bluuebunny/crossref_metadata_2025 huggingface dataset:
AMPICILLIN SULBACTAM RESISTANCE PATTERN AS A FIRST-LINE DRUG IN CHILDREN
Authors: Putrawan Oka , Sri Rejeki IGAA Putri
Published: December 2017

Infection often occurs in children with malignant hematology and causes morbidity and mortality. Antibiotics should be given based on the results of culture and antibiotic susceptibility test. Ampicillin Sulbactam is a first-line drug in children with infection. The purpose of this study was to obtain an objective overview of Ampicillin Sulbactam resistance patterns of culture in patients hospitalized in pediatric Hemato-Oncology Ward, Dr Soetomo Hospital, Surabaya. This was a descriptive study. Data on culture and susceptibility test result to Ampicillin Sulbactam were taken from medical records of those patients between September 2012 - February 2013. There were 342 culture examinations in 88 patients (44 girls and 44 boys). Most of the children aged <5 years (58%). Growth of bacterial cultures was obtained in 83 namely Escherichia coli, Burkholderia cepacia, and Klebsiella oxytoca (Gram-negative) and coagulation negative Staphylococcus (CONS), Staphylococcus aureus, and Staphylococcus saprophyticus (Gram-positive) were found in blood culture. Staphylococcus aureus (Gram positive) and E. coli, Klebsiella pneumoniae, and B.cepacia (Gram-negatif) were found in urine. The result of antibiotic susceptibility test culture showed resistance to Ampicillin Sulbactam in E. coli (69%), Burkholderia cepacia (85%), CONS (50%), Staphylococcus aureus (25%), K. pneumoniae (85%), Klebsiella oxytoca (50%), and P. aeroginosa (67%). There was ampicillin sulbactam resistance in children hospitalized in pediatric Hemato-Oncology Ward, Dr Soetomo Hospital, Surabaya against E. coli (69%), Burkholderia cepacia (85%), CONS (50%), Staphylococcus aureus (25%), K.pneumoniae (85%), and Klebsiella oxytoca (50%), P. aeroginosa (67%).
MICROBIAL PATTERN AND ANTIBIOTIC SENSITIVITY TEST OF HOSPITALIZED CHILDREN
Authors: Wiwin John , Sri Rejeki IGAA Putri
Published: December 2017

Infection often occurs in children with malignant hematology and causes morbidity and mortality in the children. Antibiotics given must be based on culture results and antibiotic sensitivity testing. This study was aimed to obtain the microbial pattern and sensitivity test in children hospitalized in the Hemato-Oncology Ward,  dr. Soetomo Hospital from September 2012 - February 2013. This was a descriptive study. Data were obtained from the  patients’ medical records  in Dr. Soetomo Hospital. There were 341 culture examinations (blood, urine, rectum swab, faecal, and others) from 88 patients (44 males and 44 females). Most of patients´ age was < 5 years (58%) and suffered from ALL (50%).There were microbial (83 of culture) and yeast (15 of culture) growth out of 98 cultures. Escherichia coli, Burkholderia cefacea, and Klebsiella oxytoca (Gram negative) dan CONS, Stapyloccocus aureus, and Stapylococcus sapropyticus (gram positive) were found in blood culture. S. aureus (gram positive) and E. coli, Klebsiella pneumoniae, and B. cefacea (gram negative) were found in urine culture. Only E. coli was found in rectal swab culture. CONS of gram positive cocci were mostly found in blood culture of children hospitalized in Hemato-Oncology Ward, Dr. Soetomo Hospital. E. coli was the mostly found gram negative rods. Gram positive cocci showed a high resistant to penicillin and co-trimoxazole. E. coli, mostly found in rectal swab and urine, has a high sensitivity to amikacin and meropenem, but highly resistant to  ampicillin and ampicillin sulbactam.
INJECTED CITICOLINE IMPROVES IMPAIRMENT AND DISABILITY DURING ACUTE PHASE TREATMENT IN ISCHEMIC STROKE PATIENTS
Authors: Wahyudi Rino , Hasmono Didik , Fitrina Ruhaya , Armal Khairil
Published: December 2017

Treatment strategy of ischemic stroke is to reduce the extent of the damage and rescue neurons from death in the early days of ischemic events. Recombinant Tissue-Plasminogen Activator (r-TPA) is the only recommended therapy, but their use is very limited. Citicoline is a neuroprotectant with a therapeutic effect on several stages of the ischemic cascade. However, its use is still being debated. The purpose of this study was to analyze the use of supplementation citicoline injection in patients with acute ischemic stroke in relations to differences in changes in the level of interference (impairment), rate limitation (disability) and the level of obstruction (handicap) between the group receiving supplementation of citicoline injection 2x500 mg iv and the group without supplementation during acute phase treatment. This study was a prospective cohort study using experimental design in patients with acute ischemic stroke who met the inclusion and exclusion criteria with or without supplementation citicoline between January - April 2015 in the National Stroke Hospital, Bukittinggi. Rate of interference was assessed with NIHSS, level of limitations with Barthel Index, and level of obstruction with modified Rankin Scale. Assessment was done 2 times, before and after the treatment. Statistical methods used in this study were Wilcoxon signed rank test, paired T-test and Mann-Whitney test. This study was conducted on 50 subjects divided into 2 groups, a control group without supplementation and group treated with injected citicoline of 2x500 mg iv. Demographic and baseline characteristics did not differ between groups. There were differences in level of interference changes. Mean decrease in control group was 0.96 ± 1.74 NIHSS, while that in treatment group was 2.84 ± 1.46 NIHSS (p <0.05). There were differences in changes in the level of limitations. Mean increase of Barthel Index in control group 9.60 ± 11.17 and in treatment group 20.40 ± 13.99 (p <0.05). However, changes in the level obstacle showed no difference. In conclusion, citicoline injection supplementation in patients with ischemic stroke during acute phase treatment showed improvement differences in changes in the level of distraction (impairment) and the rate limitations (disability), but showed no difference in changes in the level of obstruction (handycaps).
PCI IN PATIENT WITH HEAVY CALCIFIED LESION. MANAGEMENT AND BALLOON RUPTURE COMPLICATION
Authors: Oktaviono Yudi Her
Published: December 2017

Balloon angioplasty in calcified coronary lesions may have a decreased success rate and an increased incidence of complications. This lesion remain a technical challenge in interventional cardiology despite novel approaches and devices. We describe a case with heavy calcified coronary lesion in LAD that was not only resistant to high-pressure inflation of conventional, non-compliant balloons and cutting balloon but the inflations also results in balloon rupture. Even, the first balloon became fracture and entrapment in LAD. The fractured balloon could be removed using second baloon inflation in LCX. The angioplasty balloon was successfully performed after rotational atherectomy by rotablator and succesfully continued by implantation stent DES.
CHARACTERISTICS OF HELLP SYNDROME IN SEVERE PREECLAMPSIA PATIENTS IN DR. SOETOMO HOSPITAL SURABAYA
Authors: P Warih Angesti , Ernawati Ernawati , Susanti Dwi
Published: December 2017

Hemolysis, elevated liver enzyme, and low platelet count syndrome (HELLPs) is complication following severe preeclampsia which is one of the three leading causes of maternal mortality in Indonesia. The purpose of this study was to understand the prevalence, characteristics, and post-partum outcome of HELLPs patients who deliver in Dr. Soetomo Hospital in July 2012-June 2013. This study was observational-descriptive, cross sectional study. The population observed was the severe preeclampsia patients who deliver in Dr. Soetomo Hospital and have complete medical data in July 2012-June 2013. study subject taken by total sampling. HELLPs follow the 7% of severe preeclampsia patients. The maternal average age of HELLPs group was 30.2 (19-43), while in non-HELLPs was 30.8 (17-46). Most HELLPs patients were in the first and second pregnancy. The average of gestational age at labor in HELLPs was 33-34 weeks. Both in HELLPs and non-HELLPs most performed Cesarean Section delivery. No post-partum maternal mortality found in HELLPs, but 25% had stillbirth. The average of birth weight in HELLPs was 1994.4 g. First minute Apgar score >7 was 33.3% in HELLPs group. In conclusion, Most HELLPs patients were in the first and second pregnancy, while non-HELLPs were in first pregnancy. The average of gestational age at labor was lower in HELLPs group. Neonates mortality were higher in HELLPs group. The average of birth weight was lower in HELLPs group. First minute Apgar score > 7 was higher in non-HELLP group.
BARTHEL INDEX SCORE IN STROKE PATIENTS INCREASES AFTER UNDERGOING MEDICAL REHABILITATION
Authors: Maharani Ganing Sirly Nabireta , Subadi Imam , Sugianto Paulus
Published: December 2017

Stroke is the leading cause of death among Indonesian people over the age of five years, comprising 15.4% of all deaths, with a mortality rate of 99/100 000, and the number of disability is 685/100 000. Medical rehabilitation has an effect in improving functional status of patients with stroke, especially if it is done intensively in the first 6 months after stroke attack. Measurement of functional status is commonly used in clinic, including in Dr. Soetomo Hospital. However, no study had been conducted in measuring functional status using Barthel Index in Surabaya. Therefore, this study identified the difference of the functional status of stroke patients before and after undergoing medical rehabilitation. The study used an experimental method with pre and post design with total sampling. The samples were 47 stroke patients in Dr. Soetomo Hospital, Surabaya. Data were obtained from March - April 2014 using Barthel Index. Data analysis used Wilcoxon Sign Rank test, including the distribution of each variable, which showed signification value of <0.05. This study concluded that Barthel Index score increases after undergoing medical rehabilitation.
NUTRITIONAL STATUS AFFECTS INCIDENCE OF PNEUMONIA IN UNDERFIVES
Authors: Wicaksono Henry
Published: December 2017

Pneumonia is an acute infection disease which remains the main killer of children under 5 years old worldwide. Based on Unicef’s report, 17% of all children death is caused by pneumonia. Indonesia was in 10th position of the highest incidence of pneumonia and diarrhea which caused the death of children under 5 years old in 2013. In Gane Luar Public Health Center, there were at least 3 patients with pneumonia every month during 2014. The risk factors are less exclusive breastfeeding, malnutrition, low birth weight, less coverage of measles vaccine, indoor air pollution, and the high level of occupation density. The purpose of this research was to determine the relationship between exclusive breastfeeding, nutrition status, the type of house flooring, and pneumonia incidence in children under 5 in working area of Gane Luar Public Health Center, South Halmahera. A case control study was conducted to each 25 samples of case and control which were collected by simple random sampling technique during July-December 2014. Data were collected through a questionnaire using interview method, observation, and physical examination, and then it’s analyzed by Regression Logistic, Chi Square, and Odds ratio to check for strength of association between variables at 95% confidence level. The results indicated that nutrition status was significantly related to Pneumonia incidence (p = 0.019 ; OR 3.795), however exclusive breastfeeding (p = 0.29) and type of house flooring (p = 0.086) weren’t. In conclusion, the nutrition status was significantly related to the incidence of Pneumonia in working area of Gane Luar Public Health Center.
ANALYSIS OF INDUCTION PHASE GLUCOCORTICOID USE ON ADRENAL SUPPRESSION IN PEDIATRIC PATIENTS WITH ACUTE LYMPHOBLASTIC LEUKEMIA
Authors: Simbolon Octaviana , Yulistiani Yulistiani , Ugrasena I DG , Qibtiyah Mariyatul
Published: December 2017

Glucocorticoids play an important role in the treatment of acute lymphoblastic leukemia (ALL). However, supraphysiological doses may cause suppression of the adrenal. Adrenal suppression resulting in reduced cortisol response may cause an inadequate host defence against infections, which remains a cause of morbidity and mortality in children with ALL. The occurrence of adrenal suppression before and after glucocorticoid therapy for childhood ALL is unclear. The aim of this study is to analysis the effect of glucocorticoid on cortisol levels during induction phase chemotherapy in children with acute lymphoblastic leukemia. A cross-sectional, observational prospective study was conducted to determine the effect of glucocorticoid on cortisol levels in children with acute lymphoblastic leukemia. Patients who met inclusion criteria were given dexamethasone or prednisone therapy for 49 days according to the 2013 Indonesian Chemotherapy ALL Protocol. Cortisol levels were measured on days 0, 14, 28, 42 and 56 of induction phase chemotherapy. There were 24 children, among 31 children recruited, who suffered from acute lymphoblastic leukemia. Before treatment, the means of cortisol levels were 228.95 ng/ml in standard risk group (prednisone) and 199.67 ng/ml in high risk group (dexamethasone). In standard risk group, the adrenal suppression occurs at about day 56. There was a significant decrement of cortisol levels in high risk group in days 14, 28, 42 against days 0 of induction phase (p=0.001). Both groups displayed different peak cortisol levels after 6 week of induction phase (p=0.028). Dexamethasone resulted in lower cortisol levels than prednisone during induction phase chemotherapy in children with acute lymphoblastic leukemia.
CORRELATION BETWEEN INTRACELLULAR HEAT SHOCK PROTEIN 70 EXPRESSION AND CERVICAL LYMPH NODES ENLARGEMENT IN NASOPHARYNGEAL CARCINOMA
Authors: Romdhoni Achmad C , Herawati Sri , Mustikaningtyas Elida
Published: December 2017

Tumor growth and metastasis in NPC patients suspected role of several molecular biomarkers that have been identified in tumor specimens of patients with NPC. Recent research states intracellular Hsp70 is a stress protein that is a main factor for the growth, invasion and metastasis of NPC. The purpose of this study is to analyze intracellular Hsp70 protein expression of NPC patients which correlate with staging of NPC as clinical manifestation. This study used cross sectional design. In this study, formalin-fixed paraffin-embedded biopsy specimens were obtained from 18 NPCs with all of histopathology and clinically divided into N0, N1, N2, N3. The expression of intracellular Hsp70 was obtained with immunohistochemistry using monoclonal antibody Anti Human Hsp70 antibodi from Santa Cruz Biotechnology, California, USA. Assessment of the staining was performed with Remmele methode by Histopathologies doctor Consultant. The Spearman’s test was used to determine the relationship between expression of intracellular Hsp70 protein and enlargement cervical nodul of NPC. Statistical significance was defined as p <0,05. There were 18 patients NPC patients that met the inclusion and exclusion criteria. Showed negative intracellular Hsp70 expression by 16,67% for all sample in which consist 1 patient of N0, 1 patient of N1, 1 patient of N2, 0 patient of N3. Followed by 27,78% mild positive intracellular Hsp70 expression which consist 0 patient of N0, 2 patients of N1, 0 patient of N2, 3 patients of N3. Followed by 44,44% moderate positive intracellular Hsp70 expression which consist 0 patient of N0, 0 patient of N1, 1 patient of N2, 9 patients of N3. Followed by 11,11% strongly positive intracellular Hsp70 expression which consist 0 patient of N0, 0 patient of N1, 0 patient of N2, 2 patients of N3. Spearman test results test scores p = 0.01 with a correlation coefficient 0.606. Correlation of intracellular Hsp70 protein expression with enlargement cervical nodul of lymphe (N0, N1, N2, N3) in patients with NPC showed significant (p<0.05). In conclusion, there was correlation between increase of the intacellular Hsp70 expression and enlargement cervical nodul of lymphe in nasopharyngeal carcinoma.
EFFECT OF BODY MASS INDEX (BMI) ON MORTALITY AND READMISSION OF HEART FAILURE PATIENTS IN CARDIOVASCULAR OUTPATIENT CARE UNIT AT DR. SOETOMO HOSPITAL, SURABAYA
Authors: Lestari Sella Rizkita , Andrianto Andrianto , Nugroho J
Published: December 2017

Obesity is one of risk factors for heart failure in both men and women. Paradoxically, recent studies have shown that high BMIs in heart failure patients were asssociated with better outcomes. This study was aimed to prove the effect of body mass index on mortality and readmission in heart failure patients in cardiovascular outpatient care unit at Dr. Soetomo Surabaya Hospital. The research design was observational analytical study. Subjects consisted of all patients with heart disease in cardiovascular outpatient care unit at Dr. Soetomo Surabaya Hospital that meet the inclusion and exclusion criteria. Through the purposive sampling, 59 patients diagnosed with heart failure were selected. Direct measurements of body weight and height were conducted in February through March 2014 to calculate the BMIs. Based on their BMIs, subjects were then placed into two categories, which were patients with normal and elevated BMIs. Information on deaths and readmissions were gathered in October 2014. The relationship between two variables were then analyzed using Fisher Exact Test. After 8 months of follow up, 5 people (8.5%) died of cardiovascular cause and 7 (11.9%) were re-admitted to the hospital. Among 28 patients with normal BMIs, 3 (10.7%) died and 3 (10.7%) were re-admitted. Among 31 patients with elevated BMIs, 2 (6.5%) died and 4 (12.9%) were re-admitted to the hospital. By using Fisher Exact Test, it was shown that there is no effect of BMI on mortality (p=0.661) and readmission (p=1.000) in heart failure patients.
Case Report: SECONDARY LAPAROSCOPIC ASSISSTED TRANSANAL ENDORECTAL PULL-THROUGH. A PRE-ELIMINARY STUDY
Authors: Barmadisatrio Barmadisatrio , Hariono Hariono
Published: December 2017

The definitive treatment for Hirschsprung’s disease is pullthrough procedure, that can be done through conventional pullthrough approach or through minimal invasive approach. The benefit of minimal invasive technique compared to conventinal open procedure is shorter time to oral intake, shorter length of stay, and less postoperative pain. Secondary LATEP is a minimal invasive pull through technique in patients with preexisting colostomy. Primary pullthrough sometimes cannot be done because limitation of health facilities, uneven distribution of pediatric surgeons throughout the country and late diagnosis of Hirschsprung’s Disease. In dr Soetomo Hospital Surabaya, 7 secondary LATEP procedures were done in January to August 2014. The age range was 6 months to 8 years old. All patients survived, 1 patient had stenosis of anastomotic site 2 weeks postoperative, 3 had enterocolitis, 3 with no complication. Secondary LATEP is a minimal invasive approach for Hirschsprung’s Disease that can be adjusted with Indonesia’s social and economic condition, where most population was distant from an adequate health facility. As there is high incidence of malnutrition, enterocolitis and also the distance from appropriate health services, stoma formation is the first thing that can be done before definitive treatment.Secondary LATEP has never been done in Indonesia, and we still need more data and research to evaluate the benefit and disadvantage of this approach compared to conventional or minimal invasive primary pull through. In conclusion, secondary LATEP is an appropriate pullthrough alternative for Hirschsprung’s Disease and applicable in Indonesia, considering the social and economy condition. Further study must be done to develop this method.
NUCLEOTIDE VARIANCE OF MITOCHONDRIAL DNA D-Loop 126 bp (nt: 34-159) REGION IN MADURESE
Authors: Sulistyorini Nilly , Yudianto Ahmad , Margaret Nola
Published: December 2017

Endogamy continues to occur among the Madurese people in rural areas of the island of Madura, especially those areas of the smallest islands around the mainland of Madura. Endogamy as seen from a genetic standpoint will increase the frequency of homozygous genotypes. With regard to genetic variations, STRs of nuclear DNA and polymorphisms in mtDNA are frequently examined. Mitochondrial variations in the human undergo an evolutionary process through the accumulation of changes in DNA sequence, i.e. through the process of nucleotide substitutions that evolves in number with the directional development of lineage. So far, the genetic variations among the populations in Madura Island have not been known. The present study was an observational analytical research with the purpose of determining the genetic variations in the polymorphisms of 126-bp mtDNA D-Loop HV2 (nt: 34-159) in the populations of Madura Island. Results indicated that, based on the homology analysis with rCRS sequence, there were 9 variants consisting of two transition mutations, 6 transversion mutations, and one insertion mutation. This indicates that a transversion mutation had a higher probability than transition and insertion mutations. According to Mustama (2007), a gene pool is not only a collection of genes but a dynamic system organized and containing the past history of a population. Any genetic information has certain historical, anthropological and statistical aspects necessitating an interdisciplinary coordination and collaboration.
THE EFFECTS OF PHYSICAL EXERCISES ON C-REACTIVE PROTEIN IN PATIENTS WITH POST ISCHEMIC STROKE
Authors: Laswati Hening , Andriana Meisy , Subadi Imam , Yuanita Ida
Published: December 2017

Several studies have recently highlighted the important role of physical exercise in regulation inflammatory status, but there is relatively little known about markers of inflammation levels after physical exercise in post ischemic stroke patients. The aims of this study to provide the effects of physical exercise using Partial Body-Weight Supported Treadmill Training –Audio Cues (PBWSTT-AC) and Traditional method on the level of inflammatory markers C-Reactive Protein (CRP). This study using pretest-postest control group design, 14 post ischemic stroke patients were randomized and allocate to two groups: Group1 (control group) received traditional walking exercise and group 2 received PBWSTT-AC. The walking exercise study were conducted for 20 minute 3 times a week for 12 sessions (4 weeks). Before and after 12 session of exercises, the serum levels of CRP were determined using immunoserology. All statistical test were carried out using SPSS 17 and statistical significance was set at p<0.05 for all analysis. The CRP levels between group were compared using Student t test or Mann-Whitney test. From multiple comparisons statistic result, no significant difference between groups (p=0.898), that seem in this study the levels of CRP of poststroke patients is not influenced by the Traditional training and PBWSTT-AC.  The conclusion of this study that both traditional method and PBWTT-AC in 4 weeks exercise training seem have no effect on CRP levels.
THE EFFECT OF ADMINISTERING MANGOSTEEN RIND EXTRACT (Garnicia mangostana l) COMPARED WITH GLIMEPIRIDE TO THE BLOOD SUGAR LEVELS OF WHITE MALE RAT (Rattus norwegicus l) INDUCED BY STREPTOZOTOCIN
Authors: As’ari Hasyim , Mahartini Dewi Mutmainnah
Published: December 2017

The purpose of this study is to prove the differential effect of administering the mangosteen Rind extract due to lowering the blood sugar levels of Winstar white male rats induced by streptozotosin (STZ). This study used a randomized design of the ramdomized posttest only control group design. The sample consisted of 4 groups with a sample size of 7 animals each group of rats. All samples were prepared STZ induction of diabetes with a single dose of 50 mg/Kg BW through intraperitoneal (IP). K0 (control group; given 1% CMC 1 cc/day), K1 (treatment group 1; given 0,054 mg glimepiride/200 grBW, K2 (treatment group 2; given mangosteen Rind extract 50 mg/Kg BW), K3 (treatment group 3; given the mangosteen Rind extract 100 mg/Kg BW). Timing of therapy in each group was for 7 days. Shapiro-Wilk normality test (a=0.05) in the BW D variable data, pre-post STZ GDP and D GDP. Testing homogeneity used Levene's test. When data distribution was normal and homogenous, it used an ANOVA deferential test. When data distribution was normal and inhomogeneous, it proceed to apply T-test with 2 free samples. The results: 1) There were significant differences between K0 D GDP with K1 (p=0.015), K0 to K2 (p=0.003) and group K0 to K3 (p=0.002), 2) Whereas no difference was shown in the K1 with K2 (p=0.442), K1 to K3 (p=0,401) and K2 to K3 (p=0.878). Conclusion: The administration of mangosteen Rind extract doses of 50 and 100 mg/kg bw/day did not differ in lowering blood sugar levels compared with glimepiride administration of a dose of 0.054 mg/200 grBW rat/day. Mangosteen Rind extract dose of 100 mg/kg bw/day and 50 mg/kg bw/day did not provide a significant difference in lowering blood sugar levels.
PHOSPHATIDYLGLYCEROL STUDY AS FETAL LUNG MATURATION PARAMETER AFTER DEXAMETHASONE ADMINISTRATION FOR WOMEN AT RISK OF PRETERM BIRTH
Authors: Rahmadani Rizal Umar , Sulistyono Agus , Yulistiani Yulistiani , Yahya Muhammad
Published: December 2017

Phosphatidylglycerol is an important indicator of fetal lung maturation, which plays a role in stabilizing surfactant lipoprotein complex. Corticosteroid antenatal can stimulate the synthesis of pulmonary surfactant in infants with preterm birth. The objective of this study is to examine the phosphatidylglycerol levels as fetal lung maturation parameter after dexamethasone administration in women with preterm birth compared to L/S ratio parameter. This study was prospective longitudinal (cohort). The samples were pregnant women with preterm birth risk at 28-34 weeks gestation getting the therapy of antenatal dexamethasone 6 mg IM every 12 hours given 4 times in 48 hours. The samples were 17 patients. Determination of L/S ratio and PG levels was performed by ELISA. The study was conducted from May - November 2015 and reviewed to obtain ethics eligibility permit by the research ethic committees of Dr. Soetomo General Hospital. The results show that the mean value of L/S ratio is 2.28 with a range of 1.35 to 9.06 and the mean of PG level is 1.17 with a range from 0 to 3.79. L/S ratio and PG show no significant relationship between the two of them. Increased levels of PG on the gestational age of 28-32 weeks have not demonstrated clinically significant changes yet. The highest PG level occurs in the gestational age of 32-34 weeks.
ANALYSIS ON THE PATTERN OF USING THE SERVICE OF REMOVABLE PARTIAL DENTURE MAKING IN A DENTAL LABORATORY IN SURABAYA
Authors: Setyowati Okti , Kusdarjanti Endang
Published: December 2017

The making of removable denture is performed by a dental laboratory. To facilitate the identification, according to Kennedy classification, classes are divided onto groups, the Kennedy class I, II, III and IV. To suit with the needs of the dental laboratory tasks commonly done, priority are necessary for common cases and should to be taught to students of Dental Health Technology Diploma. In Surabaya, research of various cases of removable partial denture with the various Kennedy classifications has never been done before. This study was to analyze the pattern of service for the removable partial denture manufacture in dental laboratory at Surabaya (2011 – 2013). The research is an observatory analytic. The population is all dental laboratories located around the campus of the Faculty of Dentistry Airlangga University Surabaya. The sample was the whole population is willing to become respondents. Sampling by total sampling. The method of collecting data using secondary data from a dental laboratory in Surabaya from 2011 until 2013. The note is cases removable denture according to the classification of Kennedy that Kennedy Class I, II, III and IV. Also of note kinds of materials used to make the denture base that is heat cured acrylic resins, thermoplastic resins and metals coherent. The data is a compilation table charting the frequency until needed, then analyzed using cross tabulation. Mostly denture type is flexible type and the least is metal framework. Most cases by classification Kennedy is followed by class II class III and class II and more recently is the fourth. In conclusion, in 2011 and 2013 the manufacture of removable partial dentures according to the classification of Kennedy Class III is the most common in both the upper arch and lower jaw, followed by Class II, Class I and Class IV. In 2012 which is the highest grade III followed by class II, class IV and class I. The denture type most used is a flexible denture, followed acrylic denture and the last is the metal framework.
POTASSIUM MONITORING IN HEART FAILURE PATIENTS RECEIVING COMBINED THERAPY OF CAPTOPRIL AND FUROSEMIDE
Authors: Hubby Hubby , Suharjono Suharjono , Djafar Zaenab
Published: December 2017

In the treatment of heart failure is recommended the use of a combination of ACEI (captopril) with diuretics (furosemide), ACEI has the side effect of hyperkalemia 10-38% in hospitalized patients and 10% in outpatients, is increased in patients with renal failure and diabetes mellitus, the use diuretics occur hypokalemia 5-20% in outpatients. Hyperkalemia and hypokalemia both should be avoided in heart failure patients, because it can cause cardiac conduction disorders such as cardiac arrhythmias This study aims to monitor levels of potassium in the use of combination therapy with furosemide captopril in heart failure patients. The study was conducted using the method Prospective Observational Cross Sectional Analysis, conducted in January-May 2015 in heart failure patients male and female NYHA II-III receiving combination therapy with furosemide Captopril met the inclusion criteria were treated in the department CVCU Dr. Wahidin Sudirohusodo Makassar. Potassium levels were measured pre and post administration of the combination therapy. A total of 37 patients met the inclusion and exclusion criteria in this study, 31 male patients (83.8%) and 6 female patients (16.2%) aged between 35-80 years, during this study after administration of the combination therapy, 5 patients (13.5%) had hypokalemia (<3.5 mmol/L) and 2 patients (5.4%) experienced hyperkalemia (> 5 mmol/L) and 30 patients (81.1%) of normal potassium levels (3,5 to 5.0 mmol/L). The test results paired t test p = 0.432 (p> α;α = 0.05) showed no significant differences between potassium levels pre and post potassium levels. In conclusion, the use of a combination of captopril and furosemide therapy, the risk of hyperkalemia and hypokalemia not significant but need to be monitored levels of potassium and ECG patient.
Case Report: RETROGRADE APPROACH FOR CTO LESIONS: SERIAL CASE
Authors: Oktaviono Yudi Her
Published: December 2017

Chronic total occlusion recanalization still represents the final frontier in percutaneous coronary intervention. Successful revascularization is associated with improved long-term survival, reduced symptoms, improved left ventricular function and reduced need for coronary bypass surgery. Retrograde chronic total occlusion recanalization has recently become an essential complement to the classic antegrade approach. Retrograde approach through the collateral channel has been recently proposed and has the potential to improve the success rate of percutaneous coronary intervention (PCI) in chronic total occlusion (CTO) lession of the coronary arteries. We report several cases of successful CTO recanalization procedure using retrograde approach in Soetomo Hospital.
ANALYSIS OF CHANGE IN NT-proBNP AFTER ANGIOTENSIN RECEPTOR BLOCKER (ARB) THERAPY IN PATIENT WITH HEART FAILURE
Authors: Dewi Intan Kusuma , Aminuddin Muhammad , Zulkarnain Bambang Subakti
Published: December 2017

NT-proBNP is an inactive fragment of BNP secreted by stretched ventricle as response to wall stress in patients with heart failure. As a specific cardiac marker, elevated NT-proBNP correlates well with heart failure severity. The principle of heart failure therapy is modulation on neurohormonal activation. ARB can modulate neurohormon on RAA system, that result in decreasing NT-proBNP level and favorable outcomes. Reduction in NT-proBNP more than biologic variability (> 25%) shows a therapy response.This study was to analyze change of NT-proBNP after ARB therapy in ambulatory HF patients. This observational prospective study was carried from September to December 2015. Blood sampling was performed on patients who meet the inclusion criteria of the study at first visit and after 2 months therapy. NT-proBNP was measured by IMMULITE® as primary parameter and creatinin as secondary parameter. There are 14 patients met the inclusion criteria of the study (11 males and 3 females). ARB therapy used in patients were Valsartan (64%), Telmisartan (22%) and Candesartan (14%). After 2 months ARB therapy, a decrease in level of NT-proBNP with initial median 3092.5 (216 – 32112) pg/ml to 2135.5 (350 – 16172) pg/ml respectively were statistically significant (p=0.003). And the secondary parameter creatinin serum convert to eGFR shows a change in eGFR with initial median 73.33 (37.05 – 266.68) ml/minute to 81.04 (39.31 – 167.02) ml/minute respectively were statistically not significant (p=0.657). There were 7 patients (50%) have a decrease > 25%. In this study, we found that ARB therapy can change NT-proBNP level significantly after 2 months therapy.
THE EFFECT OF SOURSOP LEAF EXTRACT ON PANCREATIC BETA CELL COUNT AND FASTING BLOOD GLUCOSE IN MALE WISTAR RATS EXPOSED TO A HIGH-FAT DIET AND STREPTOZOTOCIN
Authors: Agung Alit Suka Astini Dewa Ayu , Gunawan H Ari , Wirono Aman Santoso R Mochamad , Andajani Susilowati , Basori Ahmad
Published: December 2017

Based on some researches known that soursop leaf extract can improve beta cell injury. The aims of this study was to analyze the effect of soursop leaf extract on fasting blood glucose (FBG) and pancreatic beta cell number in male Wistar rats wich were exposed to a high-fat diet and streptozotocin. This study design is the only randomized posttest control group design. The total sample size is 50 male Wistar rats. The independent variable: high-fat diet, STZ, and soursop leaf extract; the dependent variable: pancreatic beta cells number, and FBG3. Data tested for normality with Kolmogorov-Smirnov (a=0.05) and tested of homogeneity with Levene (a =0.05). Comparison test between groups with Kruskal-Wallis (a=0.05), followed by Mann Whitney. Correlation test with Pearson (a=0.05) between dose of the soursop leaf extract and FBG3, and between dose and the number of pancreatic beta cells. The results of this study showed that the soursop leaf extract at a dose of 100 mg/kg and 150 mg/kg have an effect on fasting blood glucose levels and panreatic beta cells number;2)There is a significant negative correlation between the orograstric lavage of soursop leaf extract with FBG3 (r=-0.647;p<0.001), the increasing doses of soursop leaf extract, further lowering fasting blood glucose levels;3)There is a significant positive correlation between the orograstric lavage of soursop leaf extract with the number of pancreatic beta cells (r=0,759;p<0,001), the increasing doses of soursop leaf extract, further increasing pancreatic beta cells number. In conclusion, increasing doses of soursop leaf extract, further lowering fasting blood glucose and increasing the number of pancreatic beta cells.
THE ELEVATION OF OSTEOBLAST ACTIVITY IN RAT BONE MARROW MESENCHYMAL STEM CELLS IN OSTEOGENIC MEDIUM EXPOSED WITH MELATONIN IN PHYSIOLOGICAL DOSES
Authors: Yuliyanasari Nurma , Mastutik Gondo , Putra Suhartono Taat
Published: December 2017

The objective of this study was to analyze the elevation of osteoblast activity in bone marrow mesenchymal stem cells (BM-MSCs) in osteogenic medium by physiological doses of melatonin administration by measuring alkaline phosphatase (ALP) and osteocalcin level.This studyused BM-MSCs from Rattusnorvegiccus femur bone. Rat BM-MSCs were cultured in a-Mem medium, differentiated in osteogenic medium, and administrated melatonin up to 21 days. This study was divided into 4 groups, K0 (control group), K1 (administrated of 25 nM melatonin), K2 (administrated of 50 nM melatonin), and K3 (administrated of 100 nM melatonin). Rat BM-MSCs were characterized CD 45- and CD 105+ marker using imunocytochemistry analysis and stained with Alizarin red after 15 days treatment. ALP and osteocalcin level were measured using ELISA Kit in days 21st.There weren’t differences ofALP level beetwen groups and there are differences ofosteocalcin level between control groups (K0) withK1, K2, dan K3, and beetwen K1 and K2. The conclusion of this study was that there were an elevation of osteoblast activity in rat BM-MSCs in osteogenic medium by physiological doses of melatonin administration characterized by the elevation of osteocalcin level.
PLASMA LACTATE VERSUS C-REACTIVE PROTEIN AS PROGNOSITIC INDICATOR IN UROSEPSIS
Authors: Prilistiyo Dwimantoro Iman , Santoso A , Anniwati L , Pudjirahardjo W J
Published: December 2017

Urosepsis occurs in 20-30 % of septic case. Early diagnosis were undoubtfully important to improve the results of sepsis management. Bacteriological confirmation may be difficult to obtain and negative cultures do not exclude the presence of infection. Increased understanding of inflammatory cascade mechanisms provided several indicator of infection and prognosis. Lactate measurement in patients with infection and possibly severe sepsis to help identify patients at high risk of death in order to apply aggressively therapy. Elevation in serum C-reactive protein (CRP) is also associated with an increasing risk of death in patients with infection. This study was to determine the plasma lactate and CRP levels of patients with urosepsis as a prognostic indicator. This is an analytic observational study to compare the correlation and significance of plasma lactate and CRP with prognosis of urosepsis. Each subject was measured for plasma lactate and serum CRP at time of admission. All subjects were managed according to standard protocol. At the 14th day of treatment, patients were evaluated with a clinical severity score. The outcome was classified as follows: 1=good condition/improved, 2=morbid/worsened and 3=death. The statistical analysis used Spearman’s rho test, ρ<0.05 was considerated to indicate significance. We enrolled 25 subjects with urosepsis. 14 patients who were septic, nine patients had severe sepsis and 2 patients had septic shock. Mean plasma lactate level in patients based on outcome (improved/worsened/death) was 2.08 mmol/L; 4.16 mmol/L and 5.27 mmol/L. The mean value of CRP was 13.41 mg/L; 22.28 mg/L and 24.62 mg/L. These were statistically significant (p 0.008 vs 0.016) in determining the outcome of the urosepsis patient. The coefficient correlation is better with plasma lactate than CRP (0.517 vs 0.475). In conclusion, the measurement of plasma lactate and CRP level can be used as a prognostic marker for the outcome of patient with urosepsis. Plasma lactate showed higher correlation with outcome of urosepsis than CRP.
EFFECT OF THE ROLE OF SAFETY OFFICER ON COMPLIANCE TO OCCUPATIONAL SAFETY AND HEALTH (OSH) AMONG OUTSOURCING WORKERS IN COMPANY X, SURABAYA
Authors: Widajati Noeroel , Ernawati Meirina , Martiana Tri
Published: December 2017

Up to the end of 2012, Social Security showed the occurence of 103.074 work accident cases. 91.21% of the accident casualties were recovered, 3.8% were disabled, 2.61% partially disabled, and the rest died (2.419 cases) and were totally-permanently disabled (37 cases), with the average of 282 work accident cases per day. Due to the increasingly tight corporate climate, the company tries to make production cost efficiency (cost of production). One solution that may be taken is by applying outsourcing system. With this system, the company may save expenses in funding human resources (HR) who work in the company concerned. If the aspects of the application of Occupational Safety and Health (OSH) are not properly managed, the possibility of work accidents and environmental pollution that have a negative effect on the corporate image and the continuity of company product supply will increase. This may affect the company's loss, both material and corporate image. The role and responsibility of the safety officer is very influential on the achievement of zero accident, so many safety programs are developed, such as safety briefing and safety patrol, with the aim to improve the aspect of OSH. However, some employees have not complied with the provisions of OSH implementation in the company they work at.
RADIATION EFFECT OF WIRELESS FIDELITY (Wi-Fi) ON OOCYTE NUMBER OF OOCYTE STIMULATION IN MICE (Mus Musculus)
Authors: Nurbayatin Anita , Widjiati Widjiati , Primariawan Relly Yanuari , Poernomo Bambang , Sulistiawati Sulistiawati , Yudiwati Rina
Published: December 2017

Infertility is a problem experienced by some women and men around the world. Most infertility problems in women is caused by impaired reproductive organs or disrupted ovulation.. One factor that causes impaired oocyte maturation is wireless fidelity (Wi-Fi) radiation which has a radio frequency field of 2.45 GHz. The radiation may increase the activity of free radical cells through the fenton reaction pathways that cause infertility because of the disrupted oocyte development. This study aimed to determine the effect of Wi-Fi radiation on the number of oocytes. This was an experimental study using control group design. The subjects were 32 female mice selected through complete random sampling and divided into two groups: control (R0) and exposure (R1). Each group consisted of 16 mice. The Wi-Fi radio frequency used was 2.5 GHz. Mice (R1) were placed closer to Wi-Fi source (± 15cm), and there were two types of laptop PCs and 3G mobile phones connected to internet placed next to mice for 15 hours/28 days. The mice underwent a simultaneous cycle with intraperitoneal injection of PMSG and HCG. Furthermore, the mice were mated with vasectomized male monomatingly to induce ovulation. The fertilization pouch in both oviducts were observed for oocyte collection. The number of oocytes was calculated using an inverted microscope. There was a difference in the number of oocytes between control and exposure group. Statistical tests were analyzed using Mann Whitney U and resulted in significant values (p value = 0.00). No oocytes count in exposure group. In other words, the group underwent anovulation. In conclusion, Wi-Fi radiation affected the number of oocyte stimulation in mice. Therefore, it was important to minimize the risk factors that trigger electromagnetic radiation on reproductive health.
THE EFFECT OF RECOMBINANT VASCULAR ENDOTHELIAL GROWTH FACTOR 121 ON NITRIDE OXIDE LEVEL IN MICE (Mus musculus) MODEL OF PREECLAMPSIA
Authors: Soetrisno Soetrisno , Isharyadi Isharyadi , Sulistyowati Sri
Published: December 2017

Preeclampsia is a multifactorial syndrome in pregnancy whose cause is still unknown. Several proangiogenic and antiangiogenic mediators such as Vascular Endothelial Growth Factor (VEGF) and Nitrite Oxide (NO) play important roles in preventing preeclampsia. VEGF can increase NO level that lowers maternal blood pressure, improves endothelial function and reduces placental hypoxia in preeclampsia. Recombinant VEGF 121 is expected to be an option in the prevention and treatment of preeclampsia. This experimental study used mice (Mus musculus) as the model. The objective of this study was to observe the effect of recombinant VEGF 121 in increasing the level of nitric oxide in mice (Mus musculus) model of preeclampsia. This was an experimental analytical study with Randomized Control Trial (RCT) design. The study enrolled 27 pregnant mice (Mus musculus) which met the restriction criteria divided into 3 groups. The first group (K1) were 9 normal pregnant mice. The second group (K2) were 9 pregnant mice of preeclampsia model without treatment. The third group (K3) were 9 pregnant mice of preeclampsia model receiving recombinant VEGF 121 therapy. The independent variable was the administration of recombinant VEGF 121 and the dependent variable was the serum NO level. Statistical analysis was performed by using anova statistics. NO level in the first group (K1) was 1.746±0.347, with minimum value of 1.00 µM, and maximum value of 2.28 µM, CI (1.479-2.013).  NO level in second group (K2) was 1.167±0.380, with minimum value of 0.64 µM, and maximum value of 1.94 µM, CI (0.875-1.460). NO level in the third group (K3) was 2.164±0.556, with minimum value of 1.56 µM, and maximum value of 5.96 µM, CI (1.842-2.486). With anova statistical test, there were significant differences between K1 group and K2 group (p value=0.004<0.05), K1 group and K3 group (p value=0.000<0.05) as well as K2 group and K3 group (p value=0.029<0.05). In conclusion, Recombinant VEGF 121 increased the level of nitric oxide in mice (Mus musculus) model of preeclampsia significantly.
DIABETES RISK FACTOR SCREENING IN ADULTS USING PERKENI QUESTIONNAIRE AND ORAL GLUCOSE TOLERANCE TEST IN SOCAH COUNTY, BANGKALAN
Authors: Kamal Radin H , Novendrianto Dwiki , Chadijah Faizah , Prasetya Galan Budi , Pratama Gilang Satria , Ariadnya Mentari Octarina , Larasati Nikita Gladys , Darain Nur Lia F , Nanda Ovitrani , Mavita Silvi , Usamah Usamah , Prajitno Jongky Hendro
Published: December 2017

There are 8.4 million diabetes adult patients in Indonesia and most remained undiagnosed. Screening process for diabetes is very important. PERKENI has recommended the use of questionnaire and Oral Glucose Tolerance Test (OGTT) as risk factor screening tools. This study aimed to find out the use of PERKENI questionnaire and OGTT in adults as diabetes risk factor screening tools. This was a descriptive cross sectional study conducted in 2015 in Socah County Bangkalan. Participants (n=91) were interviewed regarding diabetes risk factor using PERKENI questionnaire. Anthropometric (height, weight, and abdominal circumference) measurements were also taken. The results were categorized into: very low risk, increased risk, moderate risk and high risk. Only those categorized as high risk were asked to take OGTT. Exclusion criteria were participants who had been diagnosed with diabetes by a physician and/or routinely taking anti diabetic medication, consumed drugs during the previous two weeks and does not finish the required procedures. From 91 eligible participants, only 9 (9.89%) were categorized as high risk. The result of OGTT were: 4 were within normal limit, 1 had impaired glucose tolerance (IGT) and 4 were newly diagnosed with diabetes. The use of PERKENI questionnaire and OGTT in high risk adult population as a diabetes risk factor screening tool increased new findings of diabetes cases. Our analysis may support the adoption of diabetes risk factor screening methods through questionnaires and OGTT in high risk adult population, especially in low resource setting.