasan Sadeghian, Esmaeil Samizadeh, Mohammad Ali Ali Mohammadi-vajari, Mohammad Hossein Lashkari, Ehsan Sadeghian, Seyedeh Nasim Hosseini, Mehdi jafari, Tahereh Sorbi Online First: December 01, 2019Association between expression of ALDH1 and TGFb2 genes, histological and clinical findings in breast cancer
Yasan Sadeghian, Esmaeil Samizadeh, Mohammad Ali Ali Mohammadi-vajari, Mohammad Hossein Lashkari, Ehsan Sadeghian, Seyedeh Nasim Hosseini, Mehdi jafari, Tahereh SorbiBackground: Breast cancer is one of the most common malignancies. The relationship between the pathogenesis of breast tumours and their invasive behaviour is an important issue that has been discussed recently. ALDH1 and TGFb2 genes can be mentioned among the most crucial signalling and molecular pathways that play an active role in tumour invasive behaviour. The aim of this study was to determine the expression level of ALDH1 and TGFb2 genes in breast cancer and its relationship with histology in breast cancer patients.
Method and material: This cross-sectional study was done on 65 breast cancer patients who had been referred to the Army 501 hospital during the years of 1992-1994. Data was collected using the patient records, and the results of immunohistochemically staining were obtained in the laboratory. Data were analyzed by SPSS software using t-test, Chi-square and Fisher tests. The level of significance was considered to be 0.05.
Results: In this study, we assessed the expression of these genes in tissue samples of 65 patients with breast cancer and its relation with the histology and clinical progress. The expression of ALDH1 in the malignant breast tissue was 83.5% (55 out of 65 samples) and the expression of TGFb2 gene showed 54 samples (83.1%) were positive. There was a significant relationship between lymphatic drainage and ALDH1 expression.
Conclusion: There was a significant relationship between ALDH1 expression, tumour size, neuronal invasion, tumour grade, metastasis, and lymph node involvement. There was also a significant relationship between TGFb2 expression and tumour size, metastasis, tumour grade, and lymph node involvement. There was no significant relationship between the expression of ALDH1, TGFb2, and the type of pathology and history of chemotherapyMore ... | PDF
Physiological peculiarities of thrombocyte activity of candidates into masters of sports in athletics of preadult age
Ilya Nikolayevich Medvedev Online First: December 01, 2019Physiological peculiarities of thrombocyte activity of candidates into masters of sports in athletics of preadult age
Ilya Nikolayevich MedvedevIntroduction: Physiologically, platelets are an important component of homeostasis of the whole body and blood system. However, not everything is clear with platelet activity of young healthy persons who have systematic exercises, particularly masters of sports’ candidate. Its in vitro and in vivo should be studied further.
Aim: The aims of this investigation are to find out the abnormalities of thrombocyte activity of master of sports’ candidate in athletics of young age and compare them with thrombocyte level of young people who avoided exercises during their lifetime. Through modulation of their activity, they increase capillaries' perfusion and thereby metabolism in tissues.
Materials and methods: In our investigation group we took 125 candidates into masters of sports in athletics of preadult age regularly exercising and participating in competitions of different levels. Control group was consisted of 141 healthy youths having avoided exercises during their lifetime. Biochemical, hematological and statistical methods are applied.
Results: Athlete were found to have stable normal functional platelet activity. For subjects between 18 and 22 years, their platelets aggregation was on low level and had no reliable variations related to their stable low sensitivity to inductors. Decreased platelet activity causes conservation in athletes' blood of some quantity of circulating thrombocyte aggregates. It makes positive impact on microcirculation in organs of athlete having regular athletic exercises. Avoidance of exercise in young age promotes gradual rise of thrombocyte activity. Masters of sports’ in athletics candidate who had intensive muscle activities are characterized by persistence of stable low platelet activity. It provides low quantity of active platelets and their circulating aggregates in blood. Those young persons, who avoided exercises, are noted to have elevated platelet activity with a tendency increased aggregate formation.
Conclusion: Masters of sports in athletics’ candidate doing intensive muscle activity are characterized by preservation of stable not high platelet activity caused by low content of active platelets and their circulating aggregates. Avoiding exercises in young people are noted to have caused the increase of platelet activity with a tendency to cause platelet aggregation.
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Optimising the effect of activated carbon on the microrheological properties of erythrocyte in rats with experimentally developed obesity
Evgeniy Vladimirovich Kulikov, Svetlana Yurevna Zavalishina, Yuri Anatolyevich Vatnikov, Alexander Anatolyevich Strizhakov, Stanislav Gennadievich Drukovsky, Dmitry Anatolyevich Lozovoy, Yuliya Yurevna Voronina, Irina Anatolyevna Popova, Irina Viktorovna Bondareva, Natalia Borisovna Sambros, Abdelaziz Norezzine, Tatyana Ivanovna Glagoleva, Svetlana Alexandrovna Shemyakova Online First: December 01, 2019Optimising the effect of activated carbon on the microrheological properties of erythrocyte in rats with experimentally developed obesity
Evgeniy Vladimirovich Kulikov, Svetlana Yurevna Zavalishina, Yuri Anatolyevich Vatnikov, Alexander Anatolyevich Strizhakov, Stanislav Gennadievich Drukovsky, Dmitry Anatolyevich Lozovoy, Yuliya Yurevna Voronina, Irina Anatolyevna Popova, Irina Viktorovna Bondareva, Natalia Borisovna Sambros, Abdelaziz Norezzine, Tatyana Ivanovna Glagoleva, Svetlana Alexandrovna ShemyakovaBackground: Remains not fully clear the impact of intestinal chelators on microrheological violation of red blood cells during the early stages of obesity. It dictates the necessity of experimental investigations' fulfilment on laboratory animals with just developed obesity in them.
Method: Ninety-four of healthy male-rats of Vistar line at the age of 2.5-3 months took into investigation. Twenty-nine animals of them had experienced no impacts and composed the control group. In 65 rats after their putting into small cages (one specimen - in a cage) during 30 days there was developed OB as the result of giving them of high-caloric diet from combined feed (47%), sweet condensed milk (44%), vegetable oil (8%) and vegetable starch (1%). Of the 35 rats received a day for 60 days of activated carbon 25 mg/kg into a stomach. There used biochemical, haematological and statistical methods of investigation.
Results: At obesity development in rats, there found a steady decrease of erythrocytes-discocytes quantity in blood. It accompanied by increase of reversibly and irreversibly changed erythrocytes' quantity in examined animals' blood. At obesity development in rats there was found quick rise of erythrocytes' sum in aggregate and these aggregates' quantity at lowering of free erythrocytes' number. During experimental obesity modelling we noticed very early in rats' blood decrease of erythrocytes-discocytes' quantity, level rise of their reversibly and irreversibly varieties with strengthening of their aggregative ability. It takes place in the background of weakening of erythrocytes' antioxidant protection and activation of lipids' peroxidation in them.
Conclusion: Application of activated carbons capable of rats with experimental obesity resolve arisen they breach microrheological properties of erythrocytes. It is clear that in obesity treatment regimens must be intestinal chelators, capable of positively affect many broken with this pathology haematological indices.
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Clinical and plain x-ray findings of spinal metastases: a retrospective study of pathologically-confirmed cases
I Ketut Suyasa, Ni Made Puspa Dewi Astawa Online First: November 07, 2019Clinical and plain x-ray findings of spinal metastases: a retrospective study of pathologically-confirmed cases
I Ketut Suyasa, Ni Made Puspa Dewi AstawaBackground: Malignancy of breast, prostate, and lung contribute to metastatic bone disease, and the metastases are mostly located in the spine. Spinal metastases may involve the spinal cord, leptomeninges, epidural space and also the bone itself. Therefore, proper imaging is needed in early detection and diagnosis of spinal metastasis. This study aimed to perform the clinical and plain x-ray findings in patients with spinal metastasis.
Method: A retrospective study was conducted on 28 spine pathological fracture patients with neurologic deficits who underwent surgical intervention in Sanglah General Hospital during a year. We evaluated the present symptoms, neurological status (Frankel score), pathological reports by plain x-ray findings, metastases cell type by histological assessment, and extension of mass expansion on MRI. A total of 20 cases that met the inclusion criteria were evaluated.
Result: Most patients suffer from pathologic fracture on thoracic spine level, followed by lumbosacral level and none on cervical spine level. The compressive fracture was a major finding on plain x-ray. The extradural lesions account for most of the MRI findings, followed by intradural/extramedullary and intramedullary lesion. Primary tumours that lead to bone metastases in this serial-cases are prostate, breast, cervix, kidney and lung cancer, respectively.
Conclusion: Thoracic spine is the most common spinal metastases manifestation. Conventional plain x-ray is the most initial modality to evaluate systemic neoplasia patients with spinal pain, although it is not a sensitive indicator to identify the presence and extent of metastatic involvement.
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The potential application of conditioned media-mesenchymal stem cells on human oocyte maturation in assisted reproductive technology: a quasi-experimental based-study at Dr. Sardjito General Hospital, Yogyakarta, Indonesia
Dwi Haryadi, Ahmad Hamim Sadewa, Sofia Mubarika, Djaswadi Dasuki Online First: December 01, 2019The potential application of conditioned media-mesenchymal stem cells on human oocyte maturation in assisted reproductive technology: a quasi-experimental based-study at Dr. Sardjito General Hospital, Yogyakarta, Indonesia
Dwi Haryadi, Ahmad Hamim Sadewa, Sofia Mubarika, Djaswadi DasukiBackground: PCOS typically characterized by a decreased level of GDF9 and BMP15, which contribute to follicular arrest. Recent research related to stem cells showed that conditioned media-mesenchymal stem cell (CM-MSC) might have a positive role in folliculogenesis. Therefore, this study aimed to assess the effectiveness of CM-MSC towards oocyte maturity
Method: A quasi-experimental design was used to examine the outcome of 3 different interventions, namely group A (4-hour incubation in standard media), group B (24-hour incubation in standard media), and group C (24 hours incubation in conventional media with addition of CM-MSC). Nuclear and cytoplasmic maturity, along with GDF9 and BMP15 levels were measured and analyzed.
Results: Sixty-three patients at an infertility clinic, RSUP Dr. Sardjito, Yogyakarta was recruited and a total of 292 germinal vesicles were obtained to start in vitro maturation procedure. Multivariate analysis showed group C has OR 6.9 (3,3–14,41) to obtain metaphase II oocyte than group B (p <0,0001). Infertility causes, insulin resistance, and maternal age risk are other factors that significantly influence oocyte maturity outcome (p <0.001; p = 0.005; p = 0.017). For the oocyte morphology outcome, no significant effect was obtained from the intervention (p> 0.05). Group C has higher GDF9 levels (Δ mean = 3.31) and BMP15 (Δ mean = 1.52) compared with group B (p <0.001; p = 0.006).
Conclusion: It can be concluded that 24-hour incubation in CM-MSC was effective to induce oocyte maturation. However, other factors, such as infertility causes, insulin resistance, and maternal age, should also be considered.
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Association of serum interleukin-10 (IL-10) with the severity of acne vulgaris
Tissan Rahmayani, Imam Budi Putra, Nelva K Jusuf Online First: December 01, 2019Association of serum interleukin-10 (IL-10) with the severity of acne vulgaris
Tissan Rahmayani, Imam Budi Putra, Nelva K JusufBackground: Acne vulgaris is a common inflammatory disorder in pilosebaceous gland units, which affected more than 90% of teenagers, and half of them settled until adulthood. Inflammation is one of the four critical factors in the pathogenesis of acne vulgaris, and it could be a primary process or secondary to Propionibacterium acnes. The immune system has a various anti-inflammatory mechanism to counter-balance inflammatory mediators. One of the potent cytokines that play a role in regulating the inflammatory state is Interleukin-10 (IL-10). This study conducted to determine the association of serum IL-10 with the severity of acne vulgaris.
Methods: This is a cross-sectional analytic study involving 33 subjects with acne vulgaris and 31 normal-healthy volunteers as a control. Both groups had their serum IL-10 measured. Acne vulgaris severity was assessed with Lehmann criteria. Anova was used to determine the statistical difference of IL-10 among different groups of acne severity. This study has been approved by the Ethical Committee Faculty of Medicine, Universitas Sumatera Utara.
Results: The mean serum IL-10 of normal-healthy and acne vulgaris subjects were 5,79 ± 1,23 pg/ml and 5,25 ± 1,55 pg/ml, respectively. Mann-Whitney test showed a significant difference (p=0,029). The mean IL-10 serum levels according to acne vulgaris severity were 6,63 ± 1,94 pg/ml in the mild category; 4,89 ± 0,95 pg/ml in the moderate category and 4,38 ± 0,61 pg/ml in the severe group. ANOVA showed significant difference with p=0,001.
Conclusion: There was an association between serum levels of IL-10 with the severity of acne vulgaris.More ... | PDF
The influence of maternal age and gestational age to urinary tract infection in Lempake Primary Health Care, East Kalimantan, Indonesia
Johanes Dwi Meiyanto Online First: December 01, 2019The influence of maternal age and gestational age to urinary tract infection in Lempake Primary Health Care, East Kalimantan, Indonesia
Johanes Dwi MeiyantoIntroduction: Urinary tract infection (UTI) is the second-largest of the world’s health burden just behind the respiratory tract infection. Pregnant women are at risk of suffering from urinary tract infection due to anatomical and physiological changes along the urinary tract. The study aims to find out the influence of maternal age and gestational age to UTI in Primary Health Care Center Lempake.
Method: The research method was cross sectional with total sampling and using secondary data from the register book of emergency unit in Primary Health Care Center Lempake including all UTI cases in pregnancy from all pregnant patients undergone urinalysis from January 2017 until October 2018 (48 patients). It was then analyzed using logistic regression with STATA version 14.
Result: Most of subjects distribution were maternal age group 26-35 years old (39.6%), third trimester of pregnancy (66.7%), and negative result of bacteriuria (81.3%). Maternal age group 26-35 years old was the the most one suffering from UTI/positive result of bacteriuria (55.6%) and had tendency 5.4 times to suffer from urinary tract infection (p=0.147; CI=0.56-51.71; OR=5.36) while gestational age in third trimester showed significant influence to urinary tract infection (p=0.05; CI=0.03-1.00; OR=0.18). The prevalence of urinary tract infection in this research was 18.7%.
Conclusion: There were significant influences among maternal age and gestational age to UTI in Primary Health Care Center Lempake.
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A network meta-analysis on comparative efficacy of statins focusing for prevention of contrast-induced acute kidney injury in chronic kidney disease patients undergoing percutaneus coronary intervention
Ilham Akbar Rahman, Yeni Purnamasari, Vicky Nanu Rewa, Hasyim Kasyim, Abd Rahman Umar, Firdaus Kasim Online First: December 01, 2019A network meta-analysis on comparative efficacy of statins focusing for prevention of contrast-induced acute kidney injury in chronic kidney disease patients undergoing percutaneus coronary intervention
Ilham Akbar Rahman, Yeni Purnamasari, Vicky Nanu Rewa, Hasyim Kasyim, Abd Rahman Umar, Firdaus KasimBackground: The use of interventional diagnostic and therapeutic procedures required intravascular iodinated contrast are performed in millions of patients worldwide and are steadily increasing the risks of contrast-induced acute kidney injury (CI-AKI). Statins are primarily used in cardiovascular medicine for their lipid-lowering effects but they possess remarkable pleiotropic effects such as improving endothelial function as well as decreasing oxidative stress and inflammation. A network meta-analysis was carried out to evaluate the effect of different statins in prevention of CI-AKI and also to investigate which type and dose of statins maybe the best choice specifically in CKD patients who have higher risk.
Methods: We performed a pairwise and network meta analysis of 14 randomized studies (9847 patients) comparing a total of 6 different statins: rosuvastatin high dose, atorvastatin high dose, simvastatin high dose, rosuvastatin regular dose, atorvastatin regular dose, pravastatin regular dose versus each other and versus placebo in CKD patients undergoing PCI with iodinated contrast for prevention of CIAKI. Google Scholar, Pubmed, Science Direct databases were searched up to May 2019. The data were pooled using STATA, and R version statistics calculating odds ratios (ORs) with 95% confidence intervals.
Results: Statin loading before contrast administration was associated with a significantly reduced risk of CI-AKI in patients with CKD undergoing cardiac catheterization (pooled OR= 0.51; P=0.0001). Regular dose pravastatin comprised the best effect size for a reduction in CIAKI risk (OR = 0.32, 95% CI 0.14-0.72, p=0.006). Regular dose pravastatin and high dose atorvastatin were ranked as the highest probability to be the best treatment (Pbest) with 44% and 31% respectively for effect on CIAKI prevention.
Conclusion: Preloading with statins is associated with significantly reduced risk of CI-AKI in patients with CKD undergoing cardiac catheterization. Regular dose pravastatin and high dose atorvastatin have the highest probability to be the most effective prevention strategy.
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Management of urethral stricture due to prostate cancer and colorectal cancer radiotherapy: a systematic review
Sirin Salsabila, Muhammad Adi Satrio Lazuardi, Kharisma Ogit Rosandy Online First: December 01, 2019Management of urethral stricture due to prostate cancer and colorectal cancer radiotherapy: a systematic review
Sirin Salsabila, Muhammad Adi Satrio Lazuardi, Kharisma Ogit RosandyBackground: Prostate and colorectal cancer are the second and third most common cancer in male. Radiotherapy is performed as treatment option for both cancers. Thus, lead to the increasing case of radiotherapy-induced urethral stricture. Recurrent stricture post-correction commonly occurs.
Methods: Six relevant English literatures were found throughout online database published between 2011-2017. PICO is used to identify components of clinical evidence to create systematic review. Subjects include 222 radiotherapy-induced urethral stricture patients due to prostate and colorectal cancer who undergone various treatment modality options.
Results: Radiotherapy modality performed in sample population were External Beam Radiotherapy (EBRT) (44.1%), Brachytherapy (BT) (31.5%), EBRT/BT (16.2%), Adjuvant EBRT (6.8%), salvage EBRT (0.9%), and proton beam (0.5%). Strictures were found in bulbomembranous-urethra (64.4%), bulbar-urethra (17.1%), posterior-urethra (10.8%), membranous-urethra (5.4%), vesico-urethra (1.4%), and pan-urethra (0.9%). Known mean onset for urethral-induced radiotherapy is 5.6 years. Treatment options include anastomosis urethroplasty (61.3%), Buccal Mucosa Graft Urethroplasty (23.4%), urolume stent (10.8%), penile island flap onlay (2.2%), Genital fasciocutaneous skin flap (1.4%), and perineal flap urethroplasty (0.9%). Known mean onset for urethral stricture recurrence is 10.8 months.
Conclusion: Urethral strictures commonly occur after radiation therapy for prostate and colorectal cancer. Urethroplasty is the preferable treatment option. The recurrence onset for urethral stricture post urethroplasty is shorter than urethral strictures in general.
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The erection conundrum: risk factors for erectile dysfunction among middle-aged and elderly men in Lamongan, East Java, Indonesia
Yudhistira Pradnyan Kloping, Budi Himawan, Dimas Rio Balti Online First: December 01, 2019The erection conundrum: risk factors for erectile dysfunction among middle-aged and elderly men in Lamongan, East Java, Indonesia
Yudhistira Pradnyan Kloping, Budi Himawan, Dimas Rio BaltiBackground: The most common sexual problem affecting the general population of men is Erectile Dysfunction (ED) with a global estimated number of over 100 million. It affects the biological, psychological, and social aspect of life which can cause frustration, depression, and anxiety. Unfortunately, the attention towards the disease in Indonesia is often overlooked as evidenced by the lack of studies regarding the prevalence and risk factors for the disease. This study aims to evaluate possible risk factors of Erectile Dysfunction among elderly males in Lamongan, East Java.
Methods: This is a quantitative study with an analytical observational design, performed using a case-control approach. Respondents consisted of male inpatients as well as outpatients aged 40 years or more in Ngimbang General Hospital evaluated using the International Index of Erectile Function (IIEF) questionnaire. The patient’s comorbid data are taken from the Medical Record to ensure proper diagnosis. The acquired data are then analysed using the ordinal logistic regression method.
Results: A total of 174 men were evaluated. There are 62 people with no ED (35.6%), 39 people with mild ED (22.4%), 35 people with mild to moderate ED (20.1%), 16 people with moderate ED (9.2%), and 22 people with severe ED (12.6%). Significant risk factors are older age (OR: 1.29; CI: 1.23-1.37), Diabetes (OR: 6.56; CI: 2.77-15.56), and hypertension (OR: 5.19; CI: 2.27-11.88) (all, p < 0.05); whereas dyslipidemia and smoking habit are insignificant (p>0.05).
Conclusion: Age, diabetes, and hypertension are significant risk factors for Erectile Dysfunction.
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Predisposing factors of kidney function recovery after postrenal obstruction
Jufriady Ismy, Lea Darman Syamaun Husen, Imam Hidayat Online First: December 01, 2019Predisposing factors of kidney function recovery after postrenal obstruction
Jufriady Ismy, Lea Darman Syamaun Husen, Imam HidayatBackground: Renal function recovery in postrenal acute kidney injury (AKI) patient is not always achieved and risk factor for chronic disease. Factors that affect of kidney function recovery include duration of symptoms, AKI stage and degree of hydronephrosis. The aim of the study is to determine the correlation of predisposing factors of renal function recovery in postrenal AKI patient.
Methods: A prospective observational analytic study with a cross-sectional study approach that involves postrenal AKI with urinary tract stones formers from August to November 2017. Renal function recovery was assessed by comparing creatinine levels before obstruction and after obstruction (3rd and 7th day) and be correlated by the duration of symptoms, AKI stage, and degree of hydronephrosis.
Results: 66 patients were included in the analysis of this study. Renal function recovery was found in 29 patients (43.9%) at 3rd day and 47 patients (71.2%) on the 7th-day post obstruction. There was a significant difference in mean creatinine levels before and after obstruction (p <0.0001). Both duration of symptoms, AKI stage, and hydronephrosis showed correlation on renal function recovery on 3rd and 7th day after obstruction (p < 0.05). In logistic regression analysis, hydronephrosis was the most correlated predisposing factor for renal function recovery in 3rd and 7th day after obstruction (p = 0.0001).
Conclusion: Factors duration of symptoms, AKI stage, and degree of hydronephrosis significant correlated to renal function recovery after post-renal AKI. Degree of hydronephrosis was the most correlated predisposing factors.
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High incidence of varicocele among young men in Public Police Hospital Denpasar, Bali, Indonesia: a descriptive study
Ryuu Damara Parisudha, I Gede Suwedagatha Online First: December 01, 2019High incidence of varicocele among young men in Public Police Hospital Denpasar, Bali, Indonesia: a descriptive study
Ryuu Damara Parisudha, I Gede SuwedagathaBackground: Varicocele is a progressive disease which possibly starts from puberty. When left untreated, it could progress and causes complications such as infertility. Determination on the representative national incidence and characteristic of varicocele has been a hard challenge due to the lack of data on varicocele epidemiological studies, especially in Bali. This study aims to know the characteristic of varicocele patients undergoing varicocelectomy in Bhayangkara Denpasar Hospital from January 2017 to December 2018.
Methods: This research is a descriptive retrospective study with cross sectional approach. The population of the study consists of patients who were diagnosed with varicocele and underwent varicocelectomy in Bhayangkara Denpasar Hospital from January 2017 to December 2018. Total sampling method was used. Research data were retrieved by taking the patient’s entire medical record with varicocele in Bhayangkara Denpasar Hospital from January 2017 to December 2018.
Results: Ninty five samples were diagnosed with varicocele and underwent varicocelectomy. The highest percentage among age groups is 15 to 24 years (89.5%), with normal stature (94%), normal weight (86%), asymptomatic (90.5%), left unilateral varicocele (86.%), grade III varicocele (82,1%) and without comorbid (93.8%). The samples underwent varicocelectomy with Ivanissevich procedure (72.8%), operation time of ≤ 60 minutes (95.8%) and length of stay of ≤ 2 days (95.8%).
Conclusion: The high incidence of varicocele in young adulthood is due to a majority of the samples being young police recruitment participants who were accidentally diagnosed during general medical check-up. Early screening on varicocele in the age group of 15 to 24 years is recommended to consider the need of sperm analysis examination and further deciding on the treatment options. One of the options is surgery.
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High level of anti-helicobacter pylori-heat shock protein 60II3, interferon-γ, and neopterin are risk factors of cardiovascular events in acute coronary syndrome patients
Anak Agung Wiradewi Lestari, I Wayan Wita, Ketut Suata, Ketut Suastika Online First: November 14, 2019High level of anti-helicobacter pylori-heat shock protein 60II3, interferon-γ, and neopterin are risk factors of cardiovascular events in acute coronary syndrome patients
Anak Agung Wiradewi Lestari, I Wayan Wita, Ketut Suata, Ketut SuastikaBackground: Chronic inflammatory process that may cause acute myocardial infarction (AMI) has been known to play an important role in the pathogenesis of atherosclerosis and atheroma plaque instability. Based on inflammation process, several previous studies showed contradictory results in finding a relationship between infection H. pylori with the formation of atherosclerosis through the establishment of immunoglobulin G (IgG) anti-H. pylori-HSP60II3 (IgG anti-Hp-HSP60II3), and neopterin level due to oxidative stress. This study aims to know whether IgG anti-Hp-HSP60II3, IFN-γ and neopterin are risk factors of cardiovascular events (CVE) in patients with ACS.
Methods: A prospective cohort study was conducted among 66 patients to determine the levels of IgG anti-Hp-HSP60II3, IFN-γ, and neopterin in patients with ACS as well as the levels of IgG anti-Hp-HSP60II3, IFN-γ, and neopterin. ACS patients were grouped into two groups: patients with ACS with positive prognostic factors (high levels of IgG anti-Hp-HSP60II3, IFN-γ, neopterin, and hs-CRP) and the group of patients with ACS without prognostic factor (low level of anti-IgG levels hp-HSP60II3, IFN-γ, neopterin, hs-CRP), and then were observed for 6 months while in the hospital. Data were analyzed using SPSS version 20 for Windows.
Results: In observations over a period of 6 months, found as many as 15 (22.7%) patients with CVE, which consisted of 11 (16.7%) patients’ vascular death, 3 (4.5%) patients had IMA and 1 (1.5%) patients experienced recurrent cardiac ischemia from 66 patients with ACS. Mean difference between the time of occurrence CVE subjects with high and low levels of neopterin are statistically significant (P<0.05). When confounding factors such as dyslipidemia, diabetes, hypertension, obesity, smoking, and age are controlled, only neopterin levels affect the incidence CVE with the incidence rate ratio of 6.46 (95% CI: 1.45-28.74; p = 0.014) and path analysis found the effect of neopterin on CVE incidence about 49,1%, p < 0.05. Kaplan-Meier analysis gives result that the average time of CVE on a group of subjects with high levels of neopterin is shorter (129.09 days) than the group of subjects with low levels of neopterin (168.33 days) (P=0.008).
Conclusion: This study found that the high level of anti-helicobacter pylori-heat shock protein 60II3, interferon-γ, and neopterin have a potential role in predicting risk factors of cardiovascular events in acute coronary syndrome patients
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Platelets level response after three days therapy in children with acute Immune Thrombocytopenic Purpura (ITP): a 10 years’ experience at the tertiary hospital
Ketut Ariawati, I Made Karma Setiyawan Online First: December 01, 2019Platelets level response after three days therapy in children with acute Immune Thrombocytopenic Purpura (ITP): a 10 years’ experience at the tertiary hospital
Ketut Ariawati, I Made Karma SetiyawanBackground: Immune thrombocytopenic purpura (ITP) is the most common cause of thrombocytopenia in children that characterized by isolated thrombocytopenia that vary in bleeding manifestations. The onset of disease is sudden and a self-limiting condition that requires treatment when clinically significant bleed occurs. A treatment goal is to increase platelet level above safety level and reduce the risk of severe bleeding. This study aims to evaluate the platelets level increment after three days treatment among children with acute ITP.
Methods: An analytic retrospective cross-sectional study was conducted in Haematology-Oncology Paediatric Division Sanglah General Hospital, Bali, Indonesia from October 2008 to October 2018 in ITP patients. Diagnosis of ITP was evaluated based on the clinical manifestation and laboratory finding. Oral corticosteroid medication with dosage 2 mg/kg/day or 4 mg/kg/day with or without platelets transfusion were enrolled in this study from medical records. Data were analyzed using SPSS version 20 for Windows.
Results: There were 93 children met the inclusion criteria and included in this study. A median platelets level at admission was 6.81(1-86.8) x 109/L. Majority symptoms of children with ITP in our tertiary care centre presented with mild to moderate clinical bleeding symptoms. Only 5.6% children with platelets level below 10x109/L had intracranial bleeding. Median platelets level was 31(2.47-382) x 109/l and there was a significant platelets level increment after three days of therapy (P<0.05).
Conclusion: The platelets level increment significantly in children with acute ITP after three days of therapy.
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The histopathological features and bacterial counts after exposure to Streptococcus pneumoniae serotypes 2,3,4 and 19 F in the lung of Balb/c mice
Ni Made Adi Tarini, I Nyoman Mantik Astawa, I Dewa Made Sukrama, I Wayan Wita, Ni Wayan Winarti Online First: December 01, 2019The histopathological features and bacterial counts after exposure to Streptococcus pneumoniae serotypes 2,3,4 and 19 F in the lung of Balb/c mice
Ni Made Adi Tarini, I Nyoman Mantik Astawa, I Dewa Made Sukrama, I Wayan Wita, Ni Wayan WinartiBackground: Pneumococci cause mild or severe infections that begin with colonization in the nasopharyngeal area. Intranasal transmission is a natural route of bacterial infection in the host. This study aims to determine the type of serotype that can infect and provide an overview of inflammation in the lungs of mice after exposure to 107 bacteria S. pneumoniae serotypes 2, 3, 4, 19F and ATCC 6030 intranasally in animals try Balb / c mice.
Methods: True experimental study was conducted using Randomized Posttest Only Control Group Design among 30 Balb/c mice divided into 3 groups. The intervention used in this study was carried out twice, namely at 24 hours and 48 hours with 50 μl suspension of Streptococcus pneumoniae bacterial inoculum via intranasal drop by drop. Lung histopathology and CFU analysis of infected mice were evaluated. TNF-α was examined using ELISA. Data were analyzed using SPSS software version 17 for windows.
Results: The results showed that S. pneumoniae serotype 3 could infect Balb / c mice and found about 5x104 CFU (SD ± 7x104 CFU) at 101 dilutions and was still detected at 104 dilutions i.e. 0.5 CFU (SD ± 0.7 CFU) at 24 hours post-infection as well at 48 hours post-infection, accompanied by infiltration of neutrophil cells in the lung tissue at the same time. The TNF-α levels did not significantly differ between the treatment group (P>0.05)
Conclusion: The results of this study indicate that not all S. pneumoniae serotypes can infect experimental animals.
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Cerebrospinal fluid contents and risk of shunt exposure in hydrocephalus
Muhamad Thohar Arifin, Febriyanto Purnomo, Zainal Muttaqin, Yuriz Bakhtiar, Erie Andar, Dody Priambada, Happy Kurnia, Ajid Risdianto, Krisna Tsaniadi, Gunadi Kusnarto, Jacob Bunyamin Online First: December 01, 2019Cerebrospinal fluid contents and risk of shunt exposure in hydrocephalus
Muhamad Thohar Arifin, Febriyanto Purnomo, Zainal Muttaqin, Yuriz Bakhtiar, Erie Andar, Dody Priambada, Happy Kurnia, Ajid Risdianto, Krisna Tsaniadi, Gunadi Kusnarto, Jacob BunyaminBackground: Exposure of the shunt is a rare but severe complication after ventriculoperitoneal (VP) shunt placement. It is unclear whether particular levels of cerebrospinal fluids (CSF) protein, glucose, or polymorphonuclears (PMNs) may influence the shunt exposure in high-risk individuals.
This study aims to find the relation between CSF parameters and shunt exposure.
Methods: Examined preoperative CSF characteristics included CSF colour, protein, glucose, and PMNs content in 513 patients with hydrocephalus. Mann-Whitney test was used to determine the correlation between CSF parameters and shunt exposure.
Results: Shunt exposure was detected in 25 cases (4.87%). There was a significant relationship between distal tip exposure with preoperative glucose (p=0.000), protein level (p=0.007), or PMNs count (p=0.043).
Conclusion: Preoperative CSF contents had a significant correlation with shunt exposure in hydrocephalus patients.
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EGFR nanovaccine in lung cancer treatment
Putu Bagus Anggaraditya, Putu Anda Tusta Adiputra, I Ketut Widiana Online First: December 01, 2019EGFR nanovaccine in lung cancer treatment
Putu Bagus Anggaraditya, Putu Anda Tusta Adiputra, I Ketut WidianaLung cancer is known as the most common malignancy in the world in terms of incidence and death rate. GLOBOCAN data in 2018 showed that its prevalence reaches 11.6% with mortality reaching 1.7 million annually. The prevalence of lung cancer in Indonesia is also considerably high; there were 25,332 cases in men and 9,374 cases in women with mortality reaching 308,660 people. In general lung cancer is classified as non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Although it is less common, SCLC has a worse prognosis with a 5 year survival rate of 6.4%. In addition, SCLC is also often diagnosed when it has metastasized or already reaced extensive stage (ES-SCLC). Although SCLC is classified as chemo-responsive cancer, the overall outcome of first-line and second-line therapy is still unsatisfactory with an ORR of 10-25%. One of characteristic of SCLC is genomic instability which relates to high level of mutations especially EGFR mutation that strongly correlate with therapeutic outcome. Therefore, targeting EGFR mutation is a sensible and potential field in developing SCLC therapy. EGFR-CpG-ODN nanovaccine is one of the potential therapeutic choices that exploit this mutation. EGFR CpG ODN nanovaccine could inhibit resistance to EGFR TKI, increased dendritic cell maturation, inhibit cancer cell proliferation and apoptosis, as well as enhance the anticancer immune response. Therefore, this therapeutic approach is a promising future therapy for SCLC petients that could improve patient’s survivability.
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Identification factors affecting adolescent’s reproductive health behavior: a qualitative study
Endang Triyanto, Yayi Suryo Prabandari, Kwartarini Wahyu Yuniarti, Sri Werdati Online First: December 01, 2019Identification factors affecting adolescent’s reproductive health behavior: a qualitative study
Endang Triyanto, Yayi Suryo Prabandari, Kwartarini Wahyu Yuniarti, Sri WerdatiIntroduction: Sexual risk behavior is mostly conducted by adolescents when the puberty started. The motivations underlies such behavior are varied including those related to individual, peers, family, and the environment. Therefore, this study aimed to explore the factors that affect adolescent’s reproductive health behavior.
Methods: This study used qualitative method with purposive sampling on high risk and low risk adolescents. Exploration was conducted in accordance with several behavior theories such as Ecological Model of Health Behavior, Problem Behavior Theory and Integrated Behavior Model. Data collection was conducted by in-depth interviews in 2018 at Banyumas District. The results of the interviews were then analyzed by content analysis technique.
Results: According to the results of content analysis, we found that reproductive behavior among adolescents was affected by two broad categories of factors namely individual internal factors and external factors. Individual internal factors were including age related risk, self-helplessness, knowledge, attitude, perceived norm, and lifestyle. External factors were determined by negative influence of peers, family, and environment risk. Peers, family, lifestyle and external factors seemed to influence personal values which could act as risk factor or protective factor depending on the nature of those factors involved.
Conclusion: This research revealed that reproductive health behavior among adolescents was influenced by multiple factors that interact with one another.
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Developing Indonesian version of childbirth self-efficacy inventory (Cbsei)-C32
Farida Kartini, Ova Emilia, Djaswadi Dasuki, Yayi Suryo Prabandari Online First: December 01, 2019Developing Indonesian version of childbirth self-efficacy inventory (Cbsei)-C32
Farida Kartini, Ova Emilia, Djaswadi Dasuki, Yayi Suryo PrabandariIntroduction: Women readiness and self-efficacy for pregnancy and childbirth is an important issue which usually assessed by using CBSEI-32 but currently no evaluation is ever conducted nor Indonesian version of this instrument ever developed to enhance subject understanding. Therefore, this study aimed to develop the Indonesian Language version of CBSEI (childbirth self-efficacy inventory) instrument.
Method: A quantitative study was conducted by involving 73 pregnant mothers in their trimester III either as the primigravida or as multigravida. The selected respondents are those who lived in the working area or visited several health care centres in the area between July-August 2018. The content validity was tested by using Aiken V analysis and the construct validity was assessed using Kaiser-Meyer-Olkin (KMO) and Bartlett’s test. Finally, the reliability test was conducted using Alpha Cronbach.
Result: Analysis revealed that the Aiken V value of the instrument was in the range of 0.67-1 for the outcome expectancy and 0.75-1 for efficacy expectancy. 16 items in outcome expectancy showed KMO value > 0.5 with MSA value between 0.648-0.957. Meanwhile, 16 questions in efficacy expectancy also had KMO value > 0.5 with a MSA range between 0.798-0.937 respectively. The average values of the instrument validity for the outcome expectancy and efficacy expectancy were 0.740 and 0.726 respectively. Finally, Alpha Cronbach value for both outcome expectancy and efficacy expectancy was 0.94.
Conclusion: According to the analysis, it can be concluded that CBSEI-C32 in Indonesia language version was valid and reliable instrument to be applied in pregnant mother in Indonesia.
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Factors influencing smoking behavior and intensity of santri in Asrama Perguruan Islam (API) Islamic boarding school, Tegalrejo, Magelang, Central Java, Indonesia
Punik Mumpuni Wijayanti, Yayi Suryo Prabandari, Djauhar Ismail, Atik Triratnawati Online First: December 01, 2019Factors influencing smoking behavior and intensity of santri in Asrama Perguruan Islam (API) Islamic boarding school, Tegalrejo, Magelang, Central Java, Indonesia
Punik Mumpuni Wijayanti, Yayi Suryo Prabandari, Djauhar Ismail, Atik TriratnawatiIntroduction: Tabaco related death is estimated at 6 million people worldwide and it is portrayed to increase to 8 million in 2030. In ASEAN alone, there were approximately 121 million adult smokers in 2013, in which 50% of them were Indonesian. In Indonesia, it is illegal to sell cigarettes to people under 18 years old, but this regulation has weak field implementation and the number of under-age smokers is considerably high in Indonesia. Therefore, this study aimed to analyse the effects of knowledge and perception with smoking intention and behaviour among santris at Asrama Perguruan Islam (API) Islamic boarding school.
Methods: A mix method study with sequential explanatory approach was conducted API Islamic boarding school in two phases namely qualitatively and quantitatively. 380 santris were enrolled in this study with interviewees for quantitative study was divided into three groups: santri who < 17 years old, santri who > 17 years old, and housekeepers.
Results: The results showed that the knowledge significantly affected the smoking behaviour while had no influence toward smoking intention. On the other hand, no significant association was observed between perceptions with smoking intention while it significantly affected the smoking behaviour.
Conclusion: It can be concluded that knowledge and perception were importance factors that influence smoking behaviour but had no effects toward smoking intention.
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Validity and Reliability of the Disaster Preparedness Knowledge Instrument for Health Cadres in Volcanic Disaster-Prone Areas
Ridlwan Kamaluddin, Laksono Trisnantoro, Syahirul Alim Online First: December 01, 2019Validity and Reliability of the Disaster Preparedness Knowledge Instrument for Health Cadres in Volcanic Disaster-Prone Areas
Ridlwan Kamaluddin, Laksono Trisnantoro, Syahirul AlimBackground: Public health cadres can play an important role in improving disaster response and recovery. However, a multidimensional instrument is needed to assess the levels of disaster knowledge for community health cadres. This instrument is important to develop a complete and effective educational program for disaster preparation for health cadres. Therefore, this study aimed to test validity and reliability of the disaster preparedness knowledge instrument for health cadres in areas prone to volcanic disasters.
Methods: A cross-sectional study was conducted by involving 300 respondents. The instrument was developed by conducting literature review followed by completing a qualitative study. We reduced the original instrument from 50 items to a final instrument comprising 41 items, classified into 6 categories: 1) early warning [16 items]; 2) disaster triage [4 items]; 3) basic life support [7 items]; 4) first aid [7 items]; 5) search and rescue [5 items]; and 6) logistic, communications and team organization [2 items]. Instrument validation was assessed by using Pearson Product moment and the reliability was estimated by using internal consistency reliability.
Results: 300 respondents were involved in this study with all respondents were women aged between 40-49 years old. All of them were either health cadre or high school students. In instrumental testing, all 41 items of the instrument were confirmed through content validity (Pearson Product Moment). Using internal consistency reliability, the study found reasonable inter-item reliability for all items (Cronbach’s α: 0.785-0.807).
Conclusion: Higher score on disaster triage aspect suggest that health cadres have pivotal role in emergency care during disaster. The finding revealed that disaster triage technique and skills for health cadres or lay man is very important.
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Correlation between Loss of Cervical Lordosis and Degenerative Diseases of the Sub-axial Cervical Spine Columns
Elysanti Dwi Martadiani, Made Widhi Asih, Nyoman Srie Laksminigsih, Anastasia Tjan, Nyoman Widyasari Online First: December 01, 2019Correlation between Loss of Cervical Lordosis and Degenerative Diseases of the Sub-axial Cervical Spine Columns
Elysanti Dwi Martadiani, Made Widhi Asih, Nyoman Srie Laksminigsih, Anastasia Tjan, Nyoman WidyasariBackground: Subaxial cervical spine is the cervical segment which commonly undergo degenerative changes. There are numerous cervical lordosis angle measurement, however posterior tangential method is considered more accurate to detect any degenerative related changes.
Aim: This study aimed to find the profile of cervical lordotic curve among patients with cervical degenerative disease, and to determine the correlation between degenerative process of subaxial cervical spine columns and cervical curve malalignment.
Method: A cross sectional study was conducted by adopting the posterior tangent measurement. Cervical alignment was measured from cervical MRI mid sagittal section to identify loss of cervical lordotic and the presence of kyphosis. Degenerative disease of each vertebral column of subaxial cervical spine, anterior and posterior were evaluated. Spearman correlation test was done to identify the relationship between degenerative process of each column of subaxial cervical spine with loss of cervical lordosis and the presence of kyphosis. Multivariate analysis was done to adjust the effect of confounding variable.
Result: Total of 90 subjects with male predominance (62%), mean age 54± 1.3 years. Neck pain contributes the most presenting complain (92%). As many as 51 subjects have hypo-lordosis, while 32 subjects have kyphotic changes. There was no significant correlation between degenerative process of each column of subaxial cervical spine and loss of cervical lordotic, but significant correlation was found between posterior listhesis and cervical kyphosis defomity. (p < 0.05).
Conclusion: There was significant correlation between cervical kyphotic malalignment with posterior listheis in all three vertebra columns instead of hypo-lordosis.
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Reproductive health promotion through traditional art media reduced the of premarital sex intention among adolescent population in Gianyar, Bali
Ni Putu Widarini, Fatwa Sari Tetradewi, Ova Emilia Online First: December 01, 2019Reproductive health promotion through traditional art media reduced the of premarital sex intention among adolescent population in Gianyar, Bali
Ni Putu Widarini, Fatwa Sari Tetradewi, Ova EmiliaBackground: Sex education in adolescents is still considered taboo to be discussed in the community. Traditional arts as communicative and informative socialization media contain meaningful messages, it is expected that teenagers get a good understanding of reproductive health so that they become healthy and quality adolescents. Therefore, this study aimed to evaluate reproductive health promotion through traditional arts media on adolescent knowledge, attitudes and sexual intentions in Gianyar, Bali.
Methods: A quantitative study with a quasi-experimental design was conducted with nonequivalent (pretest and posttest) control group. Data on premarital sex knowledge, attitudes and intentions were collected before and after staging traditional arts in the intervention group (75 adolescents). Data were collected from self-filled questionnaires and analyzed using STATA (version 12.0). Data analysis was conducted using Wilcoxon rank test and Wilcoxon rank-sum.
Results: The results showed an overall significant improvement in the knowledge and attitudes of adolescents about premarital sex and a decrease intention toward premarital sex after intervention (p value 0.00). The improvement in knowledge, premarital sex attitudes and intentions was more pronounced in the intervention group compared to control group. The control group that was not given an intervention showed a higher average value of premarital sex intention.
Conclusion: Reproductive health promotion program using traditional arts media was able to significantly reduce premarital sex intentions among teenagers.
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Diagnostic test using monofilament compared to electroneuromyography (ENMG) for detection of peripheral neuropathy in leprosy at Sanglah General Hospital, Bali-Indonesia
Luh Made Mas Rusyati, Putu Arie Sasmita, Made Swastika Adiguna Online First: December 01, 2019Diagnostic test using monofilament compared to electroneuromyography (ENMG) for detection of peripheral neuropathy in leprosy at Sanglah General Hospital, Bali-Indonesia
Luh Made Mas Rusyati, Putu Arie Sasmita, Made Swastika AdigunaIntroduction: Leprosy is a chronic granulomatous infection caused by M. leprae with high affinity to Schwann cell. Primary concern of leprosy is disability due to progressive nerve damage so that patients and their families are sometimes faced with social stigma and discrimination. This can be caused by late detection and treatment of nerve damage. Electroneuromyography (ENMG) as the gold standard for nerve damage detection has limitations in terms of cost and operational procedures, so there is a need for simpler and cheaper method such as monofilament test. This study aims to determine the validity of monofilament test compared to ENMG for the detection of peripheral neuropathy in leprosy.
Method: Study design using analytic method with cross-sectional approach, a total 40 patients including paucibacillary and multibacillary type of leprosy who met inclusion and exclusion criteria were recruited by consecutive-sampling. All subjects undergo monofilament test at Dermato-Venereology Clinic of Sanglah General Hospital Denpasar and electroneuromyography test at Neurology Clinic of Sanglah General Hospital Denpasar from December 2018 to February 2019. The data was analyzed to determine sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
Result: The result of this study revealed that monofilament test had an overall sensitivity of 67.2% and specificity of 77.5%. High sensitivity and specificity were found in the sural nerve (85.7% and 75%) and radial nerve (82.7% and 80%)
Conclusion: monofilament test can be considered for early detection of peripheral neuropathy, especially for sural and radial nerve.
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Three-weeks moderate aerobic exercise in increasing production of endogenous antioxidant enzyme and lowering oxidative stress level among sedentary men
I Putu Adiartha Griadhi, Tjokorda Gde Bagus Mahadewa, I Putu Eka Widyadharma Online First: December 01, 2019Three-weeks moderate aerobic exercise in increasing production of endogenous antioxidant enzyme and lowering oxidative stress level among sedentary men
I Putu Adiartha Griadhi, Tjokorda Gde Bagus Mahadewa, I Putu Eka WidyadharmaBackground: During exercise, there will be an increase of free radical due to the elevation of oxygen consumption to fulfill the increasing demand for energy. This free radical could produce by muscle and other tissue, especially from the leakage of mitochondria respiratory chain reaction. Moderate exercise training may provide adequate protection against exercise-induced oxidative stress by elevating the antioxidant level and healthier mitochondria that will produce less free radicals. This research will investigate the change of baseline level of MDA and superoxide dismutase (SOD) and also MDA and SOD level after a single bout of moderate exercise before and after three weeks of intervention.
Methods: Seven sedentary men with age average 17.2 + 0.2 years recruited for this study. They were meet the criteria of healthy sedentary men. Moderate aerobic exercise of 30 minutes running at 11 – 13 RPE Borg Scale, three times a week for three weeks in a row was applied to the subject. MDA and SOD examination was done by chromatographic assays for total plasma level. The collected data were analyzed using dependent student t-test. Data were normally distributed.
Results: The result of this research found a significant elevation of SOD production (p<0.01) after a single bout moderate exercise after three week training (19.98 + 15.52 vs 40.43 +19.64 mg/ml) and significant depression of MDA production (p>0.05) after training program (0.79 + 0.62 vs 1.97 + 0.94 nmol/ml).
Conclusion: There is no significant change in post-exercise MDA and SOD level before and after the training program. Initial fitness status, food intake, lifestyle could affect baseline level of MDA and SOD before and after exercise.
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Albumin and leukocyte: pre-operative factors for advanced management in pleural empyema?
Yopie Afriandi Habibie, Khalis Hamdani Online First: December 19, 2019Albumin and leukocyte: pre-operative factors for advanced management in pleural empyema?
Yopie Afriandi Habibie, Khalis HamdaniBackground: Surgical intervention such as video-assisted thoracoscopic surgery (VATS) has shown the benefit of reducing morbidity and mortality in the management of pleural empyema. The objective of the study was to investigate preoperative factors that could predict the need for VATS rather than chest tube thoracostomy.
Methods: This is retrospective observational study of consecutive patients diagnosed with pleural empyema admitted to the Dr. Zainoel Abidin Hospital, Banda Aceh in period of 2015 to 2017. The demographic, clinical dan laboratory data of the patients were evaluated from hospital medical records.
Results: A total of 48 consecutive patients were identified. The mean age of the patients was 34.3 ± 20.4 years; and 31 (64.6%) were male. Twenty-six patients underwent VATS decortication and twenty-two patients underwent chest tube thoracostomy. Patient demographics were similar between VATS decortication and chest tube thoracostomy group. The significant preoperative factors associated with the VATS were serum albumin level and leukocytes (p <0.05). The mean serum albumin level was 2.81 ± 0.44 g/dL for the VATS decortication group vs 3.06 ± 0.41 g/dL for the chest tube thoracostomy group (p = 0.047). In addition, serum leukocyte level was higher in VATS decortication group compared to chest tube thoracostomy group (21,600 mm-3 vs 12,900 mm-3; p = 0.024).
Conclusion: We demonstrate that a low serum albumin level or an elevated leukocyte level may represent as preoperative factors in which surgical treatment may be required in the management of pleural empyema.
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Protective effect of rotavirus immunization in acute diarrhea due to rotavirus infection: a prospective cohort study
Anak Agung Wiwin Indayani, I Putu Gede Karyana, Made Gede Dwi Lingga Utama, I Gusti Lanang Sidiartha, Ida Bagus Subanada, Anak Agung Ketut Putra Widnyana Online First: December 26, 2019Protective effect of rotavirus immunization in acute diarrhea due to rotavirus infection: a prospective cohort study
Anak Agung Wiwin Indayani, I Putu Gede Karyana, Made Gede Dwi Lingga Utama, I Gusti Lanang Sidiartha, Ida Bagus Subanada, Anak Agung Ketut Putra WidnyanaBackground: Diarrhea is a life-threatening disease for children. In Indonesia, the incidence of rotavirus infection was 67% of all cases of acute diarrhea. Immunization is an effort that can be done to prevent acute diarrhea due to rotavirus infection. Rotarix® vaccine is expected to have protective effect against acute diarrhea due to rotavirus infection. This study aims to investigate the protective effect of immunization against rotavirus on the incidence of acute diarrhea in children due to rotavirus infection.
Methods: This was an analytical study using prospective cohort approach in private pediatric clinics in Denpasar, Bali, Indonesia. Participants include one-hundred children aged 6 months was divided into two groups, i.e. vaccinated and non-vaccinated groups, each consisting of 50 children. Incidence of acute diarrhea in both groups were measured and subsequent statistical analyses were conducted to determine contributing factors for the protective effect of rotavirus vaccine against acute diarrhea.
Results: The incidence of rotavirus infection in vaccinated children was 6%, compared to 24% in the non-vaccinated children. There was significant association between vaccination status and the incidence of acute diarrhea due to rotavirus infection (p value=0.012). The probability of acute diarrhea due to rotavirus infection in both groups were 15% and 52% for the vaccinated and non-vaccinated groups, respectively. The relative risk reduction of acute diarrhea due to rotavirus infection is 71% [RR=0.288; 95% CI (52% -82%)].
Conclusions: Immunization against rotavirus infection has a statistically significant protective effect against acute diarrhea due to rotavirus infection.
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The ethyl acetate fraction of Moringa oleifera leaves effects on endothelial stress in rat sepsis model
Tatar Sumandjar, Bambang Purwanto, Brian Wasita, Dono Indarto, Risya Cilmiaty, Vitri Widyaningsih Online First: December 26, 2019The ethyl acetate fraction of Moringa oleifera leaves effects on endothelial stress in rat sepsis model
Tatar Sumandjar, Bambang Purwanto, Brian Wasita, Dono Indarto, Risya Cilmiaty, Vitri WidyaningsihBackground: Sepsis is a life-threatening organ dysfunction caused by the dysregulation of the host response to infection, facilitated by inflammation and endothelial stress. Moringa oleifera leaves fractioned with ethyl acetate (MO-EA fraction) is proposed to have the ability to suppress inflammation and oxidative stress through the control of NF-kB. This study aims to investigate the effect of the MO-EA fraction in a rat sepsis model.
Material and Methods: The study is a laboratory experimental study. The research was conducted on a total of 30 rats, equally divided into five groups. One group did not receive lipopolysaccharide (LPS) induction as negative control group, but the others received LPS induction and received variable doses of MO-EA fraction (0, 10, 20, and 40 mg/kg of bodyweight). The measured outcome were serum concentration of of heparanase, CRP, malondialdehyde (MDA), and immunohistologic expression of e-selectin, NF-kB in cells, and histopathological necrosis in the aorta and kidney.
Results: MO-EA fraction significantly decrease the serum levels of HPA, MDA on day 3 and 7, and lower the CRP serum level on day 7 (p<0.05). Other variables of interest did not show significant differences.
Conclusion: The administration of MO-EA fraction of any dose significantly lower the serum level of HPA and MDA in mice sepsis models on day 3 and 7, and lower CRP on day 3 but not on day 7. However, examnationa of NF-kB and e-selectin expressions, and necrosis in kidney proximal tubule and aortic endothelial cells did not show the benefit of MO-EA fraction in preventing cell damage.
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Diagnostic test of thorax computed tomography scanning in lung tumors against cytopathological results at Zainoel Abidin Hospital, Banda Aceh, Indonesia period June - August 2018
Indrita Iqbalawaty, Muhammad Yani, Nurul Machillah, Fajriah Fajriah, Asnawi Abdullah, Teuku Muhammad Ilzana, Cut Rizka Rahmi, Teuku Muhammad Khaled, Dara Purnamasari Online First: December 19, 2019Diagnostic test of thorax computed tomography scanning in lung tumors against cytopathological results at Zainoel Abidin Hospital, Banda Aceh, Indonesia period June - August 2018
Indrita Iqbalawaty, Muhammad Yani, Nurul Machillah, Fajriah Fajriah, Asnawi Abdullah, Teuku Muhammad Ilzana, Cut Rizka Rahmi, Teuku Muhammad Khaled, Dara PurnamasariIntroduction: Lung cancer which is a major cause of cancer deaths provides a perspective on the importance of the diagnosis of cancer since there is suspicion that influences the clinical diagnosis of lung cancer. Imaging modalities such as the use of contrast CT-Scan are very helpful in giving initial imaging before confirming cytopathological examination. The purpose of this study was to determine the value of the diagnostic tests possessed by CT-Scan compared to the gold standard cytopathological examination in patients with clinical diagnosis of lung cancer.
Methods: This study used a diagnostic study design with a retrospective approach at Zainoel Abidin General Hospital, Banda Aceh-Indonesia during the period June - August 2018. Analysis of diagnostic tests using cross-tabulation then calculation of sensitivity, specificity, positive predictive value (PPV), negative predictive calculations value (NPV), positive likelihood ratio (LR +), negative likelihood ratio (LR-), and accuracy were performed.
Results: Most CT-scan findings were pulmonary mass (59.3%) and the most cytopathological findings were squamous cell carcinoma (47.5%). The CT-Scan diagnostic test value compared with the gold standard cytopathological examination in the form of sensitivity, specificity, PPV, NPV, LR +, LR-, and accuracy was 75%, 30.4%, 64.4%, 50%, 0.054, 0.822 and 61% respectively.
Conclusion: Lung cancer could manifest as a wide spectrum of radiological presentations. CT-Scan provide a high sensitivity and accuracy of diagnostic in person with clinical presentation of lung cancer.
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Post total splenectomy outcome in thalassemia patients
Muntadhar M. Isa, Amir Thayeb, Ahmad Yani, Muhammad Bayu Z. Hutagalung Online First: December 31, 2019Post total splenectomy outcome in thalassemia patients
Muntadhar M. Isa, Amir Thayeb, Ahmad Yani, Muhammad Bayu Z. HutagalungIntroduction: Splenectomy in thalassemia patient is indicated in the transfusion-dependent patient when hypersplenism increases blood transfusion requirement, prevents adequate control of body iron with chelation therapy and increased risk for infection.
Method: This study was retrospective study aims to evaluate the outcome of splenectomy in pediatric thalassemia patients and its related factor. A total 34 thalassemia patient with post total splenectomy patients was included in this study.
Result: Mean age was 20.7 ± 6.5 years old with majority mild malnutrition (61.8%) and the majority of spleen size Schaffner 6-7 (73.5%). The duration between thalassemia diagnosis and total splenectomy was 6-7 years. Statistical analysis showed significant decreased of mean blood transfusion volume from 4691.4 cc per year to 3764.2 cc per year (p = 0.048), decreased mean blood transfusion volume from 219.6 cc per Kg Body Weight (BW) per year to 125.5 cc per Kg BW per year (p<0.001) and decreased of blood transfusion frequency from 12-14 times per year to 6-8 times per year (p<0.001). There is only one case subcutaneous emphysema as complication after splenectomy.
Conclusion: Overall, this study showed total splenectomy improve the outcome of thalassemia with hypersplenism with low rate of complication.
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Red guava juice (Psidium guajava linn.) suppress TGF-β protein expression in secondary hyperuricemia mice (Mus musculus) model
Riska Nur Suci Ayu, Brian Wasita, Paramasari Dirgahayu Online First: December 01, 2019Red guava juice (Psidium guajava linn.) suppress TGF-β protein expression in secondary hyperuricemia mice (Mus musculus) model
Riska Nur Suci Ayu, Brian Wasita, Paramasari DirgahayuBackground: Secondary hyperuricemia can increase the risk of renal dysfunction in the form of fibrosis and glomerulosclerosis mediated by TGF-β signalling. Non-pharmacological therapy through high dietary antioxidant intakes can help in controlling and preventing renal dysfunction by suppressing TGF-β expression. This study aimed to analyse the effect of red guava juice (Psidium Guava Linn.) on TGF-β protein expression in mice (Mus Musculus) kidneys with secondary hyperuricemia model.
Method: This was an experimental study with a post-test only design. Forty-eight mice (Mus Musculus) were choosen as samples, which were distributed into six different treatment groups. The mice were induced with potassium oxonate for 14 days and given red guava juice for 21 days. TGF-β protein expression in mice (Mus Musculus) kidneys was identified through immunohistochemistry using TGF-β antibodies. The preparation was observed in the Anatomical Pathology Laboratory, Faculty of Medicine, Universitas Sebelas Maret using the Olympus XC10 light microscope. Data were statistically analysed using the Kruskal Wallis test, followed by the Post-Hoc Mann Whitney test.
Results: The results of this study showed that the administration of red guava juice had a significant effect on TGF-β expression (p = 0.001). There was a significant difference between the negative control treatment and treatment of red guava juice at a dosage of 5 ml/kg/day (p = 0.043).
Conclusion: It can be concluded that the administration of red guava juice in mice (Mus Musculus) with secondary hyperuricemia model can suppress TGF-β expression, and therefore, can be used as non-pharmacological therapy.
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The out of pocket payments in low and middle-income countries and the affecting factors: a systematic review and meta-analysis
Esmat Nemati, Shirin Nosratnejad, Leila Doshmangir, Vahideh Zarea Gavgani Online First: December 01, 2019The out of pocket payments in low and middle-income countries and the affecting factors: a systematic review and meta-analysis
Esmat Nemati, Shirin Nosratnejad, Leila Doshmangir, Vahideh Zarea GavganiIntroduction: The out of pocket (OOP) payment is the most important source of health system financial support in low and middle-income countries (LMICs); therefore, considering and controlling health expenses are pivotal issues. The present study aimed to determine the households OOP payments in LMICs.
Method: Electronic databases, including Web of Science, Scopus, and PubMed were searched systematically in September 2015. Relevant papers on OOP payment in LMICs were included in the study. OOP payment was estimated as a percentage of Gross Domestic Product (GDP) per capita and household final consumption expenditure per capita in every country.
Results: Seventeen papers out of 3714 were included in the study. Eight studies were conducted in low-income countries, eight in middle-income countries, and one in both low and middle-income countries. The mean OOP payment as a percentage of households final consumption expenditure in LMICs was 0.67(α= 0.000, CI: 0.35-1.003) and the mean of OOP payment as a percentage of GDP in these countries was 1.65(α=0.000, CI: 1.57-1.72).
Conclusion: The households in LMICs face high levels of OOP payment. Therefore, many challenges must be overcome in financial support of health sectors. Health system policies and strategies are necessary to reform interventions in financing resources and purchasing health care services.
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Comparing the effect of Angiotensin-Converting Enzyme Inhibitors versus Angiotensin Receptor Blockers in heart failure patients with type 2 diabetes mellitus: a systematic review
Ratih Puspita Febrinasari, Bambang Irawan Martohusodo, Erna Kristin, Ricvan Dana Nindrea, Iwan Dwiprahasto Online First: December 01, 2019Comparing the effect of Angiotensin-Converting Enzyme Inhibitors versus Angiotensin Receptor Blockers in heart failure patients with type 2 diabetes mellitus: a systematic review
Ratih Puspita Febrinasari, Bambang Irawan Martohusodo, Erna Kristin, Ricvan Dana Nindrea, Iwan DwiprahastoAbstract:
Introduction: Heart failure is a prevalent world wide. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are widely prescribed. The aim of this study was to determine the effect of the two drugs in heart failure patients with type 2 diabetes mellitus.
Methods: This meta-analysis was performed on research articles on the drugs of heart failure patients in PubMed, ProQuest and EBSCO database published between 2008-2018. Pooled odds ratio (OR) are calculated using fixed and random effects models. Data were processed using Review Manager 5.3 (RevMan 5.3).
Results: From total 209 articles, 10 studies met the criteria for systematic review. Meta-analysis result showed that there were no difference effect of angiotensin-converting enzyme inhibitors versus angiotensin receptor blockers in heart failure patients with type 2 diabetes mellitus (RR = 1.73 [95% CI 0.88-3.40], p=0.11). Heterogeneity test for studies (Pheterogeneity = <0.00001) showed variation of heterogeneous research. There is no publication bias on this study Egger’s test (p = 0.334) and Begg’s test (p = 0.180).
Conclusion: This analysis confirmed there were no difference effect of angiotensin-converting enzyme inhibitors (ACEi) versus angiotensin receptor blockers (ARBs) in heart failure patients with type 2 diabetes mellitusMore ... | PDF
Graft procedure on urethroplasty, in comparison with flap procedure: a literature review
Gede Wirya Kusuma Duarsa, Putu Kurnia Darma Pratama, I Made Nugraha Gunamanta Sabudi, Donny Oktavius Online First: December 01, 2019Graft procedure on urethroplasty, in comparison with flap procedure: a literature review
Gede Wirya Kusuma Duarsa, Putu Kurnia Darma Pratama, I Made Nugraha Gunamanta Sabudi, Donny OktaviusUrethroplasty is a surgical procedure to reconstruct urethral patency on urethral stricture. There are several options for repairing urethral stricture in general, one of the examples is using graft or flap for augmentation urethroplasty. The indications of augmentation urethroplasty with graft are bulbar or penile urethral stricture, risk of tension on urethral anastomosis, and stricture more than 1 cm. Graft is less reliable because it has to be revascularized, easier to harvest, on the other hand flap has generous blood supply, but it was time-consuming to collect and to dissect. In case of bulbar urethral stricture with intact corpus spongiosum, graft had more advantages rather than flap because the anatomy of the urethra moves proximally giving thicker and more robust ventrally, and makes the graft suitable on vascular bed. Plenty of sites can be used to harvest graft for urethroplasty, there are buccal mucosa, genital skin, extragenital skin, lingual mucosa, bladder mucosa, and colonic mucosal graft. Although the treatment of urethroplasty depends on the length and location of stricture until today the comparison between the use of graft and flap in urethroplasty is still controversy and under debate.Some studies reported higher success rates in grafts than flaps procedure, but only few studies showed statistically significant difference. However, grafts procedure is easier, less operative time, and less morbidity, therefore leading to satisfaction in most of the patients.
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Introducing the tolerogenic macrophage therapy as an alternative approach to manage systemic lupus erythematosus: a case series
Terawan Agus Putranto, Djoko Wibisono, Nyoto Widyo Astoro, Martina Lily Yana, Endra Tri Prabowo, Denny Irwansyah, Nurhadiyanta Nurhadiyanta, Yudo Rantung, Taruna Ikrar, Fred Fandrich Online First: December 01, 2019Introducing the tolerogenic macrophage therapy as an alternative approach to manage systemic lupus erythematosus: a case series
Terawan Agus Putranto, Djoko Wibisono, Nyoto Widyo Astoro, Martina Lily Yana, Endra Tri Prabowo, Denny Irwansyah, Nurhadiyanta Nurhadiyanta, Yudo Rantung, Taruna Ikrar, Fred FandrichIntroduction: Systemic Lupus Erythematosus (SLE) has been quite an enigma in medicine. The possibility of the host own defense mechanism attacking itself is still quite difficult to understand. Patients who suffer from this disease tend to have a problem in their qualities of life, especially as the majority affect female in their productive ages. Conservative therapy to manage this disease is widely developed and implemented. Since the known therapies have several side effects and limitation, a need to develop a new strategy that can re-establish the “tolerance” mechanism of our immune system is increasingly needed. Immunotherapy is already a promising field in the strategy against autoimmune cases. In our facility, we developed immunotherapy called ToM (Tolerogenic Macrophage) which similar to Mreg (Regulatory Macrophage) in order to utilise the “tolerance” ability of this immune apparatus.
Case: In this study, we present 2 cases of female patients who suffer from SLE, which underwent ToM Therapy in our Cellcure facility in RSPAD Gatot Soebroto Jakarta-Indonesia. After the procedure the patient was monitored one month and one year. Clinical and control parameter such as ANA (IF) and ANA profile was examined again in both patients to measure the effect of this therapy. The ANA titer and the titer of specific antibodies such as dsDNA, Nucleosomes and Histones results show significant reduction, accompanied by the improvement of the symptoms.
Conclusion: ToM Therapy seems to have a good efficacy as immunotherapy for SLE. Further study needed to establish this approach.
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Mitogen-activated protein kinase 3 (MAPK3) and human epidermal growth factor receptor 2 (HER2) on recurrent intracranial meningiomas: a case report
Ridha Dharmajaya, Abdurrahman Mouza Online First: December 01, 2019Mitogen-activated protein kinase 3 (MAPK3) and human epidermal growth factor receptor 2 (HER2) on recurrent intracranial meningiomas: a case report
Ridha Dharmajaya, Abdurrahman MouzaIntroduction. Meningiomas accounts for one-third of all adult central nervous system tumors and by far the most common primary intracranial tumor in adults. Despite their high prevalence, it remains challenging to predict their biological and clinical behavior. To date, it has been accepted that the extent of surgical resection and histological grade are the most reliable factors to predict the recurrence of meningiomas. HER2 and MAPK3 represent a well-known prognostic factor in various tumors, however only a few studies on the relationship between meningioma recurrence, HER2, and MAPK3 expression. This report presents additional data that support the relationship between the expression HER2 and MAPK3 with recurrent of meningioma.
Case: We report 39 years-old-female with recurrent meningioma. The patient had tumor removal a year ago. After the first resection, the tumor demonstrated rapid growth with significant invasion to neighboring dural tissue and brain parenchyma, which resulted in impaired brain function and intracranial hypertension manifested as severe headache, vomiting, and coma. Histopathological examination confirms a malignant meningioma (WHO grade I). The patient had the second craniotomy for tumor removal, and we performed immunohistochemical staining. The result was positive for HER2 and MAPK3
Conclusion: HER2 and MAPK3 might be a reliable predictor of recurrent meningiomas.
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Type IA urethral duplication: a case report
Miftah Adityagama, Yonas Immanuel Hutasoit Online First: December 01, 2019Type IA urethral duplication: a case report
Miftah Adityagama, Yonas Immanuel HutasoitBackground: Urethral duplication is a rare congenital malformation mainly affecting men and boys. Although a number of theories have been proposed to describe this condition, the actual mechanism of this disorder is still not clear. The most frequent anomaly occurs in the sagittal plane, in which the duplicated urethra is in either dorsal or ventral position in relation to the orthotopic urethra. The therapeutic management of these conditions is complicated and depends on the presence of symptoms as well as the type of anomaly.
Case Description: We present a case of urethral duplication in a 2 years old male child. The malformation was characterised by the presence of the meatus in the dorsal penoscrotal and accompanied by the sign of infection in it. Urethrography showed contrast stopped filling 2 cm from the meatus in the dorsal penoscrotal with a total dead-end impression as an accessory urethra and there was no abnormalities in the principal urethra looked from the contrast filled the penile urethra, bulbous urethra, prostatic urethra, and bladder. That was the form of Effmann Type IA urethral duplication. The dorsal accessory urethra was excised entirely without complication and he remains symptom-free eight months after surgery.
Conclusion: In summary, urethral duplication is a rare clinical condition. It has many variants that were classified by Effman. Management depends on the anatomy of the duplication involved and the patient’s clinical symptoms.
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Management of 14 hours penile fracture: a case report
Johannes Cansius Prihadi, Kevin Anthony Glorius Tampubolon, Dicky Dicky Online First: December 01, 2019Management of 14 hours penile fracture: a case report
Johannes Cansius Prihadi, Kevin Anthony Glorius Tampubolon, Dicky DickyIntroduction: Penile fracture is a rare urological emergency that needs immediate repair. It is usually caused by trauma in its origin, whether during sexual intercourse, exotic self-inflicted, fall, or vehicle-related. Tunica albuginea and/or corpus cavernosa are severed, it can sometimes be accompanied by rupture of the urethra. Immediate surgical repair should be done as soon as possible to prevent further complication.
Case Presentation: A 52 years old male comes with swelling and severe pain on his penis 14 hours following sexual intercourse with his partner. No blood in the external meatal nor hematuria was present, and there were no abnormal passing of urine complained. Immediate repair of the corpus cavernosum was performed. The penis was degloved and the corporal tear was closed using absorbable suture. 8 hours following surgery, the patient had a morning erection and no early signs of complication observed.
Conclusion: Immediate surgical repair should be presented after penile fracture was diagnosed. Emergency surgical repair can preserve voiding and sexual function.
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Rhabdoid adrenocortical carcinoma with brain metastasis: a case report
I Wayan Yudiana, Made Moniaga Prawira, Ida Bagus Putra Pramana, Pande Made Wisnu Tirtayasa, Kadek Budi Santosa, Gede Wirya Kusuma Duarsa, Anak Agung Gede Oka Online First: December 01, 2019Rhabdoid adrenocortical carcinoma with brain metastasis: a case report
I Wayan Yudiana, Made Moniaga Prawira, Ida Bagus Putra Pramana, Pande Made Wisnu Tirtayasa, Kadek Budi Santosa, Gede Wirya Kusuma Duarsa, Anak Agung Gede OkaIntroduction: Adrenocortical carcinoma (ACC) is a rare disease with the incidence about 0,02-0,2% from all case of malignancies. The number of malignancies cases reported annually being about 0,7-2 cases per million people. ACC can be functional or nonfunctional tumors, being diagnosed incidentally because of loco-regional symptoms or distant metastases. The overall 5-year survival rate after diagnosis was 15% to 47% and there are no significant differences in survival based on patient age, gender or tumor functional status.
Case Report: A 47 years old male came into emergency room with nauseous, vomiting, headache and weakness for 4 weeks. From the physical examination, there were slight hypertension and tenderness on left hypochondric region. Abdominal ultrasound showed a solid mass with central necrotic on upper left abdominal cavity. Then, contrast abdominal CT revealed a well defined heterogeneous solid mass, contrast enhancement with necrotic area that attached on the upper pole of left kidney suspicious on left adrenal organ. He was performed left radical adrenalectomy as initial treatment to determine the histopathology result and tumor staging. After surgery complains of his headache remained, thus head CT was performed and it concluded an intracranial metastatic process at right parietal region, left temporal brain parenchymal and cerebellum which pressing ventricle IV. Steroid and neurotrophic treatment were given by neurologic division. This patient was also consulted to neurology, hemato-oncology, neurosurgery and radiotherapy for further treatment.
Conclusion: ACC is a progressive disease with a poor prognosis because of its initial presentation with advance disease (tumor burden or distant metastases), high incidence of local recurrence, and systemic therapy still controversial. The patient has to do a complete physical examination, imaging and laboratory work-up. Multimodality treatment with a multidisciplinary approach is needed to manage the patient for optimal outcome.
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Penile glans necrosis following penile sclerosing lipogranuloma repair: a rare case
Boyke Soebhali Online First: December 01, 2019Penile glans necrosis following penile sclerosing lipogranuloma repair: a rare case
Boyke SoebhaliBackground: Ischemia or necrosis of the penile glans is a rare condition, commonly as a result of trauma, diabetes mellitus, circumcision, vasculitis and vasoconstrictive solutions administration. Sclerosing lipogranuloma of the penis is mainly a complication arising from injection of oil-based liquid to the subcutaneous tissue of the penis. No previously reported case of penile glans necrosis has been reported as the result of penile sclerosing lipogranuloma repair.
Case Description: We report a 45-year-old man presented with a hardened penile skin after injection of unknown liquid material to his penile skin 10 years earlier. The abnormality made him difficult to perform sexual activities because of pain during sexual intercourse. The suprapubic area was also affected, with a tender mass similar to the penile skin. First stage penile reconstruction using Cecil’s two stage technique was performed. After seven days, the patient noticed his penile glans was blackened, and he complained about less sensation on the glans. In the fourteenth day, debridement of the necrotic glans surface performed, and healthy glans tissue was found beneath the necrotic tissue. After six months, the second stage reconstruction was performed with a satisfying result.
Conclusion: Necrosis of the penile glans is a rare condition after reconstruction of sclerosing lipogranuloma of the penis. Debridement of the necrotic tissue and glans resurfacing can be a good choice to correct this problem.
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PKB XXVII Ilmu Penyakit Dalam: Comprehensive Management in Internal Medicine
PKB XXVII Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Udayana Online First: August 30, 2019PKB XXVII Ilmu Penyakit Dalam: Comprehensive Management in Internal Medicine
PKB XXVII Ilmu Penyakit Dalam Fakultas Kedokteran Universitas UdayanaForeword
Internal Medicine is quickly developing in all lines, from basic theories, pathophysiology, diagnostic procedures and therapy. The challenges of new cases and the re-emergence of re-emerging diseases in the era of globalization, modernization and industrialization require clinicians to constantly renew their knowledge and expertise and possess global standard quality to improve medical services. Information on medical science and technology is now easily accessible to anyone, produce an increasingly critical society and bring up challenges for clinicians.
The advancement of Indonesian doctors must be supported by access to regional, national and international scientific communication in the form of scientific forums that present the latest research information and results, as well as a forum for discussion with experts in addition to establishing family bond for doctors.
Pendidikan Kedokteran Berkelanjutan (PKB) Internal Medicine Department, Faculty of Medicine of Udayana University / Sanglah Hospital 2019 is a scientific activity in Internal Medicine topics held annually. In the series of activities of PKB XXVII in Internal Medicine Faculty of Medicine Universitas Udayana / Sanglah Hospital 2019, the update in the field of Internal Medicine will be presented in the form of training (workshops), symposiums, and expert discussions hence the opportunities for interaction between participants and experts are optimal. Development in the field of research is also a concern and we give appreciation in the form of opportunities to compete in oral papers and posters.
Dr. I Wayan Losen Adnyana, SpPD-KHOM
Chairman
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The 3rd Live Surgery Workshop International Society of Reconstructive Urology (ISORU), 2nd International Live Surgery Workshop Indonesia Genitourinary Reconstructive Society (InaGURS), and 12th Malang Continuing Urology Education (MCUE)
Paksi Satyagraha Online First: December 01, 2019The 3rd Live Surgery Workshop International Society of Reconstructive Urology (ISORU), 2nd International Live Surgery Workshop Indonesia Genitourinary Reconstructive Society (InaGURS), and 12th Malang Continuing Urology Education (MCUE)
Paksi SatyagrahaDear colleagues and friends,
It is truly a pleasure to invite you to actively participate in the upcoming meeting, The 3rd Live Surgery Workshop International Society of Reconstructive Urology (ISORU), 2nd International Live Surgery Workshop Indonesia Genitourinary Reconstructive Society (InaGURS), in conjunction with 12th Malang Continuing Urology Education (MCUE), which will be held on September 5th-7th, 2019, in Bali Nusa Dua Convention Center (BNDCC), Bali, Indonesia.
The theme chosen is Reconstructive Urology.
These three important meetings that held in conjunctionally will provide a wonderful forum for you to refresh your knowledge and explore new techniques and innovation in urology field from well-known experts. The symposia will be held on the first day and on the 2nd and 3rd day, they are going to be the highlight of live surgeries on various cases of reconstructive urology.
Additionally, we would like to also invite you to submit your recent achievement in scientific writing in various field of Urology. The scientific committee will prepare the prestigious oral presentation and poster presentation awards.
The island of the gods, Bali, awaits you!
Undisputable world well-known meeting destination is easily reach with direct flights from most major cities in the world. Since March 2016 Indonesian government has granted 169 countries for FREE Visitor Visa. Please check the list of countries and further details in visa section at the congress website www.mcue.org
Please make sure you have blocked this important dates and visit the congress website for further program update.
See you soon in Bali……
Paksi Satyagraha
Congress Chairman
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The 3rd Aceh Surgery Update 2019 in Conjugation with The 1st Indonesian General Surgeon Society (PABI) Aceh Chapter Meeting and The 1st Ikatan Alumni Bedah Unsyiah (IABU) Meeting
Yopie Afriandi Habibie Online First: December 06, 2019The 3rd Aceh Surgery Update 2019 in Conjugation with The 1st Indonesian General Surgeon Society (PABI) Aceh Chapter Meeting and The 1st Ikatan Alumni Bedah Unsyiah (IABU) Meeting
Yopie Afriandi HabibieAssalamu’alaikum Wr. Wb
Praise and gratitude we pray the presence of Allah SWT for all His mercy and guidance we can still work and work to help in the field of education and humanity. With our greetings and prayers, we are praised to the Holy Prophet Rahmatan lil alamin Rasulullah Muhammad SAW who has brought us from the realm of darkness to a world full of knowledge.
In it’s third year, the 2019 Aceh Surgery Update will be held in conjunction with The 1st Indonesian General Surgeon Society (PABI), Aceh Chapter Meeting and The 1st Unsyiah Surgical Alumni Association (IABU) Annual Meeting, on December 06th – 08th December 2019 at Dr. Zainoel Abidin Hospital and Building D Multipurpose Auditorium F-MIPA Universitas Syiah Kuala Banda Aceh, with the theme of Tips and Traps in Emergency Surgical Daily Practice. The scientific program this time was very special with the presence of the Bali Medical Journal indexed by Web of Science in scientific publications for all topics presented, both in symposium sessions and free papers.
I would like to welcome all the experts who have been willing to attend to be the resource persons at this scientific event. A big thank you to all the committees and sponsors who helped to make this big activity a great success. Finally, I also welcome to all delegates, I hope you all get a high valuable scientific experience in the Banda Aceh, the City of Gemilang. Wassalam,Sincerely yours, Yopie Afriandi Habibie, MD, SpBTKV-E, FIHA, FICS, FACSChairman
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