bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of energy needs and energy intake with health status of field workers at PT. A
Authors: Merry Sunaryo  , Ary Andini  , Pratiwi Hariyani Putri  , Mulyadi  , Novegian Sunaryo  , Iva Widyanti
Published: May 2024

Introduction: Work nutrition refers to the nutrient or food substance needed by the workforce to meet their needs according to the type of work. The aim of work nutrition is to increase the work power and health of the workforce as much as possible in accordance with the person's nutritional status. The suitability of energy intake can also affect a person's productivity Long-term energy consumption patterns can have an impact on a person's health or nutritional status. If unchecked, they can also have an impact on their activities and productivity. Therefore, the purpose of this study is to determine the energy needs and energy intake associated with health status in field workers.
Methods: This research used a quantitative approach with the type of observational research and a cross-sectional design. The population in this study was based on a total sample of workers at PT. A in the city of Samarinda, with a sample size of 41 workers.
Results: The results of this study indicate that most workers have an abnormal nutritional status. Only 29% of the 41 workers have a normal nutritional status. Then, in the comparison between energy intake and energy needs, it is known from 41 workers that only 32% of respondents have sufficient energy in accordance with what is consumed.
Conclusion: There is still a mismatch between energy intake and energy needs of the workers, and there are still many workers who have abnormal nutritional status. Therefore, it needs to be done, from socialization to supervision, such as implementing fitness at work, a healthy diet, adjusting workload, and getting enough rest.
The effectiveness of heat patch on afterpain levels during the puerperium
Authors: Lailatul Khusnul Rizki  , Nur masruroh  , Yati Isnaini Safitri
Published: May 2024

Background: Afterpain is the perception of pain, manifested by cramps and heartburn caused by uterine contractions in the postpartum period or puerperium. Afterpain can cause the postpartum period to be less comfortable. This study aimed to evaluate the effectiveness of heat patch on afaterpain levels during the puerperium at PMB Ainun Mufidah.
Methods: This study used an experimental design with a pre-post-test group using postpartum mothers who gave birth at PMB Ainun Mufidah. All samples that matched inclusion criteria were instructed to wear a heat patch by placing it on the abdomen for 8 hours/day and being observed for 3 consecutive days. The pain level assessment was done by a numerical rating of the pain scale before and after the treatment. The data was collected and analyzed using SPSS ver. 20.
Results: 24 postpartum mothers were included in this study, mostly aged 20-35 years. The highest level of afterpain reduction was found on the second postpartum day. The paired t-test showed a significant difference in afterpain levels between pre and post-treatment (p<0,001).
Conclusion: There was a significant difference in afterpain levels before and after giving heat patches to postpartum mothers.
Relationship between family support and tuberculosis transmission prevention behavior
Authors: Rusdianingseh  , Siti Maimunah  , R. Khairiyatul Afiyah  , Adi Setiawan  , Arif Helmi Setiawan  , Muhamad Khafid  , Nety Mawarda Hatmanti
Published: May 2024

Introduction: Mycobacterium tuberculosis is the disease-causing agent in pulmonary tuberculosis (TB). One of the infectious diseases that still pose a threat to public health is pulmonary tuberculosis. Support from the family will lead to better TB transmission prevention practices. In the working environment of the Sidotopo Wetan Public Health Center in Surabaya City, this study was undertaken to examine the link between family support and the behavior of avoiding the spread of tuberculosis.
Methods: TB patients in the working area of the Sidotopo Wetan Health Center were the subject of a correlational and cross-sectional study with up to 65 respondents using simple random sampling, with the criteria for respondents being TB patients in the Sidotopo Wetan Health Center area in 2021 and undergoing treatment until May 2022. The research tool is a closed questionnaire that has undergone validity and reliability testing. Data analysis was tested by the spearman correlation test (α = 0.05).
Results: Our analysis showed that family support influenced the behavior of preventing TB transmission by 99.1%. Based on statistical tests, it can be seen that the p-value <0.001 is smaller than the alpha (0.05).
Conclusion: In the working environment of the Sidotopo Wetan Public Health Center, Surabaya City, there is a substantial correlation between family support and the behavior of avoiding TB transmission, according to this study.
Intravitreal triamcinolone acetonide and bevacizumab injection as prevention of proliferative vitreoretinopathy in open globe injury
Authors: Kautsar Abiyoga  , Yulia Primitasari  , Delfitri Lutfi
Published: May 2024

Link of Video Abstract: https://youtu.be/VVibnyUdBx4
Background: Proliferative vitreoretinopathy (PVR) is common following an open globe injury (OGI) due to aberrant wound healing that can result in retinal detachment or vitreous hemorrhage. Despite the anatomical success, visual acuity improvement remains unsatisfactory. Triamcinolone acetonide (TCA) and Bevacizumab are among these therapies. This study aims to explore the effect of TCA and Bevacizumab intravitreal injection as potential preventive therapies for PVR in OGI.
Methods: This literature review compiles and elaborates on previous studies from many authors to support future experimental studies, which will be conducted to evaluate the intravitreal triamcinolone acetonide and bevacizumab injection as prevention of proliferative vitreoretinopathy in open globe injury through several relevant articles.
Results: The healing process requires inflammation that stimulates inflammatory cells and mediators, such as transforming growth factor-β (TGF-β), tumor necrosis factor-α (TNF-α), vascular endothelial growth factor (VEGF), interleukin-1 (IL-1), IL-2, IL-3, IL-6, IL-8, and IL-10. Plasminogen activator inhibitor-1 (PAI) is upregulated during inflammation, resulting in continued collagen deposition due to fibrosis. The injection of corticosteroids as immunosuppressants and anti-VEGFs as antiangiogenesis is thought to have a positive impact by reducing inflammation and the development of new blood vessels, thus suppressing fibrosis.
Conclusion: TCA injection was associated with improved anatomical and visual acuity in humans, pre-operatively or during pars plana vitrectomy. Anti-VEGFs, such as Bevacizumab, ranibizumab, conbercept, and aflibercept, demonstrated protective effects on the eyes of animal models and showed their ability to reduce VEGF, TGF-β, and PAI-1, thereby inhibiting wound fibrosis.
Relationship between the level of participation in implementing fit-to-work on unsafe behavior in lift and transport operators at PT. BJTI
Authors: Friska Ayu  , Firmansyah Ilham Sasmita Diharja  , Moch. Sahri  , Merry Sunaryo
Published: May 2024

Introduction: Lifting equipment operators risk having work accidents when loading/unloading containers. One of the risks can be minimized by doing a fit-to-work/ health check before work. This study aimed to analyze the relationship between the level of participation in implementing fit to work on the unsafe behavior of lifting equipment operators at PT. BJTI.
Methods: The research design was cross-sectional from March to May 2022. Monthly data fit to work, questionnaire sheets were used to collect data, and data were analyzed by chi-square. The respondents were as many as 77 randomly selected through cluster sampling. Data analysis was tested using chi-square test (α = 0.05).
Results: As many as 69 (89.6%) showed that operators tended to behave unsafely in the high category, with details of 28 operators participating fit to work medium and 41 operators in the low sort. The chi-square results showed a significant relationship between participation fit to work and unsafe behavior with a significance p<0.05.
Conclusion: There was a significant relationship between the level of participation fit to work on the unsafe action operator lifting equipment PT. BJTI. Therefore, it is recommended that companies provide programs to increase involvement in implementing fit-to-work by giving awards to every worker who actively participates in fit-to-work.
Comparison of the efficacy of hot saline irrigation and tranexamic acid on Boezaart score, intraoperative blood loss, and duration of surgery in functional endoscopic sinus surgery: a systematic review and meta-analysis
Authors: Timmy Wibisono  , Sutikno Budi , Ahadiah Titiek Hidayati , Utomo Budi , Kenconowungu Citrawati Dyah
Published: May 2024

Link of Video Abstract: https://youtu.be/wEp6PioGVqw
Background: Hot saline irrigation and tranexamic acid are techniques used to control bleeding during functional endoscopic sinus surgery (FESS). Hot saline irrigation and tranexamic acid can help control bleeding originating from microvascular located in the nasal cavity and paranasal sinuses. This study aims to compare the efficacy of these two techniques on Boezaart score, intraoperative blood loss, and duration of surgery in functional endoscopic sinus surgery.
Methods: This study is an intervention meta-analysis, the research formulated based on the population, intervention, comparison, outcome, and study design (PICOS). Articles were searched from five databases, including PubMed Central and publisher websites, Cochrane Library, ResearchGate, SAGE Journals, and Web of Science. There were no publication year or publication status restrictions on the selected research articles, and the date of the last search was up to February 2023. The efficacy of hot saline irrigation as a bleeding control method compared to tranexamic acid was assessed based on Boezaart surgical field score, intraoperative bleeding, and duration of surgery in functional endoscopic sinus surgery (FESS).
Results: A total of 532 research articles were identified, and fifteen articles that met the inclusion and exclusion criteria were selected. Hot saline irrigation p-value p=0.0002 and for tranexamic acid p=<0.00001 based on Boezaart score. Hot saline irrigation p= 0.0001 and tranexamic acid had a p= 0.0002 based on the Intraoperative blood loss, but the standardized mean difference in the hot saline irrigation group was smaller compared to the tranexamic acid topical group. Hot saline irrigation p=0.06 and tranexamic acid p=0.13 for duration of surgery.
Conclusion: This meta-analysis showed that the administration of tranexamic acid or hot saline irrigation could significantly reduce duration of surgery, intraoperative blood loss and improved surgical feld quality compared with room temperature saline irrigation. There is no statistically significant difference between tranexamic acid topical and hot saline irrigation.
The character of PA3235 virulence factors of Pseudomonas aeruginosa PAO1 – a preliminary study
Authors: Wahjudi Mariana , Widodo Samuel Stefanus , Artadana Ida Bagus Made , Antonius Yulanda
Published: May 2024

Introduction: Many virulence factors of Pseudomonas aeruginosa PAO1 are regulated by temperature and host conditions upon infection. Based on microarray data, the PA3235 gene is one of the upregulated genes during cell growth at 37 °C. Until now, no information about its role in PAO1 pathogenicity.
Methods: The PAO1∆PA3235 strain was constructed by overlapping polymerase chain reaction (PCR) method and through biparental mating. The deletion was confirmed by PCR and restriction analyses. The virulence factors of both P. aeruginosa PAO1 wild type and ∆PA3235 mutant strains were examined, which consisted of the amount of pyocyanin and pyoverdine, swarming, swimming, and twitching motility, biofilm formation, 3-oxo-dodecanoyl-homoserine lactone concentration, and growth curve profile. Data were analyzed using Student’s t-tests to determine differences between treatments. P-value < 0.05 were considered significant.
Results: The ∆PA3235 strain was successfully constructed. At 37 ºC, the mutant produced less pyocyanin (p-value 0.0004), pyoverdine (p-value 0.0009), and swarm area than the wild-type. The dendrites pattern of both strains was similar. The mutant and parental strains showed no differences in swimming and twitching motility when incubated at 22 ºC and 37 ºC. The mutant produced more biofilm compared to the wild-type strain (p-value 0.0013). The AHL was higher in the mutant than in wild type strain (p-value 0.0095) after 24 h incubation. Both the wild type and mutant strains exhibited similar growth patterns in LB broth. The mutant colonies also showed the same morphology as the wild type on the LB plate (not shown here).
Conclusion: The deletion of the PA3235 gene from the Pseudomonas aeruginosa genome caused some changes in virulence factors production, as the bacterium grew at body temperature 37°C. We predicted that the PA3235 gene might function to transport molecules involved in the early infection of this bacterium to humans.
Effect of medroxyprogesterone and doxycycline on vascular endothelial growth factor (VEGF) expression and corneal neovascularization in corneal alkali trauma
Authors: Fariz Muhammad , Indriaswati Luki , Sutjipto
Published: May 2024

Ocular chemical trauma is a true emergency in ophthalmology. Chemical trauma on the ocular area may disturb vision, reduce the quality of life, and functional state. Prompt and adequate treatment is needed to prevent further complications, such as a decrease in vision due to corneal neovascularization. Treatment started with immediate eradication of the chemical agent by continuous rinsing and followed by inflammation and epithelial defect control. Medroxyprogesterone and doxycycline are two common treatments used in ocular chemical trauma. We speculate that both medications may influence VEGF expression and corneal neovascularization in corneal alkali trauma. It was demonstrated that medroxyprogesterone and doxycycline reduce the expression of VEGF, hence, reducing corneal neovascularization.
The bcl-2 and caspase-3 expression after purple sweet potato treatment on isoniazid and rifampicin-induced liver injury
Authors: Artini I Gusti Ayu , Astuti Ketut Widyani , Trapika I Gusti Made Gede Surya Chandra , Indrayani Agung Wiwiek
Published: May 2024

Link of Video Abstract: https://youtu.be/9chL7pTn3bA
 
Backgrounds: Liver injury induced by antituberculosis drugs showed high proportions in many countries and might result in serious effects. Previous studies had proved the increase of reactive oxygen species formation and induction of apoptosis related to antituberculosis treatment. There has been no standard therapy for protecting the liver from damage related to antituberculosis. Purple sweet potato extract is one of natural sources that possess hepatoprotector action regarding its antioxidant activity. This research aimed to prove the action of purple sweet potato ethanol extract on apoptosis related to liver injury caused by antituberculosis.
Method: This research was an experimental study with randomized post-test only control group design. The samples were male rats (Rattus norvegicus) strain Wistar, age 8-12 weeks, weight 150-200 grams (divided into two groups: control and experimental group). Purple sweet potato ethanol extract was prepared with maceration technique. The measurement of bcl-2 and caspase-3 expression was conducted with ELISA method. Data analysis was performed using independent t-test.
Results: Our study result revealed that the liver expression of bcl-2 in treatment group was significantly higher than control group (15.83 ± 3.14 vs. 12.11 ± 1.53), whereas the liver expression of caspase-3 in treatment group was significantly lower than control group (1.96 ± 0.38 vs. 2.41 ± 0.30; p < 0.05).
Conclusion: Purple sweet potato extract potentially protects the liver from apoptosis induced by antituberculosis.
Survival analysis of breast cancer patients luminal subtype B on lymphovascular invasion (LVI), tumor-infiltrating lymphocyte (TIL), and expression of mammaglobin A
Authors: Sudarsa I Wayan , Diwiya Abdi Nuratna Nyoman
Published: May 2024

Background: With 1 in 10 women receiving a new cancer diagnosis each year, breast cancer is the most frequent cancer among women. Luminal B breast cancer incidence rates are rising in non-Hispanic white women aged 55 to 69 in Asia/Pacific and Indonesia subtype across all age groups. In Bali, Luminal B is the most prevalent subtype with the greatest fatality rate. This study aims to prove the survival analysis of Luminal B subtype breast cancer patients based on lymphovascular invasion (LVI), tumor-infiltrating lymphocyte (TIL), and mammaglobin A expression.
Methods: This study is a survival analysis using nested and prospective cohort methods. Retrospective data were taken from the Cancer Registry and Medical Records (MR) of patients in Sanglah General Hospital, mammaglobin results (Paraffin block test) on anatomical pathology analysis. Statistical Kaplan Meier and Cox Proportional hazard calculations performed with the SPSS program were significant (p<0.05).
Results: The number of research subjects was 60, with 32 subjects dying and 28 still alive until the data collection was completed. There was no difference in age between the two groups. The mean of all ages is 50.12 ± 9.93 years. Positive LVI has 9 months median survival (95% CI 8-10) with p= 0.013 risk 2,797 times. TIL high (positive 2- positive 3) median survival 8 months (95% CI 6.3-9.7) with p=0.003 and risk 3,151 times. Strong expression of mammaglobin A (3-4) had a median survival of 12 months (95% CI 4.4-19.5 months; p=0.015) and risk 3.34 times.
Conclusion: LVI, TIL, and mammaglobin A expression significantly affected poor survival in the breast cancer Luminal B subtype.
Platelet rich fibrin effect in MMP-9 and TIMP-1 expression as bacterial keratitis therapy
Authors: Putra Oggy Satriya , Sudrajat Nandang , Nurhidayat Bimanda Rizki , Indriaswati Luki , Primitasari Yulia
Published: May 2024

Bacterial keratitis is an ocular emergency and is one of the leading causes of blindness worldwide. Pseudomonas aeruginosa is the most frequent causative agent of keratitis. The infectious process of P. aeruginosa is highly invasive and can rapidly lead to corneal ulcers, ocular infections (endophthalmitis), and corneal perforation. Delayed or inadequate treatment may result in complications such as corneal fibrosis and neovascularization. Platelet-rich fibrin (PRF), which contains high levels of platelets, can aid in hemostasis, cell migration, and proliferation to accelerate the wound healing process. PRF contains several growth factors, such as Platelet-derived growth factor (PDGF), Vascular endothelial growth factor (VEGF), and Transforming growth factor (TGF- β), which are released in a time-dependent manner during the wound healing process, ranging from 7 to 28 days. TGF- β regulates the expression and activity of matrix metalloproteinases (MMP-1, MMP-2, MMP-3, MMP-9) involved in wound remodeling and healing, where MMPs are regulated or balanced with tissue inhibitors of metalloproteinases (TIMP-1, TIMP-2). In previous studies, PRF was found to be effective in managing bacterial keratitis in cats. In this discussion, we explore the molecular effects of PRF as an adjuvant therapy for bacterial keratitis
Molecular docking studies of Brucein D as a potential inhibitor of the Bcl-2 anti-apoptotic protein
Authors: Nandana Pandu Ishaq , Rasyid Haerani , Prihantono  , Yustisia Ika , Hakim Lukman
Published: May 2024

Link of Video Abstract: https://youtu.be/JOzTSty10v4Background: Brucein D (BrD), a quassinoid isolated from Brucea javanica fruit, reportedly demonstrates anti-tumor activity. Bcl-2 is an anti-apoptotic protein that inhibits apoptosis and leads to cancer progression. This study aims to evaluate the inhibitory effect of BrD against the anti-apoptotic protein Bcl-2 by molecular docking study.
Methods: We investigated the activity of BrD against Bcl-2 through molecular docking in silico compared to the chemotherapeutic drugs doxorubicin and docetaxel. Molecular docking analysis was conducted using the Lipinski rule of five drug-likeness analyses, PASS Online prediction, PyRx v0.8, Discovery Studio DS BIOVIA 2016 v16, and PyMol v2.4.
Results: Current results show that BrD is qualified as a drug and can pass cell membranes without toxicity. The PASS prediction also shows that BrD can be activated as an anti-neoplastic inside the human body with Pa higher than Pi. BrD can make a constant and stable bond to Bcl-2 with a binding energy of -8.3 kcal/mol, almost equal to doxorubicin and docetaxel. BrD can form six types of hydrogen bonds that show stability to temperature and pressure.
Conclusion: BrD has shown to be a promising alternative for an anti-cancer drug by inhibiting the Bcl-2 anti-apoptotic protein with low toxicity in normal cells.
Family support in chronic kidney failure patients with hemodialysis
Authors: Wijayanti Lono , Yusuf Ah , Widyawati Ika Yuni , Arif Moch. Faisol , Winoto Priyo Mukti Pribadi , Septianingrum Yurike , Wardani Erika Martining
Published: May 2024

Introduction: Hemodialysis is one of the treatments for kidney failure patients, although it is not always effective and has a tendency to make the patient's health worse. One such effect is a rise in interdialytic weight. In this study, patients with chronic kidney failure receiving hemodialysis at the Islamic Hospital A. yani Surabaya were examined to establish the association between family support and weight growth.
Method: a cross-sectional research strategy for analysis. 70 respondents made up the population of all hemodialysis patients with chronic renal failure, and 60 respondents made up the purposive sampling sample size. The unrestricted factor is family support. The weight gain between dialysis sessions was the dependent variable. A questionnaire and an observation sheet were used as instruments. The Spearman Rank test was utilized in data analysis.
Results: According to the findings, out of the 60 respondents, the majority's (70%) family support was excellent, and the majority (76.7%) of those who had dialysis saw modest weight gain. According to statistical analysis, the p value was 0.001, which indicates that among hemodialysis patients with chronic renal failure who receive family support, there is a relationship between weight gain.
Conclusion: In patients with chronic renal failure receiving hemodialysis, the more well-controlled the interdialytic weight increase, the better the family support. The requirement for support and assistance for dialysis patients so they can follow the recommended course of treatment.
The influence of health education on dietary approaches to stop hypertension (DASH) on knowledge and attitude of hypertension patients
Authors: Bistara Difran Nobel , Kurniawan Ganda Putra , Setiawan Arif Helmi , Handayani Nanik
Published: May 2024

Introduction: The high cases of hypertension are increasing due to the lack of public knowledge in the management of eating patterns. This revolves around cultural, environmental, and educational factors that can affect knowledge and attitudes in people with hypertension. The aim of this study is to determine the effect of health education on knowledge and attitudes of hypertension patients.
Method: This study used a one group pre-post test design. The study was conducted in one village in Java region of Indonesia, which involved 56 respondents, selected by purposive sampling. The research instruments used were knowledge and attitude questionnaire sheets. Statistic analysis by utilizing Wilcoxon sign rank test to determine the difference between pre and post test with a significance value of p < 0.05.
Results: The results of the knowledge variable before and after being given health education with a p-value = 0.000, and for the attitude variable with a p-value = 0.000. This shows that there is a difference in average between the results of knowledge and attitudes of hypertensive patients before and after being given health.
Conclusion: Health education about the DASH diet affects knowledge and attitudes in patients with hypertension.
Optimization of a local type rabbit model for arteriovenous fistula, focused on study neointimal hyperplasia
Authors: Habibie Yopie Afriandi , Emril Dessy Rakhmawati , Azharuddin  , Syahrizal Dedy
Published: May 2024

Link of Video Abstract: https://youtu.be/8kcI8mX5A6Y
Background: Hemodialysis vascular access dysfunction is a significant cause of morbidity and mortality in hemodialysis patients. Over the past decades, numerous animal models have been developed. However, there needs to be more animal model protocol with rabbits to investigate neointimal hyperplasia in the arteriovenous fistula. This study aimed to explore an alternative rabbit model using a wild-type local model for investigating neointimal hyperplasia in the arteriovenous fistula.
Methods: One local-type male rabbit performed arteriovenous fistula, in which the right carotid communis artery was anastomosed end-to-side to the right internal jugular vein. When examining vascular tissue, measurements were taken of the thicknesses of the tunica intima and tunica media, as well as the areas of the tunica intima and tunica media, vascular diameters, and vascular lumen areas.
Result: We successfully induced neointimal hyperplasia in local-type rabbits, indicated by increased tunica intima thickness after 28 days of the arteriovenous fistula procedure.
Conclusion: Optimation of the Rabbit model using a wild-type local model for investigating neointimal hyperplasia in arteriovenous fistula may be susceptible and considered as it is accessible and cost-effective besides producing the same outcome as a laboratory rabbit
Inadequate treatment in a patient with minimal change disease (MCD) nephrotic syndrome: a case report
Authors: Maslachah Alifatul , Pramudya Dana , Pranawa  , Widodo  , Mardiana Nunuk , Tjempakasari Artaria
Published: May 2024

Introduction: Minimal change disease (MCD) is the cause of primary nephrotic syndrome in about 90% of children but is rare in adults and only found in about 10% to 15% of adults. Adequate steroid therapy can lead to complete remission in more than 80% of adults with MCD nephrotic syndrome. This study aimed to report a case of an adult patient with nephrotic syndrome with renal biopsy results of MCD and her clinical improvement after adequate therapy with glucocorticoids.
Case Presentation: We report a case of a female patient, 35 years old, who complained of swelling all over the body 3 months before admission. Previously, the patient was diagnosed with nephrotic syndrome on December 2020 and received oral steroid therapy that had been tapered down early, which caused the clinical symptoms to recur. The patient underwent a kidney biopsy, and MCD was found on histopathological examination. The patient received supportive therapy and resumed steroid therapy with adequate dosage. On the six-month follow-up, the patient was in complete remission.
Conclusion: MCD is a nephrotic syndrome with a good prognosis, and 80% of patients will respond to adequate therapy. Our patient's previous medical history was re-evaluated, and concluded that the previous patient had received inadequate therapy. The patient has now reached a state of complete remission. This case highlighted the importance of adequate therapy in managing nephrotic syndrome.
A rare case surgery repair for pediatric sphenoethmoidal encephalocele with single-step transfrontobasal approach
Authors: Rangkuti Dicky Lukman , Parenrengi Muhammad Arifin , Suryaningtyas Wihasto
Published: May 2024

Link of Vidio  Abstract: https://youtu.be/nsnfWQ81oRU
Background: Basal encephalocele (BEC) is the rarest type of all encephaloceles. Several methods were used to close and repair the bony defect and prevent CSF leakage. Here we present a case of a 1-month-old pediatric patient who presented with a sphenoethmoidal basal encephalocele with a single transfrontobasal approach.
Case Presentation: A female infant one-month-old with diagnosed large sphenoethmoid encephalocele (basal encephalocele). From the 3D CT scan reconstruction, we found a defect in the planum sellae and ethmoid region with a maximum line of 2.84 cm x 2.89 cm. We performed a transfrontobasal approach by using titanium mesh/plate. After follow-up, we did not find CSF leakage.
Conclusion: Uncertainty persists on the best way to restore BEC. In this instance, we used single TBF approaches to seal and repair the basal encephalocele. There are no signs of infection or CSF leakage throughout the follow-up.
Metabolic profiles of internal medicine residents
Authors: Dwipayana I Made Pande , Gotera Wira , Saraswati Made Ratna , Semadi I Made , Nugraha Ida Bagus , Budhiartha Anak Agung Gede , Suastika Ketut
Published: May 2024

Link of Video Abstract: https://youtu.be/eXD5BJcsM-YBackground: Obesity is a pressing global health concern that affects not only developed, but also developing countries. This condition is linked not only to the rising incidence of metabolic and cardiovascular diseases, but also exerts a considerable economic burden due to its high associated costs. Moreover, metabolic disorders, including obesity, can affect both the general population and medical practitioners alike. Therefore, we conducted an observational cross-sectional study to assess the metabolic profiles of internal medicine residents at Faculty of Medicine, Universitas Udayana, Denpasar Bali.
Methods: This is a descriptive cross-sectional observational study carried out in 2022 at the Diabetic Polyclinic in the Prof. dr. I Goesti Ngoerah Gde Ngoerah Hospital, Denpasar. The study approved by the Ethical Committee of the Faculty of Medicine, Universitas Udayana. All subjects were given information regarding this study and signed the informed consent. The metabolic profiles that were evaluated included body mass index, blood pressure, lipid profile, and fasting blood glucose.
Results: Out of the 116 participants in this study, one individual (0.9%) was found to have underweight, while 20 (17.2%) were classified as normal and another 20 (17.2%) as overweight. A majority of the participants, comprising 75 individuals (64.7%), were classified as obese. Further analysis revealed that metabolic disorders were prevalent in this study, with 9 individuals (7.8%) diagnosed with hypertension, 2 individuals (1.7%) with diabetes mellitus, 99 individuals (85.3%) with dyslipidemia, and 16 individuals (13.8%) with metabolic syndrome.
Conclusion: The findings of this study indicate that a significant proportion of internal medicine residents at Faculty of Medicine, Universitas Udayana were classified as obese, and a considerable number were diagnosed with various metabolic disorders, including hypertension, dyslipidemia, diabetes mellitus, and metabolic syndrome.
Psychiatric aspects of healthcare workers during COVID-19 pandemic in Surabaya, Indonesia: prevalence of anxiety, resilience, burnout, and their correlations to stress markers
Authors: Maramis Margarita M. , Soetjipto  , Setiawati Yunias , Konginan Agustina , Muhdi Nalini , Chuanardi Winson , Ibrahim Yusuf , Malika Rosalia A. , Tang Sandra C.N. , Chandita Kadek D. , Tayibnapis Natasha A. , Hayyan Abdul J.A. , Chafid Adde M.P. , Hanindito Elizeus , Rehatta Nancy M. , Pandin Moses G.R. , Tarmono  , Tinduh Damayanti , Prakoeswa Cita R.S. , Munawaroh Fitriah
Published: May 2024

Link of Video Abstract: https://youtu.be/nI_6kXZ0cSw
 
Introduction: The coronavirus disease (COVID-19) pandemic severely affected healthcare services, including causing negative impacts on healthcare workers’ mental health. An observational study was conducted at Dr. Soetomo General Hospital aimed to measure the prevalence of anxiety, resilience, burnout and their correlations to stress biomarkers amongst healthcare workers in Surabaya, Indonesia, during the COVID-19 pandemic.
Methods: Participants were residents who managed COVID-19 patients, chosen using random sampling. All participants had a 1-week shift working with COVID-19 patients in an isolation ward. The study used online questionnaires and laboratory data at the shift’s beginning and end. Along with collecting sociodemographic characteristics, State-Trait Anxiety Inventory (STAI), Brief Resiliency Scale (BRS), and Maslach Burnout Inventory (MBI) scales were administered online. At the same time, laboratory markers such as Neutrophil to lymphocyte ratio (NLR), Interleukin-6 (IL-6), cortisol, and CD4 values were studied.
Results: 61 participants were included in the study. At the beginning of the shift, 59% of participants had moderate to severe anxiety, and 83.62% had normal to high resilience. The early proportion of the participants having burnout from combined MBI measures was 88.52%. MBI-EE median scores were lower in the married group (6.50 vs. 9.50, p-value=0.030). NLR value was significantly related to STAI-S and BRS (p-value=0.007 and 0.049, respectively).
Conclusions: Most healthcare workers had anxiety and burnout, with normal levels of resilience. Our study found that NLR might be useful as a marker for anxiety and resilience.
Brunner’s gland hyperplasia as a cause of gastric outlet obstruction in a seven year old boy
Authors: Nesa Ni Nyoman Metriani , Darma Andy , Athiyyah Alpha Fardah , Ranuh IGM Reza , Sumitro Khadijah Rizky , Sudarmo Subijanto Marto
Published: May 2024

Link of Video Abstract: https://youtu.be/9-ynkRS_wo8
Introduction: Brunner’s glands are acinotubular glands which are located mostly  in the deep mucosal or submocosal layers of the proximal duodenum. Hyperplasia of these glands is reported in almost 1 in 50 upper gastrointestinal endoscopies and accounts for approximately 5 to 10 percent of all benign duodenal tumors. Brunner’s gland hyperplasia is usually asymptomatic. It  can take form of polypoid or mass lesions and precipitate pyloric obstruction, gastrointestinal hemorrhage, and intussusception in children. Due to its rarity in pediatric population, it tends to be misdiagnosed.
Case Description: This case report presents a case of seven year old boy with Brunner’s gland hyperplasia presented with recurrent vomiting. A seven year-old boy was admitted to the hospital due to of worsening of intractable vomiting since five months prior to admission. He also felt abdominal discomfort, bloating, and early satiety since he was 3 years old. The patient had been treated with several medications without significant improvement. Epigastric pain was observed on abdominal palpation. Gastroscopy showed partial gastric outlet obstruction (pyloric obstruction), erosive gastritis, multiple ulcers, and erosive esophagitis. Histopatologic results from biopsy revealed chronic gastritis and positive for  Helicobacter pylori. Abdominal CT scan showed protrusion solid lesion intraluminal with diameter 1.18 x 1 x 1.25 cm in part II duodenum. Patient was consulted to pediatric surgeon for laparotomy exploration and duodeno-duodenostomy. Excision of Brunner’s gland dan biopsy were performed. Surgical report showed gastric dilatation with duodenal wall hypertrophy on part I-II of duodenum. Histopathological from biopsy revealed Brunner’s gland hyperplasia with lymphoid tissue.  Post surgery patient recovered well and eventually discharged without any complains. The prognosis was good.
Conclusion: Generally, Brunner’s gland hypertrophy is benign and has a good prognosis. However, with the growth of benign proliferative lesions of Brunner’s glands, mucosal ulcers may develop, thereby leading to the repair of gastric foveolar metaplasia with papillary architecture and then malignant transformation.
Diagnosis of high-grade prostate cancer in patients with unexpectedly low prostate specific antigen levels: a rare case series
Authors: Fauzan Ahmad , Djatisoesanto Wahjoe
Published: May 2024

Link of Video Abstract: https://youtu.be/PfhZ7H4kszQ
 
Background:  Prostate cancer is regarded as one of the most common leading causes of male cancer-related death worldwide. Clinicians agree that prostate specific antigen (PSA) is the best prostate cancer predictor. High PSA levels increase prostate cancer risk in most men. However, other research suggests that prostate cancer with low PSA levels is aggressive. In this uncommon case series, we present three high-grade prostate cancer patients with low PSA.
Case Description:  Between 2018 and 2019, three patients were referred for further therapeutic management after initial evaluation and treatment from secondary hospitals. All patients underwent complete diagnostic procedures including Laboratory examination, Pathological examination, and Radiologic imaging. PSA levels were 0.67 ng/mL, 4.0 ng/ml, and 4.93 ng/mL in the first, second, and third patients, respectively. The first two of three patients had a Gleason score (GS) of 9 (5+4), and one patient presented with GS of 8 (5+3). Distant metastatic disease was not found in our series. All of the patients underwent hormonal therapy, and none of them underwent radical prostatectomy. Follow-ups were completed in all patients, with the survival of 3 months, 4 months, and 12 months respectively.
Conclusion: High-grade prostate cancer in patients with low PSA levels emphasizes the need for rigorous history taking and physical examination and quick investigation of new biomarkers and criteria for prostate cancer detection. These patients' prognosis and optimal therapy are unknown. These patients have a worse prognosis than those with high PSA values, according to multiple studies.
Prognostic scoring system to predict mortality after surgery in resectable colorectal cancer
Authors: Suryaningprang Alldila Hendy Prihanda , Putranto Agi Satria , Nurachman Luthfian Aby
Published: May 2024

Link of Video Abstract: https://youtu.be/mYpKu0PcJrM
Background: Colorectal cancer remains as the major problem worldwide. Numerous studies have investigated factors associated with mortality and recurrence rates in colorectal cancer. To facilitate the everyday use of mortality predictors, they should be incorporated into a prognostic scoring system. This study aimed to identify factors affecting mortality in resectable colorectal cancer patients after surgery and to develop a prognostic scoring system capable of predicting mortality in these patients.
Methods: This retrospective cohort study involved colorectal cancer patients at Cipto Mangunkusumo Hospital, Indonesia, from January 2016 – April 2020 diagnosed with resectable colorectal cancer. Data were collected from medical records, operation reports, histopathology reports, and laboratory test results. Mortality was assessed three years after curative surgery.
Result: A total of 214 resectable colorectal cancer patients were included in the study. Tumor size ≥ 5 cm, T3/T4 staging, absence of adjuvant chemotherapy, unachieved free circumferential margin, and CEA levels > 11.4 ng/mL were significantly associated with increased three-year mortality. The constructed three-year mortality prognostic scoring system was able to predict outcomes with a sensitivity of 91.3% and a specificity of 67.6%.
Conclusion: The prognostic scoring system, consisting of five variables, is significantly capable of predicting three-year mortality rates with high sensitivity
Diagnostic accuracy of hyponatremia as a biomarker of perforated appendicitis in pediatrics in Dr. Soetomo General Hospital, Surabaya
Authors: Rachman Bela Mayvani , Hasriastawa I Gusti Bagus Adria , Setiawan Ariandi
Published: May 2024

Link of Video Abstract: https://youtu.be/BXu-DkOsh0k
 
Introduction: Acute appendicitis is the most common acute abdomen in pediatrics. The diagnosis is challenging because of the various symptoms and characteristics of children with difficulty expressing pain. This condition makes perforated appendicitis high in pediatrics. This study aimed to investigate the potential role of hyponatremia as a biochemical predictor of complicated appendicitis.
Methods: An analytical-observational study in Soetomo General Hospital was performed from 2017-2021. The natrium level of patients, particularly those under 18 years of age diagnosed with appendicitis, was examined.
Results: There were 102 pediatric patients with appendicitis. In this study, 32 subjects (31%) were diagnosed with acute appendicitis, and 70 (69%) had perforated appendicitis. It was found that there was a correlation between hyponatremia and appendicitis perforation, indicated by a sensitivity of 58.5% and specificity of 65.6%. The mean serum of natrium level in patients with perforated appendicitis, 131.1 ± 3.8 mEq/L, is lower than in patients with acute appendicitis, 136.6 ± 3.9 mEq/L. The prevalence risk value of patients diagnosed with perforated appendicitis and hyponatremia was approximately 2,69. The area under the ROC curve was 0.721, with a 95% confidence interval of 62.3% to 80.5%. With the cut-off natrium value set to ≤ 133 mEq/L, the sensitivity and specificity values were estimated at 50% and 81.25%, respectively.
Conclusions: There was a correlation between hyponatremia and appendix perforation. Hyponatremia can be potentially used as a biomarker predictor in pediatric perforated appendicitis.
PD-L1 overexpression in prostate cancer: a potential targeted therapy
Authors: Aditya Gede Andi , Dany Yurisal Akhmad , Danarto Raden , Soeroharjo Indrawarman , Hendri Ahmad Zulfan
Published: May 2024

Link of Video Abstract: https://youtu.be/AUncKUx_dlQBackground: Prostate cancer frequently presents with a non-specific clinical appearance, similar to benign prostatic hyperplasia (BPH). In many countries, early detection and treatment of prostate cancer are associated with lower mortality rates. Several prostate cancer biomarkers have been studied, one of which is programmed death ligand-1 (PD-L1), currently used as a therapeutic method. This study aimed to examine the expression of PD-L1 in prostate cancer and BPH.
Methods: This was a cross-sectional retrospective study involving subjects diagnosed with prostate cancer by histopathological examination. The expression of PD-L1 from 30 prostate tissues was analyzed using qRT-PCR. Data were then analyzed using the ANOVA test and continued with the Post Hoc test. P < 0.05 was considered significant.
Results: From a total of 30 prostate tissues that were examined histopathologically, ten samples were BPH (33.3%), ten samples were non-metastatic prostate cancer (non-MPCa) (33.3%), ten samples were metastatic prostate cancer (MPCa) (33.3%). The data analysis showed significant differences in PD-L1 expression between groups (p=0.000). The Post Hoc test showed significant differences between the non-MPCa group and BPH (p=0.003; 95% CI 36.1-142.8) and the MPCa group with BPH (p=0.000; 95% CI 50.9-127.3).
Conclusion: PD-L1 was overexpressed in the prostate cancer group, both in non-metastatic Pca and metastatic Pca. As a result, using PD-L1 inhibitors in the early stages of the disease may improve survival and prognosis.
Shunt fracture as ventriculoperitoneal shunt complication in pediatric: a case series
Authors: Balafif Fachriy , Parenrengi Muhammad Arifin , Suryaningtyas Wihasto
Published: May 2024

Link of Video Abstract: https://youtu.be/7m2n6og9EUIBackground: Shunt fracture is a ventriculoperitoneal (VP) complication requiring shunt revision. The author discusses the experience of treating 5 cases of hydrocephalus patients with shunt fracture, including a clinical manifestation, nutritional status, and age of VP shunt insertion as a risk factor of shunt fracture will be discussed further in this case series report.
Case Presentation: This study analyzed all cases treated in 6 years from 2016 to 2021, with an inclusion criterion of all pediatric patients with shunt fractures. This study is a retrospective report of the clinical manifestations and diagnoses assessed for pre-procedural and post-procedural conditions. Eight hundred fifty-two patients with hydrocephalus with VP shunt insertion and 5 patients with shunt fracture were reported. Headache, lump in the shunt line, vomiting, and seizure were the main complaints of all patients. Four of the five patients had poor nutritional status (<50th and <3rd percentile). One patient had a shunt removal, two had a shunt revision, and two had a laparoscopic shunt extraction and VP shunt insertion. All patients had improved clinical outcomes.
Conclusion: Knowing the process of shunt fracture is essential as a modality to determine the subsequent management. A comprehensive clinical and radiological examination is mandatory to rule out a shunt fracture. Monitoring patients with VP shunt is an important thing that must be done to prevent further complications.
Interobserver agreement and the role of smoothelin immunostain in the evaluation of Muscularis Propria (MP) invasion of Bladder Urothelial Carcinoma (BUC)
Authors: Winarti Ni Wayan , Sriwidyani Ni Putu , Maker Luh Putu Iin Indrayani , Gotra I Made , Mahastuti Ni Made , Tanaka  , Kosashi Silvia , Yudiana I Wayan
Published: May 2024

Link of Video Abstract: https://youtu.be/KymxBUAr9eIBackground: Bladder Urothelial Carcinoma (BUC) is common cancer in the genitourinary organs. One important determinant for its therapy modality is the presence of tumor invasion into Muscularis Propria (MP). Assessing MP invasion in routine Hematoxylin-Eosin (HE) slides of Transurethral Resection of Bladder (TUR-B) specimens is not always easy due to tissue fragmentation and morphological similarities of MP to muscularis mucosa (MM) and myofibroblasts. This study was done to determine the interobserver agreement in evaluating MP invasion and to find alternatives to overcome this diagnostic problem.
Methods: This cross-sectional observational analytic study was conducted in the Pathology Laboratory of the Faculty of Medicine, Universitas Udayana/Prof. Dr. I.G.N.G. Ngoerah Hospital, Bali, in 2022. As many as 72 HE slides of TUR-B specimens of BUC patients were examined separately by five experienced pathologists. Smoothelin immunostaining, a marker to identify MP, was also examined as a comparison. Data were processed and statistically tested using the SPSS version 20.0 program for Windows.
Results: The interobserver agreement of those five pathologists was found to be low to moderate, with an average = 0.48, ranging between 0.18-0.69. One pathologist had a low agreement with four others (<0.4) and indicated diagnostic uncertainty in 41% of the samples examined. Among four other pathologists, the agreements were moderate, with  = 0.40-0.69. The proportion of concordant examination results was only 45.8%. When the outcome of each HE slide was concluded by consensus, it was found that there was no statistically significant difference with smoothelin immunostaining results.
Conclusion: Evaluation of MP invasion of BUC in TUR-B specimens had low to moderate interobserver agreement, which indicated that this examination was subjective. However, the consensus of several pathologists seems to lead to better accuracy, close to the result of smoothelin immunostaining.