(Available online: 1 April 2018)
Vol 7, No 1 (2018): (Available online: 1 April 2018)
Abdurachman Abdurachman A Rubiyanto Suhariningsih Suhariningsih Hendromartono Hendromartono A Gunawan
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Oral administration of Neem (Azadirachta indica A. Juss) leaf extract increases Cyclin D1 expression in hepatocyte regeneration in acetaminophen-induced hepatotoxic Wistar Rats
Suhendro Suhendro Anak Agung Ayu Ngurah Susraini Herman Saputra Ni Putu Sriwidyani
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The effect of implementing nursing ethics code as a combined plan, in the School of nursing and clinical setting, Bojnurd, North Khorasan Province (2013-2015)
Maryam Maddineshat Mitra Hashemi Alireza Gharib
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The relationship of general health and marital satisfaction with job satisfaction of employees working in Melli Bank of Ahvaz, Iran
Farideh Narimisaei Amal Sharifi Fard
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Rumi’s cognitive therapy approach to health and disease
Reza Hakimi Ehsan Hakimi
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Hearing threshold differences between pre and post tympanoplasty in patients with chronic suppurative otitis media
Rina Hayati T Siti Hajar Haryuna Devira Zahara
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The aerobic-anaerobic bacteria pattern and its sensitivity pattern in chronic rhinosinusitis patients, in Medan, Indonesia
Adrian Kadafi Lubis Delfitri Munir Siti Nursiah Raden Lia Kusumawati Putri Chairani Eyanoer
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Correlation between dental health maintenance behavior with Dental Caries Status (DMF-T)
Made Ayu Lely Suratri Indirawati Tjahja N Vivi Setiawaty
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Maternal mortality audit based on district maternal health performance in East Java Province, Indonesia
Budi Prasetyo Hanifa Erlin Damayanti Rizki Pranadyan Pandu Hanindito Habibie AC Romdhoni Dian Islami
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Predictors of multidrug resistance among pulmonary tuberculosis patients in a tertiary hospital in North Sumatera, Indonesia
R. Lia Kusumawati Tryna Tania Edward McNeil Virasakdi Chongsuvivatwong
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Low Density Lipoprotein (LDL) values in bacterialistic sepsis patients at Haji Adam Malik Hospital Medan-Indonesia 2017
Ernita Sinaga Tambar Kembaren Armon Rahimi
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The role of single nucleotide Interleukin-6 (IL-6) polymorphism gene in Psoriasis vulgaris patients at Haji Adam Malik Central Hospital, Medan-Indonesia
Cashtry Meher Irma . D. Roesyanto-Mahadi Lia Iswara Kusumawati
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Comparison between ringerfundin (B Braun) and ringer lactate administration towards Interleukin-6 (IL-6) levels in sepsis and septic shock patients at Haji Adam Malik Hospital, Medan-Indonesia
Fahmi Sani Achsanuddin Hafie Muhammad Ihsan
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Antimicrobial coatings and films on meats: A perspective on the application of antimicrobial edible films or coatings on meats from the past to future
Mohammad Yousefi Maryam Azizi Mohammad Amin Mohammadifar Ali Ehsani
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Data mining approach for exploring socioeconomic patterns in cancer
Leila Hosseini Hossein Vatanpour Mehdi Mohammadzadeh Mohamadreza Abdolahi Rita Motidostkomleh
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The comparative study of pre and post-surgical experience, self-esteem, self-confidence, body image, in patients undergoing blepharoplasty surgery
Melissa Bashizadeh Farhad Adhami Moghadam Mohammad Sahebalzamani Hojjatollah Farahani
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Aging changes' inhibition of hemostasis and blood rheological features on the background of antioxidant lipisomal preparation "Lipovitam-Beta" application
O. N. Makurina V.V Zaitsev A.V Kolesnikov O.V Sokol A.V Sadykhova
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Health Information Management: Psychological factors influencing information privacy concerns in psychiatric hospitals
Maryam Ghazi-asgar Hamid Reza Peikari Asghar Ehteshami
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Serum Neutrophil Gelatinase-Associated Lipocalin (NGAL) level difference in benign and malignant epithelial ovarian tumor
Abdul Gafur Deri Edianto Roy Yustin Simanjuntak Hotma Partogi Pasaribu Edy Ardiansyah Henry Salim Siregar
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Profile of sinonasal malignant tumor patients in Adam Malik General Hospital Medan-Indonesia
Fiza Fadly Farhat Farhat Rizalina Arwinati Asnir
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The effect of prune on the severity of constipation in elderly women
Ali Mansouri Aziz Shahraki-Vahed Hossein Shadadi Hajar Noori Sanchooli Azizollah Arbabisarjou
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The effect of garlic and cumin on blood pressure and glycosylated hemoglobin in patients with type 2 diabetes
Ali Mansouri Aziz Shahraki Vahed Hossein Shahdadi Fatemeh Dashtban Azizollah Arbabisarjou
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Functional heartburn in Iranian patients with non-erosive gastroesophageal reflux disease
Hashem Fakhre Yaseri
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Quantification analysis of tissue eosinophilia in squamous cell carcinoma of the head and neck region
M Sabzijate AH Khatibi T Ghiasian S Rahrotaban E Rastegar SH Eftekharian
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Determination and comparison of stomach residual volume at two alternate gavage ways with gravity and injection force in premature infants
Samaneh Sadat Sojasi Mahnaz Gebreili Malihe Assadollahi Mohammad Baqer Hosseini Mohammad Asghari Jafarabadi
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Comparison of life expectancy, quality of life, irrational health beliefs, health locus of control and hospital depression in patients undergoing hemodialysis and heart transplant in Shahid-Rajaee hospital
Mohammad Oraki Nahid Zarrati Iran Zarrati
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Development of performance evaluation indicators for pre-hospital emergency centers
Rohollah Askari Mohammad Amin Bahrami Saeed Reza Pahlavanpoor Fatemeh Afzali
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Correlation of Matrix Metalloproteinase-9 (MMP-9) expression and bone destruction in Chronic Suppurative Otitis Media (CSOM) patients with cholesteatoma at Adam Malik General Hospital Medan-Indonesia
Sadri Yulius Harry Agustaf Asroel Askaroellah Aboet Fotarisman Zaluchu
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The effect of topiramate as an adjunct therapy to acetazolamide in Idiopathic intracranial hypertension patients.
Rahimdel Meibodi Melat Ardekani Ali Shafiee Mohammad Mansouri Mehrdad Akbarian Abolfazl
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The Concentration of Interleukin-27 in the pleural fluid of patients with exudative pleural effusion and its diagnostic value in differentiating between benign and malignant pleural effusion
Reza Hashempour Ali Aryannia Mahshid Mehrjerdian Seyyed Sadegh Baniaghil Arash Rezaie Reza Alipoor
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Effect of Andrographis paniculata tablet (AS201-01) on Transforming Growth Factor Beta (TGF-β) expression and parasite inhibition in mice placenta infected with Plasmodium berghei
Aty Widyawaruyanti Jatmiko Rachmat Nurya Viandika Hilkatul Ilmi Lidya Tumewu Budi Prasetyo
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Second victim support program and patient safety culture: A quasi experimental study in Bali International Medical Centre (BIMC) Hospital
Made Indra Wijaya Abd Rahim Mohamad Muhammad Hafizurrachman
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Reducing Methicillin-Resistant Staphylococcus Aureus (MRSA) Cross-Infection through Hand Hygiene Improvement in Indonesian Intensive Tertiary Care Hospital
Andaru Dahesihdewi Iwan Dwiprahasto Supra Wimbarti Budi Mulyono
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Comparison of analgesic effect and duration of midazolam and fentanyl addition to intrathecal bupivacaine 0.05% in lower limb orthopedic surgeries
Arazberdi Ghourchaie Kazem Kazemnejad Payam Soroudi
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The Effect of Overnutrition Toward the Risk of Dengue Shock Syndrome in Pediatric Patient: In-Depth Investigation of sVCAM-1 and Adiponectin Level
Ni Kadek Elmy Saniathi Bambang Udji Djoko Rianto Mohammad Juffrie Soetjiningsih .
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Low Vitamin D serum level increases severity symptoms in schizophrenic patients measured by Positive and Negative Symptoms Scale (PANSS) in Batak Tribe Sumatera Utara, Medan-Indonesia
Novi Prasanty Mustafa Mahmud Amin Elmeida Effendy Joeseof Simbolon
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Distribution of iNOS expressions and TNF neutrofil cells as well as PGE2 and S100 Schwann cell dermal nerves in the erythema nodosum leprosum patients
I Gusti Nyoman Darmaputra Nanny Herwanto Luh Mas Rusyati Wibi Riawan Anang Endaryanto Cita Rosita Sigit Prakoeswa
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The comparative study of strategic purchasing of health services in selected countries: A Review Study
Ghasem Abedi Jalil Shojaee Peivand Bastani Mohammad Javad Kabir Jamshid Yazdani
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Factors influencing the inpatients satisfaction in public hospitals: a systematic review
Abdollah Salehi Ali Jannati Shirin Nosratnjad Lavin Heydari
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Degenerative Spondylolisthesis : The preferable surgical technique
Komang Agung Irianto Firman W. Hatmoko Laskar P K
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Human resources challenges in health system reforms: A systematic review
Roghayeh Khalilnezhad Hassan Abolghasem Gorji Mahboubeh Bayat
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Metachronous Multiple Primary Malignancies (endometrium and breast): A case report
Ketut Suega Prayuda Prayuda
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Burkitt lymphoma in a child: a case report
Anak Agung Wiradewi Lestari Sianny Herawati Ketut Ariawati
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The effectiveness of frenotomy in the treatment of ankyloglossia: A case report from Adam Malik General Hospital Medan-Indonesia
Farhat Farhat Rizalina A. Asnir Ashri Yudhistira Elvita Rahmi Daulay Adrian Kadafi Lubis
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Maple syrup urine disease: the first case in Bali
Putu Andina Pramitasari I Gusti Lanang Sidiartha Irene Widodo
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The optimal dose of the Low-level laser therapy in the treatment of type 1 Diabetes Mellitus
Abdurachman Abdurachman, A Rubiyanto, Suhariningsih Suhariningsih, Hendromartono Hendromartono, A GunawanThe optimal dose of the Low-level laser therapy in the treatment of type 1 Diabetes Mellitus
Background: Type 1 DM (T1DM) is caused by an autoimmune destruction of pancreatic ß cells. We proposed a novel stimulation using a low-level laser therapy (LLLT) through acupuncture points to stimuli the stem cells to be adult pancreatic ß cells. This study aimed to identify an optimal dose of low-level laser therapy (LLLT) for treatment of type 1 diabetes mellitus (T1DM).
Methods: An experimental study was performed with a pretest-posttest control groups design. The intervention was tested in rats (Rattus novergicus, Wistar strain). The rats were made diabetic by injection of streptozotocin (STZ). Rats were treated with different doses of LLLT in 4 groups. The tested laser doses were 0.2 joules (group L1), 0.3 joules (group L2), 0.4 joules (group L3), and 0.5 joules (group L4). The therapy was performed by perpendicularly attaching laser probe to the animal body, at the acupuncture point pishu (BL-20) on respective sides.
Results: Rats in the L2 group were performing better compared to others. The highest decrease of blood glucose level was found in group L2. Two rats in the L2 group achieved normal blood glucose level upon laser therapy. The dose of laser therapy in the L2 group of 0.3 joules was found to be the optimum dose.
Conclusion: Clinical and statistical analyses indicated that 0.3 joule was the optimal dose for LLLT in our animal model. Further investigation of LLLT in human is warranted and validation of the identified dose in future studies should be pursued.
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Oral administration of Neem (Azadirachta indica A. Juss) leaf extract increases Cyclin D1 expression in hepatocyte regeneration in acetaminophen-induced hepatotoxic Wistar Rats
Suhendro Suhendro, Anak Agung Ayu Ngurah Susraini, Herman Saputra, Ni Putu SriwidyaniOral administration of Neem (Azadirachta indica A. Juss) leaf extract increases Cyclin D1 expression in hepatocyte regeneration in acetaminophen-induced hepatotoxic Wistar Rats
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The effect of implementing nursing ethics code as a combined plan, in the School of nursing and clinical setting, Bojnurd, North Khorasan Province (2013-2015)
Maryam Maddineshat, Mitra Hashemi, Alireza GharibThe effect of implementing nursing ethics code as a combined plan, in the School of nursing and clinical setting, Bojnurd, North Khorasan Province (2013-2015)
Background: It is very important when teaching ethics to nurse students to select an educational method and materials that are relevant to their future career as clinical nurses. The aim was to determine the effect of implementing nursing ethics codes as a combined plan in North Khorasan’s University of Medical Sciences.
Methods: This research was an action research conducted in School of Nursing and Clinical setting at Bojnurd, North Khorasan Province, Iran, from September 2013 until September 2015. Data was collected through checklists and interviews with small groups and then analyzed. First, the researchers explored the difficulties in imposing nursing ethics codes. Then a combined plan was considered to solve the ethical codes’ problem. To perform this combined plan, a combination of interferences from three different levels of scope, which are students, college, and clinic, was considered. Permission from the Bojnourd’s Nursing and Midwifery College Educational Council was obtained for this study.
Results: The results of this study showed that 65.5% of students had given the right answers to ethical codes. More than half of the students remarked that respecting the rights of patients and nurses was the most important code. More than half believed that there was a system to supervise the implementation of ethical codes. The results from the ethical rounds with students showed that disobedience to ethical codes occurred in the three fields which are clinical staff, educator, and student administrators. This study offered a practical model for implementing professional ethics code based on Iran’s sociocultural background. Along, this study was done to satisfy the need for ethical education and conduct according to these professional ethics code in the college and the clinical setting.
Conclusion: It is recommended that a suitable evaluation system should be considered to get the feedback from the implementation of this combined plan of teaching professional ethics codes.
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The relationship of general health and marital satisfaction with job satisfaction of employees working in Melli Bank of Ahvaz, Iran
Farideh Narimisaei, Amal Sharifi FardThe relationship of general health and marital satisfaction with job satisfaction of employees working in Melli Bank of Ahvaz, Iran
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Rumi’s cognitive therapy approach to health and disease
Reza Hakimi, Ehsan HakimiRumi’s cognitive therapy approach to health and disease
Background In the history of Persian literature, Rumi is a unique figure in terms of the extent of information and ideas, excitement, outpouring, diversity of themes, full awareness of the human psyche, and the knowledge of pain, understanding the causes of diseases and their treatment.
Methods: This is a qualitative study using analytical deduction method. Resources related to the subject matter, the meaning, and implication of cognitive-behavioral concepts, symbols, emblems, and parables in Masnavi and other works of Rumi were studied.
Results: The results indicate Rumi believes that psychological disorders such as depression do not belong to individuals with a history of childhood psychological trauma but it is common in all humans, and it can result from repeated vain thoughts and personal cognitive distortions. From the perspective of Rumi, a seeker prevents the penetration of negative automatic thoughts into psyche (inherent self) by mastering the subjective identity (self). On the contrary, disability and succumbing to the influx of mental automatic and dysfunctional thoughts are the main causes of mental illness; their repetition and continuity end in the dissociation from his inherent self.
Conclusion: For Rumi, staying away from primordial nature and separation from essence brings the drought and coldness of December that makes human life and existence cold, dry, and barren. Continuation of this condition causes the emergence of mental illness such as depression.
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Hearing threshold differences between pre and post tympanoplasty in patients with chronic suppurative otitis media
Rina Hayati, T Siti Hajar Haryuna, Devira ZaharaHearing threshold differences between pre and post tympanoplasty in patients with chronic suppurative otitis media
Background: Chronic suppurative otitis media (CSOM) often lead to sequelae of hearing loss. Tympanoplasty is one of the strategies to improve hearing function in patients with CSOM. Aim: To evaluate hearing threshold differences in pre and post tympanoplasty in patients with CSOM. Methods: Patients who undergo tympanoplasty (n = 21) were observed prospectively. Hearing threshold (air conduction, bone conduction, and threshold deviation) were assessed using pure tone audiometry before and 12 weeks after the surgery, at the frequency of 500 Hz, 1 kHz, 2 kHz, and 4 kHz. Results: Significant difference between pre and post tympanoplasty was shown at all frequencies in air conduction (AC), while similar results are shown at 2 kHz and 4 kHz frequencies in bone conduction (BC). There is also an increase in the mean hearing threshold between pre and post tympanoplasty. Conclusion: An average of 0-5 dB of AC enhancement in all frequencies were found after tympanoplasty. Nevertheless, further study is needed on hearing threshold improvement in various types of tympanoplasty.
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The aerobic-anaerobic bacteria pattern and its sensitivity pattern in chronic rhinosinusitis patients, in Medan, Indonesia
Adrian Kadafi Lubis, Delfitri Munir, Siti Nursiah, Raden Lia Kusumawati, Putri Chairani EyanoerThe aerobic-anaerobic bacteria pattern and its sensitivity pattern in chronic rhinosinusitis patients, in Medan, Indonesia
Background: Rhinosinusitis is one of the most concerning illness due to high medical cost and its negative effect on the respiratory tract. The etiology of chronic rhinosinusitis remains unknown. The main cause of chronic rhinosinusitis with or without nasal polyp is bacterial infections; thus antibiotics remain a main therapeutic intervention. Prescription of broad spectrum antibiotics and the inappropriate combination of antibiotics are the main factors of antibiotic resistance. This study aims to obtain the pattern of aerobic and anaerobic bacteria in chronic rhinosinusitis patient (with or without nasal polyp) and its sensitivity pattern, in Medan, Indonesia. Methods: This is a case series. Samples were patient with chronic rhinosinusitis who had undergone functional endoscopic sinus surgery (FESS). Results: The most common aerobic bacteria found is Klebsiella oxytoca (21.7%), and it is sensitive to ceftriaxone, cefotaxime, levofloxacin, and meropenem. While for the anaerobic bacteria, one patient was positive for Peptostreptococcus and it is sensitive to chloramphenicol. Conclusion: The most common bacteria in the maxilla in patients with chronic Rhinosinusitis with and without polyps in Medan are the aerobic bacteria Klebsiella oxytoca and anaerobic bacteria Peptostreptococcus. It is suggested that the antibiotic prescribed should be based on microbiology examination.
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Correlation between dental health maintenance behavior with Dental Caries Status (DMF-T)
Made Ayu Lely Suratri, Indirawati Tjahja N, Vivi SetiawatyCorrelation between dental health maintenance behavior with Dental Caries Status (DMF-T)
Background: The maintenance of oral and dental health is closely related to the people’s behavior. Behavior or habits that may influence the development of dental caries is the eating habits as well as oral hygiene such as brushing the teeth regularly and adequately. Dental caries status is a condition that describes a person's experience of dental caries which is calculated by the index DMF-T.
Objective: The study aims to determine the relationship between the behavior or habit of maintaining the teeth and mouth with dental caries status of communities in Indonesia.
Methods: It was an observational study with cross-sectional study design. The samples were household members aged ≥ 15 years with the number of 173,828 people. Data were collected by interview and examination of the teeth and mouth.
Results: The result showed that the respondents with dental caries more than the respondent without dental caries (92.60%). There was a significant relationship between hygienic behavior with dental caries status (P = 0.004; OR = 1.426; 95% CI = 1.123-2.810). However, there was no significant relationship of behaviors/habits of eating fruits and vegetables with dental caries status (P = 0.145; OR = 1.107; 95% CI = 0.966-1.270). But, there was a significant relationship between habitual physical activity with dental caries status (P = 0.000; OR = 1.443; 95% CI = 1.350-1.543).
Conclusion: There is a significant relationship between physical activity and hygiene behavior with dental health maintenance related to dental caries status. However, the behavior of eating fruits and vegetables has no significant relationship with dental caries status.
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Maternal mortality audit based on district maternal health performance in East Java Province, Indonesia
Budi Prasetyo, Hanifa Erlin Damayanti, Rizki Pranadyan, Pandu Hanindito Habibie, AC Romdhoni, Dian IslamiMaternal mortality audit based on district maternal health performance in East Java Province, Indonesia
Background: Maternal mortality rate (MMR) in Indonesia is still high, including in East Java Province. Although the successful decline in MMR has been achieved, more action still needed to maintain and accelerate the process. Several factors that affect the maternal mortality, especially referral factor, and districts maternal health services quality, need to analyze. This study was conducted to analyze the correlation between maternal mortality with labour referral and maternal health service quality in 10 regencies/cities in East Java Province, Indonesia.
Methods: The case-control study among 2 groups of 5 regencies/cities with the highest and lowest MMR in East Java Province in 2015. The indicators used, were maternal referral relay in maternal mortality report, frequencies of antenatal care, labor by health care provider, puerperal health care, obstetric complication management, detection of high-risk pregnancy by community and healthcare personnel, and family planning program.
Results: Total number of maternal mortality in East Java province in 2015 was 531, with MMR were 89,6/100.000 living birth. From the comparative study, we found a significant difference in indicators of high-risk pregnancy detection by healthcare personnel (p=0,035) and obstetrics complications management (p=0,006). There were no significant differences in frequencies of antenatal care, labor by health care provider, puerperal health care, detection of high-risk pregnancy by the community, and family planning program in 10 regencies/cities in East Java Province, Indonesia.
Conclusion: High-risk pregnancy detection by healthcare personnel and obstetrics complications management were related with MMR in 10 districts in East Java province, Indonesia.
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Predictors of multidrug resistance among pulmonary tuberculosis patients in a tertiary hospital in North Sumatera, Indonesia
R. Lia Kusumawati, Tryna Tania, Edward McNeil, Virasakdi ChongsuvivatwongPredictors of multidrug resistance among pulmonary tuberculosis patients in a tertiary hospital in North Sumatera, Indonesia
Background: Previous tuberculosis treatment for tuberculosis is known to confer a higher risk of multidrug-resistant tuberculosis (MDR-TB). Indonesia is ranked eighth among the 27 "high-burden" MDR-TB countries.
Objectives: This study aimed to determine the predictors of multi-drug resistance among patients with pulmonary tuberculosis in Indonesia.
Methods: This retrospective study was conducted in a tertiary referral teaching hospital in Medan, North Sumatera Province, Indonesia. Laboratory data and medical histories of all pulmonary tuberculosis patients attending the hospital were reviewed. Patients with culture positive for Mycobacterium tuberculosis and processed for drug-susceptibility testing (DST) to first-line anti-tuberculosis drugs between January 2010 and December 2013 were included. Logistic regression was used to determine significant predictors of MDR-TB based on odds ratios (OR) and 95% confidence intervals (CI).
Results: Of 6,174 patients with suspected pulmonary tuberculosis, 842 were confirmed positive by culture, of which DST results were reported for 765. Of these, 115 (15%) had diabetes mellitus, 73 (9.5%) were HIV-infected, and 98 (12.8%) were MDR-TB. Multivariate analysis indicated that patients with a history of previous tuberculosis treatment (OR = 3.75; 95% C.I. = 2.40 - 5.86 and aged 25 to 45 years (OR = 2.37; 95% C.I. = 1.07 - 5.27) were significant predictors of MDR-TB.
Conclusions: Previous tuberculosis treatment and age 25-45 were significant predictors of MDR-TB. Treating patients with previous tuberculosis treatment based on DST results should therefore be considered.
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Low Density Lipoprotein (LDL) values in bacterialistic sepsis patients at Haji Adam Malik Hospital Medan-Indonesia 2017
Ernita Sinaga, Tambar Kembaren, Armon RahimiLow Density Lipoprotein (LDL) values in bacterialistic sepsis patients at Haji Adam Malik Hospital Medan-Indonesia 2017
Background: Infection and inflammation will stimulate the acute phase response (APR) activation which will cause the changes in lipid metabolism. In rodents, the infection will induce an increase in cholesterol, including LDL, whereas in the primates and humans, LDL levels will decrease or normal. As lipopolysaccharides (LPS) and cytokines will lower the total cholesterol level in primates, while in mice will increase due to the stimulation of infection enhance the cholesterol synthesis de novo, reducing the lipoprotein clearance, and lowering the cholesterol conversion into bile acid.
Aim: This study aims to determine the influence of the bacterial sepsis severity to the value of Low-Density Lipoprotein (LDL)
Methods: It was a case-control observational study which conducted from January-March 2017 to the 30 sepsis patients and 30 non-sepsis patients at Haji Adam Malik General Hospital, Medan. Data were collected by measuring LDL and PCT levels in both sepsis and non-sepsis patients on days 0, 3, and 5 of study then was analyzed by using Mann-Whitney test to assess the relationship between them.
Results : The result showed that LDL value in sepsis group on pretreatment was 77,70 ± 33,42 mg / dl and increased on day 3 and 5 treatment to 83,50 ± 38,68 mg / dl. In the non-sepsis group, the mean value of LDL at baseline was 102.23 ± 45.90 mg/dl and increased on day 3 and 5 of treatment to 114 ± 38.58 mg/dl. Statistically, there were significant differences in LDL levels between sepsis and non-sepsis groups on the first day of treatment, day 3 and day 5 of care (p <0.05). Spearman correlation test results obtained a significant negative correlation between LDL levels with sepsis degree with correlation strength is moderate (r = -0.318).
Conclusion: There was a significant relationship between the severity of sepsis and the LDL value in patients with sepsis.
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The role of single nucleotide Interleukin-6 (IL-6) polymorphism gene in Psoriasis vulgaris patients at Haji Adam Malik Central Hospital, Medan-Indonesia
Cashtry Meher, Irma . D. Roesyanto-Mahadi, Lia Iswara KusumawatiThe role of single nucleotide Interleukin-6 (IL-6) polymorphism gene in Psoriasis vulgaris patients at Haji Adam Malik Central Hospital, Medan-Indonesia
Background: Psoriasis is a chronic, recidive inflammatory skin disease. The main pathogenesis process is currently unknown. This disease is known as a complex disorder, influenced by both genetic susceptibility and environmental factors.
Aim: This study is aimed to analyze and determine the distribution of single nucleotide polymorphism (SNP) in IL-6 gene of psoriasis vulgaris patients and control patients.
Method: This study uses a case-control design to compare SNP in the IL-6 gene between psoriasis vulgaris group and control group.
Results: The most common genotype of the IL-6 gene Rs 1800795 in psoriasis vulgaris patients is GG (dominant homozygous) with a total of 21 patients (46.7%). The most common genotype allele in the control group is Gc (heterozygous) with a total of 27 patients (60%). We observed a significant correlation between the groups (p = 0.044).
Conclusion:
Homozygote for IL-6 allele G (GG) is a prominent finding in the case group, while in the control group heterozygous allele (Gc) is a more common finding, thus suggesting that a patient with dominant homozygote alleles will have a more severe condition when compared to those who have the heterozygote alleles.
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Comparison between ringerfundin (B Braun) and ringer lactate administration towards Interleukin-6 (IL-6) levels in sepsis and septic shock patients at Haji Adam Malik Hospital, Medan-Indonesia
Fahmi Sani, Achsanuddin Hafie, Muhammad IhsanComparison between ringerfundin (B Braun) and ringer lactate administration towards Interleukin-6 (IL-6) levels in sepsis and septic shock patients at Haji Adam Malik Hospital, Medan-Indonesia
Background: Sepsis is the second leading cause of death in intensive care unit and one of the top 10 cause of deaths worldwide. In sepsis, an inflammation response occurs that leads to the tissue destruction. According to the Survival Sepsis Campaign in 2012, early management in septic patients with 30 ml/kg of crystalloid fluids will have better outcomes. Objective: This study aimed to determine the optimal crystalloid fluid in the resuscitation of septic patients. Method: This double-blinded study was held from March 2017- May 2017 in Haji Adam Malik General Hospital. A total of 40 patients who passed the inclusion and exclusion criteria were assessed for interleukin-6 changes before and after treatment with ringer acetate malate and ringer lactate. Results and Discussion: From 40 Patients who passed the criteria, we compared the administration of Ringer's acetate and Ringer's lactate malate in septic patients. The mean systolic and diastolic blood pressure were increased in both study groups (p <0.05) and a significant decrease in pulse rate was also present in both groups (p <0.001). In both groups, there was a significant decrease in interleukin-6 levels (p <0.001). Administration of ringer acetate malate leads to a stronger decrease of interleukin-6 compared to ringer lactate administration (p <0.001). Conclusion: Ringer's acetate malate in EGDT of septic patients is superior in decreasing interleukin-6 Compared with Ringer lactate.
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Antimicrobial coatings and films on meats: A perspective on the application of antimicrobial edible films or coatings on meats from the past to future
Mohammad Yousefi, Maryam Azizi, Mohammad Amin Mohammadifar, Ali EhsaniAntimicrobial coatings and films on meats: A perspective on the application of antimicrobial edible films or coatings on meats from the past to future
Background: Edible coatings have responded to demands concerning the production of biodegradable and environment friendly packages. Incorporation of antibacterial materials into edible films provides a valuable protective agent against spoilage of meats. Fish, poultry, and red meats due to their high nutritional contents are suitable for bacterial growth and can be preserved a few days in a refrigerator. Aim: This study aimed to investigate the importance of antimicrobial edible coatings or films on meats. In this regard, the types, effects, and traits of edible films, types of antibacterial substances incorporated into films or coatings, bacterial diversity of meats and the function of antibacterial films from the past when collagen-like substances were used on sausages to future trends, including the application of nanoparticles in coatings have been discussed. Results: Applying antibacterial edible films or coatings on meats to extend the shelf life of meats and meat products.
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Data mining approach for exploring socioeconomic patterns in cancer
Leila Hosseini, Hossein Vatanpour, Mehdi Mohammadzadeh, Mohamadreza Abdolahi, Rita MotidostkomlehData mining approach for exploring socioeconomic patterns in cancer
Background: Cancer has become an increasingly important issue for health expenditure and in the public sector. Therefore, identification of socioeconomic patterns is essential for developing novel methods of cancer prevention. A cancer risk prediction system is proposed here, which is easy and cost-effective, also saves time.
Methods: Initial data were collected from surveys with a digital audio recorder on 2014 cancer dependent and independent smokers. Patterns were found using a decision tree model. As socioeconomic patterns are neglected altogether, this study will pave the way for public health policies.
Results: This study shows that a death rate in cancers by smoking around 24.3%. According to them, the type of cancers attributed to smoking was oral cavity (8.2%) and bladder (8.2%) cancer. Some risk factors related to smoking and cancers were included male patients (66%), age <35 years old group (56.3%), employee (86.3%), married (86.2%), as well as have very good public insurance (96.5%). In addition, 98% cancer patients were known have public insurance.
Education levels have been shown most of the patients with cigarette smoking had less than a college education and in the absence of police, they use fewer safety belts.
Those with risk factors for failing to wear a seat belt under a doctor to quit smoking. Although
The health situation in cancers attributed to smoking vs. non-smoking attributed to worse evaluated.
The age factor is effective in counseling for the doctor to quit smoking, and people aged 35-65 are the most advised to quit smoking.
Conclusion: Smoking-related costs in Iran are high. The cost methodology presented is useful for policy making. Cost estimates can be used to evaluate the level of cigarette taxes and other policies related to smoking.
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The comparative study of pre and post-surgical experience, self-esteem, self-confidence, body image, in patients undergoing blepharoplasty surgery
Melissa Bashizadeh, Farhad Adhami Moghadam, Mohammad Sahebalzamani, Hojjatollah FarahaniThe comparative study of pre and post-surgical experience, self-esteem, self-confidence, body image, in patients undergoing blepharoplasty surgery
Introduction: Cosmetic surgery is one of the human’s latest achievements for creating beauty; blepharoplasty surgery is one of its kinds. Psychological issues such as self-esteem, self-confidence, body image are closely related to blepharoplasty surgery. The present study aimed at studying the above-mentioned psychological issues both before and after the surgery as well as comparing real expectations and experiences of some post-surgical complications.
Materials and Methods: In a quasi-experimental study, 60 participants were selected using purposive sampling. The data collection tool of the present study was five questionnaires including demographic questionnaire, Rosenberg self-esteem scale, self-confidence questionnaire, body image questionnaire, and experiences of post-surgical complications questionnaire. The data was classified both qualitatively and quantitatively. The data were analyzed using SPSS 22.
Findings: The findings indicated that blepharoplasty surgery did not result in post-surgical self-esteem (p=0.312) and self-confidence (p=0.251). However, the patients’ post-surgical body image increased (p=0.001). There was a positive correlation between pre and post-surgical self-esteem, self-confidence, and body image (0/4> r >0/5). Given the post-surgical complications such as pain, bruising, swelling, blurred vision, itching, inability to perform daily activities, and number of painkillers taken (p=0.05), the patients’ real experiences were by far less than their speculations.
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Aging changes' inhibition of hemostasis and blood rheological features on the background of antioxidant lipisomal preparation "Lipovitam-Beta" application
O. N. Makurina, V.V Zaitsev, A.V Kolesnikov, O.V Sokol, A.V SadykhovaAging changes' inhibition of hemostasis and blood rheological features on the background of antioxidant lipisomal preparation "Lipovitam-Beta" application
Background: One of geroprotectors for mammals are still polyvitaminic preparations, one of which is Lipovitam-beta. Purpose of research: to estimate Lipovitam-beta impact on the indices of hemostasis and blood rheology systems of aging rats.
Methods: We examined 193 healthy outbred male-rats at the age of 24 months being kept in conditions of vivarium and having traditional ration. In experimental group (98 rats) we investigated the impact of Lipovitam-beta feeding on the basis of 5.5 mg on 100 gr of body mass once in 5 days during 6 months on relevant indices. Control group was composed of 95 healthy male-rats. We estimated the basic indices of hemostasis, blood viscosity, aggregation and deformability of erythrocytes at the beginning and in 6 months of investigation.
Results: Lipovitam-beta application has led in case of rats from experimental group to reliable lowering of spontaneous and stimulated platelets' aggregation and activity weakening of plasma hemostasis. On the background of Lipovitam-beta feeding to rats we found lowering of blood viscosity and erythrocytes' aggregation index what was accompanied by increase of erythrocytes' deformability index.
Conclusion: Application of Lipovitam-beta to aging rats led to activity lowering of plasma hemostasis and platelets, improving rheological features what can positively influence microcirculation, the level of vital activity and forthcoming life duration.
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Health Information Management: Psychological factors influencing information privacy concerns in psychiatric hospitals
Maryam Ghazi-asgar, Hamid Reza Peikari, Asghar EhteshamiHealth Information Management: Psychological factors influencing information privacy concerns in psychiatric hospitals
Background: Privacy is one of the fundamental rights of patients and their families in the health sector, and the violation of their privacy is a concern among them. Despite the importance of the issue, little research has been conducted to identify the determinant factors of patients’ privacy concerns in the health sector. Hence, this research aims to address this issue in the psychiatric hospitals, where the violation of patients’ privacy can seriously harm their face.
Methods: The study was a descriptive and also a correlational study. Data gathering tool was a questionnaire adopted from published sources. Four hundred questionnaires were distributed in two psychiatric hospitals in Iran using a non-random sampling method, and 384 questionnaires were returned. SmartPLS software was used to analyze the hypotheses.
Results: The results of the analysis showed that self-efficacy, ethics, and risk-taking could significantly influence individuals’ privacy concerns in health sectors while computer anxiety and trust have no influence on privacy concerns.
Conclusion: hospitals should ensure the ethical practices of their personnel. Hospitals should also communicate with the patients their level of control over their sensitive data. Hospitals should also deploy policies to minimize the risk of privacy violation.
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Serum Neutrophil Gelatinase-Associated Lipocalin (NGAL) level difference in benign and malignant epithelial ovarian tumor
Abdul Gafur, Deri Edianto, Roy Yustin Simanjuntak, Hotma Partogi Pasaribu, Edy Ardiansyah, Henry Salim SiregarSerum Neutrophil Gelatinase-Associated Lipocalin (NGAL) level difference in benign and malignant epithelial ovarian tumor
Background: Malignant ovarian tumor is one of the most common types of cancer in women worldwide, and most patients come with advanced stage. Until now, a pre-operative diagnostic method to determine malignant ovarian tumor was considered unsatisfying. Neutrophil gelatinase-associated lipocalin (NGAL) allegedly plays a role in proliferation and metastasis of the cancer cells, so it is important to explore the difference of serum NGAL levels between benign and malignant epithelial ovarian tumor.
Aim: to determine the characteristics of patients with benign and malignant epithelial ovarian tumor, histologic types, and serum NGAL levels difference in benign and malignant epithelial ovarian tumor.
Method: This was a comparative analytic study with a cross-sectional design. Forty patients were chosen with consecutive sampling; each group consists of 20 female patients who will undergo primary surgery for suspicious of benign and malignant epithelial ovarian tumor. A blood sample was collected one day prior to the surgery and confirmed with histopathologic examination after surgery.
Results: most of the patients aged 20-50 years old, had ≥1 child and the most common histopathology type of malignant epithelial ovarian tumor was mucinous adenocarcinoma while the majority of the benign epithelial ovarian tumor was endometriotic cyst. The median rate of NGAL in the malignant epithelial ovarian tumor was 219.5 ng/ml, higher than median rate of NGAL in benign epithelial ovarian tumor with 132.5 ng/ml, the difference was statistically significant (p < 0.001). The median rate of NGAL in malignant epithelial ovarian tumor according to the stage of disease showed no significant difference.
Conclusion: A new diagnostic criteria of epithelial ovarian tumor needs to be considered which include NGAL as one of the screening components.
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Profile of sinonasal malignant tumor patients in Adam Malik General Hospital Medan-Indonesia
Fiza Fadly, Farhat Farhat, Rizalina Arwinati AsnirProfile of sinonasal malignant tumor patients in Adam Malik General Hospital Medan-Indonesia
Introduction: Malignancy of nose and paranasal sinuses (sinonasal) is 3% of head and neck malignancies, in which etiology is not known, and the prognosis is poor. Methods: This study is a descriptive case series. Samples were taken by purposive sampling method, in which all of the sinonasal malignant tumor patients (inpatient and outpatient) in Otolaryngology Department of Adam Malik General Hospital in 2010 – 2015 were recruited. Results: Nose blockage was the most common symptom (53.6%). The symptoms existed for less than six months (50.9%). Most of the tumor was located in maxillary sinus (70.5%) and was an epithelial tumor (94.6), particularly non-keratinizing squamous cell carcinoma type (47.3%). Most of the tumor graded as T4 (34.8), and most of the lymph nodes involved graded as N0 (83.9%). Tumors treated with surgery mostly by medial maxillectomy method (41.4%). Conclusions: Sinonasal malignant tumor patients in Adam Malik General Hospital, Medan, were mostly had nasal blockage symptom for less than six months. They mostly had maxillary sinus in origin, was an epithelial tumor with non-keratinizing squamous cell carcinoma type, T4 of tumor size, N0 of nodal involvement, and had a medial maxillectomy method in their surgeries.
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The effect of prune on the severity of constipation in elderly women
Ali Mansouri, Aziz Shahraki-Vahed, Hossein Shadadi, Hajar Noori Sanchooli, Azizollah ArbabisarjouThe effect of prune on the severity of constipation in elderly women
Background and Aim: Constipation is a common digestive problem in elderly people, which has a negative effect on their quality of life. There are many methods in complementary and alternative medicine to treat this problem in the elderly. The aim of this study was to determine the effect of prune as a complementary and alternative medicine on the severity of constipation in elderly women living at Zabol Elderly House.
Materials and Methods: This study was an experimental study on 60 elderly women who are qualified residents living at Zabol Elderly House with constipation based on the Rom III diagnostic criteria. The samples were randomly assigned to intervention group and control group, consisting of 30 samples each. The[A1] tools used in this study were a demographic questionnaire and a constipation scale. Data were analyzed by SPSS Software Version 20 and Mann-Whitney Test.
Results: According to the findings, the difference in the mean of constipation severity in the two groups was not significant before intervention (P = 0.61). However, at the end of the first week until the end of the third week after the intervention, there was a significant difference in the mean of constipation severity (P <0.05). This result showed that the effect of the intervention started from the first week and prune was effective in lowering the severity of constipation in the elderly women.
Conclusion: This study indicated that prune could be an effective complementary and non-pharmacological method to reduce the severity of constipation in elderly women. Therefore, nurses can use this simple, inexpensive and uncomplicated method as a complementary method to care for the elderly with constipation.
[A1]Please explain how the prune intervention was done.
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The effect of garlic and cumin on blood pressure and glycosylated hemoglobin in patients with type 2 diabetes
Ali Mansouri, Aziz Shahraki Vahed, Hossein Shahdadi, Fatemeh Dashtban, Azizollah ArbabisarjouThe effect of garlic and cumin on blood pressure and glycosylated hemoglobin in patients with type 2 diabetes
Introduction:
Type 2 diabetes is one of the most common chronic diseases. High blood pressure is seen in 70% of diabetic patients. Garlic is useful for patients with diabetes due to its active compounds. Cumin is one of the medicinal herbs that is being studied recently with highlighted role in treating diabetes. The aim of this study was to evaluate the effect of cumin and garlic on blood pressure and glycosylated hemoglobin in patients with type 2 diabetes.
Methods:
A clinical trial including 75 patients with type 2 diabetes who referred to Imam Khomeini Diabetes Clinic of Zabol were selected according to entry criteria and randomly divided into 3 groups of 25 individuals. First, glycosylated hemoglobin and blood pressure of the patients were measured. Then, the patients were divided into three groups. The first group received 300 mg of garlic powder three times a day, the second group received 100 mg cumin extract twice a day, and the control group received placebo for two months. Glycosylated hemoglobin and blood pressure of the patients were re-measured after the intervention. Data were analyzed using paired T-test and ANOVA in SPSS software version 22.
Results:
Based on the findings in the garlic consumer group and the cumin group, the difference was significant in mean systolic and diastolic blood pressure before and after the intervention (P <0.0001). In the garlic consumer group, the mean of HbA1c before and after the intervention was not statistically significant (P = 0.11). However, the mean difference was significant in the cumin group (P = 0.001).
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Functional heartburn in Iranian patients with non-erosive gastroesophageal reflux disease
Hashem Fakhre YaseriFunctional heartburn in Iranian patients with non-erosive gastroesophageal reflux disease
Aim: Esophageal multi channel intraluminal impedance-PH (MII-PH) monitoring is a new technique used for detecting the flow of fluids and gas through the esophagus, using the differences in electrical impedance between the mucosal surface, fluids, and gas that surround the catheter. The aim of this study was to determine the frequency of functional heartburn in Iranian patients with non-erosive gastroesophageal reflux disease (NERD).
Methods: In this study, 940 patients aged 11-84 years, with the chief complaint of heartburn were selected. The MII-PH monitoring was done in 215 of the patients who did not have esophageal injuries (NERD).
Results: Of the participants who filled the questionnaire, 29.4% experienced heartburn at least once a week, 24.1% had it twice daily, and 21.3% had it after each meal. The mean age of the patients with heartburn was 36.97 ± 10.8 (Range: 21- 57) years. Of the patients, 51.2% were female. MII-PH monitoring was done in 215 participants, with non-erosive esophagitis.
Esophageal acid exposure of time (EAET) was negative in 42.8% and positive in 57.2% of the NERD patients. Of the patients, 39.1% and 18.1% had functional heartburn (FH) and hypersensitive esophagus (HE), respectively
Conclusion: Functional heartburn and non-erosive gastroesophageal reflux disease are prevalent in the Iranian population. Esophageal multi channel intraluminal impedance-PH (MII-PH) monitoring is essential for discriminating functional heartburn from other types of non-erosive gastroesophageal reflux diseases.
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Quantification analysis of tissue eosinophilia in squamous cell carcinoma of the head and neck region
M Sabzijate, AH Khatibi, T Ghiasian, S Rahrotaban, E Rastegar, SH EftekharianQuantification analysis of tissue eosinophilia in squamous cell carcinoma of the head and neck region
Background and aim: Tumor-associated tissue eosinophilia (TATE) is commonly present in different neoplasms, yet its relationship with cancers has not been established. Squamous cell carcinoma (SCC) is one of the most common malignancies of the head and neck region. The aim of this study was to evaluate the relationship between TATE and histological grading of head and neck SCC (HNSCC) using Luna staining technique.
Materials and methods: In the present descriptive study, 67 samples consisting of 4-µm cross-sections of HNSCC tissue stained with hematoxylin and eosin (H&E) were re-evaluated for histological grading. The samples were divided into three categories of well differentiated, moderately differentiated, and poorly differentiated. Luna histochemical staining was used to evaluate infiltration of eosinophils in the tumor. Eosinophils were randomly counted in 10 microscopic fields and divided into 4 categories. Kruskal-Wallis test and Spearman's correlation coefficient were used to evaluate the relationship between eosinophilic infiltration and other relevant factors.
Results: The frequency of tissue eosinophilia was zero in only one case (1.5%) and was positive in the rest 66 cases (98.5%). The mean count of eosinophils was 7.5±4.5 cells per high-power field (HPF). There was a significant relationship between histopathological grading and TATE (p = 0.04). However, there were no significant relationships between TATE and factors such as age, gender, and lesion location.
Conclusion: The tissue eosinophil counts in the group with poorly differentiated SCC of the head and neck region were less than those in the two other groups; regardless, no significant relationship was found with other clinicopathological factors.
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Determination and comparison of stomach residual volume at two alternate gavage ways with gravity and injection force in premature infants
Samaneh Sadat Sojasi, Mahnaz Gebreili, Malihe Assadollahi, Mohammad Baqer Hosseini, Mohammad Asghari JafarabadiDetermination and comparison of stomach residual volume at two alternate gavage ways with gravity and injection force in premature infants
Background: Prematurity is one of the most important problems of recent years, and the number of premature infants is increasing every year. Babies who are born prematurely due to defects in the coordination of swallowing, sucking and breathing require mouth tube or nasogastric intubation feeding. Because bolus gavage feeding is more appropriate physiologically and improves the secretion of gastric hormones is more common in neonatal intensive care units. Objective: The primary objective of the study is a comparison of two alternate gavage ways with force gravity and injection with syringe in premature infants and find existence difference and compared with the results of the research have been performed yet. Methods: In this study, gastric residual volume indicators collecting method are used. The study used a questionnaire to collect data to measure indicators of the following tools. Results: Results showed that both alternate gravity and injection (push) ways, complications of gavage (vomiting, aspiration, abdominal distention and necrotizing enterocolitis) had not been seen. Conclusions: Based on the results of both currently study of methods in preterm infants feeding have same effectiveness and safety.
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Comparison of life expectancy, quality of life, irrational health beliefs, health locus of control and hospital depression in patients undergoing hemodialysis and heart transplant in Shahid-Rajaee hospital
Mohammad Oraki, Nahid Zarrati, Iran ZarratiComparison of life expectancy, quality of life, irrational health beliefs, health locus of control and hospital depression in patients undergoing hemodialysis and heart transplant in Shahid-Rajaee hospital
Introduction: Physical and mental disorders are highly prevalent in patients undergoing hemodialysis and heart transplant and thus reduce the outcomes of patients. Management of these disorders can improve heart and kidney diseases, promote quality of life of patients and reduce their treatment costs. This study compares life expectancy, quality of life, irrational health beliefs, health locus of control, and hospital depression of patients undergoing hemodialysis and heart transplant in Shahid-Rajaee hospital.
Materials and Methods: This cross-sectional study was conducted in 2016 on 190 patients with a history of hemodialysis and heart transplant in Shahid-Rajaee hospital. Data were collected by using adult hope scale, quality of life scale, multidimensional health locus of control (MHLC) scale, irrational belief test, and hospital anxiety and depression scale.
Results: the results showed a significant difference between hemodialysis and heart transplant patients in irrational health beliefs (p=0.001) and hospital depression (p=0.001). Moreover, there was no significant difference between hemodialysis and heart transplant patients in life expectancy (p=0.70), quality of life (p=0.68) and hospital depression (p=0.21).
Conclusion: hemodialysis patients and heart transplant patients are significantly different in irrational health beliefs and hospital depression considering their physical and mental conditions caused by the disease.
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Development of performance evaluation indicators for pre-hospital emergency centers
Rohollah Askari, Mohammad Amin Bahrami, Saeed Reza Pahlavanpoor, Fatemeh AfzaliDevelopment of performance evaluation indicators for pre-hospital emergency centers
Abstract
Introduction
Pre- hospital emergency health care plays an important role in saving people’s lives. Proper performances of various parts of this system result in rapid and timely deployment of ambulance in patient’s place and prevention of death and disability. Thus, the present study was done in order to Compiling of performance evaluation indicators for pre-hospital emergency Centers in 2017.
Methods
The present study is a qualitative- quantitative research which was conducted in 2017. In order to compiling the indexes for evaluating the performance of pre-hospital emergency centers, the study was done in two phases. In phase one of the study, primary items and their fields were identified in accordance with the present literature. In the second phase, Delphi technic in three rounds was used to finalize the items and the fields. In the first round of Delphi technic, the identified items and fields were given to experts in forms of check list. The items and fields with average of >4 and standard deviation of <1 were confirmed, items with average of <2 and standard deviation of <1 were removed, and other items were randomly passed into round two. In the second round, all the items with average of >4 and standard deviation of <1 were confirmed, items with average of <3 and standard deviation of <1 were removed, and other items were randomly passed into round three. In round three, only items with average of >4 and standard deviation of <1 were confirmed and other items were removed.
Results
The results of the study showed that 9 items in field of facilities and physical space, 10 items in field of communication, 10 items in field of ambulance, 8 items in field of human resources, 9 items in field of regulations and protocols, 3 items in field of storing equipment in the center, and 3 items in field of training were identified.
Conclusion
Considering the identification of seven effective factors in improving quantitative and qualitative level of pre-hospital emergency services, it is highly important for authorized managers and decision-makers to plan and enhance all necessary factors.
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Correlation of Matrix Metalloproteinase-9 (MMP-9) expression and bone destruction in Chronic Suppurative Otitis Media (CSOM) patients with cholesteatoma at Adam Malik General Hospital Medan-Indonesia
Sadri Yulius, Harry Agustaf Asroel, Askaroellah Aboet, Fotarisman ZaluchuCorrelation of Matrix Metalloproteinase-9 (MMP-9) expression and bone destruction in Chronic Suppurative Otitis Media (CSOM) patients with cholesteatoma at Adam Malik General Hospital Medan-Indonesia
Introduction: Cholesteatoma is a cyst which coated by stratified squamous epithelium containing keratin epithelial desquamation. The recurrence and bone destruction arerelevant features in cholesteatoma pathophysiology, which makes cholesteatoma tend to be dangerous and difficult to treat. Recent studies have shown that variations in cellular systems of matrix metalloproteinase-9 (MMP-9) production contribute to the pathophysiology of cholesteatoma, especially in of bone erosion.
Objective: The aim of this study is to determine the correlation between MMP-9 with bone destruction in CSOM with cholesteatoma patients.
Materials and Methods:This study was conducted by using cross-sectional design to the 40 samples of cholesteatomas patients at Otorhinolaryngology Department of Adam Malik General Hospital in May 2016. The level of MMP-9 expression was assessed by immunohistochemical staining of cholesteatoma tissue. The immunoreactivity score was obtained by calculating the broad scores with the intensity score in the assessment. Then, the correlation test was also carried out between MMP-9 expression and bone destruction statistically.
Results: This study found that most of participants were male gender patients (23 patients; 67.5%), 6-24 years old interval (23 patients; 67.5%), having intratemporal complication (35 patients; 87.5%); moderate level bone destruction (19 patients; 47.5%), and MMP-9 overexpression (34 patients; 85%). In addition, there was a significant correlation between MMP-9 expression and bone destruction (P = 0.000) in this study.
Conclusion: There was a significant correlation between MMP-9 expression with bone destruction in this study.
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The effect of topiramate as an adjunct therapy to acetazolamide in Idiopathic intracranial hypertension patients.
Rahimdel Meibodi, Melat Ardekani Ali, Shafiee Mohammad, Mansouri Mehrdad, Akbarian AbolfazlThe effect of topiramate as an adjunct therapy to acetazolamide in Idiopathic intracranial hypertension patients.
Background: Idiopathic intracranial hypertension (IIH) is a nervous disease characterized by increased intracranial pressure around the brain. It is induced by increased production or decreased reuptake of cerebrospinal fluid (CSF). The standard treatment of IIH includes medicines to reduce CSF production. Acetazolamide is the most commonly used drug in treating IIH and is also considered as the first-line treatment. Topiramate is used to treat obesity. Since obesity is a risk factor of IIH, topiramate is used to treat IIH. We investigated the effect of topiramate as an adjunct drug along with acetazolamide in patients with IIH who presented to Shahid Sadoughi Hospital in Yazd, central Iran.
Methods: This study was a double-blind clinical trial. Forty-eight IIH patients presenting to Shahid Sadoughi Hospital participated in the study, divided into two groups. The acetazolamide group received acetazolamide 750-1000 mg qd and the Acetazolamide+topiramate group received acetazolamide 750-1000 mg qd and topiramate 25-50 mg qd. CSF pressure, body mass index (BMI), and visual field were assessed at the beginning of treatment and 6 months after intervention. The gleaned data were analyzed with SPSS20 using statistical tests.
Results: Our findings showed significant differences in CSF pressure in acetazolamide group and CSF pressure, BMI, and visual field in acetazolamide+topiramate group at baseline and 6 months after treatment. There were also statistically significant differences between the mean score of retinal examination in IIH patients in both groups at second, fourth, fifth, and sixth months (P-value <0.05).
Conclusion: Topiramate can be used as an adjunct to acetazolamide to increase the effect of treatment in IIH patients.
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The Concentration of Interleukin-27 in the pleural fluid of patients with exudative pleural effusion and its diagnostic value in differentiating between benign and malignant pleural effusion
Reza Hashempour, Ali Aryannia, Mahshid Mehrjerdian, Seyyed Sadegh Baniaghil, Arash Rezaie, Reza AlipoorThe Concentration of Interleukin-27 in the pleural fluid of patients with exudative pleural effusion and its diagnostic value in differentiating between benign and malignant pleural effusion
Introduction: The excessive accumulation of the pleural fluid in the pleural cavity results in pleural effusion, which is either exudative or transudative. The effective treatment of pleural effusion calls for the differential diagnosis of benign pleural effusion (BPE) and malignant pleural effusion (MPE). The present research objective was to measure the concentration of IL-27 and examine its diagnostic value in differentiating BPE from MPE in the pleural fluid of patients with exudative pleural effusion.
Materials and Methods: The samples for this research were obtained from 130 patients with exudative pleural effusion. The concentration of IL-27 in the pleural fluid was measured using the ELISA method. The statistical analysis was carried out using descriptive statistics tests and independent t test in SPSS 19. The significance level in all of the calculations was set to 0.05. The ROC curve analysis was carried out to determine the sensitivity of IL-27 in diagnosis benign pleural effusion.
Findings: Of the 130 patients included in this research, 88 were MPE cases and 42 were suffering BPE. The average age of the patients of the MPE and BPE groups was 57 and 59 years, respectively. The average IL-27 concentration in the BPE group (344.15 236.42) was significantly higher than the MPE group (203.05 76.03) (P=0.000). The area below the ROC curve was 0.803, which reflected the differential power of the IL-27 measurement in differentiating between BPE and MPE.
Conclusion: Given the significant difference between the levels of IL-27 in the two study groups, the measurement of this biomarker in exudative pleural effusion cases can differentiate between BPE and MPE with good sensitivity and specificity.
Key words:
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Effect of Andrographis paniculata tablet (AS201-01) on Transforming Growth Factor Beta (TGF-β) expression and parasite inhibition in mice placenta infected with Plasmodium berghei
Aty Widyawaruyanti, Jatmiko Rachmat, Nurya Viandika, Hilkatul Ilmi, Lidya Tumewu, Budi PrasetyoEffect of Andrographis paniculata tablet (AS201-01) on Transforming Growth Factor Beta (TGF-β) expression and parasite inhibition in mice placenta infected with Plasmodium berghei
Background: Transforming Growth Factor β (TGF-β) is a cytokine regulator of inflammation that important in inhibited parasite growth and preventing inflammation. Andrographis paniculata was empirically used as traditional medicine in Indonesia to cure malaria by activating TGF-β. Preliminary studies showed that AS201-01 tablets containing the ethyl acetate fraction of A. paniculata had been shown to inhibit the growth of Plasmodium berghei.
Aims: This study aims to determine the effect of the AS201-01 tablet on parasite inhibition and TGF-β expression in P.berghei infected mice placenta.
Methods: About 24 pregnant mice were divided into 4 groups: healthy pregnant mice (normal) (G1), untreated infected pregnant mice (negative control) (G2), infected pregnant mice treated by AS201-01 tablets (G3), and infected pregnant mice treated with Dihydroartemisinine-piperaquine (positive control) (G4). About 1x106 parasitemia were infected on the 9th day of pregnancy, while therapy was administered on the 11th day of pregnancy. The placenta was collected at the 15th day of pregnancy. The parasite inhibition and TGF-β expression were evaluated using Hematoxylin-Eosin (HE) and immunohistochemistry assay.
Results: The results showed that the parasite still found in the placenta of G2, G3, and G4 still, but parasite of placental in G2 was higher than G3 and G4. There was a significant difference in the parasite inhibition between G2 with G3 and G4 (p<0.05). In addition, the immunohistochemistry assay found that there was a significant difference in TGF-β expression between G2 with G3, G4, and G1 (p<0.05).
Conclusion: Administration of the AS201-01 tablets inhibit parasite P. berghei and increase TGF-β expression on the placenta of infected mice.
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Second victim support program and patient safety culture: A quasi experimental study in Bali International Medical Centre (BIMC) Hospital
Made Indra Wijaya, Abd Rahim Mohamad, Muhammad HafizurrachmanSecond victim support program and patient safety culture: A quasi experimental study in Bali International Medical Centre (BIMC) Hospital
Background: Patients are the first victims in patient safety incidents. However, healthcare providers are also the victims. In 2000, a doctor named Wu introduced the term “second victim” to describe the healthcare providers who involved in patient safety incidents. In Indonesia, there is no second victim support program implemented in the hospitals. A study needs to be done regarding second victim support program and its effect on patient safety culture.
Objective: To study the effect of second victim support program on patient safety culture.
Method: This study is a quasi-experimental study conducted from 2015 to 2017. The treatment given is the Second Victim Support Program. Healthcare providers in BIMC Hospital Kuta (87) are selected as the treatment group, while healthcare providers in BIMC Hospital Nusa Dua (103) are the control group. The study is analyzed with difference in-differences and paired-sample t-test. Phase 1 (2015) is the baseline, phase 2 (2016) is when the program is implemented up to one year (to study its effect on patient safety culture), and phase 3 is one to two years after the treatment is given (to study the sustainability of its effect).
Result: Difference-in-differences revealed that the treatment significantly increased the patient safety culture (β coefficient of 0.738, SE = 0.258, P-value = 0.007). There is no significant difference between patient safety culture in phase 2 and phase 3 (t (11) = 0.378 with P-value of 0.713 and Cohen’s d of 0.0476).
Conclusion: Second victim support program increases patient safety culture. If the program is maintained, the effect on the patient safety culture will be sustainable.
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Reducing Methicillin-Resistant Staphylococcus Aureus (MRSA) Cross-Infection through Hand Hygiene Improvement in Indonesian Intensive Tertiary Care Hospital
Andaru Dahesihdewi, Iwan Dwiprahasto, Supra Wimbarti, Budi MulyonoReducing Methicillin-Resistant Staphylococcus Aureus (MRSA) Cross-Infection through Hand Hygiene Improvement in Indonesian Intensive Tertiary Care Hospital
Methods: A quasi-experimental before-after design was conducted to evaluate the implementation of the WHO multimodal hand hygiene improvement strategy which was adjusted to the local needs, based on the qualitative study result from the intensive care from June 2014
to April 2016. All workers who have frequent contact with patients were observed for their hand hygiene compliance by trained observers. The incidence of HA-MRSA was recorded through active surveillance accompanied by microbiology data.
Results: There were 92 healthcare workers (18 medical doctors, 45 nurses, 29 other staffs) and 5,280 patients involved throughout the study period. There were 16,313 hand hygiene opportunity observations which resulted in a signifcantly improved practical accuracy-consistency-sustainability, after intervention in the initial and end-evaluations. There was a
signifcant decrease in the HA-MRSA rate from 12.6% before intervention to 1.2% and 0.3% at the initial and end-evaluations, respectively.
Conclusion: Increasing hand hygiene compliance in intensive care reduced HA-MRSA signifcantly. It suggested cross-infection can be used as an indicator of hand hygiene compliance.
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Comparison of analgesic effect and duration of midazolam and fentanyl addition to intrathecal bupivacaine 0.05% in lower limb orthopedic surgeries
Arazberdi Ghourchaie, Kazem Kazemnejad, Payam SoroudiComparison of analgesic effect and duration of midazolam and fentanyl addition to intrathecal bupivacaine 0.05% in lower limb orthopedic surgeries
Background and Aim: Local anesthesia has gained popularity in recent years; therefore, the present study was aimed to test the effect of adding midazolam and fentanyl to intrathecal bupivacaine in patients with orthopedic surgeries of lower limbs.
Materials and Methods: A double-blind, randomized clinical trial was conducted on 75 patients who underwent orthopedic surgery of their lower limbs in the 5Azar Teaching Hospital in the city of Gorgan, Iran. Patients were randomly allocated to the test groups of bupivacaine plus normal saline (BN), bupivacaine plus midazolam (BM), and bupivacaine plus fentanyl (BF). Duration of analgesia, pain intensity, chills, nausea, vomiting, systolic and diastolic blood pressure as well as pulse rate and SpO2 were assessed. Descriptive analysis was used to explain the mean and standard deviation. One-way ANOVA, repeated measure ANOVA, and chi-square tests were carried out using SPSS Statistics software version 19.
Results: The mean age of patients was 45.29 ± 14.02, 42.16 ± 15.68, and 40.7 ± 14.72 years respectively in the groups of BF, BM, and BN. Tukey test showed a considerable difference between the BM and BF groups (p < 0.001), and BM and BN groups (p < 0.001) regarding the duration of analgesia. Moreover, Tukey test showed a significant difference between the BM and BN groups in minutes of 60 (p = 0.02) and 90 (p = 0.001), the BM and BN groups, and in final, between the BM and BF groups in minutes of 120 (p < 0.001).
Conclusion: The combination of either BM or BF may be useful to provide patients with longer duration of analgesia and also enable them to tolerate pain better.
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The Effect of Overnutrition Toward the Risk of Dengue Shock Syndrome in Pediatric Patient: In-Depth Investigation of sVCAM-1 and Adiponectin Level
Ni Kadek Elmy Saniathi, Bambang Udji Djoko Rianto, Mohammad Juffrie, Soetjiningsih .The Effect of Overnutrition Toward the Risk of Dengue Shock Syndrome in Pediatric Patient: In-Depth Investigation of sVCAM-1 and Adiponectin Level
Introduction: Overnutrition has become an emergent health problem worldwide and could signifcantly alter the normal human physiology. It still unknown how overnutrition could affect the
outcome of pediatric patient with dengue infection. This study aimed to unveil how overnutrition affects the risk of dengue shock syndrome (DSS) in dengue pediatric patient by evaluating the adiponectin which has immune-modulatory property and the inflammation
marker sVCAM-1.
Methods: An analytic observational nested case-control study was conducted in Paediatric Division Sanglah General Hospital, Bali, Indonesia from January 2015 to October 2016. Initially, patient’s anthropometric parameters were measured and the diagnosis of the
dengue infection was established according to the medical record and blood plasma was isolated to determine the level of adiponectin and sVCAM-1.
Result: The study showed that overnutrition increased the risk of DSS as much as 2.67 times greater than normal but it was not statistically signifcant (95%CI: 0.72 - 9.95). The mean level of sVCAM-1 was observed to be higher in overnutrition patients in almost all categories
of dengue infection, but none is statistically signifcant. However, its level appears to be lower in over nutritious DSS patients compared to their non-DSS counterparts (4638.64 (±934.99) vs. 5680.80 (±601.77); P = 0.013). The adiponectin level was found to be consistently lower
in patients with overnutrition regardless the category of dengue infection, but signifcant differences only observed in over nutritious DHF and overnutritious non-DSS comparisons.
Conclusion: It can be concluded that overnutrition increase the risk of DSS in pediatric patient with dengue infection whether it was not statistically signifcant. The lower level of adiponectin and elevated expression of sVCAM-1 could be the explanation of this phenomenon.
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Low Vitamin D serum level increases severity symptoms in schizophrenic patients measured by Positive and Negative Symptoms Scale (PANSS) in Batak Tribe Sumatera Utara, Medan-Indonesia
Novi Prasanty, Mustafa Mahmud Amin, Elmeida Effendy, Joeseof SimbolonLow Vitamin D serum level increases severity symptoms in schizophrenic patients measured by Positive and Negative Symptoms Scale (PANSS) in Batak Tribe Sumatera Utara, Medan-Indonesia
Background: Schizophrenia is the most common psychotic disorder found in population. It is a severe form of psychotic disorders and tends to be chronic. Nearly 1% people suffer from schizophrenia. It has been proved that vitamin D plays crucial roles in neuroprotection and neurodevelopment, therefore low levels are commonly associated with schizophrenia. Methods: A total of 54 schizophrenic patients, Batak tribe, male, and female are diagnosed with semistructured MINI ICD-X. A Positive and Negative Syndrome Scale (PANSS) was used to evaluate disease activity and serum vitamin D level was measured using ELFA. Regression linear was used to analyze the relationship between serum vitamin D level and disease’s symptom. Results: There was a negative correlation between serum levels of vitamin D and the PANSS score in schizophrenic patients with r = -0.686 (p<0.001) for positive PANSS score, r = -0.773 (p<0.001) for negative PANSS score, r = -0.448 (p<0.001) for general psychopathology, and r = -0.631 (p<0.001) for total PANSS score. Conclusion: There was a negative correlation between serum vitamin D levels and the total score of PANSS, the lower the serum levels of vitamin D, the higher the total score of the PANSS.
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Distribution of iNOS expressions and TNF neutrofil cells as well as PGE2 and S100 Schwann cell dermal nerves in the erythema nodosum leprosum patients
I Gusti Nyoman Darmaputra, Nanny Herwanto, Luh Mas Rusyati, Wibi Riawan, Anang Endaryanto, Cita Rosita Sigit PrakoeswaDistribution of iNOS expressions and TNF neutrofil cells as well as PGE2 and S100 Schwann cell dermal nerves in the erythema nodosum leprosum patients
Background: The infiltration of neutrophil increased in the Erythema Nodusum Leprosum (ENL) which is thought to have a role in releasing the free radicals and TNFα which causes dermal nerve damage. ENL occurs in leprosy type LL and BL which has lipid droplets as a synthesis site of Prostaglandin E2 which plays a role in suppressing nerve inflammation. This study investigates neutrophil distributions that express TNFα and iNOS as well as PGE2 expressions of the S100b distributions on ENL patient’s Schwann cells.
Methods: The cross sectional study used 23 samples of biopsy skin pedis of patients with MB leprosy type (10 ENL samples and 13 as control samples), from the Skin Polyclinic Sanglah Hospital, Denpasar, Indonesia. Punch biopsy of 4 mm in diameter is performed. Slides are conducted with Hematoxylin-Eosin standard staining as a structural confirmation, type of leprosy and distribution of neutrophil cells. Observation of TNFα, iNOS, PGE2, and s100b are conducted with immunohistochemistry techniques. Expression analysis is performed with immune ratio software (freeware). The PGE2, s100b, TNFα and iNOS expression percentage are put on a list, T-test is performed and IBM-SPSS 21 for Windows is used in the relationships between groups test.
Results: In the present study, it was found that the distributions of neutrophil increased in the ENL compared to the ones in the control. The increased neutrophils appeared in the dermis area around the blood vessels. INOS and TNFα distributions on neutrophil cells increased significantly in the ENL. And in line with that, the s100b expressions on the ENL were significantly lower.
Conclusions: The significant increase of the iNOS and TNFα neutrophil cells in the ENL may play a role in the dermal nerve damage. This study digs into the possibility of the role of Prostaglandin E2 in maintaining the peripheral nervous system on leprosy with ENL. Hence the understanding of PGE2 as the main mediator in the inflammatory process especially in the Schwann cell damage is very important.
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The comparative study of strategic purchasing of health services in selected countries: A Review Study
Ghasem Abedi, Jalil Shojaee, Peivand Bastani, Mohammad Javad Kabir, Jamshid YazdaniThe comparative study of strategic purchasing of health services in selected countries: A Review Study
Introduction: strategic purchasing is the constant search for achieving the best method through deciding on what to purchase, how to do it, and choosing service providers in a way that maximizes the health system performance to the desired level. In other words, strategic purchasing is defined as interventions that enhance system's accountability and causes financial balance. Methods: This study is explained as a comparative study with the purpose of strategic purchasing of health services in the world. In this study, 13 databases and search engines with relating key words have been searched in published papers of national and international journals from 2000 to 2016. CAPS tool is used to ensure the reliability of the paper. The obtained information was then extracted and exploited in the summarized form of data. Results: Findings of the study indicate that countries have considered several factors effective in strategic purchasing of health services. The quality and purchasing with the reasonable price were referred in 7 studies, motivating factors in 6 studies, interventions on the supply side in 7 studies (manufacturers), interventions on the demand side in 8 studies (recipients and purchasers), and transportation and resource allocation in 4 studies. Conclusion: According to the World Health Organization report in 2000 and the results of studies, countries will be required to use strategic purchasing of services for financing and optimal and equitable use of health services that using countries experiences will be very beneficial in this field. Therefore, studying in other areas is recommended.
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Factors influencing the inpatients satisfaction in public hospitals: a systematic review
Abdollah Salehi, Ali Jannati, Shirin Nosratnjad, Lavin HeydariFactors influencing the inpatients satisfaction in public hospitals: a systematic review
Objective: The aim of the current study is designing a model for patient satisfaction and defining priority factors that impact patient satisfaction of healthcare services. Method: The preliminary literature search was undertaken in December 2014. A subsequent search was carried out in October 2015, which covered a majority of databases including PubMed, Scopus, ProQuest, and Magiran. Studies related to inpatients in hospitals included and related to specific area were excluded. No time bound was applied. Two of the authors independently appraised the quality of studies and subsequently, the grouping of the variables was done using MAXqda 12 software and the analysis was done through vote – counting method. Result: Out of 1315 articles, 85 articles were chosen for final consideration. Most of which have been carried out in developed countries. The main factors affecting consumer satisfaction in hospitals were grouped into two categories. 1- Patient attribute factors: that involved expectations, health status, demographic and socio-economic. 2- Health system factors: that involved service quality, hospital features, staff satisfaction and insurance. Conclusion: In this study the risk of bias for each study not researched. It has been contended that the construct of consumer satisfaction is a multidimensional and subjective one. The finding of the current study suggests that all these variables be considered when evaluating patient satisfaction. The evaluation process should be performed cautiously as service providers have little direct influence over patient attribute factors.
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Degenerative Spondylolisthesis : The preferable surgical technique
Komang Agung Irianto, Firman W. Hatmoko, Laskar P KDegenerative Spondylolisthesis : The preferable surgical technique
Introduction: Degenerative Spondylolisthesis is the major cause of low back pain, radiculopathy, and neurogenic claudication. The incidence rate for the general population ranged from 5% to 7%. Surgical method on degenerative spondylolisthesis is highly recommended. Objective: The purpose of this review is to determine the preferable surgical procedures for degenerative spondylolisthesis, which are still debatable.
Methods: A total of ffty relevant literatures were researched regarding degenerative spondylolisthesis, the diagnostic procedure, and the treatment from the period of 2007-2017. The author has chosen which surgical technique that is preferable between TLIF (Transforaminal
Lumbal Interbody Fusion) and PLF (Posterior Lumbal Fusion), from the so-called 50 literature journals.
Results and Discussion: The results showed that there was no signifcant difference regarding the back pain using Visual Analog Scale (VAS) during the preoperative procedure, in the operating level, the treatment duration, and the post-surgical complications between the two groups. There was also no signifcant difference in terms of leg pain (using VAS) between those two groups. On the other hand, the amount of blood loss, the duration of the surgery and successful fusion were signifcantly higher in the TLIF group than the PLF group.
Conclusion: When determining the surgical procedure, the author discovered the TLIF to be comparatively superior to the PLF regarding the fusion success, despite the longer surgical duration and higher amount of blood loss.
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Human resources challenges in health system reforms: A systematic review
Roghayeh Khalilnezhad, Hassan Abolghasem Gorji, Mahboubeh BayatHuman resources challenges in health system reforms: A systematic review
Background: The health system reform in many countries has been focused on the structural changes, cost reduction, market mechanisms and service consumers, and despite the importance of human resource management, these issue have been discussed less or even neglected altogether in HSR reforms. This study seeks to sensitize decision-makers and policymakers to the role of human resource policies in advancing the goals of health system reforms through systematic review of the studies on human resource challenges in implementing health system reforms.
Materials and Methods: This study is a systematic review based on PRISMA. The selected time period for data collection is the interval of 2000-2017. Different database search methods and manual search was used to find the related articles. Results of the manually reviewed articles were analyzed using thematic analysis by two members of the research team and conflicts were referred to the third person.
Results: According to the considered inclusion and exclusion criteria in this study finally 13 Article were selected to determine the human resource challenges in implementing the health system reforms. Selected studies were analyzed in three general themes; context and dynamics of the reform process, Capacities needed to implement the reform and negative impact of Reform on HR.
Conclusion: Achievement of the health goals is completely dependent on provision of the adequate high quality effective human resources in appropriate positions and available in all geographical regions. The lack of clear human resources policies simultaneous and consistent with the goals of health reforms is one of the main reasons for the failure of these reforms to achieve the intended goals. Therefore, determining human resource problems and development of the related HR policies should be the start point for planning any kind of health system reform.
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Metachronous Multiple Primary Malignancies (endometrium and breast): A case report
Ketut Suega, Prayuda PrayudaMetachronous Multiple Primary Malignancies (endometrium and breast): A case report
Introduction: Advanced progression the field of diagnosis and treatment of cancer patients causes increased survival of patients. Increasing life expectancy can lead to new health problems, including Multiple primary malignancies (MPM). Although the incidence of MPM is increasing, the diagnosis of MPM remains very rare. Based on the interval between tumor diagnosis, MPM can be divided into synchronous MPM and metachronous. Studies of MPM may provide useful information not only for clinical purposes but also can provide clues about etiology and management of this type of cancer. This case report was a woman with metachronous MPM (endometrium-breast). Case: A 60-year-old female presented with a lump on the right breast since 2 months before admission. Patients also complained multiple marble sized lumps on the right armpit and right neck since 1 ½ months ago. From previous medical record data (5 years ago), the patient was diagnosed with endometrial carcinosarcoma stage IV. On physical examination on neck showed supraclavicula lymph nodes enlargement. Examination of right mammary region showed Peau d’orange skin with hyperemic colour, and a palpable solid mass. On right axillary region, there was lymph nodes enlargement. Mammae and axilla Ultra Sonography (USG) showed solid malignant in right upper-lateral quadrant breast with diffuse skin edema and multiple solid nodules in right axilla. Mammae histopathologic biopsy results conclusion is invasive carcinoma of no special type grade 3. Conclusion: Our case was a woman with a metachronous MPM endometrial and breast, with the first malignancy was endometrial carcinosarcoma stage IV (type II endometrial carcinoma) followed by the appearance of second malignancy as a breast cancer dextra grade 3 stage IIIC. Time interval between these malignancies more than 6 months (5 years).
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Burkitt lymphoma in a child: a case report
Anak Agung Wiradewi Lestari, Sianny Herawati, Ketut AriawatiBurkitt lymphoma in a child: a case report
Background: The diagnosis of Burkitt Lymphoma is made based on a medical history, physical examination, complete blood count (CBC), blood smear and bone marrow examination. Many other diseases with similar symptoms must be excluded. Typically, the higher white blood cell count, the worse prognosis. A bone marrow aspiration provides conclusive proof of the cases. Blast cells were seen on blood smear in the majority of the cases. Case Presentation: A six-year-old male was admitted to Sanglah General Hospital with vomiting for few days and found hepatomegaly. After several days of being treated, patients showed deterioration with decreased awareness and convulsions. Burkitt Lymphoma enforced by peripheral blood smear and bone marrow examination. Bone Marrow smear showed lymphoblastic infiltrations about 20% lymphoblasts with heterogeneous morphology. Moreover, there were some lymphoblasts with many vacuoles on the cytoplasm, and from all of the features, it concluded as Acute Lymphoblastic Leukemia (L3) or Burkitt type.The disease had metastasized to the kidney and central nervous system (CNS) showing a decrease in consciousness and the presence of convulsions. Conclusion:The patient may have a CNS leukemia leading to a bad prognosis.
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The effectiveness of frenotomy in the treatment of ankyloglossia: A case report from Adam Malik General Hospital Medan-Indonesia
Farhat Farhat, Rizalina A. Asnir, Ashri Yudhistira, Elvita Rahmi Daulay, Adrian Kadafi LubisThe effectiveness of frenotomy in the treatment of ankyloglossia: A case report from Adam Malik General Hospital Medan-Indonesia
Background: Ankyloglossia is a congenital oral anomaly, which the lingual frenulum unusually short, restricting the movement of the tongue. Also, no relevant report has been published in Indonesia. This study was conducted to report an ankyloglossia case in Universitas Sumatera Utara/Adam Malik General Hospital Medan-Indonesia, and the frenotomy procedure that was taken to handle the cases.
Case: A 6 years old girl was unable to speak, was admitted to Adam Malik General Hospital. According to the alloanamnesis from her parents, she has been suffering from slurred speech for 5 years. The physical examination found her frenulum was attached very close to the tip of the tongue, and such condition was able to affect the ability to produce speech sounds which require raising or extending the tip of the tongue, the patient then diagnosed with ankyloglossia or tongue-tie. We did frenotomy to make her tongue free and able to touch her hard palate, post operation the patient learns speech therapy.
Results and discussion: The 6 years old girl underwent functional re-education and reported back with considerable improvement in her speech.
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Maple syrup urine disease: the first case in Bali
Putu Andina Pramitasari, I Gusti Lanang Sidiartha, Irene WidodoMaple syrup urine disease: the first case in Bali
Background: Maple syrup urine disease (MSUD) is a rare genetic disease of metabolic disorder inherited as an autosomal recessive trait. The disease is caused by branched-chain alpha-keto acid dehydrogenase (BCKD) deficiency. It results in the accumulation of branched-chain amino acids (BCAA) which are toxic to the nervous system.
Case Presentation: A one-week-old infant was brought to Siloam Hospital because she suddenly became lethargic, had a poor feeding, and an intermittent muscle spasm. She was the fourth child in her family. At her admission, she was diagnosed with neonatal sepsis. On advanced clinical and laboratory examination, we found ketoacidosis, hypoglycemia, and the typical odor of maple syrup in the urine. Plasma amino acids analysis showed a marked elevation of BCAA (leucine, isoleucine, and valine), confirming the diagnosis of MSUD. The patient was treated with intravenous glucose infusions and dietary support, including formulas free of BCAA. She was monitored for blood sugar and urine ketones.
Conclusion: Metabolic disease should be considered in an infant who suddenly suffered a critical illness several days following a normal delivery.
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