bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlation of chest radiography of confirmed COVID-19 patients with comorbid hypertension and diabetes mellitus
Authors: Majdawati Ana , Annisa
Published: December 2022

Introduction: Several studies showed 324 severe cases of COVID-19 and 1234 mild cases with the highest comorbidities of Hypertension, Diabetes Mellitus, Chronic Obstruvtives Pulmonary Disease (COPD), and Cardiovascular disease. These comorbid factors lead to a poor prognosis in COVID-19. Chest radiography is an important modality as one of the parameters that can indicate the severity of COVID-19. This study aims to determine the relationship between Covid-19, comorbid Hypertension, and Diabetes Mellitus with chest radiography.
Method: This research is analitic observational with cross-sectional, relationship between Covid-19 patients with comorbid Hypertension and Diabetes Mellitus with chest radiography (type, location, and extent of lesions) that Modified Chest X-Ray Scoring System in Evaluating Severity of COVID-19 Patient in Dr. Soetomo General Hospital Surabaya, Indonesia in 2021, COVID-19 radiology category.  The data from PKU Muhammadiyah Gamping Hospital, Yogyakarta retrospectively from the medical records of Covid-19 patients who met the inclusion and exclusion criteria. Chi-Square analyzed the results variables with unpaired categorization.
Result: Most of the respondents who had comorbid diseases had moderate chest radiological features (65.4%) and those who did not have comorbid diseases had mild chest radiological features (71.9%), the results of chi-square data analysis between variables were p: 0.000.
Conclusion: The results of data analysis showed that comorbid diseases had a significant relationship with chest radiography in patients with confirmed COVID-19. The novelty of this study is the importance of radiological modalities as one of the parameters that can indicate the severity of Covid-19 patients with comorbidities.
Factors related to family resilience during the COVID-19 pandemic
Authors: Pakpahan Martina , Kartika Lia , Sampepadang Mega
Published: December 2022

Introduction: The COVID-19 pandemic has dramatically impacted people's lives. Families are affected in many ways, including daily life, the economy, social life, and health. Families who have resilience can face the COVID-19 pandemic situation. This study aims to determine the factors related to family resilience during the Covid-19 pandemic, including Family income, education, family type, family relations, and social support.
Methods: This study is a cross-sectional study conducted on 403 respondents using purposive sampling. Inclusion criteria include Husband or wife (with or without children) who live together, ages 18-65 years, in Jakarta and Tangerang. Data collection using an online questionnaire consisted of demographic data, the Family Resilience Assessment Scale (FRAS), and the Multidimensional Scale of Perceived Social Support (MSPSS). The questionnaire has passed the validity and reliability test. The Ethics Board of the Mochtar Riady Institute of Nanotechnology (MRIN) provided ethical approval.
Results: Multivariate analysis using a logistic regression test showed that factors related to family resilience were income (p-value: 0.028, OR: 3.08) and social support (p-value: 0.001, OR: 7.16). Social support is the dominant variable related to family resilience. An increase in social support increases the likelihood of family resilience by 7.16 times. Furthermore, an increase in family income has a 3.08 times greater chance of increasing family resilience.
Conclusion: Families and the government can collaborate to improve family resilience during the Covid-19 pandemic by optimizing social support and family income.
Expression of Na+/K+ATPase and changes of corneal endothelium cell density after phacoemulsification with hypothermic perfusion
Authors: Kartika Ratih Justitia , Prastyani Reni , Fauziah Dyah , Melaniani Soenarnatalina , Sasono Wimbo
Published: December 2022

Background: Intraocular hypothermic perfusion can be used as an alternative to reduce corneal endothelial cell damage in phacoemulsification procedures. This study aimed to analyze the effect of hypothermic intraocular perfusion on cell density and expression of the Na+/K+-ATPase on corneal endothelial cells after exposure to ultrasonic phacoemulsification energy.
Methods: Sixteen New Zealand white rabbits (n=16 eyes) were randomly divided into two groups and exposed to phacoemulsification ultrasonic energy. The control group received room-temperature Intraocular Balanced Salt Solution (BSS) hyperthermic perfusion (24oC) and the treatment group received low-temperature intraocular BSS hypothermic perfusion (4oC). Corneal endothelial cell density (ECD) was measured before and 1 day after surgery using a specular microscope. On the first postoperative day, the expression of Na+/K+ATPase was examined using immunohistochemical antibody staining. Data were analyzed using SPSS version 26 for Windows.
Results: There was no statistically significant difference in the expression of corneal endothelial Na+/K+-ATPase between the control and treatment groups (p=0.053). There was no significant difference in corneal endothelial cell density changes between the control and treatment groups (p=0.115). There was no correlation between changes in cell density and corneal endothelial Na+/K+ATPase expression in the control and treatment groups (p=0.216).
Conclusion: The effect of intraocular hypothermic perfusion on phacoemulsification procedures remains controversial. Endothelial cell density decreased in hypothermic perfusion after phacoemulsification and Na+/K+ATPase expression was not significantly affected by hypothermic perfusion.
Systemic Lupus Erythematosus Flare Triggered by COVID-19 Infection: A Case-Based Review
Authors: Tio Maria Sarce , Sanyoto Arundina
Published: December 2022

Introduction: The coronavirus disease 19 (COVID-19) and autoimmune disease has been associated bidirectionally, several reports has shown COVID-19 precipitate an exacerbation of an autoimmune disease that has already stable. Recognize and treatment of flare in SLE condition with COVID-19 is challenging in this pandemic era. This review aims to report a case SLE patient who experienced severe flares after being infected with COVID-19 and review of the literature.
Case report: We presented a 27-year-old female with a history of Systemic Lupus Erythematosus (SLE) who experienced severe flares after being infected with COVID-19 and a review.
Methods and Results: A total of 72 potentially relevant citations were identified. After removing the duplicate citations, the title, and abstracts of 61 articles were evaluated and 11 relevant articles were reviewed in detail. A total of 72 potentially relevant citations were identified. After removing the duplicate citations, the title, and abstracts of 61 articles were evaluated and 11 relevant articles were included.
Conclusion: The COVID-19 pandemic is a devastating situation all over the world. SLE patient has already been in a susceptible condition as the disease progressed and continued having immunosuppressant therapy also one of the risk factors. A Flare condition can be happened during the COVID-19 Infection or after the infection is resolved. In SLE patient having COVI-19, close monitoring, high adherence to the therapy, and the health protocol are needed.
Transformation of the learning system in nursing education after the COVID-19 pandemic
Authors: Sulastri  , Wachidah Yuniartika  , Diah Ayu Agus Triana  , Giyoto
Published: December 2022

Introduction: As the next generation of professional nurses, nursing students must adapt to the learning system implemented in Indonesia during the COVID-19 pandemic. This study aimed to explore information on the transformation that occurred from the application of the learning system.
Method: Using a qualitative descriptive research design with the guidance of the Meleis Transition Theory, which was used to gather information from nursing students about the application of learning systems, both theory and laboratory practice at the Nursing department, Universitas Muhammadiyah Surakarta during the pandemic, interviews were conducted on 13 participants. Data was collected by interviewing one by one using a semi-structured format and then transcribed. Data were analyzed using Colaizzi phenomenological reduction. The interview results obtained three themes: technological challenges, academic challenges, and resilience.
Result: The study's results obtained a theme that revealed a number of challenges experienced by students during this transition period, such as technological challenges, academic challenges, and resilience.
Conclusion: The COVID-19 pandemic requires the world of nursing education to adapt to maintain the skills and knowledge of its students to become the successors of professional nurses.
The relationship between self efficacy and medication adherence in elderly with hypertension
Authors: Nina Dwi Lestari  , Vivi Nur Anisa
Published: December 2022

Introduction: The elderly will experience a decrease in health status caused by either disease or nature, so they are at risk of suffering from hypertension. Hypertension can be controlled by medication adherence. Self-efficacy is a factor that plays an important role in medication adherence. The important role of self-efficacy lies in a person's self-knowledge, which refers to self-confidence in achieving hypertension treatment goals. To identify the relationship between self-efficacy and the level of medication adherence in the elderly with hypertension.
Methods: This study used a cross-sectional method with a random sampling technique. The sample of this study was 60 older people in Mejing Wetan. The measuring instrument used was MASES-R to measure self-efficacy and MMAS-8 to measure medication adherence. Univariate analysis used descriptive statistical analysis, while Bivariate analysis with SPSS used the Chi-Square analysis method. There will be a significant relationship if p is < 0.05.
Results: The results showed that the respondents' self-efficacy is dominated by the moderate category (41.7%), (73.3%) respondents were disobedient in taking medication, and the significance value was p=0.000. It indicated a significant relationship between self-efficacy and medication adherence as p<0.05. In addition, the correlation results were very strong (r=0.781).
Conclusion: There was a strong relationship and a positive direction between self-efficacy and the level of medication adherence in the elderly with hypertension
Liver function characteristics of COVID-19 patients with obesity at Dr. Soetomo Hospital: case series
Authors: Putra Erwin Maulana Farmanda , Ummi Maimunah
Published: December 2022

Background: Coronavirus disease 2019 (COVID-19) patients with obesity are more susceptible to liver injury. There is currently no published overview regarding COVID-19 patients with liver injury in Indonesia. Our study reported 7 cases of obese COVID-19 patients with an increase of serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT), followed by 5 of them developing severe symptoms of COVID-19 in isolation room of Dr. Soetomo Hospital Surabaya within June-December 2020.
Case Presentation: A total of 7 COVID-19 patients, by the average age 46.2±15.5 years, were obese. The mean body mass index (BMI) was 36,3±3,4 kg/m2. Five of them experienced serious symptoms. There were 3 patients (patient no. 2, 4, 7) who had normal SGOT level, while the rest had an increased SGOT level for <2x upper limit of normal (ULN) at admission. During treatment, SGOT level increased in 5 patients for 1-<3x ULN and normal in the rest of them (patient no. 2, 4). Meanwhile, the normal SGPT levels were shown in 3 patients (patient no. 2, 4, 7) and increased in 4 others at admission for 1-<4x ULN. All of them tended to have an increased SGPT level during treatment for 1-<5x ULN. However, since the increase of SGOT and/or SGPT for >3x ULN is defined as liver injury, it happened in 2 patients that occur since admission (patient no. 3) and during treatment (patient no. 5).
Conclusion: Obesity may impede the recovery of COVID-19 and manifest in the deterioration of liver function.
Platelet-rich fibrin (PRF) graft and amniotic membrane graft on transforming growth factor-β (TGF-β) and type 1 collagen post conjunctival excision
Authors: Nababan Abdi Roy , Suryowati Daniar Indah , Komaratih Evelyn , Yulia Primitasari  , Legowo Djoko , Notopuro Paulus Budiono , Notobroto Hari Basuki
Published: December 2022

Background: Conjunctiva, when injured, can heal spontaneously. However, in extensive wounds, wound healing is often accompanied by scarring and wound contraction. Currently, for cases of disease and trauma to the surface of the eyeball, it can be reconstructed using the amniotic membrane, but there are still weaknesses in the use of amnion. Platelet-rich fibrin (PRF) is currently being developed for the reconstruction of ocular surface wounds.
Methods: A total of 20 male New Zealand rabbits (20 eyes) were divided into two groups. In the first group, conjunctival excision and PRF membrane graft suturing were performed on the right eye conjunctival defect, while the second group had an amniotic membrane sutured on the right eye conjunctival defect. On the 14th day, enucleation was carried out and continued with histopathological examination using immunohistochemistry using TGF antibodies and type 1 collagen to evaluate the levels of TGF and type 1 collagen in the conjunctiva.
Results: The results after 14 days of treatment showed that there was a very significant difference in TGF Beta expression between the AMT group and the PRF group (p = 0.007*; <0.05). However, in the expression of type 1 collagen, there was no significant difference in the expression of type 1 collagen between the AMT group and the PRF group (p = 0.791; >0.05).
Conclusion: There were differences in the expression of TGF-β and type 1 collagen in the administration of the PRF membrane compared to the administration of the amniotic membrane after conjunctival excision of experimental male New Zealand rabbits on day 14.
Relationship between CYP2C19 polymorphisms and weight gain in epilepsy patients treated with divalproex sodium: does gender matter?
Authors: Islamiyah Wardah Rahmatul , Nasronudin  , Machin Abdulloh , Ernawati Iin , Sugianto Paulus
Published: December 2022

Introduction: Epilepsy is an unprovoked seizure caused by an abnormal paroxysmal neuronal release in the brain. One of epilepsy treatments is anti-epileptic drug divalproex sodium. It is often prescribed to control seizures but it increases body weight. Weight gain may decrease the effectiveness of epilepsy treatment and cause endocrine disorders. CYP2C19 polymorphism may help physicians map patients vulnerable to weight gain due to divalproex sodium. This study aimed to determine the relationship between CYP2C19 polymorphisms and the incidence of weight gain based on gender in epilepsy patients treated with divalproex sodium.  
Methods: This cross-sectional study consisted of 17 male and 23 female patients. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to identify CYP2C19 polymorphism which was grouped into: extensive metabolizer, intermediate metabolizer and poor metabolizer. The results were analyzed using Chi-squared test to determine the relationship between CYP2C19 and each variable (gender, age, epilepsy types, valproic acid types, family history of obesity and presence of weight gain) based on of gender.
Results: The results showed that there was no statistically significant association between CYP2C19 polymorphisms and gender-based epilepsy patients groups (p>0.05). We found that most of the subjects in this study were women with an increase in body weight by 57.5%. There was no association of CYP2C19 polymorphism with type of divalproex sodium, dose of divalproex sodium, length of treatment, type of epilepsy and family history of obesity.
Conclusion: There is no significant association between CYP2C19 polymorphism and weight gain between genders in epilepsy patients.
The description of pregnancy status and type of delivery attachment technique in postpartum mothers at the Roemani muhammadiyah hospital Semarang: assessed by latch score analysis
Authors: Machmudah  , Yunitasari Esti , Triharini Mira , Rejeki Sri
Published: December 2022

Background:  Breast milk plays a role in cognitive, sensory, and motor development and protects against infections and chronic diseases. The process of breastfeeding will protect the baby from illness, and increase cognitive intelligence and social-emotional development between mother and baby. Duration of breastfeeding was associated with acute illnesses, diarrhea, constipation, and a lower likelihood of being overweight/obese. Thus, this study aimed to the investigated correlation between pregnancy status and delivery type with successful breastfeeding in postpartum mothers at Roemani Muhammadiyah Hospital Semarang
Methods: This type of research was analytical descriptive, conducted in December 2021 with purposive sampling and a sample size of 120 respondents. The inclusion criteria of postpartum mothers who breastfeed their babies, mothers who are in good health, and baby who has no congenital abnormalities. Respondents who refused and who have babies with congenital abnormalities are excluded from the study. The data was extracted from the questionnaire and also coded into the SPSS 25 ver. Data were analyzed descriptively and analytically by using chi-square analysis.
Results: The participant with a planned pregnancy was 107 mothers (89.2%), unplanned 13 mothers (10,8%), section Caesarea type of delivery was 70 mothers (52%) and vaginal type of delivery was 50 mothers (48%). Based on LATCH score analysis planned pregnancy showed good category 38 mothers (31,7%), medium category 69 mothers (57,5%), and planned pregnancy showed good category 4 mothers (3,4%), medium category 8 mothers (6,7%), bad category 1 mother (0,8%). Based on the type of delivery, the vaginal type score was good for 25 mothers (50%), medium for 25 mothers (25%), and the section Caesarea type score was good for 17 mothers (24%), medium for 52 mothers (75%) and bad 1 mothers (1%). Either pregnancy status and type of delivery have P value scores of 0,016 and 0,012, respectively.
Conclusion: A mother that delivers a vaginal has a better level of breastfeeding than SC, and pregnancy status such as planned pregnancy also shows a better level than they are not.
Benefits and challenges of peer learning methods in health professional students: A literature review
Authors: Sriwigati Dyah , Musharyanti Lisa
Published: December 2022

Introduction: The curriculum for health profession education uses a variety of teaching techniques. A strategy is needed to create a creative learning environment during the implementation of the academic learning process so that students can achieve the expected competencies. Peer learning is one of the learning methods to facilitate student learning experience. Peer learning (PL) uses peers as tutors in the learning process and the process of students learning with and from each other. The application of the peer learning method in the health student learning curriculum is considered to have several advantages and challenges.
Purpose: To identify the benefits and challenges of implementing peer learning methods on health professional students.
Methodology: This study is a literature review with databases form ScienceDirect, PubMed, Scopus and Emerald. The articles search results obtained 10 articles that were screened using the PRISMA guide. This study is looking for articles about peer learning methods in health students who are included in the inclusion criteria.
Findings: There are total 1273 articles obtained from 4 databases, with details ScienceDirect 499 articles, PubMed 366 articles, Scopus 255 articles and Emerald 153 articles. The results of a review of 10 articles show that the peer learning method can be implemented in academic learning settings as well as clinical learning. The application of peer learning methods in the learning process has several benefits including; improve social skills, increase knowledge and better understanding of learning materials, increase self-confidence, improve clinical skills. Apart from the benefits, there are some challenges in implementing the PL method.
Implication: PL can be applied in health student learning because it has many benefits for health students.
Diagnostic test of Immature Granulocyte Ratio (IG Ratio) to detect Early-Onset Neonatal Sepsis (EONS)
Authors: Simanjuntak Sherly Karolina , Herawati Sianny , Sukmawati Made , Yasa I Wayan Putu Sutirta , Mulyantari Ni Kadek , Lestari Anak Agung Wiradewi , Wande I Nyoman , Wirawan I Made Ady
Published: December 2022

Background: Based on the onset of events, the most common neonatal sepsis is early-onset neonatal sepsis (EONS), which occurs within the first 72 hours of life. Blood culture is the gold standard for EONS, but this examination takes a long time to provide the results. However, the latest method is obtained to determine the shift to the left granulocytic image by counting Immature Granulocyte (IG). This study aims to evaluate the accuracy of the IG Ratio for diagnosing EONS in neonates suspected of having sepsis.
Methods: A cross-sectional observational study was conducted among 60 EONS patients consecutively, who met the inclusion criteria from January to June 2022 at Prof. dr. I.G.N.G Ngoerah Hospital, Bali. Variables assessed in this study included age, gender, delivery methods, birth status, birthweight, blood culture, complete blood count (CBC), I/T ratio, and IG ratio. Data were analyzed using SPSS version 23 for Windows.
Results: The cut-off point of the IG Ratio was 2.21 (AUC=0.670 (0,490-0,851); p=0.041; OR: 8.021 (2.283-28.185); p=0.001), which had a sensitivity of 64.7% and a specificity of 81.4% for diagnosing EONS in neonates suspected of having sepsis. The results also obtained a Negative Predictive Value (NPV) of 85.35 and a Positive Predictive Value (PPV) of 57.89.
Conclusion: The cut-off point of the IG Ratio of 2.21 has a risk factor of 8.021 times higher for diagnosing EONS in neonates with sepsis.
Acute Erythroleukemia (AML-M6) in one-year-old boy: a case report
Authors: Prabawa I Putu Yuda , Mahartini Ni Nyoman , Herawati Sianny , Mulyantari Ni Kadek
Published: December 2022

Background: Acute Erythroleukemia (AML-M6) is a rare case with approximately 3-4% of all Acute Myeloid Leukemia (AML) cases. AML-M6 is less common in the pediatric population, with an incidence of <1% of all pediatric leukemia cases. This case study aims to evaluate Acute Erythroleukemia (AML-M6) in a one-year-old boy at Prof. dr. IGNG Ngoerah Denpasar.
Case Presentation: A one-year-old boy with clinical manifestations of fluctuating fever for a month, paleness, bleeding gums, bruising all over his body, swelling of both eyelids and splenomegaly. Peripheral Blood Smear (PBS) examination revealed bicytopenia with moderate normochromic normocytic anemia, severe thrombocytopenia and leukocytosis. A hypercellular picture was obtained from the examination of Bone Marrow Aspiration (BMA) with an increase in erythroblast activity of 74%, proerythroblast at 50% and normal myeloblasts activity at 10%. The patient was diagnosed with Acute Erythroleukemia (AML-M6). The patient died on day 16 of treatment.
Conclusion: Based on the examination results, it was concluded that the patient was diagnosed with AML-M6 according to the PBS and BMA evaluation.
The Effect of Beta vulgaris L. on the Malondialdehyde Levels in Male Wistar Rats Exposed to Cigarette Smoke
Authors: Alya Berliana Suharso  , Dewi Puspita Kusuma , Edward Kurnia Setiawan Limijadi  , Amallia Nuggetsiana Setyawati
Published: December 2022

Introduction: Oxidative damage can be brought on by inhaling free radicals from cigarette smoke. Malondialdehyde (MDA), a byproduct of lipid peroxidation, is a biomarker for oxidative stress. Beta vulgaris L., sometimes known as beetroot, is a root vegetable with phenolic and betalain chemicals that have antioxidant qualities and can reduce oxidative stress in the body.
Determine how beetroot juice affects male Wistar rats exposed to cigarette smoke regarding their MDA levels.
Methods: 24 samples of male Wistar rats, separated into 4 groups, were utilized in this genuine experimental investigation using a posttest-only control group design. Traditional food and beverages were served to Group N. Two cigarettes were smoked each day by the cigarette smoking group, BV1, and BV2. Beta vulgaris L. juice was also administered to group BV1 at a dose of 8 ml/kg BW per day and to group BV2 at 16 ml/kg BW per day. MDA serum levels were measured using the TBARS technique after 28 days of therapy. The one-way ANOVA and the Games-Howell test were used to evaluate the data.
Result: The group control's mean MDA level was 1,539 ppm; the cigarette smoking group was 3,167 ppm; BV1's was 2,452 ppm, and BV2's was 2,0527 ppm. Between-group control and cigarette smoking group BV1 and BV2, as well as between BV1 and BV2, there were significant differences in MDA levels (p 0,05).
Conclusion: The MDA levels of the groups exposed to cigarette smoke and given beetroot juice were lower than those of the groups exposed to cigarette smoke alone, with the MDA levels of the group given a dosage of 8 ml/kg BW being lower than the group given a dose of 16 ml/kg BW.
Bacterial colonization in atopic dermatitis
Authors: Paramita Deryne Anggia , Khairina  , Lubis Nova Zairina
Published: December 2022

Background: Atopic dermatitis (AD) is the most common skin disease in infants and children, influenced by hereditary and environmental factors and characterized by an inflammatory reaction in the skin. The increase in AD has been explained by two hypotheses: the "hygiene hypothesis" and the "diet–microbiome hypothesis." AD is driven by a familial or personal predisposition to induce immunoglobulin E (IgE) antibodies and sensitize in response to stimuli. Microorganisms on the skin have been shown to play an important role in the pathogenesis of AD, and changes in the composition of the skin microbiome have been investigated in disease progression in pediatric AD patients.
Method: This descriptive observational study with a cross-sectional approach aims to determine the bacteria found in AD. The samples were taken from both the lesion and non-lesion areas in children with AD, which grown anaerobically and aerobically in blood and Brucella agar at 37C. The bacteri then indentified by Vitek® 2 and the data presented in percentage.
Result: Thirty-five pediatric patients (18 males and 17 females) with a mean age of 7.58 (0,17 – 16) years were diagnosed with AD and were examined for bacterial culture on lesions and non-lesions. A total of 4 types of bacteria were found on the neck, 20 on the forearm, 2 on hand folds, 2 on fingers, 1 on the knee, and 5 on the lower limbs.
Conclusion: The most common bacteria were Gram-negative bacilli, namely, Acinetobacter baumannii (15%) and Burkholderia cepacian (14.3%), followed by the Gram-positive coccus Staphylococcus hominis (11.4%).
The role of serum ferritin level and disease severity in COVID-19 with type 2 diabetes mellitus patients
Authors: Liani Fauzia Noor , Mudjanarko Sony Wibisono , Novida Hermina
Published: December 2022

Introduction: The disease progression of coronavirus disease 2019 (COVID-19) in individuals with comorbidities, such as type 2 diabetes mellitus (T2DM) in particular, has been associated with the occurrence of the cytokine storm. Ferritin, an acute-phase protein indicating inflammation, has been linked to T2DM and the severity of COVID-19. Our study aimed to investigate the association between the level of ferritin and the severity of COVID-19 in T2DM patients.
Methods: A cross-sectional study was conducted among COVID-19 patients admitted at Dr. Soetomo General Hospital, Surabaya, from April to September 2020. The patients who met the inclusion criteria were enrolled in the study. The data used in this study was secondary data obtained from the medical records at Dr. Soetomo General Hospital, which consisted of serum ferritin levels, the severity of COVID-19, the results of blood analysis, and other demographic and clinical characteristics (age, gender, hypertension, the number of complaints, and vital signs). Data analysis was performed using SPSS software and presented in percentage (%), mean ± standard deviation (SD), or median (min-max). A chi-square test was carried out to identify the association between serum ferritin level and the severity of COVID-19 in T2DM patients at α=0.05.
Results: Of the total 159 patients were included and 80.8% of them had moderate severity of COVID-19, whereas the rest (19.5%) had severe COVID-19. Out of total patients, 78.6% had ferritin levels of ≥400 mg/dL, suggesting hyperferritinemia syndrome (mean ± SD: 1177.21 ± 1275.90 mg/dL). The Chi-squared analysis revealed a significant association between serum ferritin levels with the severity of COVID-19 in T2DM patients (p=0.024).
Conclusion: There was a significant relationship between serum ferritin levels and the severity of COVID-19 in T2DM patients and further study with a bigger sample size is needed to confirm this finding.
Emergency thrombectomy in acute upper limb ischemia patient with diabetes mellitus
Authors: Arif Yunita , Novida Hermina
Published: December 2022

Background: Acute limb ischemia is a sudden decrease in limb blood perfusion with an onset of less than 14 days, most commonly occurs in lower extremities. Diabetes mellitus, one of diseases underlying peripheral artery disease, complicates the pathophysiology of acute limb ischemia. In this case report we present a patient with type 2 diabetes mellitus and acute limb ischemia in the left upper extremity that had successful thrombectomy treatment.
Case presentation: A 58-year-old female patient came to the Emergency Care Unit of Dr. Soetomo General Hospital with the continuous pain in the five fingers to the palm of the left hand for the past two days. The numbness spread from the elbow to the left fingers, making them weak and difficult to grip. Those five fingers were pale and cold as well. The left hand had no pulsated radialis and ulnar artery, weak brachial pulse and undetected pulse oximetry result. The patient was diagnosed with type 2 diabetes mellitus since 2005 and has a controlled treatment. On the first day of hospitalization, the patient was scheduled for emergency thrombectomy at Dr. Soetomo General Hospital. Follow-up on the seventh-day post-surgery, the patient had no complaints of pain and pale in the left hand and the brachial, ulnar and radial arteries were palpable.
Conclusion: Acute limb ischemia is uncommon in the upper extremities but we found that it has an excellent prognosis with early revascularization, even in a patient with diabetes mellitus. The treatment must be in conjunction with aggressive diabetes mellitus treatment to avoid acute limb ischemia worsening
Diagnostic challenges and management a patient with micropenis and pituitary microadenoma
Authors: Pridanta I Putu Surya , Ardiany Deasy
Published: December 2022

Background: Micropenis is a condition where the penis size is smaller than 2.5 standard deviation on average without any anatomical malformations. Hypogonadotropic hypogonadism is one of the causes of micropenis and one of the structural disorders that could lead to hypogonadotropic hypogonadism is a pituitary microadenoma that alters the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH) and testosterone. In this case-report we present a patient with micropenis caused by pituitary adenoma.
Case presentation: A 40-year-old male patient, presented to Dr Soetomo Hospital with a chief complaint of having a small penis that did not match the proportions of the body but could still erect and ejaculate. The patient experienced fatigue for about two months before the admission and struggled to concentrate while walking for the last six months. The laboratory results were hyperprolactinemia, hypo albumin, and dyslipidemia. From the MRI examination with contrast, a mass was found in the left pituitary. The patient was diagnosed with pituitary microadenoma, hypogonadotropic hypogonadism, micropenis, hypotestosterone, hypocortisolism, and hypothyroidism. The patient was assigned for monthly monitoring. Consultation with a neurosurgeon suggested there were no indications for surgery. The patient was treated with testosterone intramuscular injection 250 mg every month, methylprednisolone 4 mg every 8 h, simvastatin 20 mg every 24 h, and levothyroxine sodium 50 mg every 24 h. One month follow up, fatigue was disappeared and nine months follow up found improvements in hormone levels and balance during walking.
Conclusion: Pituitary microadenoma can manifest as micropenis, hypocortisolism, and shift hormone levels. The main therapy for pituitary microadenoma is hormone therapy as presented this present case report.
The pattern of osteocyte in dental socket bone regenerative induced by hydroxyapatite bovine tooth graft
Authors: Zubaidah Nanik , Kunarti Sri , Febrianti Nadira Nurin , Nurdianto Arif Rahman , Oktaria Wanda , Luthfi Muhammad
Published: December 2022

Background: Tooth extraction is a procedure with the highest prevalence of causing alveolar bone damage. After extraction, the dimension will change. This procedure needs a balance of bone formation and resorption. Osteocytes are the most common cells in bone and have an essential role in bone formation. This study explores the effect of bovine tooth grafts on the number of osteocytes in the socket preservation process post-dental extraction.
Methods: A total of 28 Wistar rats, 14 control and 14 treatment groups, were extracted on the lower left incisor. Control group with PEG without induction and treatment group with bovine tooth graft and PEG induction. On the 14th and 28th days, the rats were euthanized. Then perform histological examination with HE staining and cell counting using a light microscope
Results:  We found the treatment group had higher the average number of the osteocyte, which was 146.43±11.41 on 14th day and 288.14±161.91 on 28th day. There was a significant increase in osteocytes among the treatment group compared to the control (p=0.000).
Conclusion: Bovine tooth graft application as dental socket preservation was proven to increase the number of osteocyte cells in the alveolar bone of Wistar rats after extraction. Bovine tooth grafts as dental socket preservation materials increased the number of osteocytes at a peak at 28 days.
A success story of modified Sugiura technique surgery in a non-cirrhotic portal hypertension (NCPH)
Authors: Faredisto Aditya Satrio , Widodo Budi
Published: December 2022

Background: Non-cirrhotic portal hypertension refers to elevated portal vein pressure in the absence of liver cirrhosis. Surgery could be an effective procedure for patients with recurrent variceal bleeding who fail to respond to pharmacotherapy or endoscopic therapy. We report a success story of modified Sugiura technique in managing a patient with non-cirrhotic portal hypertension.
Case presentation: A male, 24-year-old, complained of recurrent vomiting of dark red blood color for six months. Anemic conjunctiva and splenomegaly were discovered during a physical examination. Pancytopenia and normal hepatobiliary function were revealed in the laboratory examination. Ultrasonography of the abdomen demonstrates nonspecific splenomegaly. An abdominal computerized tomography scan revealed hepatosplenomegaly and pelvic fluid accumulations. Grade IV esophageal varices and mild portal hypertensive gastropathy were observed during endoscopic examination. Active bleeding still presented despite initiation of medical treatment and endoscopic ligation. Finally, a surgical procedure using the Sugiura technique was performed. The patient was recovered, no recurrent symptom of hematemesis was reported after one year of follow-up.
Conclusion: Modified Sugiura technique is a useful treatment of choice in non-cirrhotic portal hypertension patients who failed to respond other medical treatments. However, comprehensive assessment is critical prior to choose this procedure.
Renal function features in pediatric acute lymphoblastic leukemia during high-dose methotrexate chemotherapy
Authors: Muslihatin Adkhiatul , Andarsini Mia Ratwita , Andi Cahyadi  , Risky Vitria Prasetyo  , I Dewa Gede Ugrasena  , Maria Christina Shanty Larasanti
Published: December 2022

Introduction: High-dose Methotrexate (HD-MTX), a chemotherapy agent for acute lymphoblastic leukemia, is a cytotoxic agent for some organs, including kidneys. One of the most important toxicities due to HD-MTX is acute kidney injury due to Methotrexate crystallization in renal tubules. The prevalence of Acute kidney injury due to HD-MTX administration in pediatric ALL in dr. Soetomo General Hospital was unknown. The study aims to analyze renal function features in pediatric ALL during HD-MTX chemotherapy.
Methods: An analytical observational study with a prospective approach was conducted at Dr. Soetomo General Hospital Surabaya from December 2021 - July 2022. The subjects were ALL children aged 1-18 years who met inclusion and exclusion criteria. High-dose Methotrexate chemotherapy was given 3 times every 2 weeks during the consolidation phase. Laboratory examinations were performed before and after HD-MTX chemotherapy. Laboratory results were recorded to determine the GFR value. The difference test was performed using Wilcoxon signed rank test and the Friedman test with a significance value of p<0.05.
Results: A total of 20 subjects, the median age was 78 months old, and boys and girls were equal. Standard Risk of ALL was in 55% of subjects, and 45% were at high risk. There was no significant difference in laboratory parameters between before and after HD-MTX chemotherapy in all cycles with a p-value >0.05. The median value of GFR in each cycle is 257.5; 243.5; 228.5. Minimal GFR was 119 ml/min/1.73 m2, and maximum GFR was 638 ml/min/1.73 m2. It showed a median value of GFR in all cycles was >175 ml/min/m2 (hyperfiltration).
Conclusions: We concluded there was no AKI due to HD-MTX chemotherapy in pediatric ALL. It may be caused by providing adequate hydration, urine alkalinization, and leucovorin rescue.
Diagnosis challenges of a patient with peritoneal tuberculosis masquerading as ovarian malignancy: a case report
Authors: Bimantoro Anggoro Satrio , Maimunah Ummi
Published: December 2022

Background: Peritoneal tuberculosis (PTB) could mimic advanced ovarian cancer cases, making its diagnosis challenging. Comprehensive and conscientious examinations for diagnosis are needed to differentiate such cases to avoid inappropriate treatment. We report a problematic diagnosis of PTB that mimic ovarian malignancy.
Case Presentation: A 20-year-old female patient with history of multiple rehospitalizations, presented with complaints of abdominal pain, nausea/vomiting, low-grade fever, and weight loss in the last five months. In the first admission, patient was suspected with malignant ovarian cyst due to clinical features of malignancy with normal chest X-ray, abdominal USG suggested ovarian cyst in both ovaries, high levels of Ca125. However abdominal CT-scan showed thickening in peritoneum which suggested PTB. The patient was planned for urgent laparotomy while waiting for GenExpert result. On the second admission, patient presented with recurrent abdominal pain, GenExpert sputum and stool showed negative result, and planned for surgery but the patient refused. On the last admission, patient diagnosed with impending bowel obstruction and underwent abdominal CT-scan with contrast showed diffuse multiloculated cystic lesion in cavum pelvic and multiple prominent mesenteric lymph nodes that suggested abdominal TB with abscess in cavum pelvic. Exploratory laparotomy revealed conglomeration, pus and tubercles in the peritoneum. A TB was confirmed based on pathology and microbiology examination from tissue biopsy and pus.
Conclusion: We reported patients with PTB with unspecific clinical symptoms which suspected as ovarian malignancy. This study highlights the challenges in diagnosing PTB and therefore PTB could be considered a differential diagnosis in patients suspected of ovarian malignancy in the TB endemic countries.
Sarcopenia as an indicator of nutritional status and outcome predictor for colorectal cancer in Javanese ethnic
Authors: Hipolitus Damianus , Handaya Adeodatus Yuda , Barmawi Agus
Published: December 2022

Background: Sarcopenia is a negative predictor of colorectal cancer outcomes, while colorectal cancer is at risk of developing malnutrition due to the disease process. This study aims to determine the relationship between sarcopenia and nutritional status and analyze the effect of sarcopenia on the outcome of rectal cancer patients.
Method: A cross-sectional study was conducted on colorectal cancer patients of Javanese ethnicity who performed preoperative abdominal CT scans at dr. Sardjito Hospital in Yogyakarta between June and December 2019. Sarcopenia is based on measuring muscle mass index at the third lumbar vertebra level <36.0 cm2/m2 for men and < 29.0 cm2/m2 for women. Statistical analyzes using SPSS version 20 for Windows were performed to find out the correlation.
Results: Of 46 patients, 56.5% were male and 43.5% female, with a mean age of 53.57. Sarcopenia was found in 47.8% of patients, mostly in women than men (63.6% vs. 36.4% p=0.019). Underweight was mostly found in the sarcopenia group compared to non-sarcopenia (59.1% vs. 20.8% p=0.019). The sarcopenia group has longer LOS than non-sarcopenia (14.73±13.474 vs. 12.29 ±4.165; p=0.404). The mortality of the sarcopenia group was 1.56 times higher compared to the non-sarcopenia (57.1% vs. 42.9%; OR=1.56; 95%CI=0.307-7.890; p=0.964). Haemoglobin, albumin, total protein, CEA, histopathology, tumor location and procedure were not significantly correlated to sarcopenia.
Conclusion: Underweight nutritional status and females are correlated with sarcopenia. Sarcopenia tends to be treated longer and has higher mortality than non-sarcopenia.
Role of myostatin protein in sarcopenia (aging muscle) after conditioned medium umbilical cord mesenchymal stem cells (secretome) therapy: mini review
Authors: Ronald Winardi Kartika  , Veronika Maria Sidharta  , Djuartina Tena , Rika Ignatio , Cynthia Retna Sartika  , Kris Herawan Timotius
Published: December 2022

Umbilical Cord Mesenchyme stem cell (UC-MSCs) /secretome has been applied for treating several diseases, such as cardio-protection and diabetes. Secretome-derived paracrine modulating effects of various growth factors, cytokines, chemokines, angiogenic factors, and exosomes are used in aging therapy. In recent clinical trials on sarcopenia therapy such as pharmaceutical interventions, nutrition, and physical exercise are reported to be effective strategies to reduce sarcopenia.
The pathomechanism of the secretome in the treatment of sarcopenia is unclear. This study looked into how secretome might affect myostatin, a biomarker of sarcopenia, at the molecular level. Myostatin, a member of the TGF-family, significantly increases muscle growth when it is absent while suppressing muscle growth when it is present. A bioactive substance called secretome is secreted by MSCs in conditioned conditions. It is rich in growth factors and cytokines, which are crucial for speeding up tissue regeneration. Secretome intervention is a promising approach for treating sarcopenia as showed by its ability to prevent muscle loss and to improve molecular biomarkers.
Potential diagnostic biomarkers for early detection of idiopathic sensorineural hearing loss in type 2 diabetes mellitus patients
Authors: Santosa Agus , Suastika Ketut , Saraswasti Made Ratna , Suardana Wayan , Sujaya I Nengah
Published: December 2022

Background: Sensorineural hearing loss (SNHL) is a hearing loss that accounts for almost 90% of all hearing loss. Various factors can cause this disorder, one of which is diabetes mellitus (DM). However, few studies still discuss biomarkers to detect the incidence of SNHL in patients with DM as early as possible. The purpose of this paper is to determine the potential of biomarkers to detect SNHL in type 2 diabetes mellitus (T2DM) patients.
Methods: The author uses a database in the form of PubMed, Cochrane, and ScienceDirect used to search for articles using the Boolean operator "AND" or "OR" using the keywords "hearing loss," "diabetes," "biomarkers," "Prestin," "lipid profile," and "Nox2". A total of 276 studies were obtained, followed by the title and abstract screening and feasibility assessment (eligibility) to get inclusion studies included in the qualitative analysis (systematic study).
Result: A total of 10 inclusion studies consisted of 2 cross-sectional studies, 2 case controls, and six preclinical studies with 105 and 101 patients in the cross-sectional and case-control studies, respectively. A total of 5, 3, and 2 studies reported associations between hearing loss and Prestin, Nox2, and lipid profile values, respectively.
Conclusion: The biomarkers such as Prestin, Nox2 and lipid profile have a role in the early diagnosis of SNHL, but no related studies discuss T2DM. Therefore, basic and clinical studies are still needed to determine its effectiveness.
MAKROFAG PENGEKSPRESI IL-1? SERTA RESPONS INFLAMASI SISTEMIK PADA FIKSASI INTERNA DINI FRAKTUR FEMUR TERTUTUP LEBIH RENDAH DIBANDINGKAN DENGAN YANG TERTUNDA
Authors: Astawa P. , Bakta M. , K. Budha
Published: December 2022

Fiksasi interna merupakan salah satu modalitas terapi dalam penangananfraktur. Fiksasi interna dini dan tertunda masih menjadi suatu perdebatan karenaadanya perbedaan komplikasi yang ditimbulkan, terutama yang berhubungandengan respons inflamasi sistemik. Tujuan penelitian ini adalah untuk mengetahuiperbedaan makrofag pengekspresi IL-1? (dengan pengecatan imuno histokimia)antara saat tindakan fiksasi interna dini dan tertunda serta untuk mengetahuiperbedaan respons inflamasi sistemik ( IL-6 sebagai marker) pascafiksasi internadini dan tertunda pada fraktur femur tertutup.Penelitian ini merupakan penelitian quasi eksperimental " post test onlycontrol group design". Penelitian ini dilakukan di Bagian Bedah RSUP SanglahDenpasar dengan besar sampel dihitung dengan rumus Pocock. Kemudiandilakukan uji normalitas K-S, t test, t-paired test dan uji korelasi.Dari penelitian ini diperoleh hasil bahwa (1) terdapat perbedaan bermaknaantara makrofag pengekspresi IL-1? pada saat perlakuan (hari I) dan makrofag saatkontrol (hari III-V) (2.37Â±2.98 % vs 4.99Â±4.89 %, p<0.05) dan (2) terdapatperbedaan yang bermakna kadar IL-6 serum sesudah fiksasi interna antarakelompok fiksasi interna dini dan tertunda (51,17Â± 23,19 pg/ml vs 95,39Â± 80pg/ml, p<0.05).Dari penelitian ini dapat dibuat suatu kesimpulan, yaitu (1) reaksi inflamasisekitar lokasi fraktur lebih rendah pada fiksasi interna dini daripada pada fiksasiinterna tertunda dan (2) kadar IL-6 pasca fiksasi interna dini lebih rendah daripada yang tertunda, dan kadar IL-6 serum sebelum fiksasi interna dapat dipakaisebagai prediktor kadar IL-6 pascafiksasi interna.