(Available online 1 August 2019)
Vol 8, No 2 (2019): (Available online 1 August 2019)
Ira Puspitawati Ahmad Yun Jufan Vidya Cahyaningrum Chandra Trianna Dewi Isniyanti Chasanah Teguh Triyono
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The compatibility measurement of Mentzer, England & Fraser, Shine & Lal, and Srivastava indices to the hemoglobin electrophoresis result for beta thalassemia trait screening
Raja Iqbal Mulya Harahap Delita Prihatni Tiene Rostini
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The comparison of ion exchange-high performance liquid chromatography (IE-HPLC) and capillary electrophoresis (CE) for HbA1C measurement
Catur Suci Sutrisnani Edwin Darmawan Anik Widijanti Sidarti Soehita
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The incidence of Clostridium Difficile infection in diarrhea patients after receiving antibiotics at Dr. Soetomo Hospital Surabaya
Rima Hayyu Chrisnanda Puspa Wardhani
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The Correlation between total lymphocyte count, hemoglobin levels, lymphocyte/leukocyte ratio (LLR), and lymphocyte/neutrophil ratio (LNR) to CD4 levels in patients with Human Immunodeficiency Virus infection at Sanglah Hospital
I Nyoman Wande Muhamad Robi'ul Fuadi Solichul Hadi
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The ability of earthworm Lumbricus rubellus extract in slowing down the activation of NFkB and TNF-α in lipopolysaccharide-induced Rattus norvegicus
Neiny Prisy Foekh I Dewa Made Sukrama Anak Agung Wiradewi Lestari
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The description of corrected count increment on one hour and 24 hours after platelet apheresis transfusion in Sanglah General Hospital Denpasar
Anak Agung Ayu Lydia Prawita Ni Kadek Mulyantari Sianny Herawati
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The relationship of lactic acid, neutrophil lymphocyte ratio and monocyte lymphocyte ratio with the outcomes of coronary arterial disease patients following coronary artery bypass surgery
Cynthia Citradinata Nyoman Suci Widyastiti
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Levels of protein C, protein S, and anti-thrombin III in acute ischemic stroke patients at Haj Adam Malik Hospital, Medan
Jenie Erawati Muchti Yuneldi Anwar Adi Koesoema Aman
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Administration of pismatom juice increasing of potassium serum levels and faster of recovery in middle run athletes PASI Denpasar, Bali-Indonesia
I Wayan Juniarsana Nyoman Adi Putra Ketut Tirtayasa Putu Gede Adiatmika Made Linawati
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The stability of sample storage for complete blood count (CBC) toward the blood cell morphology
Arie Rahmanitarini Yetti Hernaningsih Yulia Nadar Indrasari
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The comparison of erythrocyte sedimentation rate (ESR) modify Westergren Caretium Xc-A30 and Westergren Manual in Clinical Pathology Laboratory, Sanglah General Hospital, Denpasar, Bali
Made Minarti Witarini Dewi Sianny Herawati Ni Kadek Mulyantari I Putu Yuda Prabawa
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The comparison of blood gas analysis (BGA) parameters in samples transported by the pneumatic tube system and manual transport at Dr. Soetomo Hospital, Surabaya, Indonesia
Hantoro Gunawan Ferdy Royland Marpaung
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The role of serum albumin level within the first 24-hours of hospitalization to the mortality risk in burn patients at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
Ummi Muthiah Tiene Rostini Nina Tristina
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Correlation between verruca vulgaris and superoxide dismutase
Farica Amanda Fachri Nelva K Jusuf Imam B Putra
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Pregnant gymnastics, ANC, and IEC pregnancy lower the stress on pregnant women
Nurlaily Prasetyawati Didik Gunawan Tamtomo Diffah Hanim Harsono Salimo
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The different effects of banana juice and sport drink on lactic acid among volleyball students in Surakarta
Ryan Rohmansyah Muchsin Dowes Agus Kristiyanto Khairul Imam
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Betel nut (Areca catechu L.) extract toxicity on the kidney and liver of white rats (Rattus norvegicus)
Anak Agung Gde Arjana I Made Sukada N. Adi Suratma
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Intraarterial heparin flushing effect on motor evoked potentials in chronic ischemic stroke patients
Terawan Agus Putranto Tugas Ratmono Irawan Yusuf Bachtiar Murtala Andi Wijaya
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The effect of Sargassum duplicatum extract on SGPT level in Rattus norvegicus infected by Plasmodium berghei
Herin Setianingsih Dimas Bathoro Bagus Pamungkas Prawesty Diah Utami
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The characteristics of mandibular fractures among patients attending Plastic Surgery Unit in Sanglah General Hospital, Bali, Indonesia: A preliminary study
Sang Ayu Arta Suryantari Agus Roy Rusly Hariantana Hamid I Gusti Putu Hendra Sanjaya
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An Efficient Polymerase Chain Reaction (PCR) Enhancer for Highly Guanine-Cytosine (GC)-Rich DNA Sequences
Ima Arum Lestarini Dewi Suryani Yunita Sabrina
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The mucin 5AC level in medical faculty students with Computer Vision Syndrome (CVS)
I Gusti Ayu Made Juliari Ratna Sari Dewi Ni Luh Made Novi Ratnasari Ariesanti Tri Handayani
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Desperately needed in Indonesia: Basic Epilepsy Surgery Centers with Simple but Reliable pre-surgical investigations, based on Semarang’s Experience
Zainal Muttaqin Thohar Arifin Yuriz Bakhtiar Erie BPS Andar Dody Priambada Happy Kurnia Ajid Risdianto Krisna Tsaniadi Gunadi Kusnarto Aris C Bintoro Vega Karlowee
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The surveillance of antibiotics resistance in Indonesia: a current reports
Andaru Dahesihdewi Adhi Kristianto Sugianli Ida Parwati
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The hypercoagulation state among major β-thalassemia patients at H. Adam Malik Hospital, Medan, Indonesia
Jane Tetraulina Silitonga Adi Koesoema Aman Bidasari Lubis
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Erythrocyte alloantibodies in chronic kidney disease patients receiving packed red cell transfusions in Sanglah General Hospital, Denpasar
Ni Komang Krisnawati Sianny Herawati Ni Kadek Mulyantari
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Hemostasis changes and its relationship with SOFA score in sepsis patients
Sarah Hanna Nadya Giri Adi Koesoema Aman Achsanuddin Hanafie
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Coagulation Defects in Βeta-Thalassemia Major Patients at Haji Adam Malik Hospital Medan
Eduward Situmorang Adi Koesoema Aman Bidasari Lubis
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Hyperferritinemia and oxidative stress in the kidney of beta thalassemia major
Dian Ariningrum Purwanto Adhipireno Lisyani Budipradigdo Suromo
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The relationship between Epidermal Growth Factor Receptor (EGFR) mutation and computed tomography findings in lung adenocarcinoma
Agnes Septiani Pande Putu Ayu Patria Dewi Anita Widyoningroem Anggraini Dwi Sensusiati Muhammad Yamin
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The correlation between caspase-9 and caspase-3 on sepsis case: an experimental study on the Balb/C Mice induced by lipopolysaccharide
Sotianingsih Haryanto Suharyo Hadisanputro Lisyani Budipardigdo Suromo
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Relationship of Plasma Cystatin C level and renal dysfunction in patients with preeclampsia
Makmur Sitepu Azano Sitepu Johny Marpaung Dudy Aldiansyah Edy Ardiansyah Deri Edianto Khairani Sukatendel
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Analysis of nerve growth factor serum levels in psoriasis vulgaris patients
Riana Novatina E. Pangaribuan Imam B. Putra Kristo A. Nababan
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Correction of motor disturbances in children with cerebral paralysis and moderate mental retardation
Irina Vitalevna Mikhaylova Svetlana Vasilyevna Shmeleva Vladimir Yurievich Karpov Viktor Ivanovich Sharagin Yanina Vasilevna Shimanovskaya Margarita Alexandrovna Petrova Anatoly Ivanovich Alifirov Maxim Viktorovich Eremin
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Cytogenetic mutation in a family with sickle-cell beta-thalassemia in North Sumatera, Medan, Indonesia: A preliminary study
Christie Nur Andani Adi Koesoema Aman Herman Hariman Bidasari Lubis
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P2B2 PABI XVI Manado 2019 Continuing Professional Development in Surgery: The Patients and Surgeon in Universal Health Coverage Era
Fery Kalitouw
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The 1st International Conference on Global Health and Innovation: Multiple Burden of Diseases in the Developing Countries
GHI Lombok
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Low plasma levels of IGF-1 and IL-1RA with high plasma levels of IFN-γ as prognostic factor for mortality in hospitalized geriatric patients with delirium
I Nyoman Astika I Gde Raka Widiana Ketut Suastika RA Tuty Kuswardhani
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Development of rabies eradication package, a family-based health promotion media to prevent rabies in Buleleng, Bali, Indonesia
Komang Hendra Setiawan Ari Natalia Probandari Eti Poncorini Pamungkasari Didik Gunawan Tamtono
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Incidence of deep vein thrombosis in patients with diabetic foot ulcers
Dairion Gatot Dharma Lindarto Andri I Mardia
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Comparison of antithrombin III levels in type 2 diabetes mellitus patients with and without ulcers at Haji Adam Malik Hospital Medan Indonesia from may to july 2017
Zulfahmi Zulfahmi Andri I Mardia Savita Handayani Santi Syafril Dairion Gatot
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1,4-bis-3,4,5-trimethoxy-phenyl-tetrahydro-furo(3,4-c) furan from mahogany (swietenia macrophylla king) seed significantly reduces glucose and malondialdehyde levels in diabetic wistar rats
Muthmainah Muthmainah Kristanto Yuli Yarso Bambang Purwanto Ambar Mudigdo Mustofa Mustofa
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Characterizing the SLC39A14 zinc transporter and collagen products of the chondrocytes from the human umbilical cord-derived mesenchymal stromal cell
Ketut Dewi Kumara Wati Endah Dianty Pratiwix Yanni Dirgantara Cynthia Retna Sartika Meita Dhamayanti Budi Setiabudiawa Ida Parwati
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Electroencephalogram (EEG) features and clinical presentation in the elderly patient at neurologic policlinic Sanglah General Hospital between July 2015-2017 period
Anak Agung Ayu Meidiary Anna Marita Gelgel I Gusti Ngurah Purna Putra
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The Correlation between leucocyte CD64, Immature Granulocyte and Presepsin with Procalcitonin in Bacterial Sepsis Patient
Citra Novita Yetti Hernaningsih Puspa Wardhani Anna Surgean Veterini
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Increasing the quality of life of post-shackling patients through multilevel Health promotion of shackling prevention
Arif Widodo Yayi Suryo Prabandari Aris Sudiyanto Ibrahim Rahmat
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Geriatric fractures in single Orthopedic Hospital: The role of domestic fall and comprehensive geriatric assessment
Komang Agung Irianto Dionisius Rianto William Putera Sukmajaya Oen Alina
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Functional characteristics of children with Down syndrome and possibilities of their correction with the help of athletic activity in Russia
Alexander Sergeevich Makhov Ilya Nikolayevich Medvedev
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Measuring motor evoked-potentials in children with autism spectrum disorders accompanied with cerebral vein thrombosis following intraarterial heparin flushing
Erwin Setiawan Ristaniah Soetikno Nelly Amalia Risan Shelly Shelly Tugas Ratmono Terawan Agus Putranto Ardianto Pramono
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The effect of lean six sigma toward maternal emergency lead time in Penembahan Senopati Hospital, Bantul, Yogyakarta
Firman Firman Tjahjono Koentjoro Kuncoro Harto Widodo Adi Utarini
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Hospital Deductions, Types and Causes
Mohamad Taghi Mousarrezaei Leila Doshmangir Ali Jannati Ali Imani
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Anti-Mullerian Hormone (AMH) as a Novel Marker for Ovarian Function: A Review
Sianny Herawati
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The role of brain-derived neurotrophic factor (BDNF) in cognitive functions
Dedi Silakarma Anak Agung Raka Sudewi
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Short insight of pediatric cerebral venous thrombosis and the safety of intra-arterial heparin flushing as a new therapeutic method
Ardianto Pramono Ristaniah Soetikno Achmad Hussein Sundawa Kartamihardja Tinni Trihartini Maskoen Terawan Agus Putranto Erwin Setiawan
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Cardiorenal syndrome type 1: a literature review
Starry Homenta Rampengan
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Orthopaedic complications of falls in elderly patients: a brief review
I Ketut Suyasa
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Spontaneous recovery of Medial Prefrontal Syndrome following Giant Olfactory Groove Meningioma resection: A case report
Michael Lumintang Loe Sri Maliawan
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Deep vein thrombosis (DVT) in ovarian clear cell carcinoma with liver metastasis: a case report
Fahrani Imanina Putri Nurtyas Astuti Giantini
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A rare case of Hb H disease caused by compound heterozygous for α thalasemia and Hb Quong Sze in Chinese Indonesian proband: a case report
Nyoman Suci Widyastiti Ita Margaretha Nainggolan Edward L Kurnia Dwi Retnoningrum Imam Budiwiyono
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Myelodysplastic Syndrome (MDS) in a Child who Transformed to Acute Myeloid Leukaemia with Myelodysplasia-Related Changes (AML-MRC)
Ni Komang Ayu Parmawati Sianny Herawati I Nyoman Wande
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Testicular carcinoma in a female with 46-XY karyotype: a case report
Siti Nurul Hapsari Betty Agustina
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A T-acute lymphoblastic leukemia in children with CD 117 expression: a case report
Komang Juwita Endrawati Ni Nyoman Mahartini Sianny Herawati
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Cardiac Myxoma Resection in Sanglah General Hospital Denpasar, Indonesia: Serial Case Report
I Nyoman Semadi Ni Kadek Sulistyaningsih I Wayan Sudarma IGA Sri Mahendra Dewi
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Urine neutrophil gelatinase-associated lipocalin (NGAL) as an initial biomarker of acute kidney injury (AKI) in an intensive care unit (ICU) patients: a preliminary study
Ira Puspitawati, Ahmad Yun Jufan, Vidya Cahyaningrum, Chandra Trianna Dewi, Isniyanti Chasanah, Teguh TriyonoUrine neutrophil gelatinase-associated lipocalin (NGAL) as an initial biomarker of acute kidney injury (AKI) in an intensive care unit (ICU) patients: a preliminary study
Background: Acute kidney injury (AKI) is one of the complications in critical patients that can increase morbidity and mortality. The condition of AKI is reversible and must be detected as early as possible. One of a potential marker for early detection is urine Neutrophil gelatinase-associated lipocalin (NGAL). This study aims to evaluate urine NGAL as an early AKI detection marker among critically ill patients.
Methods: This is an observational prospective cohort study involving 39 patients who were admitted to the Intensive care unit (ICU) of Dr. Sardjito General Hospital Yogyakarta during June-August 2018. The inclusion criteria were ICU patients with age>19 years old, and exclusion criteria were chronic renal failure and kidney transplantation. The AKI established based on an increase in serum creatinine levels ≥0,3 mg/dl in 48 hours or urine volume <0.5 ml /kg/hour in 6 hours. Mann Whitney test, Spearman correlation, and Chi-Square were used for statistical analysis. Data were analyzed using SPSS version 17 for windows.
Results: The results showed that there were no significant differences between the urine NGAL levels of AKI and non-AKI patients (130 (85-177) ng/dL; 56.65 (2.8-1500) ng/dL, p=0.407). In this study, only 3 cases of AKI were obtained from 39 subjects. Further analysis was carried out by looking at the correlation between urine NGAL levels and urine leukocyte count. The results showed a moderate correlation between them (r=0.6, p=0.001). The proportion of patients with elevated urine NGAL levels was greater in the group of patients with elevated urine leukocyte counts compared to the group with normal urine leukocyte counts (86,7%; 13,3%, p=0,008).).
Conclusions: Evaluation of urinary NGAL application as an early marker of AKI was not optimal in this study. An increase of urine leukocytes interfered urine NGAL.Full Article (HTML) | download PDF
The compatibility measurement of Mentzer, England & Fraser, Shine & Lal, and Srivastava indices to the hemoglobin electrophoresis result for beta thalassemia trait screening
Raja Iqbal Mulya Harahap, Delita Prihatni, Tiene RostiniThe compatibility measurement of Mentzer, England & Fraser, Shine & Lal, and Srivastava indices to the hemoglobin electrophoresis result for beta thalassemia trait screening
Background: Thalassemia is an autosomal recessive disease. It occurs due to abnormalities in hemoglobin synthesis, causes the imbalance of globin production. Identification of thalassemia’s carrier plays a role to prevent disease’s inheritance. Diagnostic approaches regarding anemia, especially in families are important because they are prone to inherit the disease. This study was aimed to know the compatibility of Mentzer, England & Fraser, Shine & Lal, and Srivastava indices with hemoglobin electrophoresis in transfusion-dependent thalassemia patient’s family.
Methods: This was a cross sectional study by obtaining routine hematology and hemoglobin electrophoresis from thalassemia major patient’s family screening. The data then analyzed with Kappa and chi-square to get the compatibility and significance between variables. Data were analyzed using Microsoft Excel and SPSS version 17 for Windows
Results: From 99 subjects, most of them are women aged 18-55 years. Beta thalassemia trait based on Mentzer, England & Fraser, Srivastava, and Shine & Lal was in 46,5%, 55,6%, 55,6%, and 54,5% research subjects respectively. Hemoglobin electrophoresis results showed that beta thalassemia trait was in 47.5% subjects. Kappa test showed good and significant compatibility result of hemoglobin electrophoresis with Mentzer (k=0,663,p= 0,0001) and England & Fraser (k=0,636,p=0,002) indices, also moderate and significant compatibility for Srivastava (k=0,558,p=0,018) and Shine & Lal indices(r=0,527,p= 0,015) with hemoglobin electrophoresis
Conclusions: There were compatible and significant results between Mentzer and England & Fraser with hemoglobin electrophoresis. Meanwhile, Srivastava and Shine & Lal indices have medium compatibility so that they can be used as an initial screening for beta thalassemia trait in transfusion-dependent thalassemia patient’s familyFull Article (HTML) | download PDF
The comparison of ion exchange-high performance liquid chromatography (IE-HPLC) and capillary electrophoresis (CE) for HbA1C measurement
Catur Suci Sutrisnani, Edwin Darmawan, Anik Widijanti, Sidarti SoehitaThe comparison of ion exchange-high performance liquid chromatography (IE-HPLC) and capillary electrophoresis (CE) for HbA1C measurement
Background:HbA1c is a glycosylated hemoglobin that routinely performed in patient with Diabetes Mellitus. There are several methods for HbA1c measurement. One of them are based on the molecular charge such as High Performance Liquid Chromatography(HPLC) and Capillary Electrophoresis (CE). Each method has its own advantages and disadvantages. Thus, the selection of HbA1c measurement method is an important thing. This study was aimed to compare HbA1c measurement with HPLC and CE method.
Methods:HbA1c measurement was done by HPLC and CE methods in 110 patient samples which have data of average blood glucose level during three months. We investigate the correlation of HbA1c results with average blood glucose level during three months,precision, methods comparison and interference including Hb varian. This study was conducted in Central Laboratory of dr. Saiful Anwar Hospital during March–August 2018. Correlation analysis were done by Pearson analysis while precision test and methods comparison were done by Bland Altman Plot and Passing-bablok Regression analysis.
Results:There were correlation between estimated Average Glucose from HbA1c (eAGHbA1c) calculation with average blood glucose level during 3 months in both methods.From precision test we found intra-assay coefficient of variation in normal level (HbA1c ±5%) by HPLC vs CE was 1,7% vs 0.63% and in high level (HbA1c ±11%) was 0,59% vs 0,61% and inter-assay coefficient of variation by HPLC vs CE was 2,47% vs 2,17%. Method comparation results showed strong correlation on both method. The results of HbA1c in group without Hb variant by CE method was slightly lower than HPLC. In Hb variant group, CE method was slightly higher than HPLC, but it was not significant for HbA1c interpretation.
Conclusion:HbA1c measurement by HPLC and CE method are comparable and there is no significant difference in the results obtained.
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The incidence of Clostridium Difficile infection in diarrhea patients after receiving antibiotics at Dr. Soetomo Hospital Surabaya
Rima Hayyu Chrisnanda, Puspa WardhaniThe incidence of Clostridium Difficile infection in diarrhea patients after receiving antibiotics at Dr. Soetomo Hospital Surabaya
Introduction: Improper use of antibiotics is a risk factor for C. difficile infection. The increasing incidence of C. difficile infection is one of the indications of failure in infection prevention and control in hospitals. The aim of this study was to analyze the incidence of C. difficile infection in diarrhea patients after receiving antibiotics in the ICU and internal medicine ward of Dr. Soetomo Hospital Surabaya.
Methods: Stool samples were taken from 31 diarrhea patients with at least 2 x 24-hours of antibiotic use who were admitted to the ICU and hospitalized at Dr. Soetomo Hospital Surabaya from August 2017 to May 2018. Each sample was examined for glutamate dehydrogenase (GDH) and A and B toxins of C. difficile. The results of this study were analyzed descriptively.Results: The average age of respondents was 48.94 (21 – 86) years old. In addition, based on demographic data, it was predominant by females (65%), diabetes mellitus and fever (16%), and ceftriazone usage (22%). The results showed one sample (3%) with positive results and 30 samples (97%) with negative results for both A/B toxins and GDH enzyme.
Conclusion: It can be concluded that the incidence of diarrhea in these patients was not due to C. difficile infection. The cause of diarrhea in these patients could be due to other causes such as a virus, fungus, or other bacterial infections. More sample collection is needed to provide more accurate data about C. difficile infection, so it can help to fulfill data for infection prevention and control in hospitals.Full Article (HTML) | download PDF
The Correlation between total lymphocyte count, hemoglobin levels, lymphocyte/leukocyte ratio (LLR), and lymphocyte/neutrophil ratio (LNR) to CD4 levels in patients with Human Immunodeficiency Virus infection at Sanglah Hospital
I Nyoman Wande, Muhamad Robi'ul Fuadi, Solichul HadiThe Correlation between total lymphocyte count, hemoglobin levels, lymphocyte/leukocyte ratio (LLR), and lymphocyte/neutrophil ratio (LNR) to CD4 levels in patients with Human Immunodeficiency Virus infection at Sanglah Hospital
Background. Acquired immunodeficiency syndrome (AIDS) is caused by the Human immunodeficiency virus (HIV) infection and characterized by a progressive decrease in the immune system function which eventually leads to the development of opportunistic infections and other complications. In order to monitor the disease progression the CD4 examination and additional Complete Blood Count (CBC) were commonly used.
Objectives. To determine the correlation of total lymphocyte count, hemoglobin level, lymphocyte/leukocyte ratio (LLR) and lymphocyte/neutrophil ratio (LNR) to CD4 levels in patients with HIV infection.
Methods. This a retrospective cross-sectional analytic study conducted from July to August 2017. The total lymphocyte count, hemoglobin level, lymphocyte/leukocyte ratio (LLR) and lymphocyte/neutrophil ratio (LNR) and CD4 level were measured in the study. The data normality and the correlation were analyzed using the Kolmogorov-Smirnov test and the Pearson Correlation test, respectively, performed in SPSS version 14. The p-value less than 0.05 was considered significant for the results.
Results. A total of 60 samples conducted CD4 and complete blood counts (CBC) examinations during the period July-August 2017. The mean CD4 levels were 341.73 ± 243.48 cells/µL, the total leukocyte count was 6.98 ± 2.93 x 103/µL, the total lymphocyte count was 2.09 ± 0.87 x 103/µL, hemoglobin level 13.38 ± 2.09 g/dL, lymphocyte/leukocyte ratio (LLR) 0.31 ± 0.11, lymphocyte/neutrophil ratio (LNR) 0.67 ± 0.40. Statistical analysis showed that data is normally distributed. Pearson correlation analysis showed that there was a significant relationship between CD4 levels with total lymphocytes counts, hemoglobin levels, RLL, RLN with correlation coefficients of 0.571 (p = 0.000), 0.324 (p = 0.012), 0.509 (p = 0.000), 0.463 (p = 0.006), respectively. There was no significant correlation between CD4 levels and total leukocytes with a correlation coefficient of 0.171 (p = 0.19).
Conclusion. There is a positive correlation between CD4 levels and total lymphocytes, hemoglobin levels, RLL and RLN in patients with HIV at Sanglah Hospital.Full Article (HTML) | download PDF
The ability of earthworm Lumbricus rubellus extract in slowing down the activation of NFkB and TNF-α in lipopolysaccharide-induced Rattus norvegicus
Neiny Prisy Foekh, I Dewa Made Sukrama, Anak Agung Wiradewi LestariThe ability of earthworm Lumbricus rubellus extract in slowing down the activation of NFkB and TNF-α in lipopolysaccharide-induced Rattus norvegicus
Background: Earthworm (L. rubellus) contains many compounds such as Lumbricin I, G-90 glycoprotein, and polyphenols as antimicrobial, antioxidant, and hepatoprotective toward bacterial infections. Tumor necrosis factor (TNF-α) has been identified as a mediator for necrosis tumor inside animal serum treated by lipopolysaccharide (LPS). High concentrated LPS can cause tissue damage and death. The increasing number of Nuclear Factor Kappa Beta (NFkB) activation has been responded by macrophage to produce cytokines pro-inflammation TNF-α as an indicator of inflammation.
Methods: The research was conducted in the Animal Laboratory Pharmacology Unit, Biomolecular Laboratorium, Faculty of Medicine Udayana University and the Pathology Clinic Sanglah General Hospital with a post-test only control group design. Thirty-two experimental rats were made as samples and divided into four groups, which are negative control, positive control, treatment 1, and treatment 2. Treatment was performed for 14 days. The containment of NFkB and TNF-α was measured on the 16th day using quantitative technique sandwich enzyme immunoassay (ELISA).
Results: The results of the Shapiro-Wilk test and Levene’s test showed that the data were normally distributed and homogeneous, with p > 0.05. As the data were normally distributed, the one way ANOVA was used to analyze the data, followed by the Least Significant Difference (LSD) test. There was a significant difference between the average amount of TNFα found in each treatment group p = 0.001 (< 0.05). There were also significant differences between the average amount of NFkB found in each treatment group p = 0.001 (< 0.05). Advanced test using LSD shows more significant differences by p < 0.05.
Conclusion: It can be concluded that earthworm extract (L.rubellus) raises the amount of NFkB and TNF-α in male experimental rats injected with LPS.
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The description of corrected count increment on one hour and 24 hours after platelet apheresis transfusion in Sanglah General Hospital Denpasar
Anak Agung Ayu Lydia Prawita, Ni Kadek Mulyantari, Sianny HerawatiThe description of corrected count increment on one hour and 24 hours after platelet apheresis transfusion in Sanglah General Hospital Denpasar
Introduction: Evaluating the response after platelet transfusion is vital to measure the success rate of the therapy and plan the subsequent management of patients. The evaluation can be done by calculating the corrected count increment (CCI) at 1 hour and 24 hours after transfusion. The purpose of this study was to determine the therapeutic response to apheresis platelet transfusion by measuring the CCI at 1 hour and 24 hours after transfusion.
Methods: This study was a cross-sectional descriptive study of patients who received apheresis platelet transfusions. In total, 35 samples were examined for platelet counts before and after transfusion. The CCI was measured at 1 hour and 24 hours after transfusion. Descriptive statistical analysis was performed to calculate the percentage and mean count.
Result: The mean count of transfused platelets was 2.7 × 10¹¹ / unit. The mean platelet count before transfusion was 18.5 × 10³ / μL. The mean platelet increment at 1 hour was 25.4 10³ / μL and 24 hours was 22.6 × 10³ / μL. The mean CCI ± SD at 1 hour and 24 hours was 15,036.63 ± 13,709.73 and 13,625.60 ± 13,580 respectively. A total of 63% of samples reached the target CCI at the 1-hour measurement, while the remaining 37% did not. Meanwhile, 60% of the samples reached the CCI target at the 24-hour measurement, while 40% did not.
Conclusion: The response to apheresis platelet transfusion by measuring the CCI reached the target in 63% of patients at 1 hour after transfusion and 60% of patients at 24 hours after transfusion.Full Article (HTML) | download PDF
The relationship of lactic acid, neutrophil lymphocyte ratio and monocyte lymphocyte ratio with the outcomes of coronary arterial disease patients following coronary artery bypass surgery
Cynthia Citradinata, Nyoman Suci WidyastitiThe relationship of lactic acid, neutrophil lymphocyte ratio and monocyte lymphocyte ratio with the outcomes of coronary arterial disease patients following coronary artery bypass surgery
Background: Coronary artery bypass surgery (CABG) is a surgical procedure for coronary arterial disease (CAD). It has a risk of postoperative complication, extending from a long length of stay in the intensive care unit (ICU) to death. CABG needs a long duration of perioperative time, which decreases tissue oxygenation. It causes increased lactic acid production and initiates the secretion of inflammatory factors. Neutrophil/lymphocyte ratio (NLR) and monocyte/lymphocyte ratio (MLR) become inflammatory signs that are caused by the failure of heart microcirculation during the operative procedure. This study aimed to determine the relationship of lactic acid, NLR and MLR with the outcomes of CAD patients following CABG surgery.
Methods: This was a prospective study including 42 CAD patients who had undergone CABG procedure at Dr. Kariadi Hospital Semarang between December 2017 and July 2018. Lactic acid data were taken using the spectrophotometer method. NLR and MLR were taken by the calculation index. The outcomes data were ICU length of stay (LoS), complications, and death, which were obtained from the medical record. The data were analyzed using bivariate analysis.
Results: There was a significant correlation between lactic acid with ICU LoS (p = 0.001), complication (p = 0.01), and mortality (p = 0.044). There was a significant correlation between NLR with ICU LoS (p = 0.003), complication (p = 0.009), and mortality (p = 0.014). There was a significant correlation between MLR with ICU LoS (p = 0.02), complication (p = 0.027), and mortality (p = 0.017).
Conclusion: There was a significant correlation between lactic acid, NLR dan MLR with the outcomes of CAD patients (ICU LoS, complication and mortality) that have undergone CABG procedure.
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Levels of protein C, protein S, and anti-thrombin III in acute ischemic stroke patients at Haj Adam Malik Hospital, Medan
Jenie Erawati Muchti, Yuneldi Anwar, Adi Koesoema AmanLevels of protein C, protein S, and anti-thrombin III in acute ischemic stroke patients at Haj Adam Malik Hospital, Medan
Background: Ischemic stroke is a clinical syndrome with rapid brain function loss due to a disturbance of blood supply to the brain. The role of natural anticoagulants protein C, protein S and antithrombin III (AT III) in ischemic stroke is still unknown. This study aimed to determine the differences in the levels of protein C, protein S and AT III, which were examined on days 1, 3 and 7 of acute ischemic stroke during treatment.
Methods: This was a longitudinal prospective study carried out in Haj Adam Malik General Hospital Medan, from January to May 2018. This study included 21 acute ischemic stroke patients with three times of sampling (day 1, 3 and 7). Protein C, protein S and AT III were examined using the Coatron A4 device. Protein C and AT III were examined using chromogenic assay principles and protein S using clotting assay principles.
Results: Twenty-one patients who participated in this study were 12 men (57.1%) and nine women (42.9%). There was no significant difference in the level of protein C (p = 0.980), protein S (p = 0.680) and AT III (p = 0.872) between day 1, 3, and 7. There was a positive correlation in protein C, protein S and AT III levels between day 1, 3, and 7. There was a negative correlation between protein C and AT III levels on day 3 (r: - 0.498; p: 0.022).
Conclusion: There was no significant difference in the level of protein C, protein S and antithrombin III between day 1, 3, and 7.Full Article (HTML) | download PDF
Administration of pismatom juice increasing of potassium serum levels and faster of recovery in middle run athletes PASI Denpasar, Bali-Indonesia
I Wayan Juniarsana, Nyoman Adi Putra, Ketut Tirtayasa, Putu Gede Adiatmika, Made LinawatiAdministration of pismatom juice increasing of potassium serum levels and faster of recovery in middle run athletes PASI Denpasar, Bali-Indonesia
Introduction: Intense prolonged physical exercises such as athletic need more energy. It causes fatigue and sweat excretion which is possibly related to decreasing of electrolyte and recovery delay. This research aimed to prove that administration of mix juice of banana, honey, and tomato (pismatom) increasing of potassium serum levels and faster of recovery in middle run athletes.
Method: This research was an experimental design using randomized pre-test-post-test control group design using 28 middle run athletes. Selected samples divided into two groups using random allocation technique. Treatment group was given pismatom juice before and after physical activity with 240 of volume and control group was given mineral water before and after physical activity with 240 ccs of volume during 14 days. Blood-vein measurement was used to evaluate potassium serum levels and measure of pulse recovery rate. The statistical analysis using SPSS version 20.0 for windows, comparison of electrolyte level and recovery time using t-independent test and General Linear Model (GLM).
Result: The results showed that potassium serum levels increasing significantly (p<0.05) in the Treatment Group (4.90 + 0.17 mmol/L vs 3.69 + 0.15 mmol/L). Pulse rate indicate the recovery more faster in the Treatment Group to 3rd minute recovery pulse (RPR3) (124.21+6.61 x/mnt vs 131.57+12.49 x/mnt), to 4th minute recovery pulse (RPR4) (120.14+8.29 x/mnt vs 126.50+12.13 x/mnt) and to 5th minute recovery pulse (RPR5) (111.29+6.69 x/mnt vs 123.14+12.06 x/mnt) that was significantly different (p<0.05).
Conclusion: The conclusion of this research was the administration of Pismatom juice increasing potassium serum levels and faster of recovery.Full Article (HTML) | download PDF
The stability of sample storage for complete blood count (CBC) toward the blood cell morphology
Arie Rahmanitarini, Yetti Hernaningsih, Yulia Nadar IndrasariThe stability of sample storage for complete blood count (CBC) toward the blood cell morphology
Background: Peripheral blood smear examination had a pivotal role in determining diagnosis and as confirmation of the automatic hematology analyzer results. The storage process was highly influential on the morphological stability of the cell. This study aimed to assess the morphological changes in blood cells stored at certain period and temperature.
Method: Sample of 30 blood specimens of healthy people with dipotassium ethylenediaminetetraacetic acid (K2EDTA) anticoagulants. The specimens were stored at room temperature (18-25ºC) and refrigerator temperature (2-8ºC) and were analyzed at the preliminary examination i.e., 8 hours, 16 hours, 24 hours, 48 hours, 72 hours, and 96 hours. Kappa test was used in validating the reading of PBS (Peripheral Blood Smear). The discrimination testing used were paired t-test and Kolmogorov Smirnov test with p value <0.005, which stated to be significant.
Result: The changes in erythrocytes morphology stored at room temperature (18-25ºC) was that the erythrocytes crenation started to happen at 8 hours storage with the grading scale of +2 that were found in 24 (80%) samples, whereas at refrigerator temperature (2-8ºC) the grading scale was +1 and found in 13 (43.3%) samples. Spherocytes on erythrocytes began to form at room temperature (18-25ºC) at 8 hours storage with grading scale of +1 and was found in 2 (6.7%) samples, whereas at refrigerator temperatures (2-8ºC) spherocytes on erythrocytes began to form at 24 hours storage with grading scale of + 2 and was found in 3 (10%) samples.
Conclusion: Peripheral blood smear (PBS) examination shall be done immediately to obtain significant results.
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The comparison of erythrocyte sedimentation rate (ESR) modify Westergren Caretium Xc-A30 and Westergren Manual in Clinical Pathology Laboratory, Sanglah General Hospital, Denpasar, Bali
Made Minarti Witarini Dewi, Sianny Herawati, Ni Kadek Mulyantari, I Putu Yuda PrabawaThe comparison of erythrocyte sedimentation rate (ESR) modify Westergren Caretium Xc-A30 and Westergren Manual in Clinical Pathology Laboratory, Sanglah General Hospital, Denpasar, Bali
Background: The erythrocyte sedimentation rate (ESR) test is one of the most widely performed laboratory test to assess acute phase of inflammation, infection, autoimmune or malignancy. The reference method for ESR measurement was introduced by Westergren. This method is generally easy, un-expensive, yet, time consuming. Automatic instrument has been introduced to decrease the measurement time. Caretium XC-A30 is automatic instrument to measure ESR; it is used in Sanglah General Hospital Denpasar without previous research. Aim of this study was to assess comparison, correlation and agreement of Caretium XC- A30 to the reference method.
Methods: A total of 35 samples in consecutive sampling were taken during August 2018 at Sanglah General Hospital, Denpasar. The samples were examined for ESR with Caretium XC-A30 and manual Westergren. Comparison, correlation and agreement were tested for both methods used.
Results: The Westergren method was the reference method and Caretium XC-A30 was the tested method. Wilcoxon signed rank test showed no difference between two methods (p= 0.439). There was a very strong correlation and excellent agreement showed by Spearman coefficient correlation r= 0.989 and kappa coefficient 0.942.
Conclusion: This study showed no difference between Caretium XC-A30 and Westergren as the reference method for ESR measurement, with very strong correlation and excellent agreement. Thus, Caretium XC-A30 has a potential use in performing ESR measurement with high throughput and lesser time than manual Westergren method.
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The comparison of blood gas analysis (BGA) parameters in samples transported by the pneumatic tube system and manual transport at Dr. Soetomo Hospital, Surabaya, Indonesia
Hantoro Gunawan, Ferdy Royland MarpaungThe comparison of blood gas analysis (BGA) parameters in samples transported by the pneumatic tube system and manual transport at Dr. Soetomo Hospital, Surabaya, Indonesia
Background: Pneumatic Tube System (PTS) can reduce the time needed to transport laboratory samples, thus resulting in faster turn-around time. Blood gas analysis (BGA) is a critical laboratory examination, and it would benefit from sending the sample using PTS. Some studies showed the effect of PTS on BGA’s parameters, so the laboratory should validate the usage of PTS before delivering the samples. This study aims to determine the comparison of BGA parameters in Sample Transported by Pneumatic Tube System and Manual Transport at Dr. Soetomo Hospital, Surabaya, Indonesia.
Method: A cross sectional analytic study was conducted among 31 blood patients and divided into two syringes. One syringe was delivered by PTS as well as the other was transported by courier. The delivery distance was 250 meters for both transportations. Both samples then were examined by qualified laboratory analyst. The pH, pCO2, and pO2 were compared. Data were analyzed using SPSS version 17 for windows.
Result: The result of pH, pO2 and pCO2 in PTS samples was not significantly different compared to manual transportation (p=0,799; p=0,955 and p=0,856 respectively). Bland-Altman plot was found a good agreement between both types of transportation method.
Conclusion: The result of this study showed no significant difference in BGA’s parameters sent by PTS or manual transportation. PTS can be used to replace manual transportation in delivering blood gas samples to the central laboratory.Full Article (HTML) | download PDF
The role of serum albumin level within the first 24-hours of hospitalization to the mortality risk in burn patients at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
Ummi Muthiah, Tiene Rostini, Nina TristinaThe role of serum albumin level within the first 24-hours of hospitalization to the mortality risk in burn patients at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
Introduction: Serum albumin level may predict the mortality risk in burn patients. This study aimed to determine the mortality risk in burn patients based on serum albumin level within the first 24 hours of hospitalization.
Method: A cross sectional study was conducted reprostecively to the patient’s medical records. The subjects were burned patients who were hospitalized in Dr. Hasan Sadikin General Hospital Bandung during January-December 2017. The subjects were divided into two groups, which were dead and survived at the end of hospitalization. The mortality risk based on serum albumin level within the first 24 hours of admission was assessed using the odds ratio (OR) of two groups. Data were analyzed using SPSS version 17 for windows.
Result: The subjects were 47 patients, consisted of 9 dead subjects and 38 survived subjects. Males were predominant in both groups such as 12.8% in dead subjects and 70.2% in survived subjects. The OR value based on serum albumin level <2 g/dL within the first 24 hours of hospitalization was 14.40 (p=0.009; CI:2.1–100).
Conclusion: The subjects with serum albumin level <2 g/dL within 24 hours of hospitalization has 14 times higher mortality risk compared to the subjects with serum albumin level >2 g/dL. Therefore, burn patients need to be examined for serum albumin level within the first 24 hours of hospitalization.
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Correlation between verruca vulgaris and superoxide dismutase
Farica Amanda Fachri, Nelva K Jusuf, Imam B PutraCorrelation between verruca vulgaris and superoxide dismutase
Background: Verruca vulgaris is a form of benign tumors that infected epidermal cells caused by Human papillomavirus (HPV). In several studies states that imbalances in oxidant and antioxidant systems play an important role in HPV infection. SOD is a potent protective enzyme that selectively cleanses radicals of antioxidants by catalyzing dismutation to hydrogen peroxide.
Aim: The study aimed to determine the correlation between SOD level and verruca vulgaris.
Methods: This was an analytic study with a cross sectional design involving 35 subjects with verruca vulgaris and 35 healthy controls. Diagnosis of verruca vulgaris was made based on history and clinical examination. The authors conducted blood sampling and measurement of plasma SOD level to the patients and controls.
Results: The study found that the mean of SOD levels in verruca vulgaris patients were higher (49.27 ± 100.47 U/L) than controls (35.12 ± 50.44 U/L), but it didn’t find a correlation between verruca vulgaris and SOD with p = 0.511. The mean level of ≥ 6 months were higher (59.69 ± 140.85 U/L) than < 6 months (39.43 ± 36.09 U/L) with p = 0.369. The mean multiple lesion levels were higher (62.12 ± 140.76 U/L) than the SOD level of patients with a single lesion (37.14 ± 34.89 U/L) with p = 0.405. The mean of SOD levels of patients who had previously experienced verruca vulgaris was higher (72.79 ± 151.73 U/L) than those who had not it (31.63 ± 18.26 U/L) with p = 0.961.
Conclusion: We didn’t found a correlation between verruca vulgaris and SOD.
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Pregnant gymnastics, ANC, and IEC pregnancy lower the stress on pregnant women
Nurlaily Prasetyawati, Didik Gunawan Tamtomo, Diffah Hanim, Harsono SalimoPregnant gymnastics, ANC, and IEC pregnancy lower the stress on pregnant women
Background: Psychosocial stress in pregnant women is one of the factors that cause the disorder of metabolism for pregnant women. Maintaining physical and mental health on a pregnant woman can be conducted by ANC, pregnant gymnastics, and IEC pregnancy to optimize health degrees while pregnant and expedited the process of childbirth.
Aim: This study aimed to analyze the relationship of the gymnastics, ANC, and the IEC pregnancy with stress rate on pregnant women.
Methods: This was an observational analytical with a case-control approach. The subject of this study was the mother of a toddler as many as 390, ages 2 to 2.5 years that live settled in Klaten Regency, Karanganyar and Sragen.
Results: Stress while pregnant is significantly associated with the gymnastics pregnant (p = 0.023; CI 0.38-0.93; OR 0.69), ANC (p = 0.001; CI 0.01-0.57; OR 0.75) and IEC of pregnancy (p = 0.049; CI 0.45-1.00; OR 0.69).
Conclusion: Stress during pregnancy can be reduced by doing pregnant gymnastics and the ANC. Granting education can also be used as an alternative to reduce stress during pregnancy.
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The different effects of banana juice and sport drink on lactic acid among volleyball students in Surakarta
Ryan Rohmansyah, Muchsin Dowes, Agus Kristiyanto, Khairul ImamThe different effects of banana juice and sport drink on lactic acid among volleyball students in Surakarta
Introduction: The response of lactic acid as a result of exercise in recent times has received considerable attention from physiologists, particularly in term of sports aspect. Lactic acid level is one of the most common measured parameter to determine the performance of athletes. Provision of supplements containing potassium for athletes is usually given such fruit juice or sport drink to prevent muscle fatigue. This study examined the effect of the banana juice and sport drinks to lactic acid in volleyball students.
Methods: The study was a randomized experimental trial using pre-post test with control group. The study populations were all volleyball students aged 15-17 years in Pundong Senior High School. The subjects divided into three equal group, 10 subjects in each group treated with either banana juice, sport drink and mineral water as a control group. Sampling was done by a double-blind method.
Results: The results of the paired sample T-Test showed a significantly difference of lactic acid levels by intervention with banana juice and sport drink compared to control group with mean difference the mean were 4.43, 3.59, 2.68 respectively (p<0.05).
Conclusions: Intervention of banana juice significantly decreased the lactic acid levels compared to sport drinks in volleyball students.
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Betel nut (Areca catechu L.) extract toxicity on the kidney and liver of white rats (Rattus norvegicus)
Anak Agung Gde Arjana, I Made Sukada, N. Adi SuratmaBetel nut (Areca catechu L.) extract toxicity on the kidney and liver of white rats (Rattus norvegicus)
Background: Medication using herbal medicine is one of the alternatives chosen to reduce the adverse effects caused by synthetic drugs. Betel nut (Areca catechu L) usually used as an alternative drug such as anthelmintic and others.
Aim: The study aims to determine the chronic toxicity effect of betel nut.
Method: Five hundred grams of simplicial powder was macerated using 95% ethanol in a container, then sealed and let them for three days. They were protected from light while repeatedly stirred. Rat was given Betel nut extract for three weeks. The histopathological examination was observed under the microscope.
Result: The mean GOT serum, GPT serum, BUN, and creatinine serum levels between control (no extract given) and each dose, i.e., 0.2 ccs, 0.4 ccs, and 0.8 ccs, showed insignificant results (p > 0.05). According to the histopathological observation, there was no difference between control and treatment.
Conclusion: Various orally doses of betel nut extract did not cause toxicity in white rats (rattus novergicus).
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Intraarterial heparin flushing effect on motor evoked potentials in chronic ischemic stroke patients
Terawan Agus Putranto, Tugas Ratmono, Irawan Yusuf, Bachtiar Murtala, Andi WijayaIntraarterial heparin flushing effect on motor evoked potentials in chronic ischemic stroke patients
Background: Stroke has always been a complicated disease which affects not only the patient quality of life but also the patient family. In ischemic stroke patients, one of the most complicated outcomes was the disruption of motor function. Increased motor function is a visible positive outcome of stroke patients.
Aim: This study aims to measure the motor evoked potentials values which the results might give us more insights into how this disease affects the motor neuron pathway.
Methods: This study was an experimental pre-posttest study involved 75 patients diagnosed with chronic ischemic stroke (onset of more than 30 days). The MEPs value was measured by adjusting the IAHF procedure in 2015.
Results: There was no significant difference between motor evoked potential value (amplitude, latency, central motor conduction time) pre and post intraarterial heparin procedure (IAHF) (p>0.05). Occasionally, there was a significant difference in latency value in lacunar, subcortical, and cortical-subcortical area after IAHF (p<0.05).
Conclusion: This study shows that the size and localization of the affected area might determine the results of IAHF.
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The effect of Sargassum duplicatum extract on SGPT level in Rattus norvegicus infected by Plasmodium berghei
Herin Setianingsih, Dimas Bathoro Bagus Pamungkas, Prawesty Diah UtamiThe effect of Sargassum duplicatum extract on SGPT level in Rattus norvegicus infected by Plasmodium berghei
Background: Malaria still becomes a major health problem in Indonesia, especially in the eastern part of Indonesia. The occurrence of Plasmodium resistance against antimalarial medications increases the difficulty of malaria wipe-out effort. As regard with such a great potential Sargassum production that Indonesia possesses, it is very likely to develop Sargassum as adjuvant therapy to prevent and even to stop the resistance.
Aim: This research aims to develop adjuvant therapy of Sargassum extract to avoid the resistance of malaria therapy on the SGPT level.
Method: There were 24 white rats (Rattus norvegicus) that had been infected by Plasmodium berghei and were given dihydroartemisinin-piperaquin (DHA-PPQ) therapy as antimalarial therapy at the dose of 3mg/KgBW for three consecutive days. The rats were later divided into three groups. Group 1 received only (DHA-PPQ), group 2 received Sargassum duplicatum extract as adjuvant therapy at the dose of 100 mg/KgBW for ten consecutive days. Group 3 also received Sargassum duplicatum extract as adjuvant therapy but the dose was at 300 mg/KgBW for ten consecutive days.
Result: SGPT level decreased more significantly in groups in which the rats received dihydroartemisinin-piperaquine and 100 mg/kgBW Sargassum extract as adjuvant therapy and on the other hand only received Sargassum extract at the dose of 300 mg/kgBW. After ten days of therapy the blood SGPT level was examined from all rats. The data were analyzed using one-way ANOVA test.
Conclusion: Sargassum duplicatum (100 mg/kgBW) showed a more significant decrease of SGPT level in Rattus norvegicus (Wistar strain) inoculated by Plasmodium berghei as against those in the dose 300 mg/kgBW.
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The characteristics of mandibular fractures among patients attending Plastic Surgery Unit in Sanglah General Hospital, Bali, Indonesia: A preliminary study
Sang Ayu Arta Suryantari, Agus Roy Rusly Hariantana Hamid, I Gusti Putu Hendra SanjayaThe characteristics of mandibular fractures among patients attending Plastic Surgery Unit in Sanglah General Hospital, Bali, Indonesia: A preliminary study
Background: Trauma is the fourth leading cause of death in the world and occurs at all ages. The high incidence of traffic accidents is equivalent to the increasing incidence of maxillofacial trauma, especially mandibular fracture. This study aims to determine the characteristics by age, gender, mechanism of injury and anatomical site of mandibular fractures among patients attending the Plastic Surgery Unit of Sanglah General Hospital as a preliminary study
Methods: A descriptive cross-sectional study was enrolled among 45 patients attending plastic surgery who recorded in medical records from January 2014 until December 2016 as well as met the inclusion criteria. Data were analyzed using SPSS version 17 and presented in percentage regarding Age, mechanism of injury, gender, and fracture site
Results: There were 45 patients with 61 mandibular fracture sites. Most of the patients were male (84.4%). Based on age, the mandibular fracture is most common in the productive age (20-30 years old) at 22 cases (36.1%). Majority cause of fractures was road traffic accident (82.2%). Parasymphysis region was the most common site of fracture (39.3%).
Conclusion: The characteristics of mandibular fracture patients describe trauma patterns in the community. This finding is similar with some readily available literature with RTAs was the most common etiology and parasymphysis was the most common fracture site.
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An Efficient Polymerase Chain Reaction (PCR) Enhancer for Highly Guanine-Cytosine (GC)-Rich DNA Sequences
Ima Arum Lestarini, Dewi Suryani, Yunita SabrinaAn Efficient Polymerase Chain Reaction (PCR) Enhancer for Highly Guanine-Cytosine (GC)-Rich DNA Sequences
Background: Polymerase chain reaction (PCR) has become a fundamental technique in molecular biology. Nonetheless, PCR amplifications are frequently impaired by high GC content of the target sequence, leading to low yield and specificity of products, with no product at all in the worst cases. Locally high-temperature melting regions within the template can act as permanent termination sites.
Method: Here we designed and tested an effective and low-cost PCR enhancer, a combination of dimethyl sulfoxide (DMSO) 10% (v/v) and magnesium chloride (MgCl2) 1,5 mM that broadly enhanced the qualitative output of PCRs. We used Mycobacterium tuberculosis strain H37vR as a PCR template.
Result: It was found that PCR enhancer containing 10% (v/v) of DMSO and 1,5 mM of MgCl2 improved the amplification of GC-rich template of M. tuberculosis gene other than without the PCR enhancer.
Conclusion: Therefore, this PCR enhancer could be widely useful to improve the amplification of GC rich construct from another genome.
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The mucin 5AC level in medical faculty students with Computer Vision Syndrome (CVS)
I Gusti Ayu Made Juliari, Ratna Sari Dewi, Ni Luh Made Novi Ratnasari, Ariesanti Tri HandayaniThe mucin 5AC level in medical faculty students with Computer Vision Syndrome (CVS)
Introduction: Prolonged computer use will lead to a group of symptoms such as dryness of eyes, tired, headache and others called Computer Vision Syndrome (CVS). The decrease of Mucin 5 AC (MUC5AC) level could be one of the signs of dry eye disease on persons with CVS.
Objective: The purpose of this study is to describe the Mucin 5AC level in medical faculty students of Udayana University, Bali, Indonesia with CVS.
Method: It is an observational cross-sectional analytic study at Medical Faculty Udayana University on October 2018. Thirty four subject selected by purposive sampling and examined with Schirmer I test, Tear Break Up time (TBUT) test, and Mucin 5AC test. All of the subject then divided into CVS group and non-CVS group. Mucin 5AC level which less than 186.33 ng/mL categorized as low mucin, while more than 186.33 ng/mL categorized as normal mucin level. Data was analyzed by crosstabulation table and chi-square test with significant value p < 0.05.
Result: Most of the students who diagnosed with CVS had lower mucin 5AC levels as much as 77,3% and 33,3% students with CVS had normal mucin 5AC level. This study analyses found there is significant association between level of mucin 5AC with CVS. The students with low level of mucin 5AC had 6,8 higher risk tend to be CVS (OR=6,8; CI 95%= 1,42-32,37; p=0,012).
Conclusion: Low level of mucin 5AC has association with the risk of CVS in the medical students with prolonged computer use.
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Desperately needed in Indonesia: Basic Epilepsy Surgery Centers with Simple but Reliable pre-surgical investigations, based on Semarang’s Experience
Zainal Muttaqin, Thohar Arifin, Yuriz Bakhtiar, Erie BPS Andar, Dody Priambada, Happy Kurnia, Ajid Risdianto, Krisna Tsaniadi, Gunadi Kusnarto, Aris C Bintoro, Vega KarloweeDesperately needed in Indonesia: Basic Epilepsy Surgery Centers with Simple but Reliable pre-surgical investigations, based on Semarang’s Experience
Background: Even with optimized anti-epileptic medications, 30% of epilepsy patients will be refractory and this condition leads to cognitive and psychosocial decline, resulting in worse quality of life and higher mortality. With 0,75% prevalence, there are more than 2.0 million epileptic in Indonesia, about 360.000 will be refractory, and half of them are potential candidates for epilepsy surgery (ES). After 17 years since the first ES on July 1999, number of ES increases every year reaching around 50 cases per year. By the end of 2017, the total number reached 615 and most was temporal lobe epilepsy (TLE) cases. Pre-surgical investigations were compared in relation to the seizure free results between the first five-year and the recent twelve-year. Despite the excellent result shown, all of these ES were still performed in Semarang (Diponegoro University), and demographic analysis showed that 80% patients came from Java-Bali area. So that new basic centers capable of performing ES for simple TLE cases are desperately needed to improve treatment for refractory epilepsy cases elsewhere.
Material and methods: Until the end of 2017, there were 615 ES cases, including 514 Temporal Lobe Epilepsies (TLEs). Pre-surgical investigations were grouped as Simple (MRI with specific protocol and routine EEG), Difficult (needs long-term ictal EEG, and /or PET CT), and Complex (needs invasive or intracranial/ subdural grid EEG, and or Electrocorticography/ ECoG during the surgery). For the first five year-period, besides seizure semiology, decision to operate were based on MRI and routine EEG (Simple) in 54 out of 56 (96,4%) TLE cases. One patient had long-term ictal EEG and another had subdural grid EEG implanted, both patients showed visually normal MRI. But for the recent twelve-year, Simple TLEs occupy only 234 out of 458 (51%) TLE cases. Long-term ictal EEG were performed in 161 patients (35,2%), PET study in 39 patients (8,5%), subdural grid EEG in 30 patients (6,5%), and ECoG in 61 patients (13,3%).
Results: As a new ES center performing only simple TLE cases, our surgical results were Class I: 82%, Class II: 11%, and Class III: 7% (9). As a semi advance ES center (after more than 5 years, and only half were simple ES cases), the Class I or seizure free results were 78,7% for simple TLEs, 73,4% for Difficult TLEs, and 65,2% for Complex TLEs.
Demographic distribution showed that almost 80% of ES patients came from Java-Bali area, and half of them were from Central Java Province with Semarang as its capital. Patients from other parts of the country were scarce, especially from remotely located islands of East Indonesia.
Conclusion: For the first five year, -as a basic ES center- we relay most on good MRI besides detailed study on seizure semiology and routine EEG. The Class I or Seizure Free result was best in the Simple TLEs with MRI showing discrete unilateral lesion in the temporal lobe. With 17 years experience, and a structured ES program including those patients needed invasive pre-surgical investigations, Semarang is a semi-advance center capable for research and training. This fact should encourage hospitals with micro-neurosurgical capabilities to initiate a new Basic ES Center by sending their neurologist and neurosurgeon to Semarang, so that ES services may become available to PWEs in all part of Indonesia.Full Article (HTML) | download PDF
The surveillance of antibiotics resistance in Indonesia: a current reports
Andaru Dahesihdewi, Adhi Kristianto Sugianli, Ida ParwatiThe surveillance of antibiotics resistance in Indonesia: a current reports
Background. Antimicrobial resistance (AMR) has become serious problem globally. Surveillance AMR is important to be part of quality indicator in antimicrobial stewardship program (ASP).
Method. Surveillance of microbial pattern and their antibiotics susceptibility in Indonesia 2017 were developed by Indonesian Association of Clinical Pathology and Laboratory Medicine. Data aggregation was sourced from 31 hospitals antibiogram report which were joined the system of national data collection in forlabinfeksi.or.id. with standardized inclusion criteria. Data was analyzed descriptively, based on hospital type-A-B-C.
Result. There were 15.302 isolates included, 4.761 (31,1%) were positive Gram and 10.541 (68,9%) were negative Gram, 61,6% reported by type-A hospital, 16,4% by type-B and 22% by type-C. Positive and negative Gram patterns respectively were E. faecalis and E.coli (blood and urine), Streptococcus spp and K. pneumoniae (sputum), S. aureus and E.coli (pus), E. faecalis and E.coli (wound), coagulase negative Staphylococcus and Enterobacteriaceae (CSF). Antibiotic susceptibility pattern was slightly different among various types of hospital and among various clinical specimens. Positive Gram bacteria had good vancomycin susceptibility in all hospital types, except in sputum from Type-A and B hospital, also in blood and urine from Type-C hospital, similarly with linezolide susceptibility. Susceptibility pattern among Gram negative- bacteria for carbapenem and amikacin was good, in all hospital types, except on A. baumannii. For A. baumannii, antibiotic carbapenem, amikacin and ceftazidime susceptibility were 20-66%, 35-80%, and up to 83%, respectively. For P. aeruginosa, antibiotic susceptibility pattern was equal among all hospital types. Their susceptibility against cephalosporin (ceftazidime), fluoroquinolone (ciprofloxacin) and aminoglycoside (amikacin) were better in higher type-hospital.
Conclusion. This result may become part of national epidemiological data for ASP program evaluation. This data may also be referred for local empirical antibiotic guideline among limited resources appropriate hospital. There will be improvement forward for more representative beneficial data.
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The hypercoagulation state among major β-thalassemia patients at H. Adam Malik Hospital, Medan, Indonesia
Jane Tetraulina Silitonga, Adi Koesoema Aman, Bidasari LubisThe hypercoagulation state among major β-thalassemia patients at H. Adam Malik Hospital, Medan, Indonesia
Background: Thalassemia is the most common hereditary blood disorder in the world and Indonesia. Major β-thalassemia is classified as Transfusion-Dependent Thalassemia (TDT). Specific changes in the composition of red cell membrane lipids and hemosiderosis may lead to hypercoagulation. This study aimed to determine the difference in Protein C, Protein S, Antithrombin III (AT-III), and D-dimer between major β-thalassemia patients and normal people.
Methods: This was an observational analytical study with a cross-sectional design, including 18 major β-thalassemia patients in H. Adam Malik Hospital Medan who met the study criteria and 18 normal controls. Subjects were examined for Protein C, Protein S, AT-III and D-dimer. The assessment was also carried out among patients based on their transfusion frequency and serum ferritin.
Results: There were significant differences in Protein C, Protein S, and D-dimer levels between major β-thalassemia patients and normal controls (p < 0.05). AT-III level in major β-thalassemia patients was lower than healthy controls, however the difference was not significant. The level of Protein C in patients who infrequently and frequently underwent blood transfusions were 34.88 ± 8.6 and 45.19 ± 7.8 respectively, which was significantly different (p < 0.05). A significant differences in Protein C, Protein S and D-dimer were also found between patients with serum ferritin level < 2,500 ng/ml and ≥ 2500 ng/ml.
Conclusion: Significant changes were found in anticoagulation proteins of major β-thalassemia patients. Frequent blood transfusions and chelation therapy should be emphasized for major thalassemia patients because they affect anticoagulation protein levels.
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Erythrocyte alloantibodies in chronic kidney disease patients receiving packed red cell transfusions in Sanglah General Hospital, Denpasar
Ni Komang Krisnawati, Sianny Herawati, Ni Kadek MulyantariErythrocyte alloantibodies in chronic kidney disease patients receiving packed red cell transfusions in Sanglah General Hospital, Denpasar
Introduction: In Chronic kidney disease (CKD) patients, as the consequences of the pathogenesis, anemia due to the failure of erythropoietin production requires Packed Red Cell (PRC) transfusion. The presence of alloantibodies in CKD patients who routinely require transfusion in Bali has never been evaluated. This study aims to determine the erythrocyte alloantibodies of CKD patients who received PRC transfusions in Sanglah Hospital.
Methods: This study was a cross sectional descriptive study in adult CKD patients with history of PRC transfusion more than twice.
Results: A total of 50 patients with Chronic Kidney Disease consisting of 31 men and 19 women, mostly 46-65 years old (60%) and the most blood group were blood group O (44%). There were 3 patients with positive antibody screening and identification results, 2 male patients (66.67%) and 1 female (33.33%). Two patients 46-65 years (66.67%) while 1 person 18-45 years (33.33%), with 2 person with blood group A (66.67%) and one person with blood group O (33.37% ). These three patients presented multiple alloantibodies in the form of anti-K, anti-Kpa, anti-Lua
Conclusion: From the CKD patients who received PRC transfusions in Sanglah Hospital, ±6% formed alloantibodies. All of the alloantibodies formed were multiple alloantibodies, in the form of anti-K, anti-Kpa and Lua.
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Hemostasis changes and its relationship with SOFA score in sepsis patients
Sarah Hanna Nadya Giri, Adi Koesoema Aman, Achsanuddin HanafieHemostasis changes and its relationship with SOFA score in sepsis patients
Introduction: Sepsis is a major health problem, and the incidence is still increasing. Generally, sepsis occurs in about 2% of all inpatients in developed countries. The immunologic response that causes sepsis is a systemic inflammatory response that causes activation of the inflammatory and coagulation pathways. If sepsis untreated, it can lead to organ failure then death. Organ dysfunction is expressed as an acute change of Sequential Organ Failure Assesment (SOFA) score >2 points as a consequence of infection.
Methods: This is a cohort prospective’s study. Prothrombin time (PT), activated partial thromboplastin time (aPTT), Thrombin time (TT), Fibrinogen, D-dimer were examined 3 times (first, second, third day), and then assessed to see its relation with the corresponding SOFA score. Twenty-four subjects of the study were ICU patients in H. Adam Malik Hospital who matched the inclusion and exclusion criteria.
Results: There were significant differences of PT on the first, second and third day (p =0.03). There were no significant differences in aPTT, TT, Fibrinogen, D-dimer on the first, second, third day. There were no significant correlations of PT, aPTT, TT, Fibrinogen with the corresponding SOFA score on the first, second, third day. There was a moderate positive correlation between D-dimer and SOFA score in the first, second and third day of examinations (p <0.05).
Conclusion: PT changes occurred significantly on the first, second, third day of sepsis and D-dimers can be used to asses the risk of organ failure in septic patients.
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Coagulation Defects in Βeta-Thalassemia Major Patients at Haji Adam Malik Hospital Medan
Eduward Situmorang, Adi Koesoema Aman, Bidasari LubisCoagulation Defects in Βeta-Thalassemia Major Patients at Haji Adam Malik Hospital Medan
Background: The prognosis of patients with beta-thalassemia major has improved in the last few decades, but some complications occur in thalassemia patients such as the prolongation of blood coagulation time. This study aimed to determine the difference in prothrombin time (PT), activated partial thromboplastin time (aPTT), and thrombin time (TT) between beta-thalassemia major patients and healthy children, frequent and infrequent transfusion, and ferritin levels ≥ 2,500 ng/ml and < 2,500 ng/ml.
Method: This was an analytical cross-sectional study performed at Haji Adam Malik Hospital from April to August 2018 including 20 thalassemia patients and 20 healthy children. Patient data consisted of full blood count, transfusion status, coagulation parameters, serum iron, and ferritin level. The difference between coagulation parameters was analyzed using the independent t test.
Result: There was a significant difference in PT and aPTT between patients with thalassemia and healthy children (15.7 ± 1.5 vs. 13.0 ± 1.0; 42.5 ± 4.8 vs. 36.3 ± 4.8 respectively). There was a significant difference in PT between frequent and infrequent transfusion (15.41 ± 1.30 vs. 17.16 ± 2.08). There was significant difference in PT and aPTT between ferritin levels ≥ 2,500 ng/ml and < 2,500 ng/ml (18.97 ± 0.57 vs 15.93 ± 1.18; 52.92 ± 1.17 vs 42.11 ± 3.88 respectively).
Conclusion: There was a prolongation of PT and aPTT in beta-thalassemia major patients and ferritin levels ≥ 2,500 ng/ml. There was also an elongation of PT in patients who had infrequent transfusions.Full Article (HTML) | download PDF
Hyperferritinemia and oxidative stress in the kidney of beta thalassemia major
Dian Ariningrum, Purwanto Adhipireno, Lisyani Budipradigdo SuromoHyperferritinemia and oxidative stress in the kidney of beta thalassemia major
Background: Thalassemia is a genetic disorder which until now has become a global health problem. Regular blood transfusions in managemen of BTM result in iron overload. Free iron in the form of intracellular ferrous (Fe2+), in the presence of oxygen, will initiate the formation of reactive oxygen species (ROS), produce another free radical superoxide that will oxidize the lipid and protein compounds of the cell membrane. F2-IsoPs is the best, most stable and more accurate marker of lipid peroxidation in vivo, found urine. This study aimed to determine the association between hyperferritinemia and lipid peroxidation in kidney reflected as elevated u-F2IsoPs as controlling several factors affecting oxidative stress in the kidney.
Methods: This cross sectional study was conducted between May and June 2016. Thirty subjects of BTM admitted to pediatrics unit of Dr. Moewardi Hospital Surakarta who met the inclusion and exclusion criteria were enrolled. The data were analyzed to calculate prevalence ratio and 95%CI for each variable, followed by multivariate analysis with logistic regression.
Results: The prevalence of lipid peroxidation in kidney, characterized with elevated u-F2IsoPs of > 2 ng/mg urine creatinine, was 67%. Age, hyperferritinemia status and duration of illness did not associate with lipid peroxidation in the kidney. Transfusion volume of ≥25 unit/year showed statistically significant association with lipid peroxidation (PR 24.10; 95%CI 2.16-268.42; p=0.010).
Conclusion: Transfusion volume, rather than hyperferritinemia, independently associated to oxidative stress and lipid peroxidation of the kidney in BTM.
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The relationship between Epidermal Growth Factor Receptor (EGFR) mutation and computed tomography findings in lung adenocarcinoma
Agnes Septiani, Pande Putu Ayu Patria Dewi, Anita Widyoningroem, Anggraini Dwi Sensusiati, Muhammad YaminThe relationship between Epidermal Growth Factor Receptor (EGFR) mutation and computed tomography findings in lung adenocarcinoma
Background: Adenocarcinoma is the highest histology subtype of lung cancer. Epidermal Growth Factor Receptor (EGFR) is a factor that can predict the prognosis or response to treatment in patients with lung adenocarcinoma. Adenocarcinomas with EGFR mutations generally have a component of Ground Glass Opacity (GGO), smaller size, oval shape, multiple nodal metastases, and distant metastases. The aim of this study was to determine the relationship between EGFR mutations and CT scan images in pulmonary adenocarcinoma patients.
Methods: This was a retrospective analytical study consisting of 92 samples, which were categorized into the mutation group (n = 62) and wild group (n = 30). This study was conducted at Dr. Soetomo General Hospital from January 2015 – December 2017. The assessed CT-Scan findings were tumor size, shape, density, lymph node size, pleural effusion, and metastasis presence. The relationship was analyzed using the chi-square test and considered significant if the p-value was < 0.05.
Results: This study found a significant relationship between EGFR mutations status with tumor size ≤ 3 cm (p = 0.02), lymph node size < 1.5 cm (p = < 0.001) and metastasis (p = 0.026). However, tumor density, tumor form, and pleural effusion did not have significant relationship with EGFR mutation.
Conclusion: Tumor size ≤ 3 cm, lymph node size < 1.5 cm and presence of metastasis can be found in EGFR mutations pulmonary adenocarcinoma patients.
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The correlation between caspase-9 and caspase-3 on sepsis case: an experimental study on the Balb/C Mice induced by lipopolysaccharide
Sotianingsih Haryanto, Suharyo Hadisanputro, Lisyani Budipardigdo SuromoThe correlation between caspase-9 and caspase-3 on sepsis case: an experimental study on the Balb/C Mice induced by lipopolysaccharide
Introduction: Sepsis mortality rate in Indonesia reaches over 50 %, hence, acknowledgement of its pathophysiology need to be elucidated, including the pathway of apoptotic. The objective of this study was to describe the lipopolysaccharide (LPS)-induced sepsis in which triggers intrinsic apoptotic pathways in terms of the expression of caspase-9 (Cas9) and caspase-3 (Cas3).
Method: By experimental with time series randomized post test-only control group design, 48 Balb/C mice divided into 2 groups (control and treatment). Each group was injected intra-peritoneally with saline 250 µL/mice and saline 250 µL + 0.1 mg E. coli LPS/mice. Each group divided into 4 termination time (12th, 24th, 36th and 48th hours), examined by immunohistochemistry (IHC) for Cas9 and Cas3 expression, and analyzed by mean difference test (Mann-Whitney and t test) and correlation test (Spearman’s test).
Results: The LPS-induced sepsis in the treatment group revealed increasing number of caspase-9 compared to control group (2.34+0.24 vs 0.82+0.08; p<0.001. There were increasing trends in the treatment group compared to control group includes for: all groups Cas3 (1.54+0.10 vs 0.48+0.05; p<0.001), t12 Cas3 (3.25+0.22 vs 0.50+0.06; p<0.001), t24 Cas3 (1.37+0.27 vs 0.45+0.05; p=0,002), and t36 Cas3 (1.03+0.20 vs 0.52+0.22; p=0,002). Instead, there were no difference between treatment group and control group for t48 Cas3 (0.50+0.14 vs 0.43+0.10; p=0,485). There was decreasing pattern on serial time 12, 24, 36 and 48 hours for Cas9 (p<0,001) and Cas3 (p=0,002). There was a correlation between Cas9-Cas3 (rs=0.835;p=0.001).
Conclusion: The LPS-induced sepsis caused an increase of caspase-9 and caspase-3, strongly correlated with decreasing pattern on time serial.
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Relationship of Plasma Cystatin C level and renal dysfunction in patients with preeclampsia
Makmur Sitepu, Azano Sitepu, Johny Marpaung, Dudy Aldiansyah, Edy Ardiansyah, Deri Edianto, Khairani SukatendelRelationship of Plasma Cystatin C level and renal dysfunction in patients with preeclampsia
Background: Renal dysfunction is an important aspect of the pathophysiology of preeclampsia besides vascular endothelial dysfunction and placental hypoperfusion. Cystatin C is one of the most important inhibitors of extracellular protease enzymes and can be reliable marker for the calculation of Glomerular Filtration Rates (GFR). This study aimed to determine the relationship between plasma levels of cystatin C and renal dysfunction in patients with preeclampsia.
Method: This was an analytical cross sectional study conducted at Haji Adam Malik General Hospital Medan, Dr. Pirngadi Hospital Medan, several affiliated hospitals of the Faculty of Medicine University of North Sumatra and Prodia Clinical Laboratory Medan. A total of 26 preeclamptic patients were included in this study. Samples were divided into renal dysfunction and without renal dysfunction group.
Results: Eleven subjects with renal dysfunctions were mostly aged 20 – 35 years (73.3%), and the other eight subjects without renal dysfunctions were at the age of 20 – 35 years (72.7%). Most of the subjects had multigravida pregnancies, five subjects (33.3%) with renal dysfunctions, and six subjects (54.5%) without renal dysfunctions. The mean level of cystatin C in renal dysfunction (1.52 ± 0.37 mg/L) was significantly higher than without renal dysfunction (1.17 ± 0.12 mg/L) (p < 0.05).
Conclusion: The cystatin C level in preeclamptic patients with renal dysfunctions patient was higher than those who did not have renal dysfunction.Full Article (HTML) | download PDF
Analysis of nerve growth factor serum levels in psoriasis vulgaris patients
Riana Novatina E. Pangaribuan, Imam B. Putra, Kristo A. NababanAnalysis of nerve growth factor serum levels in psoriasis vulgaris patients
Background: Psoriasis is a complex chronic inflammatory skin disease with multifactorial mechanism affected by immunological, genetic, environmental and nervous system factors which its mechanism is still unknown. The involvement of nervous system in psoriasis is ruled by nerve growth factor (NGF). Increased levels of NGF serum are expected occurring in psoriasis vulgaris.
Aim: To determine the differences between NGF serum levels in psoriasis vulgaris patients and controls
Methods: This study is an analytic study with cross sectional design involving 30 psoriasis vulgaris patients and 30 healthy controls. Diagnosis of psoriasis vulgaris was made based on history and clinical examination; we conducted blood sampling and measurement of NGF serum level to the patients and controls. The differences between NGF serum levels in psoriasis vulgaris patients and controlled is analyzed by independent-t test. This research approved by the health research ethics committee of the Faculty of Medicine of Sumatra Utara University/ H. Adam Malik Medan General Hospital.
Results: In this study, we found the mean NGF serum level of female psoriasis vulgaris patients (810.30 ± 299.97 pg/ml) was higher compared to male (806.70 ± 256.04 pg/ml). The mean NGF serum of psoriasis vulgaris patients were highest on ages group 15 – 23 years (930.14 ± 69.03 pg/ml). The mean NGF serum level of psoriasis vulgaris without family history (875.38 ± 203.91 pg/ml) was higher compared to patient with a maternal history (600.87 ± 387.45 pg/ml) and paternal history (477.88 ± 406.97 pg/ml). The mean NGF serum level in the psoriasis vulgaris group (808.38 ± 272.48 pg/ml) was higher compared to the control group (524.92 ± 281.22 pg/ml) dengan with p=0.0001.
Conclusion: There were significant differences in NGF serum levels between psoriasis vulgaris patients and control.Full Article (HTML) | download PDF
Correction of motor disturbances in children with cerebral paralysis and moderate mental retardation
Irina Vitalevna Mikhaylova, Svetlana Vasilyevna Shmeleva, Vladimir Yurievich Karpov, Viktor Ivanovich Sharagin, Yanina Vasilevna Shimanovskaya, Margarita Alexandrovna Petrova, Anatoly Ivanovich Alifirov, Maxim Viktorovich EreminCorrection of motor disturbances in children with cerebral paralysis and moderate mental retardation
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Cytogenetic mutation in a family with sickle-cell beta-thalassemia in North Sumatera, Medan, Indonesia: A preliminary study
Christie Nur Andani, Adi Koesoema Aman, Herman Hariman, Bidasari LubisCytogenetic mutation in a family with sickle-cell beta-thalassemia in North Sumatera, Medan, Indonesia: A preliminary study
Background: The prevalence of Hb S/β Thalassemia has not been widely reported, and until now, there is a lack of statistical data on the prevalence of the disease in Indonesia. In 1974, cases of β thalassemia with Hb S were found in one family in Jakarta. The aim of this study was to describe the cytogenetic mutation in a family with Hb S/β thalassemia in North Sumatera.
Methods: This was a descriptive study with a cross-sectional design conducted in one family of HbS patients with thalassemia trait, with a total of five samples. Complete blood count, hemoglobin electrophoresis examination, peripheral blood smear, PCR, and amplicon were performed to describe the hematology and cytogenetic profile of samples. Data were analyzed descriptively.
Results : The father (64 years old) suffered from HbS (HbA = 58.3%, HbS = 38.3%, HbA2 = 2.8%) with heterozygote HbS mutation type. The mother (36 years old) suffered from β-thalassemia trait (HbA = 93.8, HbF = 1.2%, HbA2 = 5%) with β-thalassemia heterozygote IVS1-nt5 mutation type. The first child (male, 18 years old) suffered from HbS/β thalassemia (HbA = 25.9%, HbF = 22.4%, HbS = 48.2%, HbF = HbA2 = 3.5%), the second child was normal (HbA = 97.4%, HbA2 = 2.6%) and the third child (female, 10 years old ) suffered from HbS β-thalassemia (HbA = 3.3%, HbF = 25.5%, HbS = 67.6%, HbA2 = 3.6%). The first and third child had β-thalassemia with double heterozygote HbS and IVS1-nt5 mutation type.
Conclusion: Population migration between nations followed by marriage could lead to cytogenetic mutations and cause sickle-cell beta-thalassemia. The finding of double heterozygous HbS mutation and beta thalassemia need to be explored further about the patient’s fathers family.
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P2B2 PABI XVI Manado 2019 Continuing Professional Development in Surgery: The Patients and Surgeon in Universal Health Coverage Era
Fery KalitouwP2B2 PABI XVI Manado 2019 Continuing Professional Development in Surgery: The Patients and Surgeon in Universal Health Coverage Era
Assalamu’alaikum Wr. Wb.
Shalom.
Friends of PABI members throughout Indonesia, we praise and thank you to the presence of God Almighty because we are still in good health. In favor of God, we will carry out the XVI P2B2 in the City of Manado.
Welcome to Manado City. A city full of natural beauty and culinary delights. In the framework of the XVI P2B2, the event will be held on July 2, 2019 until July 6, 2019 at the Grand Kawanua Ballroom, the Novotel Manado hotel with a theme
"Safety of Patientes of Surgeons in the Age of Universal Health Coverage"
The activities held in the form of panel discussions, symposiums, workshops, tours of the city of Manadoo and its surroundings, and the Family Program. We invite all of you to come and attend the activities we have summarized
Hopefully what we present can be useful for PABI members and other colleagues as well as accompanying families. Enjoy Manado City.
Wassalamu alaikum Wr. Wb
Fery Kalitouw, MD
chairman of the committee
P2B2 PABI XVI Manado
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The 1st International Conference on Global Health and Innovation: Multiple Burden of Diseases in the Developing Countries
GHI LombokThe 1st International Conference on Global Health and Innovation: Multiple Burden of Diseases in the Developing Countries
Welcome remark The Chairman of GHI Conference
Dear all participants and invited speakers,
It is my privilege and pleasure, on behalf of Dean of Faculty of Medicine and Rector University of Mataram, to welcome you all to the 1st International Conference on Global Health and Innovation. This conference is held by the Faculty of Medicine Universitas Mataram with the support of Chungnam National University, Indonesian Doctor Association of West Nusa Tenggara, and Indonesia Pharmacist Association. This conference is in conjunction with the 57th Dies Natalis of Universitas Mataram and 16th Dies Natalis of the Faculty of Medicine Universitas Mataram.
The theme of the conference this year, “Multiple Burden of Diseases in the Developing Countries” reflects the current health situation faced by Indonesia and other developing countries, where due to the demographic and socio-economic transition and the increasing trend of non-communicable diseases, more constraints are imposed to our health systems in dealing with the pre-existing burden of communicable diseases. This is a challenge that calls out further action and innovation.
This conference is presenting you with internationally recognized, multidisciplinary expert speakers from Indonesia and abroad to share their knowledge in regards to the current global health concerns of the multiple burdens of diseases in developing countries. We have 100 participants with 53 abstract.
To further disseminate the scientific endeavors of researchers who have submitted their study to be presented in this conference, we are partnering with Bali Medical Journal, an experienced and internationally-indexed journal in Indonesia.
Conferences such as this provide a valuable opportunity for health professionals, researchers and students to share knowledge, ideas, and experiences. It is also a forum for young and senior researcher to connect and explore potential future collaboration.
We would like to thank the provincial government of West Nusa Tenggara, Indonesian Doctor Association, Indonesia Pharmacist Association and all sponsors for the supports.
I am sure you will have fruitful and rewarding exchanges during this conference. I wish you every success with this important conference and I look forward to learning about the outcome. We once again welcome you to Lombok and we hope that you are enjoying this conference.
Thank you.
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Low plasma levels of IGF-1 and IL-1RA with high plasma levels of IFN-γ as prognostic factor for mortality in hospitalized geriatric patients with delirium
I Nyoman Astika, I Gde Raka Widiana, Ketut Suastika, RA Tuty KuswardhaniLow plasma levels of IGF-1 and IL-1RA with high plasma levels of IFN-γ as prognostic factor for mortality in hospitalized geriatric patients with delirium
ABSTRACT
Background: Delirium is common and serious problem with high morbidity and mortality, especially in geriatric patients. Decrease in the number of neuroprotective factors (IGF-I and IL-1RA) and increase in IFN-γ had been correlated with the incidence of delirium. This study aims to understand whether these markers can be used as predictors for mortality in geriatric patients with delirium in an effort to prevent the adverse events of delirium.
Methods: In this observational analytic study with prospective cohort design carried out in the Geriatric Installation care room at Sanglah General Hospital in Denpasar in 2018, 76 samples were examined for their IGF-1, IL-1RA, IFN-γ plasma levels. Patients were then followed during their hospital stay until they were declared cured or died due to delirium or its complications. The relationship between each group and mortality rate were then analyzed using univariate, bivariate and multivariate analysis.
Results: In this study, median was used as the cutoff point for IGF-1 levels [21.38 (0.00-91.07)], IL-1RA levels [2,491.48 (193,44-6720,13)] and IFN-γ [194.29 (0.00-2200.96)]. In multivariate analysis, low plasma levels of IGF-1 (HR= 4.12 [95% CI: 1,458 - 11,642, p=0.008]) and IL-1RA (HR=2.91 [95 % CI: 1.037 - 8.154, p= 0.043]) proved to be an independent factor in the occurrence of death in geriatric patients with delirium. However, IFN- γ failed to show any correlations.
Conclusion: Both low plasma levels of IGF-1 and IL-1RA can be used as predictors for mortality in geriatric patients with delirium.
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Development of rabies eradication package, a family-based health promotion media to prevent rabies in Buleleng, Bali, Indonesia
Komang Hendra Setiawan, Ari Natalia Probandari, Eti Poncorini Pamungkasari, Didik Gunawan TamtonoDevelopment of rabies eradication package, a family-based health promotion media to prevent rabies in Buleleng, Bali, Indonesia
Background : Rabies occurred in Bali since 2008, and in 2017 rabies cases were still found in Bali, including in Buleleng Regency. Prevention of rabies in Bali must involve the participation of the community especially family, which is in direct contact with dogs. This study aims to develop family-based health promotion media, which is later called as the rabies eradication package, to overcome rabies in Buleleng, Bali.
Methods: This study uses the research and development (R&D) method. which consists of 5 phases, namely analysis, design, development, implementation and evaluation. at the implementation and evaluation stage researchers used a quasi-experimental approach. The total number of samples used was 100 families taken from 2 villages. The variables measured were the level of knowledge and attitudes towards prevention of rabies. data analysis using the Mann-Whitney U test.
Result : This study develop rabies eradication package as a family-based health promotion media. This package consists of a rabies eradication book, a dog vaccination card, a medical history cards and bite wound treatment tools. Of the 100 respondents in the study sample, 50 respondents who were included in the treatment group, which received a rabies eradication package for 1 month, experienced a significant increase in knowledge (p <0.001) and attitudes (p <0.001) in prevention of rabies compared to the control group.
Conclusion : Rabies eradication package can be used as a family-based health promotion media to increase rabies prevention efforts because it can increase knowledge and attitudes in preventing rabies
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Incidence of deep vein thrombosis in patients with diabetic foot ulcers
Dairion Gatot, Dharma Lindarto, Andri I MardiaIncidence of deep vein thrombosis in patients with diabetic foot ulcers
The mortality in type-II diabetes mellitus (T2DM) patients relates to the occurrence of thrombosis events in the peripheral vascular, one of which, diabetic foot ulcers (DFU). Theoretically, an increased tendency for thrombosis in patients with DFU will increase the incidence of thrombosis in the lower limbs that are part of the venous thromboembolism, also known as deep vein thrombosis (DVT). This research was a descriptive study, with a cross-sectional design, aimed to investigate the incidence of DVT in DFU patients in Haji Adam Malik Central General Hospital Medan from September to November 2017. A total sample of 45 patients diagnosed as T2DM with DFU, was selected to join the study based on the inclusion and exclusion criteria. All subjects were asked for their consent before being included in the study. The data collected included patients’ personal information, complete diagnosis, hemostatic laboratory results, and doppler USG examination. All data were statistically processed using SPSS software. The results showed that the incidence of DVT in DFU patients was 93.3% based on physical and radiological examination using doppler USG.
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Comparison of antithrombin III levels in type 2 diabetes mellitus patients with and without ulcers at Haji Adam Malik Hospital Medan Indonesia from may to july 2017
Zulfahmi Zulfahmi, Andri I Mardia, Savita Handayani, Santi Syafril, Dairion GatotComparison of antithrombin III levels in type 2 diabetes mellitus patients with and without ulcers at Haji Adam Malik Hospital Medan Indonesia from may to july 2017
Introduction: People with diabetes mellitus (DM) have an increased risk for thrombosis compared with non-diabetic patients. Several studies showed contradicting in data on levels of antithrombin III (AT-III) in people with type 2 DM and diabetic ulcers.
Methods: This is a descriptive and analytical cross-sectional study on AT-III concentration of patients with type 2 DM with and without foot ulcers. A total of 40 subjects are divided equally into the control group, which consist of type 2 DM patients without foot ulcers, and the case group of type 2 DM patients with a diabetic foot ulcer based on the Wagner criteria. Blood samples are then taken after 8 to 10 hours of fasting to check for AT-III concentration and hemostasis examination including platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT), fibrinogen levels, and D-dimers.
Results: The mean AT-III level of diabetic foot ulcers group was 216.02 ± 71.23 pg/mL, which was lower than the mean AT-III level of the group without diabetic foot ulcers, i.e. 243.05 ± 48.05 pg/mL. The mean AT-III concentration in the diabetic foot ulcers group with hypercoagulation state was 221.52 ± 64.25 pg/mL, which was slightly higher than the mean AT-III concentration of the diabetic foot ulcers group with hypocoagulation state of 203.18 ± 90.92 pg/mL.
Conclusion: No statistically significant difference was found in the levels of AT-III between the diabetic foot ulcers group and the non-diabetic foot ulcers group (p> 0.05). There was no statistically significant difference in AT-III levels of diabetic foot ulcers with hypercoagulation compared with no diabetic foot ulcers with hypocoagulation and no statistically significant relationship between grade diabetic foot ulcers and AT-III concentration.
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1,4-bis-3,4,5-trimethoxy-phenyl-tetrahydro-furo(3,4-c) furan from mahogany (swietenia macrophylla king) seed significantly reduces glucose and malondialdehyde levels in diabetic wistar rats
Muthmainah Muthmainah, Kristanto Yuli Yarso, Bambang Purwanto, Ambar Mudigdo, Mustofa Mustofa1,4-bis-3,4,5-trimethoxy-phenyl-tetrahydro-furo(3,4-c) furan from mahogany (swietenia macrophylla king) seed significantly reduces glucose and malondialdehyde levels in diabetic wistar rats
Background: Diabetes mellitus (DM) is an urgent global health issue with increased annual prevalence. The uncontrolled hyperglycemia may induce an oxidative stress state which could lead to the development of diabetic related complications. Several studies showed that mahogany seed contains 1,4-bis-3,4,5-trimethoxy-phenyl-tetrahydro-furo(3,4-c) furan which has glucose-lowering properties. However, its efficacy toward oxidative stress condition is yet to be investigated.
Objectives: This study aimed to examine the activity of 1,4-bis-3,4,5-trimethoxy-phenyl-tetrahydro-furo(3,4-c) furan in reducing the malondialdehyde (MDA) level as oxidative stress biomarker and blood glucose levels in diabetic rats.
Method: 36 male Wistar rats were used and divided randomly into six groups: Normal control, DM, DM+glibenclamide, DM+isolate10, DM+isolate20, and DM+Isolate40. The isolate and glibenclamide were given for 21 consecutive days. Streptozotocin and nicotinamide were used to induce the diabetic model. Levels of glucose and MDA were measured in successive phases: Before induced by streptozotocin and nicotinamide; before treatment; and after 7, 14, and 21 days of treatment.
Results: Within 21 days of treatment, mean glucose and MDA levels in each therapy group: (DM+glibenclamide, DM+isolate10, DM+isolate20, and DM+Isolate40) showed significant decreases over time. Mean of glucose and MDA levels in the therapy groups were significantly lower than in DM (diabetic control) group. Mean of glucose level in DM+Isolate40 group was significantly different from the normal control group but the MDA level showed no significant difference. The results between the DM+Isolate40 group and DM+glibenclamide group showed no significant difference.
Conclusion: The 1,4-bis-(3,4,5-trimethoxy-phenyl)-tetrahydro-furo(3,4-c) furan had significant glucose lowering and anti-oxidant effect in diabetic rats.
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Characterizing the SLC39A14 zinc transporter and collagen products of the chondrocytes from the human umbilical cord-derived mesenchymal stromal cell
Ketut Dewi Kumara Wati, Endah Dianty Pratiwix, Yanni Dirgantara, Cynthia Retna Sartika, Meita Dhamayanti, Budi Setiabudiawa, Ida ParwatiCharacterizing the SLC39A14 zinc transporter and collagen products of the chondrocytes from the human umbilical cord-derived mesenchymal stromal cell
Background: The SLC39A14 zinc transporter showed a role in the growth of the mouse model. There was no report regarding SLC39A14 protein expression in human chondrocyte, which might prevent further identification of SLC39A14’s function in human growth. This study aims to describe the SLC39A14 protein expression in chondrocyte using human umbilical cord (UC)-derived mesenchymal stromal cell (MSC) isolation and differentiation.
Methods: A cross sectional study was conducted at the Faculty of Medicine, Universitas Padjajaran Bandung, Indonesia, in 2019. The UC was derived after the respondents signed informed consents were documented. Specimens transferred, UC tissue digestion, cell isolation, cultures, and passages were done under the laboratory standard protocols. The immuno-phenotyping and differentiation toward chondrocyte procedure were done after third passage. The SLC39A14 expression of the chondrocytes was observed under immunofluorescence microscopy after staining using polyclonal anti SLC39A14 antibody. The collagen 2A and 10A production was measured using the medium supernatant and analyzed using GraphPad Prism 8 edition.
Results: The adherent fibroblast-like cells appeared on day 5th, which continued to proliferate and showed MSC characteristic with positive markers for CD 73, CD90 and CD105, but absent for negative lineage markers. Upon differentiation, cells positive for Alcian blue staining denoted the chondrocyte which shown capacity for further proliferation on Methyl Tetra Toluene assay. Zinc transporter SLC39A14 was expressed on cell membrane. The Collagen 2A produced at a mean level 0.097 ng/ml (SE 0.011;95%CI 0.073-0.12) and Collagen 10A at mean level 31.078 ng/ml (SE 3.792;95%CI 22.870-39.287).
Conclusion: Zinc transporter SLC39A14 was expressed in monolayer human chondrocyte from UC-derived MSC. The chondrocyte shown capacity for proliferation and collagen-producing enables future utility to identify the role of SLC39A14 in chondrocyte pathology.
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Electroencephalogram (EEG) features and clinical presentation in the elderly patient at neurologic policlinic Sanglah General Hospital between July 2015-2017 period
Anak Agung Ayu Meidiary, Anna Marita Gelgel, I Gusti Ngurah Purna PutraElectroencephalogram (EEG) features and clinical presentation in the elderly patient at neurologic policlinic Sanglah General Hospital between July 2015-2017 period
Background: Epilepsy has the highest prevalence and many diagnostic process challenges in the elderly population. Research about clinical, type of seizure, and electroencephalogram (EEG) features is very limited in Indonesia, including in Bali. This study aims to know clinical, type of seizure and electroencephalogram (EEG) features in elderly patients.
Methods: Cross-sectional descriptive study was conducted among 76 elderly-patients consecutively at Neurologic Policlinic of Sanglah General Hospital Denpasar Bali between July 2015-2017. The clinical aspect, age, gender, and type of seizure were analyzed. Digital electroencephalogram (EEG) was obtained from all patients by 30 minutes of routine EEG recording. Data were analyzed using univariate analysis to determine the frequency distribution of each variable and showed as a percentage in SPSS version 17 for Windows.
Results: There were 43 (56,57%) males and 33 (43,43%) females enrolled. Most of the epilepsy in elderly are symptomatic epilepsy which consists of post-stroke epilepsy (30,26%), post-traumatic epilepsy (1,32%), epilepsy-related to brain tumor (10,53%), and post encephalitis epilepsy (6,58%). The type of seizure dominated by partial seizure (57,9%) compared with others. EEG result of 76% of patients was classified as normal EEG, and 24% were abnormal EEG.
Conclusion: Most of epilepsy in the elderly are symptomatic epilepsy, and the most cause is post-stroke epilepsy. The partial seizure is the most frequent type of seizure in the elderly.
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The Correlation between leucocyte CD64, Immature Granulocyte and Presepsin with Procalcitonin in Bacterial Sepsis Patient
Citra Novita, Yetti Hernaningsih, Puspa Wardhani, Anna Surgean VeteriniThe Correlation between leucocyte CD64, Immature Granulocyte and Presepsin with Procalcitonin in Bacterial Sepsis Patient
Background: Sepsis is a critical emergency that causes morbidity and mortality worldwide. The latest sepsis diagnosis is made by using quick Sepsis-Related Organ Failure Assessment (qSOFA). Cluster of Differentiation 64 (CD64) is a surface antigen leukocyte that is deregulated during infection and sepsis. The percentage of immature granulocyte (IG) could rise in patients with infection and sepsis, mainly in severe circumstances. Procalcitonin (PCT) is a calcitonin prohormone that increases in sepsis and is already known as a bacterial infection marker. Presepsin (CD14) is a glycoprotein that is known to increase in bacterial infection. This study aimed to determine the correlation of leucocyte CD64, IG, and presepsin with PCT in bacterial sepsis patients.
Method: This cross-sectional study was performed from June to September 2018 at Dr. Soetomo General Academic Hospital. Twenty-five patients who met the qSOFA criteria with positive bacterial blood cultures were included. All samples underwent examinations of leucocyte CD64, IG, presepsin, and PCT. The correlation of leucocyte CD64, IG and presepsin with PCT was analyzed using Spearman correlation.
Results: The samples comprised 17 males (68.0%) and 8 females (32.0%). The mean age was 51.24 ± 14.85 years. The mean ± SD of leucocyte CD64 was 6.95 ± 2.13%, the median (min-max) of IG, presepsin and PCT was 3.67 (0.33–17.33)%, 2,641(487-20,000) pg/mL and 5.96 (0.39–181.5) ng/mL respectively. There was no correlation between leucocyte CD64 with PCT (p = 0.281). There was a significant correlation between IG and presepsin with PCT (p < 0.0001).
Conclusions: Presepsin and IG can be used as alternative bacterial sepsis markers that are supported by other examinations. leucocyte CD64 still needs to be studied further before it can be used as a bacterial sepsis marker.
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Increasing the quality of life of post-shackling patients through multilevel Health promotion of shackling prevention
Arif Widodo, Yayi Suryo Prabandari, Aris Sudiyanto, Ibrahim RahmatIncreasing the quality of life of post-shackling patients through multilevel Health promotion of shackling prevention
Introduction: Shackling still poses a significant obstacle to rehabilitate patient with mental disorder and often resorted by family or community. Shackling could have a negative impact toward patient’s mental health and often resorted due to lack of information. Therefore, this study aimed to evaluate the effect of multilevel health promotion to shackling prevention (MHPSP) toward the behavioral component of family/caregivers, neighbors, cadres, and health workers (stakeholders) and also evaluating its effect toward patient’s quality of life.
Method: This study uses a quasi exeperimental method with pre-test and post-test model with repetead measures design. The research subjects were 32 post-shackling patients lived in Sukoharjo Regency and 31 from Klaten Regency as well as. MHPSP was given to 32 caregivers and stakeholders who come from Sukoharjo Regency as a treatment group and psychoeducation only to 31 caregivers of control group from Klaten Regency. Quality of life measurments were carried out before treatment and four months after giving MHPSP.
Result : The result showed that MHPSP significantly enhance the behavioral component of the family/caregivers as well as neighbors, cadres and health workers (p<0.05). Furthermore, patient quality of life was significantly improved in the treatment group (MHPSP) compared to the control.
Conclusion: It can be concluded that MHPSP could significantly enhance the behavioral aspects of the families, neighbors, and health workers toward post-shackled PMD patients and significantly improved their quality of life. Therefore, MHPSP is needed to be implemented not only to the patient but also to the people that directly interact with them.
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Geriatric fractures in single Orthopedic Hospital: The role of domestic fall and comprehensive geriatric assessment
Komang Agung Irianto, Dionisius Rianto, William Putera Sukmajaya, Oen AlinaGeriatric fractures in single Orthopedic Hospital: The role of domestic fall and comprehensive geriatric assessment
Background: The geriatric population has continued to grow globally. The incidence of geriatric fractures increases along with the population. The geriatric assessment could be useful to build a warning sign for the fall risk.
Aim: The authors aimed to describe the geriatric fractures; the factors affecting; to further give recommendation regarding its prevention and management.
Methods: This is a cross-sectional study involving 741 patients with geriatric fractures admitted to Surabaya Orthopedics and Traumatology Hospital from 2012-2017. All data acquired from medical records.
Results: The number of female patients in our study are three times the male patients. The distribution of the cases across ethnicity, gender, and different age group were quite similar. The case of vertebral and hip fracture was significantly higher. Domestic accident was the mechanism of injury in 80% of all cases, and this MOI is significant across all fracture types. Only 32% patients do not have confounding disease. However 25% has diabetes mellitus, and 42% has hypertension. Although patients with diabetes mellitus, hypertension, moderate to severe anemia, and hyponatremia were more frequent but not significant to be the risk factor for certain fracture type.
Conclusion: Domestic accident, female, and cofounding disease were the most common factors found for all type of fractures. The most common geriatric fractures admitted to our institution were hip and vertebral fractures.Full Article (HTML) | download PDF
Functional characteristics of children with Down syndrome and possibilities of their correction with the help of athletic activity in Russia
Alexander Sergeevich Makhov, Ilya Nikolayevich MedvedevFunctional characteristics of children with Down syndrome and possibilities of their correction with the help of athletic activity in Russia
Abstract: The presence of trisomy in chromosome 21 cause a whole range of internals’ pathology. These internal’s pathology could cause abnormal motor development that can lead to inadequacy of physical activity. One way to rehabilitate children with Down syndrome is by giving them adequate physical activity in the form of physical training or sports. It is necessary to conduct some organizational arrangements in Russia intended for groups of persons with limited health possibilities into athletic activity.
Aim: The aim of the research was to show the impact of athletic activity in Down syndrome children and to determine modern problems of its wide application to the given groups in Russia.
Methods: Questioning and the method of mathematical statistics. Interviewing the parents of children with Down syndrome was conducted in some regions of Russia during November 2016. A total of 300 families having children with Down syndrome was included in this study.
Results: It was found that lack of popular information and diversified scientific researchers in the field of athletic activity in children with Down syndrome is a great problem for trainers and parents. Many parents can’t find a qualified trainer. On the other hands, specialists who are ready to train children with Down syndrome, have no opportunity to get full information to conduct an effective training process with such children and often work instinctively.
Conclusion. It is clear that with the right approach and competently worked out program of available sports, children with Down syndrome can become sportsmen who can not only compete at different levels but also represent Russia with dignity at great international competitions.
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Measuring motor evoked-potentials in children with autism spectrum disorders accompanied with cerebral vein thrombosis following intraarterial heparin flushing
Erwin Setiawan, Ristaniah Soetikno, Nelly Amalia Risan, Shelly Shelly, Tugas Ratmono, Terawan Agus Putranto, Ardianto PramonoMeasuring motor evoked-potentials in children with autism spectrum disorders accompanied with cerebral vein thrombosis following intraarterial heparin flushing
Background: The use of the term "Autism Spectrum Disorder" has led to confusion over this substance. Prior to DSM-V criteria, symptoms of Autism Spectrum Disorder (ASD) refers to the problems in brain vasculature and brain chemistry most likely affect the children behavior, whereas the authors' findings suggest such problems depicting a similar anomaly in cerebral vein thrombosis case (CVT). Recently, the evoked potentials, that demonstrated in CVT, have a possible prognostic value on patients suffering from ASD. This study purposes to measure the motor evoked potentials (MEPs) on patients following the intervention of intraarterial heparin flushing (IAHF).
Methods: A descriptive study was conducted on 17 patients admitted in Cerebrovascular Center of RSPAD Gatot Soebroto, Jakarta, diagnosed with ASD presenting CVT. The MEPs value was measured by conforming the IAHF procedure.
Results: The MEPs value (amplitude, latency, CMCT) pre and post-IAHF showed an increasing value. Meanwhile, there was a lowering value of latency and CMCT in left cortical participants after IAHF.
Conclusion: The group tends to perform more expected positive MEPs changes after IAHF.
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The effect of lean six sigma toward maternal emergency lead time in Penembahan Senopati Hospital, Bantul, Yogyakarta
Firman Firman, Tjahjono Koentjoro, Kuncoro Harto Widodo, Adi UtariniThe effect of lean six sigma toward maternal emergency lead time in Penembahan Senopati Hospital, Bantul, Yogyakarta
Introduction : Indonesia is one of the countries with high Maternal Mortality Rate that result partially from in management inefficiency, causing in obstruction of flow, underutilized resources, and imbalance between the number of patients with the availability of care facilities and the alternative care strategies. One of the strategies that can be applied to reduce lead time is Lean Six Sigma (LSS). Therefore, the purpose of this study was to evaluate the impact of Lean Six Sigma (LSS) methodology on patient lead time in Maternal Emergency of district government hospital.
Methods: Researcher and the participants were involved in planning, gathering data, analyzing, and choosing the best solutions. The participants were trained on LSS methods, its implementation tools and procedures. Evaluations were conducted using lead time observation before and after implementation, and midwives were interviewed about their perceptions. The analysis was based on Value Stream Mapping tools.
Results: Patients’ lead time from being admitted in emergency unit definitive diagnosis was decreased by 26.04 minutes or 16.4% in Caesarean Section (CS) and 15.25 minutes or 21.7% in other maternal high risk. For emergency CS, the improvement was 33.06 minutes or 26% from decision until incision. The benefit of LSS implementation was primarily in accelerating service processes and improving communication and team work.
Conclusion: This study showed that the implementation of LSS had great potential benefit in a maternal emergency unit. Participation of the midwives is crucial for successful implementation of LSS to reduce patients lead time.
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Hospital Deductions, Types and Causes
Mohamad Taghi Mousarrezaei, Leila Doshmangir, Ali Jannati, Ali ImaniHospital Deductions, Types and Causes
Objective: The current study aims to provide valid information about the causes and types of hospital deduction records via a systematic review.
Method: This systematic review was performed by searching the databases including PubMed, Scopus, Science Direct, Ovid, Medline, Cochrane, ProQuest, and IranMedex, Magiran, Sid, and Medlib databases for studies without time limitation. Updates were added to the searches during the study. Search strategies included the combination of keywords including “Billing error” OR “Deductive” OR “Error payment” OR “Insurance claim” OR “Medical claim” OR “Improper payment” OR “Insurance reimbursement” OR “Medical payment” OR “payment error” with “Hospital” and “medical records”. The reference lists of each article were manually searched to find additional relevant articles. All records without time limitation, those written in Persian and English, and the ones investigating the types and causes of deductions in hospital inpatient bills records were included. To determine the eligible records, two authors extracted the data independently; and discrepancies were resolved through discussion or, if required, through consultation with a third author. The quality of the articles was analyzed using STROBE checklist.
Results: The search strategy yielded 1,264 records from electronic databases, and 15 records were identified by the manual search. After removing the duplicates and screening the database by titles and abstracts, 39 of these records remained. The full text of these 39 records was checked and, finally, 22 of them met inclusion criteria. The major causes of deductions in the documentation included human errors, incomplete document registration, documentation errors, added prices, added request, and calculation errors.
Conclusions: Education and cooperation of staff and collaboration of all stakeholders such as hospitals, insurance organizations, and related staff in this field are necessary for conducting a substantial action to reduce hospital deduction.
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Anti-Mullerian Hormone (AMH) as a Novel Marker for Ovarian Function: A Review
Sianny HerawatiAnti-Mullerian Hormone (AMH) as a Novel Marker for Ovarian Function: A Review
Background: Anti-Mullerian Hormone (AMH) is a homodimeric glycoprotein linked by disulfide bonds which belongs to the Transforming Growth Factor (TGF) beta superfamily. AMH is produced by gonadal tissue namely testicular Sertoli cells and ovarian granulosa cells especially pre-antral and antral follicles. AMH involved in embryonic sexual differentiation in male, while it has an inhibitory effect on primordial follicle recruitment and responsiveness of the growing follicles to FSH, in female. Current studies show promising clinical utilities of AMH measurement in predicting ovarian function.
Objective: This review aims to explore further about the physiology of AMH and its role as a novel marker for ovarian function.
Method: A review of relevant literature was performed to elaborate AMH involvement in ovarian function. A total of 14 qualified published literature of all years until 2018 were collected from several electronic database and manual search and included in this review.
Results: AMH level reflected ovarian follicular reserve, an important indicator in infertility treatment (assisted reproduction technique) and a sensitive marker for ovarian aging. AMH is also a valuable tool in diagnosis and recognition of recurrence granulosa cell tumors, and a marker of ovarian dysfunction particularly polycystic ovary syndrome. A low circulating AMH level is observed in obesity and male with fertility problems.
Conclusion: AMH level can be used as primary or supplementary markers to aid in the diagnosis and treatment of several reproductive related conditions in males and females. A set of guidelines about sample storage and handling and age-specific standardized reference values are needed to optimize clinical application of AMH.Full Article (HTML) | download PDF
The role of brain-derived neurotrophic factor (BDNF) in cognitive functions
Dedi Silakarma, Anak Agung Raka SudewiThe role of brain-derived neurotrophic factor (BDNF) in cognitive functions
Nerve growth factor (NGF) was uncovered in near beginning the 1950s which had a growth effect on sympathetic and sensory neurons. In the dorsal root neuron ganglion, the second member of a group of neurotrophic factors widely known as the brain-derived neurotrophic factor (BDNF) appeared. Like other members of the neurotrophin group, such as neurotrophin 3 (NT-3) and NT-4/5, it is explained to have trophic effects on peripheral and central neurons. Since BDNF purification in 1982 evidence of its involvement in development, physiology, and brain pathology demonstrated. BNDF is significant within the molecular mechanism of synapse plasticity regarding neuronal growth and cell survival. The initial step associated with the central nervous system depends on its adaption of synapse transmission, especially in the hippocampus and neocortex. Pathological intensities of the BDNF relationship and synapse plasticity affect sort of situations such as epilepsy and chronic pain sensitization, where BDNF applications can affect therapy in neurodegenerative diseases and neuropsychiatric diseases. BDNF plays a pivotal role in cognitive processes, affecting the advancement and brain structures’ motion. Predominantly in the hippocampus and prefrontal cortex, by modulating synaptic neurotransmission, it changes the plasticity and proliferation of neurons through regulation of neuronal migration processes such as differentiation, perseveration, neuronal modification and replacement of synaptic structures. BDNF also affects the development of dopaminergic, serotonergic, cholinergic and GABAergic. BDNF further causes rapid postsynaptic reactions in ion channels and N-Methyl D-Aspartate (NMDA) receptors. BDNF as a vital component in the normal functioning of the brain is one of the neurotrophins that contributes to the development, maintenance of function and healthy neuron cells and cynical plasticity.
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Short insight of pediatric cerebral venous thrombosis and the safety of intra-arterial heparin flushing as a new therapeutic method
Ardianto Pramono, Ristaniah Soetikno, Achmad Hussein Sundawa Kartamihardja, Tinni Trihartini Maskoen, Terawan Agus Putranto, Erwin SetiawanShort insight of pediatric cerebral venous thrombosis and the safety of intra-arterial heparin flushing as a new therapeutic method
Introduction. The incidence rate of Cerebral Venous Thrombosis (CVT) in children has been increased quite significantly due to the availability of advanced imaging technology and the trends of increasing awareness about health-related problem. Systemic anticoagulant was mainstay treatment for CVT. The author proposed a method of heparin deliveries through existing Digital Subtraction Angiography (DSA) procedure called Intra-arterial Heparin Flushing (IAHF). The safety of this procedure in children was still few known and reported. The purpose of this study is to provide insights on CVT and the potential complication of IAHF as the primary therapeutic modality.
Methods. This was a descriptive longitudinal study involving all patients with age 0-18 years diagnosed with Cerebral Venous Thrombosis whom admitted in RSPAD Gatot Soebroto from 2016 to 2018 through MRI examination and will undergo IAHF Procedure as the primary treatment. All subject had signed informed consent regarding the nature of the study. The descriptive data were presented in tables and narratives.
Results. The study found that the highest age group found in this study was between 6-12 years old (46,6%) with male-predominant (70,6%). The origins of the patients were mostly from Indonesia (88%) and several from Vietnam (12%). The most common symptoms of CVT in this study was the speech/communication problem (12%). The most common complication after IAHF procedure was wound swelling at the puncture site (2,6%).
Conclusion. CVT predominantly affect male aged 6-12 years old with speech problem was the most common symptoms. IAHF procedure shown minimal side effects in pediatric with CVT.
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Cardiorenal syndrome type 1: a literature review
Starry Homenta RampenganCardiorenal syndrome type 1: a literature review
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Orthopaedic complications of falls in elderly patients: a brief review
I Ketut SuyasaOrthopaedic complications of falls in elderly patients: a brief review
Falls are frequent and often cause morbidity, mortality, and disability that require regular nursing. Most of these falls are associated with one or more identifiable risk factors, such as weakness, unsteady gait, confusion and medication use. Usually, it occurs due to a combination of multiple risk factors, such as imbalance, degenerative diseases, porotic bone, and metabolic disturbances. Though in the orthopaedic field, falls will most often result in injury such as femoral neck and proximal humerus fractures, all other parts of the body may also be affected due to various mechanisms of injury. As a disabling phenomenon, fractures due to falls in elderly may then proceed to series of complications, from early to late complications, from local (such as nonunion, muscle atrophy, disuse osteoporosis, etc) to systemic complications (such as pressure sores, pneumonia, ulcers, urinary tract infection, ileus, etc). Therefore, prevention will play a critical role in this particular situation.
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Spontaneous recovery of Medial Prefrontal Syndrome following Giant Olfactory Groove Meningioma resection: A case report
Michael Lumintang Loe, Sri MaliawanSpontaneous recovery of Medial Prefrontal Syndrome following Giant Olfactory Groove Meningioma resection: A case report
Introduction: Anterior skull base meningiomas are frequently associated with changes in personality and behavior. Olfactory groove meningiomas take their origin from the cribriform plate and frontoethmoidal suture in the floor of the anterior cranial base. The cardinal clinical features usually observed are mental changes, visual deterioration, and headaches as a result of olfactory or optic nerve and frontal lobe compression. However, several authors have reported minimal changes in cognition or behavior following surgical resection, and many patients do not return to their premorbid level of function.
Case presentation: A 42-year-old male with four months history of changes in behavior, apathy, and lack of motivation. Over the course of two months, his vision progressively worsened in both eyes, and he developed a diffuse, mild headache. On examination, he was fully alert and cooperative. He only had light perception and could see faint silhouettes of people. All other neurological examinations were normal. Head Computed Tomography (CT) demonstrated a large, extra-axial mass consistent with an anterior skull base mass extending to the sellar and suprasellar region, which suggests an olfactory groove meningioma. The patient underwent a bifrontal approach craniotomy tumor resection and subsequently recovered from medial prefrontal syndrome following tumor resection. Surgical tissue pathology confirmed the diagnosis as an olfactory groove meningioma.
Discussion: The anatomical location of the olfactory groove meningioma may cause prolonged psychiatric symptoms before the onset of more overt neurological deficits. Personality changes that occur may be subtle, so patients may avoid seeking treatment for their headaches and delay ophthalmic care until their complaints become severe. Anterior skull base meningiomas often involve the ventromedial prefrontal cortex (vmPFC) that is associated with elevated levels of apathy.
Conclusion: Olfactory groove meningiomas are treatable. Reversal of cognitive impairments and changes in behavior can be expected after surgical resection.
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Deep vein thrombosis (DVT) in ovarian clear cell carcinoma with liver metastasis: a case report
Fahrani Imanina Putri Nurtyas, Astuti GiantiniDeep vein thrombosis (DVT) in ovarian clear cell carcinoma with liver metastasis: a case report
Introduction: Deep vein thrombosis (DVT) is a common complication found in malignancy patients. If not handled properly, this condition can be fatal. As many as 1-8% of cases developed into pulmonary embolism and cause death. Malignancy associated thrombosis is second leading cause of death in patients with malignancy. Ovarian clear cell carcinoma has the highest risk of thrombosis compared to other carcinomas, 5-16% of patients with ovarian malignancy. This condition is aggravated by liver metastasis.
Case: 36-year-old woman with left ovarian clear cell carcinoma stage IVB, get a series of Carboplatin and Paclitaxel chemotherapy, complained severe pain in the left leg that progressively increase with edema and erythema from the thigh to the calf. Patient was diagnosed as suspected DVT with Wells’ scores 5 that supported by an increase in D-dimer and bilateral lower extremity venous doppler ultrasound showing DVT in the communal femoral, superficial femoral, and popliteal veins of the left leg. Abdominal CT scan result show liver metastasis with massive ascites. The patient was treated with 2 x 40 mg furosemide, 5000 units of heparin bolus followed by 20000 units of heparin drip / 24 hours and 1 x 2 mg bridging Simarc. PT and APTT result show prolongation.
Conclusion: We reported a case of DVT in left ovarian clear cell carcinoma stage IVB with liver metastasis. This case emphasizes coagulopathy manifestation in malignancy that can be caused by cancer management and the use of anticoagulants that are aggravated by liver metastasis.
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A rare case of Hb H disease caused by compound heterozygous for α thalasemia and Hb Quong Sze in Chinese Indonesian proband: a case report
Nyoman Suci Widyastiti, Ita Margaretha Nainggolan, Edward L Kurnia, Dwi Retnoningrum, Imam BudiwiyonoA rare case of Hb H disease caused by compound heterozygous for α thalasemia and Hb Quong Sze in Chinese Indonesian proband: a case report
Background: Hemoglobin H (HbH) disease is alpha thalassemia characterized by inactivation of three of four α-globin genes due to deletions with or without non-deletional α-thalassemia. Hb Quong Sze (Hb QS) is a very rare non-deletional α-thalassemia in Indonesia caused by a CTGLeu>CCGPronucleotide substitution at codon 125 of α2 globin gene generating highly unstable hemoglobin. Compound heterozygosity for Hb QS and Southeast Asian double α-globin gene deletion (--SEA) result in accumulation of b-globin tetramers, causing hemolytic anemia.
Case Report: A 49 years old Chinese Indonesian female was assessed for thalassemia screening. The phenotype of the proband was normal and only mild anemia was noticeable. She experienced blood transfusion five years ago due to a sudden fall of hemoglobin level after malarial infection. Complete blood count found hemoglobin 8.3 g/dL, Mean Corpuscular Volume (MCV) 65.7 fl and Mean Corpuscular Hemoglobin (MCH) 17.1 pg. HbH disease suggested by abundant Hb H inclusion bodies in the red blood cells. Microcapillary hemoglobin electrophoresis result showed HbH 31.8 %, Hb Bart 0.4%, HbA 67.3% and HbA2 0.5%. Molecular studies were carried out using multiplex polymerase chain reaction (PCR) method, and the common a0-thalassemia(--SEA) was detected in one allele. Direct sequencing analysis of the α1 and α2 globin genes revealed Hb QS in the other allele.
Conclusion: Non-deletional Hb H disease due to compound heterozygous of Hb QS with Southeast Asian double α-globin gene deletion (--SEA) has a very low incidence in Indonesia. An advanced molecular analysis should be performed to determine this rare mutation.
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Myelodysplastic Syndrome (MDS) in a Child who Transformed to Acute Myeloid Leukaemia with Myelodysplasia-Related Changes (AML-MRC)
Ni Komang Ayu Parmawati, Sianny Herawati, I Nyoman WandeMyelodysplastic Syndrome (MDS) in a Child who Transformed to Acute Myeloid Leukaemia with Myelodysplasia-Related Changes (AML-MRC)
Background: Myelodysplastic syndromes (MDS) are a group of clonal hematopoietic stem cell diseases, accounting for < 5% of all hematologic malignancies in children. MDS is characterized by cytopenia, dysplasia in one or more of the major myeloid lineages, ineffective hematopoiesis, and recurrent genetic abnormalities. Approximately 30% of patients with MDS show progression to AML within a few months up to several years. This is an MDS case report in children who have undergone Acute Myeloid Leukaemia transformation with Myelodysplasia-Related Changes (AML-MRC).
Case Report: A 16-year-old boy came to the Emergency Department of Sanglah General Hospital with a complaint of pain and swelling in both knees and joints since last month. Fatigue and fever happened a week before admission. Previously, he had been hospitalized twice with the same symptoms. Physical examination revealed pale conjunctiva with pancytopenia in the laboratory result. A blood smear showed normochromic normocytic anemia, neutropenia, and thrombocytopenia. Bone marrow aspiration morphology showed hypercellularity with blast presentation > 10% and multilineage dysplasia > 50% supporting MDS diagnosed transformation to Acute Myeloid Leukaemia with Myelodysplasia-Related Changes (AML-MRC). Leukemia phenotyping showed positive results on CD 33, CD 36 and HLA-DR presenting Monocytic Lineage.
Conclusion: High degree dysplasia and blast percentage in blood and bone marrow increase tendency to transform into acute myeloid leukemia (AML). The diagnose of MDS requires analysis of blood and bone marrow morphology and cytogenetic analysis as a recommendation by WHO classification.Full Article (HTML) | download PDF
Testicular carcinoma in a female with 46-XY karyotype: a case report
Siti Nurul Hapsari, Betty AgustinaTesticular carcinoma in a female with 46-XY karyotype: a case report
Background: Testicular cancer is now the most common malignancy in young males. Markers available in the management of patients with testicular cancer are alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and lactate dehydrogenase (LDH). Female patients with androgen insensitivity syndrome (AIS) and pure gonadal dysgenesis have a pure XY karyotype and an increased risk of developing a gonadal malignancy.
Case Description: A 26-year-old female presented with a hardened stomach and primary amenorrhoea. Physical examination revealed Tanner Stage I for both the right and left breast and no pubic or axillary hair. On local examination, there was a large firm non-tender mass extending across the abdominopelvic region. Gynecological examinations revealed normal labia; however there was clitoromegaly, the vagina was blind (5 cm) with the absent cervix. Laboratory tests with increased abnormal results were as follows: LDH 3,448 U/L, AFP 1,842.6 ng/mL, Cortisol 22.41 ug/dL and Testosterone 128.7 ng/dL. An MSCT of the abdomen showed a solid mass with no signs of a vagina or uterus. Blood karyotyping results were 46 XY with the presence of the SRY gene. Due to an increase in LDH, AFP, Cortisol and Testosterone, with 46 XY karyotyping, Tanner stage 1 breasts, pubic and axillary hair, female genitalia phenotype and abdominal MSCT showing a solid mass with no signs of vagina and uterus, this patient was diagnosed with non seminoma testicular cancer with widespread disease and 46, XY karyotype (male).
Conclusion: Testicular cancer is common in patients with gonadal dysgenesis, due to an increase in malignancy risk.Full Article (HTML) | download PDF
A T-acute lymphoblastic leukemia in children with CD 117 expression: a case report
Komang Juwita Endrawati, Ni Nyoman Mahartini, Sianny HerawatiA T-acute lymphoblastic leukemia in children with CD 117 expression: a case report
Background: Leukemia is a group of clonal disorders originating from single cells with genetic changes in the bone marrow or peripheral lymphoid tissue. Acute T-cell lymphoblastic leukemia is estimated to be 12-15% of ALL cases. Immunotyping examination is essential in establishing the diagnosis of T-ALL, CD 1a, CD 2, CD 3 (membranous and cytoplasm), CD 4, CD 5, CD 7, and CD 8 as T- cell antigen markers. CD 33, CD 117, CD 34 and CD 56 are a myeloid-related antigen. The occurrence of co-expression of T cell markers with markers myeloid is infrequent. This study aimed to report cases of T- Acute Lymphoblastic Leukemia (ALL) in children with CD 117 expression.
Case description: A-13 years boy had a fever and bruising on the skin one year ago. Physical examination found a blood pressures 150/70 mmHg , axillary temperature 37.8 ° C, right and left enlargement of the glands of the neck and inguinal, enlarged liver and petechiae in both lower extremities. Complete blood tests showed leukocytosis, anemia, and thrombocytopenia. Edge blood smear suggests the presence of cigar cells, target cells and lymphoblasts > 50%. Bone marrow aspiration smear revealed lymphoblast >30% and concludes an ALL (L2). Immunophenotyping examination found CD 3, CD 5, CD 117 positively supported T-ALL with co-expression of CD 117. During treatment, the patient experienced seizures due to spontaneous intracerebral bleeding that caused the patient to die.
Conclusion: The case of a 13-year-old boy suffering from T-ALL (L2) with co-expression of CD 117 had a poor prognosis.
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Cardiac Myxoma Resection in Sanglah General Hospital Denpasar, Indonesia: Serial Case Report
I Nyoman Semadi, Ni Kadek Sulistyaningsih, I Wayan Sudarma, IGA Sri Mahendra DewiCardiac Myxoma Resection in Sanglah General Hospital Denpasar, Indonesia: Serial Case Report
Background: Cardiac myxoma is a primary tumor that grows intracardiac. Primary heart tumors are rare, and incidents range from 0.0017 to 0.03%. Around 75% of primary heart tumors are benign, and 50-80% are cardiac myxoma. Echocardiography is the gold standard in detecting tumor mass in the heart. With the development of diagnostic modalities and cardiac surgery techniques, cardiac myxoma can be detected and treated correctly and leading to a better prognosis.
Objective: To report a series of cases of cardiac myxoma resection carried out by the Cardiac Surgery team of Sanglah General Hospital Denpasar.
Cases: Data collected from 2016 to March 2019 cased based on Sanglah General Hospital Denpasar. Six cases were diagnosed based on the clinical, electrocardiographic, radiological, and histopathological basis.
Conclusion: This series of cases reported six intracardiac tumor patients who were found through echocardiographic examination and five patients had open heart surgery for tumor resection; also all histopathological examination results were following cardiac myxoma. There were no reported post-treatment complications and the patients were discharged hemodynamically stable after hospitalized for approximately one week. Until now, there have been no reports of recurrence in patients who have taken resection and patients have normal daily life activities.
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