bluuebunny/crossref_metadata_2025 huggingface dataset:
Sleeve gastrectomy and pancreas omentoplasty improved Î² cell insulin expression and interleukin-1Î² serum level in non-obese diabetes mellitus rat
Authors: Dimas Erlangga , Mughni Abdul , Wiryawan Chemy , Mahendra Vito , Riwanto Ignatius
Published: February 2022

Background: Diabetes mellitus is one of the health problems that is growing rapidly today. In Asia, majority of the population are non-obese with Type 2 Diabetes Mellitus (T2DM). Two main defects of T2DM, insulin resistance and impaired insulin secretion due to reduced pancreatic Î² cells. Persistent metabolic stress due to hyperglycemic conditions, causes inflammation of the islets of Langerhans. Interleukin-1Î² (IL-1Î²) signaling is the most frequent pathway inducing Î² cell dysfunction. The bariatric Sleeve Gastrectomy (SG) procedure increases particular hormone which stimulates Î² cell growth and pancreatic insulin production. Aside from the role as a blood glucose regulator, insulin also plays a role in anti-inflammatory modulation. Omentoplasty can be used to wrap organ or tissue structures. The Omentum has unique biological functions, including promote tissue regeneration and anti-inflammatory effect. The study evaluates the effect of Sleeve Gastrectomy and pancreas Omentoplasty procedures on Î² cell insulin expression and Interleukin-1Î² (IL-1Î²) serum levels in non-obese diabetes mellitus subjects.Methods: Experimental study with "post-test control group design" on 27 rats with Diabetes Mellitus was divided into 3 groups: K (control), P1 (Sleeve Gastrectomy), P2 (Sleeve Gastrectomy + Omentoplasty). 10 days after procedure, we evaluated the insulin expression of Î² cells using monoclonal antibody anti-insulin stain and IL-1Î² serum levels using rat IL-1Î² Enzyme-Linked Immunosorbent Assay (ELISA) kit. Statistical analysis with Kruskal Wallis and Mann Whitney test. Correlation test with Spearman.Results: Î² cell insulin expression increased in P2 (p=0.020), compared to control. While the IL-1Î² serum levels reduced significantly in all groups (p<0.001) compared to control. Moderate negative correlation (r = -0.476) between Î² cell insulin expression and IL-1Î² serum levels.Conclusion: Sleeve gastrectomy and omentoplasty increased Î² cell insulin expression and decreased IL-1 Î² serum levels in non-obese rats with diabetes mellitus.
Keloid after orthopedic surgery: prevention, current therapy modalities, and emerging therapies modalities
Authors: Sutheno Andrew
Published: February 2022

Keloid is a benign fibroproliferative tissue growth that exceeds the initial wound margins. It is caused by the disruption in the wound healing phase with increased fibroblast activity and excess collagen deposition. Keloid usually develops after tissue trauma. Orthopedic surgery inevitably causes tissue trauma that will lead to the formation of keloids in a few patients. Keloids can cause cosmetic and functional problems, thus interfere with a person's quality of life. Keloid therapy modalities are mainly divided into three, which are prophylactic therapy modalities, current therapy modalities, and emerging therapy modalities that are being developed. This literature review aims to evaluate further prevention, current therapy modalities, and emerging therapies modalities in Keloid following orthopedic surgery.
Pulsatile pseudoaneurysm: a delayed diagnosed with a risk of limb ischemic in toddler: a case report
Authors: Habibie Yopie Afriandi , Anggraini Vera
Published: February 2022

Background: Pseudoaneurysm is a vascular injury complication in lower extremity thatâ€™s rarely been reported, especially in toddlers. Should it not appropriately treated, it can lead to worst conditions and even limb ischemic.Case description:Â  a 3-year-old toddler, presented in the emergency room (ER) of Dr. Zainoel Abidin General Hospital (RSUZA) with bleed wound in the left limb persistent active bleeding. The shattered glass hit the patient On the physical examination, we found bleeding wound on the medial malleolus region of left limb, a pulsatile mass on the palpation, history of active bleeding was positive. To confirm the diagnosis, we performed CT angiography showing a sac shaped vascular lesion measuring 2.8 x 2.2 x 2.8 cm of proximal segment of the left posterior tibial artery, suggesting a pseudoaneurysm. We performed open surgery with excision procedure and a clot was found in medial malleolus region. As a result of open surgery, the left medial malleolus region is red, indicating a good blood flow and the patient discharged from hospital 4 days after surgery with a good result.Conclusion: Pseudoaneurysm resulting from vascular injuryÂ  or iatrogenic injury can lead on various serious complications. If pseudoaneurysm is not appropriately treated, it can even threaten the patientâ€™s life.Â
Post-traumatic renal artery thrombosis secondary to blunt abdominal trauma: a rare case report
Authors: Nugraha Harry Galuh , Aristiady Eppy Buchori , Hilman Hilman , Dewi Dian Komala , Santiana Leni , Arum Puspita
Published: February 2022

Background: Blunt abdominal trauma is one of the leading causes of morbidity and mortality among populations worldwide. However, renal artery injury due to blunt abdominal trauma is a rare occurrence. In this case, a patient who suffered multiple trauma was found in the emergency department, including blunt abdominal trauma, after a motor vehicle accident.Case report: A 13-year-old boy with multiple trauma was referred to our emergency department, with the primary consideration being to lose consciousness 3 hours before admission due to a traffic accident. After receiving examination, there was no evidence of abdominal bruising, whereas the results of the head CT scan show epidural hemorrhage. After four days of treatment, the urea and creatinine serum levels increased, abdominal CT scan shows right renal infarction suggestive of right renal arterial rupture. The patient was diagnosed with a moderate head injury and right renal trauma AAST grade IV. The patient was referred to the interventional radiology unit. The endovascular revascularization techniques were performed with renal artery stent placement and vasodilator (nitroglycerin) flush into the renal artery before stent placement. Renal artery stenting placement performed on main right renal artery demonstrates the absence of intraluminal defects and substantially blood flow was established, abdomen CT Scan shows an enhancement on right renal parenchyma which mean right kidney vascularization appears to be improved with the return of glomerular filtration rate to normal value at the time the patient was discharged.Conclusion: Traumatic renal artery thrombosis is a rare occurrence with devastating consequences if any imaging is missed. Endovascular therapy plays a significant role in the treatment of renal artery thrombosis with a better prognosis.
The correlation between demographic factors and urolithiasis composition in a tertiary hospital
Authors: Ismy Jufriady , Pratama Mochammad Ecky , Dahril Dahril , Ridha Muhammad , Mauny Muhammad Puteh
Published: February 2022

Introduction: Urolithiasis is the formation of biomineral stones in the urinary tract, kidneys, and bladder. The formation of stones (uroliths) is still a multifactorial and complex phenomenon that has not been clearly understood; this cannot be attributed to a multifactorial leading to increased excretion of stone-forming components. Renal stones' etiology is still not well understood. Some studies stated that demographics in the population have a strong correlation as a risk factor for urolithiasis. This study was aimed to know the correlation between demographic factors in society and urolithiasis composition in the Aceh population between the year 2018 to 2020.Methods: This study included 52 patients diagnosed clinically and radiographically with their first episode of urolithiasis at Dr. Zainoel Abidin General Hospital, Aceh, Indonesia, from 2018 to 2020. All samples were first characterized using Fourier Transform Infrared spectroscopy (FTIR) to obtain the mineralogical compositions.Results: Obtained 52 patients diagnosed with urolithiasis were aged 3-67 years, with most patients (27 patients; 51,92%) were aged 45-64 years old. The mean age of the subjects of this study is 45,52 + 13,90. Of the 52 patients included in this study, 37 patients (71,15%) were male, and 15 patients (28,85%) were female. Of 52 patients, 22 (42,31%) presented with one stone only. Of 52 patients, most of the uroliths consisted of Calcium oxalate monohydrate (Whewellite), which is presented in 27 (51,92%) patients, followed by uric acid (Uricite) in 19 (36,54%) patients.Conclusion: most of the urolithiasis patients were aged 45-64 years. The ratio of male to female patients was found to be 2:1. Most of the patients presented with one stone only. Most of the uroliths consisted of Calcium oxalate monohydrate (Whewellite) as the main composition, followed by uric acid (Uricite).
A rare case of microcystic and macrocytic lymphangioma in 12-year-old girl
Authors: Lestari Wahyu , Hajar Sitti
Published: February 2022

Introduction: Lymphangioma is an idiopathic digression in the lymphatic vessels morphogenesis. It is a lymphatic malformation that involves the lymphatic vessels of the superficial dermis. The lesions were observed since birth for 50% of the cases. Lymphangioma is typically rare of the lymphatic vessels disorder. This case report aims to explain lymphangioma, which is typically rare of the lymphatic vessels disorder.  Case report: Our study reported a chief complaint in a 12-year-old girl was painless multiple small blisters on the left thigh and the left inguinal in the past 11 years. Physical examination revealed the groups of lobulated mass consist of erythematous papules, cysts, skin-colored and purplish papules, purplish macule, tense vesicles & reddish-brown crusts. The blisters were not itchy, followed by the slight swelling under the lesion of the left groin. They were skin-colored papules on the abdomen. It was also found that there was a hypertrophic scar on the upper side of the posteromedial side of the left thigh. Histopathology examination showed hyperkeratosis where the keratinocytes proliferation in the areas lined with endothelium. Eosinophilic amorphic mass found inside the lumen. There were hair follicles, sudoriferous glands and sebaceous glands. The proposed diagnosis was lymphangioma (combined microcystic and macrocystis lymphatic malformation) on the abdomen and soft tissue tumor on the left thigh and the buttock. The treatments were carbon dioxide (CO2) laser for lymphangioma and surgical excision for soft tissue tumor.Conclusion: Lymphangioma is a rare lymphatic vessel disorder that manifests on the superficial dermis. It is commonly found in children. This disease can be treated by CO2 laser.
The correlation of neutrophil-to-lymphocyte ratio (NLR) and monocytes-to-lymphocytes ratio (MLR) with disease severity in hospitalized patients with Coronavirus disease 2019 (COVID-19)
Authors: Suhartono Suhartono , Wijaya Indra , Dalimoenthe Nadjwa Zamalek
Published: February 2022

Background: Early intervention of cases with potential progression to severe disease is essential to improve survival probability in Coronavirus disease 2019 (COVID-19). Systemic inflammation plays an essential role in the process of disease aggravation. This study aimed to assess the correlation of systemic inflammatory response related biomarkers neutrophil-lymphocyte ratio (NLR) and monocyte-lymphocyte ratio (MLR) on time to admission with the disease severity of inpatients with COVID-19.Methods: We performed a retrospective study using secondary data from medical records of inpatients with COVID-19 at Murni Teguh Memorial Hospital, Medan, Indonesia, from June 1 to September 30, 2020. The demographic data were collected from the medical record and the hematologic parameter from the laboratory. NLR and MLR were calculated by dividing the absolute neutrophils and monocytes counts by the absolute lymphocyte counts. The data were tabulated and analyzed by univariate and bivariate analysis with a significance level of p<0.05.Results: Study subjects consisted of 55 non-severe cases and 40 severe cases. The median NLR and MLR of severe and non-severe groups were 7.65 vs 2.92 (p<0.001) and 0.46 vs 0.25 (p=0.013). The correlation coefficients of NLR and MLR with disease severity were 0.564 (p<0.001) and 0.257 (p=0.012). The AUC of ROC analysis was 0.830 (cut-off:>4.81;p<0.001) in NLR and 0.650 (cut-off:>0.31; p=0.013) in MLR to predict the severe disease.Conclusion: NLR and MLR had a significant positive correlation with the disease severity. NLR is better than MLR in predicting severe disease in hospitalized patients with COVID-19.
Lung metastasis of gynecologic cancers
Authors: Tjokroprawiro Brahmana Askandar
Published: February 2022

The lung is a distant metastatic site of gynecologic cancers. These metastases have clinical characteristics which can be solitary, multiple, solid, or manifest by pleural effusion. Diagnosing and managing lung metastasis is challenging because each type of gynecological cancer has different clinical characteristics. Some gynecologic cancers have tumor markers that can help diagnose lung metastasis; however, others do not have them. The options for managing lung metastasis in gynecologic cancer include; chemotherapy, surgery, or combination therapy. The clinical aspects of lung metastasis from cervical, endometrial, ovarian, vaginal, and vulvar cancers and gestational trophoblastic neoplasia were discussed in this article.
Hippocampal atrophy and levels of posterior cingulate cortex (PCC) metabolites in Alzheimer's disease, vascular dementia and normal cognitive
Authors: Ferriastuti Widiana , Notopuro Harianto , Sensusiati Anggraini Dwi , Sugiarto Paulus
Published: February 2022

Introduction: Dementia defined as an acquired condition marked by multiple cognitive impairments. The most prevalent type is Alzheimer's disease, followed by vascular dementia. Studies have examined hippocampal atrophy and its relationship to aging and dementia. This study aimed to calculate the amount of hippocampal volume loss associated with dementia, also a,nxto examine the possible role of proton magnetic resonance spectroscopy (1H-MRS) in common type of dementia.Methods: This study compared hippocampal volume measures and metabolites level in posterior cingulate cortex (PCC) between Alzheimer's disease patients, vascular dementia patients, and controls using volumetric-based MR and 1H-MR spectroscopy. Metabolite levels were calculated from the peak integral value of the metabolite N-Acetyl Aspartate (NAA) (2 ppm), Myo-inositol (MI) (3.5 ppm), Cholin (Cho) (3.2 ppm), and Creatin (Cr) (3 ppm), then a comparison was made to the levels of brain metabolites in the form of: NAA / Cr, Cho / Cr, and MI / Cr.Results: Between Alzheimer's disease and control, a significant difference was observed in the total volume of the hippocampus of 20.45 % (p = 0.004). The comparison of brain metabolite levels in PCC patients with Alzheimer's disease, vascular dementia, and control subjects revealed no statistically significant differences in the levels of Cholin, Creatine, NAA, MyoInositol, Cho / Cr, NAA / Cr, and mI/ Cr for any of the metabolites.Conclusion: There was a significant difference in the mean total size of the hippocampus between patients with Alzheimer's disease and controls, but not in the PCC metabolites measured by MR spectroscopy.
Growth factors of hypoxia Freeze-Dried Adipose Stem Cell- Conditioned Medium (FD ASC-CM) and Fresh Adipose Stem Cell Conditioned-Medium (FR ASC-CM): a comparative study
Authors: Putri Winawati Eka , Endaryanto Anang , Tinduh Damayanti , Rantam Fedik , Alinda Medhi Denisa , Prakoeswa Cita Rosita Sigit
Published: February 2022

Background: Adipose Stem Cells (ASC) are multipotent stem cells which mechanism of action is mainly secretion of various paracrine molecules known as secretome or conditioned medium (CM). Adipose Stem Cell-Conditioned Medium (ASC-CM) collects several soluble factors, such as cytokines, chemokines, and Growth Factors (GF) secreted by almost all types of living cells in the extracellular space. The freeze-dried (FD) form of ASC-CM can reduce the instability of the fresh (FR) form of ASC-CM. This study aims to compare the GF levels between FD ASC-CM and FR ASC-CM as a comparative study.Methods: ASC-CM was prepared from human adipose tissue. After we got the FR ASC-CM, some of them were changed into an FD form. We measured the several GF levels using ELISA methods in ng/L. Data were presented in mean and standard deviation as well as analyzed using SPSS version 25 for Windows.Results: The average levels of EGF in both FD ASC-CM and FR ASC-CM were 256.80±9.70 ng/L and 290.20±53.20 ng/L, followed by TGF-? (564.20±12.70 ng/L and 633.10±11.40 ng/L), PDGF (2.90±0.19 ng/L and 2.90±0.20 ng/L), and VEGF (711.10±21.70 ng/L and 788.70±204.80 ng/L) respectively. There was a statistically significant difference in TGF-? levels between FD ASC-CM and FR ASC-CM (p=0.002). However, there was no a significant difference in EGF, PDGF, and VEGF levels between FD ASC-CM and FR ASC-CM (p>0.05)Conclusion: There was a statistically significant difference between FD and FR ASC-CM only in TGF-? levels.
Fractional erbium laser in vaginal laxity
Authors: Setyaningrum Trisniartami , Tjokroprawiro Brahmana Askandar , Listiawan M Yulianto , Santoso Budi , Prakoeswa Cita Rosita Sigit
Published: February 2022

Vaginal laxity is a condition that often occurs in women, especially after vaginal delivery, and its prevalence increases with age. This review aimed to explain the role of fractional Erbium laser as a new modality for vaginal laxity management. The typical symptom reported by patients was reduced vaginal sensation. One therapeutic option for vaginal laxity is fractional Erbium laser: yttrium aluminum garnet (Er: YAG) at 2,940 nm frequencies. The laser's thermal stimulation of the dermis appears to stimulate the formation of new collagen, resulting in the thickening of the vaginal mucosa. Previous studies on Er: YAG fractional lasers have shown satisfactory results with minimal side effects.
A new innovation in topical diabetic foot ulcer; hyaluronic acid platelet-rich fibrin (HAPRF) gel - a study in inflammation and angiogenesis
Authors: Kartika Ronald W. , Alwi Idrus , Yunir Em , Waspadji Sarwono , Bardosono Saptawati , Immanuel Suzzana , Silalahi Todung , Sungkar Saleha , Rachmat Jusuf , Suyatna Franciscus D. , Reksodiputro Mirta Hediyati
Published: February 2022

Background: Indonesia ranks 6th out of ten countries with the highest number of diabetes patients. An increase followed this condition in the prevalence of diabetic foot ulcers by around 15%. This study demonstrated the ability of combination of Platelet Rich Fibrin (PRF) and Hyaluronic Acid (HA) to reduce inflammation in diabetic foot ulcer (DFU) healing.Methods: In the baseline, all patients received the same treatment including wound debridement. There were 20 subjects divided into two groups; HAPRF and  PRF. A part of sample was processed into lysate and stored in -80oC. The rest is applied as a topical therapy in DFU base on intervention. We analyzed the inflammation using two methods; swab in DFU and fibrin gel of HAPRF or PRF and ELISA on day-3 and day-7. We also measure the granulation index by digital photograph and analyze use ImageJ at the same time.Result: There were 20 diabetic patients with DFUs, performed analysis of  IL-6  lysate gel HAPRF decrease  significantly compare with PRF on day 3 (p= 0.038) and day-7 (p = 0.034). Granulation index evaluation, in HAPRF increase on day-3 (p = 0.043), day-7 (p = 0.049), and day-14 (p = 0.041).Conclusion: A-PRF +HA  administration leads to reduce  IL-6 levels, and accelerated wound healing of DFUs patients. HAPRF  directly aids epithelialization and granulation index.
The Association between Medical History-based Risks and Sepsis Events in Immunocompromised Patients according to Type III Stratification of the Indonesian Regulation on the Prospective Antimicrobial System (Regulasi Antimikroba Sistem Prospektif / RASPRO)
Authors: Natadidjaja Ronald Irwanto , Kusuma Armi Setia , Sudradjad Gede Bangun , Nugrohowati Lies
Published: February 2022

Background: The Indonesian Regulation on the Prospective Antimicrobial System (Regulasi Antimikroba Sistem Prospektif / RASPRO) is a novel program. Its role has been reinforced by the Indonesian Ministry of Law and Human Rights Stipulation, which may predict the risk of sepsis events. Our study aimed to evaluate whether the risk factors listed in the RASPRO consensus have actual effects on sepsis events.Method: The study was a retrospective cohort using secondary data with 98 subjects. The subjects were categorized into two groups, i.e., the RASPRO group with type III stratification (RASPRO Group) and Non-type III stratification RASPRO group (Non-RASPRO Group). Subjects with infection but with conditions other than the abovementioned criteria were categorized into the Non-RASPRO group.Results: We found that among subjects in the RASPRO group, a history of antibiotic use over the past <30 days (OR 3.42; 95%CI 1.32–8.85; p=0.011) and a history of having procedure using medical instruments within the last <30 days (OR 2.62; 95%CI 1.06–6.45; p=0.037) seemed to be greatest risk factors for sepsis events.Conclusion: The RASPRO group has a higher risk for sepsis events than the non-RASPRO with a history of antibiotic undergoing a procedure using a medical instrument within the last <30 days possessed the greatest risk factors for sepsis events.
Expression of Growth Associated Protein-43 (GAP-43) and Brain-derived Neurotrophic Factor (BDNF) from Adipose Mesenchymal Stem Cells (ASC) with fresh frozen nerve scaffold in 5% hypoxic condition
Authors: Pradana I Putu Gede Pradnyadewa , Fauzi Asra Al , Suroto Heri
Published: February 2022

Background: Peripheral nerve injury is one of the most common musculoskeletal injuries, and the healing is prolonged and affects the patient's quality of life. Secretomes derived from Adipose Stem Cells (ASC) is widely researched in tissue engineering. Various studies currently focus on observing potential scaffolds in nerve regeneration. This study aims to analyze the expression of Growth Associated Protein-43 (GAP-43) and Brain-derived Neurotrophic Factor (BDNF) produced by ASC culture with fresh frozen nerve scaffold under 5% hypoxic conditions in vitro.Methods: An in vitro experimental laboratory research using the randomized control group post-test only design was conducted at the Dr. Soetomo Hospital Tissue Bank, Surabaya, East Java, Indonesia. Isolated mesenchymal stem cells from fat tissue were characterized using CD-105. If more than 90% of the MSCs membrane surface binds to the CD-105 marker is indicated positive. Hypoxic conditions were applied to culture stem cells with oxygen levels of 5% and several days of cultivation time until they reached passage four and passage eight. ELISA-test for GAP-43 and BDNF was carried out using secretomes obtained from ASC culture with fresh frozen nerve scaffold in normoxic (21%) and hypoxic (5%) conditions. The analysis was performed on the 2nd to 4th day and 6th day of culture using IBM® SPSS® program version 23 for Windows.Results: In this study, there was a significant difference in BDNF expression in the group given fresh frozen nerve scaffold (p=0.040) but no significant difference in the expression of GAP-43 in the group given fresh frozen nerve scaffold (p=0.214) in normoxic conditions.Conclusion: The 5% hypoxic medium did not provide a significant difference in the expression of GAP-43 and BDNF.
Assessment and Detection of male Reproductive Outcome (ANDRO) model as a concept for improving the contribution of general practitioners in Indonesia for male infertility management
Authors: Rizal Dicky Moch
Published: February 2022

Specialist distribution in Indonesia was not equally between urban and rural areas. In this condition, the role of general practitioners is critical as a front guard for handling patients with infertility problems, especially male infertility, before making a referral to an andrologist. There has been no guidance for general practitioners in Indonesia to contribute to managing male infertility until now. We identify male infertility problems and the level of competence of general practitioners in providing interventions based on “Standar Kompetensi Dokter Indonesia (SKDI)” or Standard of Competencies Indonesian Doctors. Furthermore, a guideline, namely the Assessment and Detection of male Reproductive Outcome (ANDRO) model, is made by conducting a literature review based on male infertility problems and the level of competency that have been identified before. ANDRO model is consists of major and minor aspects of male infertility make a star form. The significant elements including the risk of a reproductive problem, sexual dysfunction, abnormal sperm, presence of testicular mass, and small testicular volume. While the minor aspects including physical activity, body mass index management, metabolic problem management, lifestyle modification, and stress management. ANDRO model offers the opportunity for general practitioners to contribute to a couple who wants to have a baby by treating or improving factors related to male infertility.
Factors affecting the occurrence of covid-19 transmission on health workers: a literature review
Authors: Arofiati Fitri , Muntu Untu Feiby F
Published: February 2022

Introduction: The COVID-19 pandemic has a serious impact on health care workers both physically and psychologically since they become more susceptible to COVID-19 infection due to frequent exposure to individuals infected by COVID-19, work pressure, inadequate conditions of protective equipment, and the accuracy of decision making. This study aims to identify factors affecting the spread of COVID-19 in hospitals.Methods: The study used the literature review method, with article searches on five databases, namely PubMed, EBSCOhost, MEDLINE, ProQuest, and google scholar. The searching process for articles used keywords, including related word synonyms and MESH. The number of the research articles identified included PubMed, EBSCOhost, MEDLINE, ProQuest and google scholar, with 1302. The next step was to use prism chart analysis and select 15 journals that met the inclusion and predefined exclusion criteria.Results: The research analysis results showed that the health workers who were most affected by the COVID-19 transmission were the nursing profession. Factors that influenced the message of COVID-19 in hospitals included internal factors, such as comorbidities, work experience, education and training, stress, hand hygiene, and external factors: hospital environmental design, reduction of personal protective equipment, culture and ethnicity, government policies.Conclusion: The COVID-19 pandemic that has not ended requires changes in the design of care facilities, culture, the behavior of health workers, government policies that can break the chain of transmission of COVID-19 to health workers in hospitals.
Mapping the prevalence of dengue fever in sragen regency Indonesia
Authors: Sudaryanto Agus , Ainnurriza Ulfiana Savira , Supratman Supratman , Dewi Shinta Kurnia
Published: February 2022

Introduction: Dengue fever is a disease that is transmitted by vectors. The intermediary vector for dengue fever transmission is the Aedes Aegepty mosquito. Dengue fever cases occur in almost all districts in Indonesia, including the Sragen regency. From 2016 to 2019, the incidence of dengue fever was higher than the previous year. This unusual condition needs to be further monitored and studied. This study's purpose was to map the prevalence of dengue fever in the Sragen regency.Methods: A retrospective research design was performed using secondary data provided by the regency health office and the Central Bureau of statistics from the government of Sragen regency. A free and open-source software, namely Quantum Geographic Information System (QGIS), was utilized to produce maps and spatial figures. The results of this study are presented by map and prevalence.Results: The incidence of dengue fever in the Sragen regency in 2017-2019 fluctuated between 15.83 per 100,000 population and 33.54 per 100,000 population. The dengue fever case in Gemolong district is the highest in 2018 and 2019.Conclusion: The conclusion for this research is mapping the dengue fever prevalence helping to figure up the spatial pattern of the disease in Sragen regency.
Exclusive breastfeeding behavior of adolescent mothers: A qualitative study
Authors: Yulyani Linda , Makiyah Sri Nabawiyati Nurul , Sulistyaningsih Sulistyaningsih
Published: February 2022

Introduction: The overall rate of exclusive breastfeeding for infants under six months of age is only 41%. Many factors are known to contribute to unsuccessful exclusive breastfeeding, including maternal age. Adolescent mothers are associated with the incidence of early marriage. Currently, there has been an estimated number of early marriages of around 650 million in the world. This study aimed to explore the exclusive breastfeeding behavior of early marriage mothers. Methods: This is a qualitative study with a phenomenological approach. The data were collected through one-to-one interviews with seven adolescent mothers with babies aged 6-9 months as the research participants. Interviews were recorded, transcribed, translated and thematically analyzed using NVivo 12 trial version software. Results: This study found that the breastfeeding behavior of adolescent mothers can be grouped into 5 themes: perspectives and attitudes about exclusive breastfeeding, initial response of breastfeeding, knowledge of exclusive breastfeeding, challenges and difficulties in breastfeeding and the strategies to deal with these challenges, failure of exclusive breastfeeding. The results of this study also showed that of the seven participants, only one adolescent mother succeeded in her exclusive breastfeeding. Conclusions: Most of adolescent mothers with an early marriage who participated in this study had an unsuccessful exclusive breastfeeding of their babies. Therefore, it is necessary to have a comprehensive and sustainable education and counseling program on exclusive breastfeeding for adolescent mothers of early marriages by also considering the family involvement, particularly the husband and parents of these adolescent mothers.
The effect of using booklets on patients’ self-efficacy knowledge and interdialytic weight gain
Authors: Isnaini Nur , Styandini Dwi Agus , Ratnasari Dewi
Published: February 2022

Introduction: The inability of patients with chronic renal failure to follow a diet is influenced by low self-efficacy. (Inter Dialytic Weight Gain) IDWG is used as a common measure of patient compliance, as it shows fluid retention that occurs between two hemodialysis sessions. This study aims to analyze the effect of providing education using a booklet on self-efficacy, and level of knowledge, and IDWG in hemodialysis patients.Methods: The research design was a pre-experimental design, with a group comparison design approach. The use of samples using accidental sampling. A sample of 48 respondents was divided into two groups: 25 and 23 respondents in the intervention and control groups respectively. The intervention group was given education using lecture and booklet methods for 45 minutes. The Control group was given education using the lecture method only.  IDWG was measured by observing weight between hemodialysis sessions. The measurements of self-efficacy and level of knowledge were undertaken by employing a questionnaire. Wilcoxon test was used to determine the difference between the pre and post mean of the intervention group and the control group. Mann Whitney statistical test was used to determine the mean difference in the intervention and control groups on the variables of self-efficacy, level of knowledge, and IDWG.Results: Intervention group increased self-efficacy (p <0.05), increased knowledge (p <0.05) and decreased IDWG (p <0.05). Control group increase self-efficacy (p <0.05), increase knowledge (p <0.05), but not the value IDWG (p> 0.05).Conclusion: Education using booklets helps patients in increasing self-confidence, knowledge of CKD patient care including controlling fluid overload.
The correlation between sebum levels and pityriasis versicolor
Authors: Mustika Arzia , Kusuma Meidina , Nasution Lukmanul Hakim
Published: February 2022

Introduction: Pityriasis Versicolor (PV) is an infection caused by Malassezia, especially Malassezia furfur, most commonly seen in adolescents and young adults. In the skin, sebum lipid is an essential ingredient in supporting the growth of Malassezia because of its lipophilic properties. Higher sebum levels are detected in some body regions, such as the face, scalp, chest, and back. Therefore, in these areas, a higher amount of Malassezia is found. Thus, sebum levels may affect the occurrence of PV. This study aims to determine the correlation between sebum levels and PV.Methods: This research studies the correlation between sebum levels and PV with a cross-sectional design on 31 subjects with PV and 31 non-PV subjects. They were treated at the Dermatology and Venereology Polyclinic, Haji Adam Malik General Hospital, Medan. The assessment was based on examining sebum levels on the chest and back of the PV and non-PV groups. Research subjects who met the inclusion and exclusion criteria underwent anamnesis, physical examination, and dermatological examination and examination with 10% KOH solution on subjects with PV. Then, all PV and non-PV subjects recorded primary data, including age, gender, education level, and sebum levels. The data collected were tabulated and presented in a frequency distribution table and analyzed statistically.Results: The age with the most suffering from PV was <20-40 years, as many as 24 people (77.4%). The most affected sex was male as much as 87.1%, and the highest level of education affected was high school as many as 25 people (80, 6%). The mean level of sebum in the chest of the PV group was 20.97 mg/cm2, while in the non-PV group, it was 16.29 mg/cm2. The average sebum level in the back of the PV group was 24.13 mg/cm2, while in the non-PV group, it was 21.71 mg/cm2. There was no significant difference in the sebum levels on the chest and back between PV and non-PV groups.Conclusion: There was no significant difference in sebum levels between PV and non-PV. Indicating other factors are influencing the onset of the disease.
Correlation between short-term heart rate variability and QT-Interval with left ventricular systolic function in patients with stable Coronary Artery Disease (CAD): a cross-sectional study
Authors: Panda Agnes Lucia , Polii Natalia Christina Intania , Rooroh Victor Giovannie Xaverison , Haurissa Andreas Erick , Sarayar Agustinus Mahardhika , Yofrido Filipus Michael
Published: February 2022

Background: The ischemic process in stable Coronary Artery Disease (CAD) causes cardiac remodeling and dysfunction, signaling the progress towards irreversible heart failure. Early identification for the presence of Left ventricular (LV) remodeling and dysfunction is important. Several methods can be used to assess LV dysfunction using echocardiography, including peak Global Longitudinal Strain (GLS) and ejection fraction measurements. Short-term Heart Rate Variability (HRV) and QT interval are considered practical parameters in electrocardiography identifying LV dysfunction. This study aimed to determine the relationship between short-term HRV and QT interval with LV systolic function in stable angina pectoris patients.Methods: This cross-sectional study was conducted in Prof. Dr. R. D. Kandou Hospital, Manado, from March to September 2021. All study subjects who met the inclusion criteria underwent a clinical history and further examinations, including electrocardiography, laboratory, and echocardiography examinations. The relationship of HRV variables and QT interval with LV systolic function were analyzed using Pearson correlation and linear regression models by SPSS version 21 for Windows.Results: A total of 33 subjects were included with a mean age of 62.3±8.9 years. Non-parametric correlation analysis between HRV variables and left ventricular systolic function showed no significant correlation. There was a significant correlation between QTc interval by Fridericia and LV peak GLS, but not with ejection fraction (r=0.426; p=0.013). The univariate regression analysis showed a relationship between QTc interval by Bazett and Fridericia with peak GLS (Bazett B=0.036; ?=0.35; R2=0.122; p=0.046; Fridericia B=0.052; ?=0.426; R2=0.181; p=0.013).Conclusion: There was a weak and moderate positive correlation between the QTc interval by Bazett and Fridericia formula with left ventricular systolic function. There was no statistically significant correlation between the short-term HRV variable and left ventricular systolic function.
Determinants factors affecting the implementation of the COVID-19 health protocol in the community
Authors: Waliyanti Ema , Sulistiyaningrum Astri , Oktariza Atika , Nurrahaf Syifa Hafidhni , Satria Faudyan Eka
Published: February 2022

Background: The COVID-19 case is a recent problem faced by people worldwide, including in Temanggung Regency. The local government has made various efforts to reduce the spread of the COVID-19 virus, namely by enforcing public health protocols such as physical distancing, prohibition of going to hometown, quarantine system, wearing masks, implementing handwashing and temperature measurement in every place to limiting community activities. However, many people have not obeyed the rules that the COVID-19 cases in the area increase. This study aims to identify the factors that influence the implementation of health protocols in the community in the Temanggung Regency.Method: This study used a qualitative method. Data were collected using in-depth interviews with 12 participants consisting of the community, village officials, and health workers selected using the purposive sampling technique. The instrument used was an interview guide. In addition, unstructured observations were carried out to identify the community's implementation of current health protocols. The data validity test was conducted by triangulating sources, methods, and peer debriefings. Thematic data analysis was carried out using Open code 4.02 software.Results: The results showed that the factors that influenced the implementation of health protocols to prevent the spread of COVID-19 in the community in Temanggung Regency included awareness of implementing health protocols, limited infrastructure, limited health personnel, monitoring of officers, perceptions of COVID-19, and public attitudes towards health protocols. Conclusion: Based on the results of this study, it is expected that it can be used as evaluation material for the community and local government in implementing health protocols to prevent the spread of the COVID-19 virus in the region.
The potential effect of intradermal Botulinum Toxin Type-A (BTA) injection to increase extended random skin flap survival
Authors: Fiona Caroline , Saputro Iswinarno Doso , Budi Agus Santoso
Published: February 2022

Background: Extended random skin flap failure often occurs due to insufficient vascularization. Several attempts have been tried to increase the viability of the flap, but none of these attempts have achieved maximal success. Previous research has shown that Botulinum toxin type A (BTA) increases the viability of cutaneous flaps by inhibiting muscle contraction along with increasing vasodilation and angiogenesis. This study examines the effect of intradermal BTA injection on extended random skin flaps viability.Methods: In thirty-six Wistar rats, a rectangular random cutaneous flap (6 cm × 1.5 cm) was made on each dorsal rat area and then elevated the flap. The treatment group was intradermally injected evenly with BTA 8 IU and saline solution for the control group. Each rat flap viability was observed after five days. Primary outcome measures are survival flap area using Visitrak, microscopic assessment of the number and diameter of capillaries and Vascular Endothelial Growth Factor (VEGF) expression was analyzed using immunohistochemistry semi-quantitative scoring system. Data were analyzed using SPSS version 21 for Windows.Results: The treatment group has better results in all observed parameters than the control group. However, Only the VEGF expression of proximal edge showed a statistically significant increase in the group treated with BTA injection (p=0.004).Conclusion: This study showed that the BTA treatment has a positive effect on random skin flap survival and the reduction of distal necrosis in rats, so it has been proven that BTA has the potential to increase flap survival rates in small animal models. Further studies are needed to determine whether BTA treatment can produce similar findings in humans.
Advanced MRI prediction of meningioma histopathological classification: a literature review and case presentations
Authors: Utomo Sri Andreani , Bajamal Abdul Hafid , Yueniwati PW Yuyun , Haq Irwan Barlian Immadoel , Fauziah Dyah , Fajarini Eunike Serfina
Published: February 2022

Meningioma is not uncommon case; however, the differentiation of high-grade from low-grade meningioma is important. The rate of recurrence of grade I meningioma is 7-20%, but in grade II meningioma is 30-40% and in grade III 50-80%. Non-invasive MRI techniques that can differentiate high-grade from low-grade meningiomas before surgery are useful for surgical planning and subsequent treatment. We present a review article and some case studies of low-grade (WHO grade I) and high-grade (WHO grade II and grade III) meningioma with conventional MRI and continue with advanced MRI; we performed diffusion weighted imaging (DWI) with apparent diffusion coefficient (ADC) value, dynamic susceptibility contrast (DSC), dynamic contrast-enhanced (DCE) magnetic resonance (MR) perfusion and 3D ASL. From these three cases show that advanced magnetic resonance imaging with ADC value, DSC, DCE, and 3D arterial spin-labelling (ASL) is an essential sequence to differentiate high-grade from low-grade meningioma.
Medical education system in Coronavirus Disease 2019 (COVID-19) pandemic: what has been changed from the past era?
Authors: Manuaba Ida Bagus Amertha Putra , Supadmanaba I Gede Putu , Darmayani I Gusti Ayu Sri , Sindhughosa Dwijo Anargha , Yani Made Violin Weda
Published: February 2022

The magnitude of coronavirus disease 2019 (COVID-19) pandemic leads to the significane difference in daily living. Less direct interaction between people is emphasized to prevent the spread of the virus. Consequently, the medical education had been affected considerably. The concept of medical education compromised of pre-clinical curriculum and clinical curriculum (clinical clerkship). Indeed, the implementation of self-distance makes the essence of clinical clerkship disappeared. In order to overcome this issue, several methods have been employed. The use of virtual or online learning method had been developed with the use of online platform. Regardless of the various approach, pros and contras still existed. The common challenge in the use of online learning method including technical issue and less interaction between patient and student. The hybrid combination of online learning with traditional method could be beneficial for the current medical education in this era.
Insulin resistance is associated with severe coronary artery stenosis in non-diabetic chronic coronary syndrome at Sanglah General Hospital, Bali
Authors: Wulandari Ni Luh Eka Sriayu , Artha I Made Junior Rina , Gotera Wira , Widiana I Gede Raka
Published: February 2022

Background: The prevalence of insulin resistance (IR) increases worldwide due to the increasing number of the elderly population, obesity, and physical inactivity. IR modifies insulinâ€™s effect on blood vessel walls, with anti-atherogenic effects on insulin-sensitive and pro-atherogenic effects on IR conditions. However, the relationship between IR and the degree of atherosclerosis is still not conclusive. This study will examine the relationship between insulin resistance marker HOMA-IR and the degree of coronary artery stenosis using SYNTAX score measurements in non-diabetic subjects with the chronic coronary syndrome.Methods: The study was conducted on 68 subjects with non-diabetic chronic coronary syndrome taken by consecutive sampling. The diagnosis of the chronic coronary syndrome (CCS) is defined as subjects with significant â‰¥50% stenosis findings on coronary angiography. The degree of insulin resistance was measured using HOMA-IR and subjects were divided according to the HOMA-IR quartile. Data were analyzed in bivariate and multivariable modeling by SPSS version 25 for Windows.Results: The prevalence of severe coronary stenosis was 11.8%, 17.6%, 29.4% and 64.7% in quartiles 1, 2, 3 and 4, respectively. In multivariate analysis, it was found that quartile 4 subjects with cut-off value HOMA-IR â‰¥12.30 (OR 7.0; 95% CI=1.3-39.0; p=0.025) is an independent predictor of severe coronary stenosis, along with age â‰¥50 years (OR 13, 8; 95% CI=1.1-174.1; p=0.042), BMI â‰¥25 kg/m2 (OR 15.1; 95% CI=2.4-96.7; p=0.004), smoking (OR 18,0; 95% CI=2.0-160.5; p=0.010)Â  Also found that statin therapy â‰¥2 months (OR 0.11; 95% CI 0.02-0.59; p=0.010) is an independent protective factor against severe coronary stenosis in non-diabetic CCS subjects.Conclusion: This study shows an independent association between IR and severe coronary stenosis in non-diabetic CCS subjects. This finding further strengthens clinical evidence of the direct pro-atherogenic effect of IR regardless of its glucose control effect and other metabolic syndrome components.
Ethanolic extract of grape (Vitis vinifera) prevents bone defect in the overtraining-induced rat
Authors: Siswanto Ferbian Milas , Sasanthi Iftitah Yuniar , Sukoco Hendro , Pangkahila Alex
Published: February 2022

Introduction. Excessive physical activity can lead to an early aging and degenerative disease such as osteoporosis characterized by decreasing bone density and the number of osteoblasts and increasing the number of osteoclasts. This study aimed to examine the activity of grapes ethanol extract to prevent bone damage in overtraining-induced rats.Methods. The study design was experimental research using a completely randomized posttest-only control group design. Subjects were 36 male albino rats, aged 2.5 months, weighing 180-200 grams divided randomly into two groups. Control group (n= 18) was treated with overtraining + placebo for three weeks and the treatment group (n= 18) was treated with overtraining + 1.25 g/kgBW grapes ethanol extract for three weeks.Results. The result showed that the average number of osteoblasts in the control group after treatment was 125.44 Â± 7.770 cells per field of view, while in the treatment group was 137.06 Â± 12.037 cells per field of view (p<0.01). The control group's bone density was lower than the treatment group (308.84 Â± 17.195 vs. 438.11 Â± 25.940 Î¼m, p<0.01). In contrast, the number of osteoclasts in the control group after 14 days was higher than the treatment group (19.89 Â± 3.411 vs. 13.33 Â± 4.485 cells per field of view, p<0.01).Conclusion. This study suggests that grape extract's antioxidant capacity can prevent a bone defect in the overtraining-induced rat.