bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of giant thyroglossal duct cyst in Dr. Moewardi Hospital Indonesia: A case report
Authors: Putra Muhammad David Perdana , Purnomo Joko , Yarso Kristanto Yuli
Published: February 2022

Introduction: Thyroglossal duct cyst (TGDC) is a developmental abnormality in which the thyroglossal duct settles after the decline of the thyroid gland.A 57-year-old female patient presented with complaints of a lump in the middle of her neck that slowly enlarged. The lump was first realized around 10 years ago. When she swallowed, the lump also moved. The swelling was cystic, painless surrounded by healthy skin except for a small area that showed a sign of inflammation. The ultrasound and Magnetic resonance of the neck confirmed TGDC with a size of 120 x 100 x 50 mm. We performed a surgical excision on the cyst and the central part of the hyoid bone (sistrunk procedure) and sent the specimen for histopathological examination, to confirm the preoperative diagnosis. TGDC diagnosis and management are not related to age or size. Operative management standards are carried out with sistrunk procedures.Case Description: The standard management of giant tyroglossal duct cyst is the sistrunk procedure with maximum result. The surgical procedure has been succesfully performed in this case.Conclusion: The standard management of TGDC is the sistrunk procedure with maximum results. The surgical procedure has been successfully performed in this case. The standard diagnosis and management of TGDC are not related to the patient's age or cyst size.
Pectoralis major myocutaneous flap for head and neck reconstruction: a case report
Authors: Oktahermoniza Oktahermoniza , Oktavenra Ari , Khambri Daan
Published: February 2022

Introduction: Cancer surgery in the head and neck area generally causes a wide defect and usually cannot be closed primarily or by using the surrounding tissue, thus a flap is needed. There are several types of flaps, namely local flaps, pedicle flaps, and free flaps. Although the free flap is currently the gold standard for reconstruction of the head and neck in developing countries, the resources for a free flap in most healthcare center are still lacking, as well as the large number of patients with poor economic and nutritional status. Thus, the pectoralis major myocutaneous flap (PMMF) remains popularly used.CaseÂ Description: A 46-year-old male patient with squamous cell carcinoma in the neck area, underwent wide excision procedure and the surgical defect was reconstructed with a pectoralis major myocutaneous flap. Â The results of reconstruction with pectoralis major myocutaneous flap were viable, and were functionally and aesthetically acceptable. There are no postoperative complications such as hematoma or abscess observed.Conclusion: Pectoralis major myocutaneous flap was one of the main and easy to learn modalities for head and neck reconstruction surgery and it was acceptable functionally and aesthetically in situations where free flap could not be performed for one or many reasons.
Aggressiveness tumor: a case report of recurrent ameloblastoma in the mandible
Authors: Wibowo Marjono Dwi , Fathurochman Agung Fuad
Published: February 2022

Background: Ameloblastomas are rare odontogenic neoplasms of the mandible and maxilla. They have high recurrence rates if improperly treated. Due to their aggressive nature and high recurrence rate, treatment remains a matter of debate. Complete excision of the lesion with the least morbidity would be the therapeutic challenge.Case Report: A 67 years old woman complained of swelling on her left jaw four years ago, the jaw was small swelling initially, and then it has grown to the size of a tennis ball. She had a history of similar swelling on the same site 12â€‰years back for which she was operated on (enucleation). On physical examination, there is a mass in the left mandibular bone above the surgical wound, hard, painless and motionless, with a size of 18 cm x 11 cm x 11 cm. Plain x-ray examination showed multiple cystic lesions in the left mandible. In this case, segmental mandibular resection was performed, followed by reconstruction using a K-wire.Discussion: Many treatment options range from conservative treatment of curettage, enucleation to radical surgical approaches of wide margin excision. Radical treatment approaches have the advantage of lowering the recurrence rates but at the same time pose extremely difficult challenges of reconstruction of the surgical defects.Conclusion: Ameloblastoma has high recurrence rate if it is not treated properly. At least 1â€‰cm of healthy bone should be removed during surgical procedure beyond panoramic radiograph visible margins. In our patient, though radical surgery eliminated a large possibility of recurrence.
Liver resection profile in Prof. dr. R.D. Kandou General Hospital: 1-year experience
Authors: Iskandar Michael , Tendean Michael , Mambu Toar Deliezer Bram , Tjandra Ferdinand , Panelewen Jimmy , Martino Celine
Published: February 2022

Background: The role of liver surgery is increasing for primary and secondary liver tumors. One of the most feared complications of liver surgery is Post-Hepatectomy Liver Failure (PHLF). The authors would like to present their experience in a year for liver surgery with morbidity and mortality, including PHLF as evaluation parameters.Methods: This is a prospective study from July 2019-2020 in a single-center, in which patients with pre-existing liver pathology were assigned to receive liver resection. Types and duration of liver resection, duration of Pringle maneuver, and blood loss were measured. PHLF was evaluated using the ISGLS classification, and morbidity was evaluated using Clavien-Dindo and FABIB classification. The energy device used varies from the harmonic scalpel, ligature, and Thulium-doped fiber laser (TDFL). Data were processed descriptively with IBM SPSS 25 (SPSS Inc., Chicago, USA). Data are presented in descriptive frequency tables as medians and means.Results: A total of 17 procedures were performed, including minor hepatectomies (58.82 %) and major hepatectomies (41.18%). The mean duration of operation 5.3 hours, the duration of parenchymal transection 91.5 minutes, and the estimated blood loss 1638.2 cc. Vascular occlusion method using Pringle maneuver with mean duration of 31.67 minutes. PHLF incidence found were grade B (5.88 %) and grade C (11.7%), while morbidities by Clavien-Dindo mostly are grade 2 (38.2%) and FABIB classification mostly are Bleeding (45%). The mean postoperative ICU is 3.06days, and the mortality rate is as high as 23.52%.Conclusion: Liver resection in our center is quite fair judging from the low incidence of PHLF, although the mortality rate is at 23.52%. Due to that, surgical technique and teamwork between units involved need to be improved even further.
Sexual satisfaction of Indonesian women with breast cancer in Central Java, Indonesia
Authors: Prajoko Yan Wisnu , Supit Tommy
Published: February 2022

Background: The negative impact of breast cancer diagnosis on the sexuality of women patients is well-known. Sexual dissatisfaction arises from the disruption of physical appearance by the tumor or as a result of both operative or non-operative treatments. This study aimed to describe the perception of sexuality and its quality of breast cancer in Indonesian women.Methods: This descriptive study recruited women diagnosed with breast cancer that have undergone chemotherapy, radiotherapy, and surgery, either in singular, combination, or no treatment at all. The sexuality was assessed using the Indonesian version of the Sexual Satisfaction Questionnaire (SEXSAT-Q).Results: A total of 113 female breast cancer patients ranging from 20 to 71 years old participated in the study. The majority of respondents were clinically diagnosed with stage II (36.2%) or higher (54.9%). Most patients underwent surgery (91.1%) and chemotherapy (85.8%). Before the diagnosis of cancer, the level of sexual satisfaction was good on average, which remained stagnant for 64 (56.6%) participants during cancer treatment. Significant anxiety and distress were reported by 35 patients (31.0%), depression by 21 patients (18.6%), and tiredness by 48 patients (42.5%).Conclusion: The sexual satisfaction of women with breast cancer patients in our study group is average on general, prior or after cancer diagnosis. However, the treatment's negative psychological impact is quite profound, affecting almost half of the study participants.
Correlation of CD44 and CD24 expression with the positive response after neoadjuvant chemotherapy in stage IIIB breast cancer patient at Dr. Saiful Anwar Hospital, Malang, Indonesia
Authors: Budianto Muhammad Bachtiar , Isharanto Artono , Haris Andry
Published: February 2022

Background: Breast cancer is a type of cancer due to abnormal cell growth of breast tissue. CD44 and CD24 is a potential target in breast cancer therapy. This study aims to evaluate the responsiveness of stage 3 breast cancer to chemotherapy by measuring the expression levels of CD44 and CD24 moleculesMethods: We conducted an observational study with pre-and â€“post-intervention or test research types. This study was performed on 49 Luminal Stadium IIIB subtype breast cancer patients who received 3 series of neoadjuvant chemotherapy at RSUD dr. Saiful Anwar Malang, immunohistochemical examination, and painting of tissue specimens from the biopsy results. Data were analyzed using SPSS version 20 for Windows.Results: Based on the Paired t-test and discriminant analysis, there were no significant differences between CD44 and CD24 expression before and after chemotherapy (p=0.501 and p=0.097, respectively). Therefore, the results of the study prompt that the expression of CD44 and CD24 could not be a predictor of the chemotherapy response.Conclusion: There are different expressions of CD44 and CD44 in primary breast cancer before and after chemotherapy, but no significant difference was found.
Relationship of gallbladder histopathology towards types of stones in cholelithiasis patients at Universitas Sumatera Utara Hospital, Medan, Indonesia
Authors: Muhar Adi Muradi , Siregar Denny Rifsal , Prabisma Doddy
Published: February 2022

Background: Cholelithiasis is a common disease of the gall bladder. It is estimated that around 10-15% of the population in western countries suffer from cholelithiasis. Types of gall bladder stones can be classified into cholesterol stones (containing cholesterol> 50%), mixed stones (containing 20-50% cholesterol), and pigment stones (containing cholesterol <20%). Cholelithiasis causes various histopathological changes in the gallbladder mucosa such as acute and chronic inflammation, Cholelithiasis, hyperplasia and carcinoma. The general objective of this study was to determine the histopathological relationship of the gallbladder to the type of stone in cholelithiasis patients at USU Hospital.Method: The design in this study was cross-sectional. The sample of this study was 49 samples of patients with cholelithiasis who underwent cholecystectomy either by open cholecystectomy or per-laparoscopic cholecystectomy at Universitas Sumatera Utara (USU) Hospital. Gallstones and gall bladder will be examined in the laboratory. Data analysis will use the chi-square test.Â Result: From 49 research samples found the most types of stones were mixed stones with 24 (49%) and histopathological results showed 18 examples (36.7%) were chronic inflammation. Based on the Chi-Square test found a significant relationship between the types of stones with histopathology of the gallbladder with a p-value of 0.001.Â Conclusion: There is a significant relationship between the type of stone with histopathology in patients with cholelithiasis.Â
Radiofrequency ablation for management of thyroid nodules: a case report
Authors: Yarsa Kristanto Yuli , Bellynda Monica
Published: February 2022

Background: Thyroid nodules constitute a frequently seen clinical problem and the incidence of thyroid nodules has increased with the recently increased use of thyroid ultrasonography. Radiofrequency ablation (RFA) is an effective and safe method for treating benign thyroid nodules and recurrent thyroid cancers.Case Presentation: A 48 years old woman came to the surgical oncology clinic with the presence of a getting bigger, moves when the patient swallows, and painless mass on her neck since 20 years ago. The physical examination measured 5x5 cm mass, mobile on swallowing, no pain on palpation, and the laboratory examination shows a euthyroid state. Â The ultrasound result has revealed an enlargement of the right and left thyroid with increased echo intensity of parenchyma and increased vascularisation. This mass was concluded as struma nodus bilateral. The FNAB was follicular neoplasm, Bethesda system class 4. The patient underwent a single session RFA. RFA was performed employing transisthmic access using a 7 cm 18 gauge electrode-needle with a 1 cm active needle tip. The patient well tolerated the procedure and no adverse events were noted.Â Conclusion: Radiofrequency ablation for thyroid lesions is a safe and effective method for treating benign thyroid nodules and even recurrent thyroid cancers. Therefore, various factors, including serum TSH, clinical risk factor assessment, size of the nodule, ultrasound characteristics, patient preferences, and results of the FNA biopsy, should be considered to manage thyroid nodule.
The success rate of distal transradial access on invasive cardiology procedures: the first Indonesian experience
Authors: Lubis Leonardo , Yahya Achmad Fauzi , Melina Ananda Lisa , Wirata Gede , Lesmana Ronny , Nasution Gita Tiara , Purba Ambrosius
Published: February 2022

Background:Â Distal transradial access (dTRA) in invasive cardiology procedures is becoming popular. It has greater potential and benefits than conventional transradial access (TRA) and transfemoral access (TFA) to reduce the risk of post-procedure complications and provide comfort to the patient and operator. This advantage is obtained from the distal radial artery located in the anatomical snuffbox that is more distal and superficial to bony foundation bearing, and anastomoses create the palmar arch. In Indonesia, the first invasive cardiology procedure using dTRA was performed at Hasan Sadikin Hospital.Aim: This study aims to determine the success rate of the distal radial artery access in invasive cardiology procedures at Hasan Sadikin General Hospital (RSHS).Methods:Â A quantitative study has been performed using 105 medical records of participants who had undergone invasive cardiology procedures via dTRA at RSHS from July 2017 to March 2020.Result:Â The study shows 97 patients successfully performed cannulation and sheath insertion, and 87 patients completed the procedure via dTRA. Conversion to other access was 13.33% and most of them were converted to TFA. A small number of post-procedure complications occurred in 3 patients (2.86%). There were no post-procedure complications such as major bleeding, radial artery occlusion and arteriovenous fistula.Conclusion:Â The tremendous success rate and the minimum vascular complications of dTRA in RSHS proved that dTRA is safe and feasible to be performed as the first choice on invasive cardiology procedures for Indonesian.
The role of endoscopic spinal surgery for the management of degenerative spinal diseases
Authors: Risdianto Ajid , Arianto Happy Kurnia Broto , Priambada Dody , Arifin Muhammad Thohar , Bakhtiar Yuriz , Brilliantika Surya Pratama , Tsaniadi Krisna
Published: February 2022

Background: Degenerative spinal disease increases in proportion to life expectancy. Surgical treatments that play an essential role in the management of degenerative spinal disease have evolved from open surgery to minimally invasive surgery as well as endoscopic spinal surgery. Advanced pathological understanding, diagnostic imaging, and instrument progress have support for endoscopic spinal surgery. The study aims to report the current situation of endoscopic spinal surgery to treat degenerative spinal diseases in the Department of Neurosurgery of Kariadi Hospital.Method: Review the Endoscopy Spine Surgery case in the Department of Neurosurgery of Kariadi Hospital with degenerative spinal diseases including canal stenosis and disc herniation at all levels.Results: A total of 123 degenerative spinal diseases have been treated with endoscopic spinal surgery. Most of patients comes with HNP (89 patients, 72.4%) and operated in lumbal segment (87 patients, 70,7%). Estimated blood loss parameter in <50 years group had mean 72.85 Â± 44.79 ml and >50 years group had mean 115.00 Â± 95.25 ml with p=0.001. We got high correlation between operation time and estimated blood loss with r = 0.779 and statistically significant (p=0.000)Conclusion: Endoscopic surgery appears to be an option for treating degenerative spinal diseases especially for herniation and canal stenosis. The lumbar and thoracic regions are common areas for endoscopic spinal surgery.
Use of smartphone-based self-monitoring blood glucose application in type 2 diabetes mellitus patients in Indonesia: A pre and post-test study
Authors: Kshanti Ida Ayu , Mokoagow Md Ikhsan , Rosandi Rulli , Epriliawati Marina , Nasarudin Jerry , Magfira Nadya
Published: February 2022

Background: The utilization of technology in diabetes management, especially self-monitoring blood glucose (SMBG), is growing rapidly. However, the effectiveness of SMBG applications on the smartphone is not yet known. This study aims to assess the effectiveness of using a smartphone-based SMBG application in type 2 diabetes mellitus (T2DM) patients in the Indonesian population.Methods: This is a quasi-experimental (before and after) study conducted at three tertiary hospitals in Jakarta and Malang, Indonesia. Inclusion criteria were T2DM patients aged 18 years and above who have been familiar with performing SMBGÂ  and manually record the results. All subjects were asked to use a smartphone-based SMBG application named Teman Diabetes application for six months, and patients' SMBG performance was assessed at the end of the study Bivariate analysis using T-test or with the Mann Whitney U test performed. Chi-square test is used to analyze the categorical with Risk Ratio (RR) and 95% Confidence Interval (CI). The p-value <0.05 (two-tailed) is considered statically meaningful.Results: From 100 patients enrolled in the study, 78 patients completed the follow-up. We found that the use of the SMBG application helped the subject overcome the difficulty in remembering to perform SMBG (p=0.004), helped change the subject's perception of the benefits of SMBG (p=0.049), improved the subject's diet pattern (p=0.006), and decreased the number of subjects who stopped performing SMBG due to self-perception of lack of benefit SMBG activity (p=0.049).Conclusions: The study found that using the SMBG application helps manage diabetes in T2DM patients.
Prognostic significance of double expressor lymphoma subtype in patient with diffuse large B-cell lymphoma
Authors: Istiadi Hermawan , Sadhana Udadi , Puspasari Dik , Miranti Ika Pawitra , Karlowee Vega , Listiana Devia Eka , Prasetyo Awal
Published: February 2022

Background: DLBCL is the most common type of non-Hodgkin lymphoma in Asia and Indonesia. DLBCL, based on cell of origin is divided into germinal center B-cell-like (GCB) and non-GCB subtypes. 20% of patients have a molecular profile double expressor lymphoma (DEL), which has a worse prognosis. The study aims to determine the relationship between DEL subtypes and cell of origin subtypes with clinical stage and 3-year overall survival of double large B-cell lymphoma (DLBCL) patients in Kariadi General Hospital Semarang.Methods: This study sample was 36 DLBCL patients in Kariadi General Hospital from January to September 2017. The data collection including age of diagnosis, location, stage, cell of origin subtype, DEL subtype and 3-year overall survival. Data analysis using chi-square test and Kaplan Meier curve.Results: DLBCL DEL subtype patients were significantly associated with advanced-stage (p: 0.028). DLBCL non-GCB subtype and DEL subtype patients had a 3-year overall survival that was significantly worse than GCB subtype and non-DEL subtypes (p: 0.026 and p: 0.006, respectively), with a 3-year survival rate of non-GCB subtypes was 38.9% and DEL subtypes were 33.3%. DLBCL patients with advanced stages also have a 3-year overall survival significantly worse than the early stage (p: 0.000), with a 3-year survival rate of 14.3%.Conclusion: DLBCL non-GCB subtype patients, DEL subtypes and advanced stages have a lower 3-year overall survival rate and thus have a worse prognosis
Phytochemical test and identification of active compounds with LC-MS/MS in green meniran leaf (Phyllanthus niruri Linn)
Authors: Widiadnyani Ni Kadek Eka , Astawa I Nyoman Mantik , Yasa I Wayan Putu Sutirta , Sukrama I Dewa Made
Published: February 2022

Background: Green meniran plant (Phyllanthus niruri Linn) is traditionally believed to treat many diseases, such as reducing fever, diarrhea, cough with phlegm, inflammation, malaria, and acne. This research aims to determine the class of compounds and active compounds in the ethanol extract of green meniran leaf.Methods: An experimental study was conducted using phytochemical testing includes qualitative and quantitative tests to identify the active compounds in green meniran leaf (Phyllanthus niruri Linn) by Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS). Crude powder packaging of green meniran leaf was conducted at Materia Medika Herbal Laboratory, Malang, Indonesia. The ethanol extraction from green meniran leaf was conducted at Pharmacology Laboratory, Faculty of Mathematics and Natural Sciences, Udayana University.Results: Based on the results of the phytochemical qualitative test, the green meniran leaf extract was positive for flavonoids, saponins, steroids, terpenoids, alkaloids, phenols, tannins, and glycosides. From quantitative phytochemical tests, we found the levels of phenolic, flavonoid, tannin 5.13%, 3.30%, 5.01%, respectively and 28.212.67 mg/kg chlorophyll. Identification using LC-MS/MS showed the suspected compounds Apigenin-8-C-glucoside from the glycoside group and 5,6,7-trimethoxyflavone from the flavonoid group.Conclusion: Green meniran leaf contains flavonoids, saponins, steroids, terpenoids, alkaloids, phenols, tannins, and glycosides with the active compounds Apigenin-8-C-glucoside and 5,6,7-trimethoxyflavone.
COVID-19 with ischemic stroke manifestations
Authors: Rahmawati Maria Belladonna , Andhitara Yovita , Ardhini Rahmi , Kurnianto Aditya , Pertiwi Amelia Carissa , Sinaga Rony Parlindungan , Larastiti Adinda
Published: February 2022

Background: Continuous pandemic caused by coronavirus disease (COVID-19) have been associated with high morbidity and mortality. COVID-19 has been linked to a hypercoagulable state that causes cerebrovascular complications. The most common cerebrovascular complication is ischemic stroke.Case Presentations: We report six cases of ischemic stroke with COVID-19, age 51-81 years old, consists of four males and two females. The main risk factors are hypertension and diabetes mellitus. Brain CT scan showed large vessel ischemic stroke in four patients. The patients were treated with Low Molecular Weighted Heparin followed by dual antiplatelet (aspirin and clopidogrel). The outcome was good recovery with minimal sequelae in four patients and death in two patients.Conclusion: Most of the stroke type in COVID-19 is large vessel disease, with main risk factors of hypertension and diabetes mellitus. Treatment with low molecular weight heparin (LMWH) followed by dual antiplatelet showed promising clinical improvement.
Correlation between the stress scale with cortisol levels in leprosy patients
Authors: Nazli Putri Astrid Novianti , Lubis Syahril Rahmat , Khairina Khairina
Published: February 2022

Introduction: Leprosy is an infectious disease caused by Mycobacterium leprae (M. leprae) that causes a complex problem. Stress can trigger several physiological responses, including the endocrine, nervous, and immune systems. In leprosy patients, stimulation in the form of infection and cytokine secretion lasts a long time, causing adrenal exhaustion, resulting in decreased serum cortisol production. This study aims to determine the correlation between the stress scale and cortisol levels in leprosy patients.Methods: This was a cross-sectional analytic correlation study with a consecutive sampling method. The research subjects were obtained from the Dermatology and Venereology Polyclinic of Universitas Sumatera Utara Hospital and the Dermatology and Venereology Polyclinic of Dr. Pirngadi Hospital Medan from March until November 2020. The research variables consisted of a stress scale and cortisol levels. Data analysis using the Spearman test. P-value <0.05 was significant. The study was conducted after approval from the Ethics Committee Faculty of Medicine, Universitas Sumatra Utara.Result: A total of 35 patients enrolled in the study, the majority had characteristics of the male gender, multibacillary type of leprosy, duration of leprosy in the group > 12 months, with a median age of 36 (19 - 79) years. The mean stress scale was 15.17 ± 6.3, with the mild stress scale was the most common. The median cortisol levels were 9.5 (4 – 20,8) g/dl, which was still in the low category. The lowest median cortisol levels were found in the multibacillary type of leprosy, duration of leprosy in the group > 12 months, and severe stress scale. There was a significant moderate negative correlation between the stress scale and cortisol levels in leprosy patients (p = 0.017; r = -0.402).Conclusion: The heavier the stress scale, the lower the cortisol levels in leprosy patients.
Analysis of malondialdehyde (MDA) levels in skin tags patients
Authors: Ridlo Muhammad , Putra Imam Budi , Jusuf Nelva Karmila
Published: February 2022

Â Background: Skin tags (known as acrochordon) are the most common benign skin tumors, usually skin-colored or hyperpigmented, found in the natural folds of the skin. They have been associated with various clinical conditions. A few studies results have been reported regarding the oxidative stress are strongly associated with skin tumor. Malondialdehyde (MDA) is an end product of lipid peroxidation by free radicals in the body. MDA assay is widely used as a biomarker to evaluate systemic oxidative stress in biomedical fields. This study evaluated the difference in serum MDA level in skin tags patients and controlMethods: This study is an analytic observational study with a cross-sectional design, including 40 patients with skin tags and 40 healthy volunteer controls, based on inclusion and exclusion criteria. Age, sex, and family history of skin tags were estimated on the patients. Diagnosis of skin tags was made based on history and clinical examination. Measurement of MDA level by enzyme-linked immunosorbent assay (ELISA) to the patients and controls. Mann- Whitney test is used to determine the differences in serum MDA levels. The results were significant, with a p-value <0.05.Results: Mean MDA level of skin tags patients was highest at age 50â€“ 59 years (27,01 Â± 10,87 nmol/ml). The mean MDA level of male skin tag patients (15,99 Â± 8,23 nmol/ml) was higher than females (15,23 Â± 8,17 nmol/ml). The mean MDA level of skin tag patients with a family history (19,77Â± 7,92 nmol/ml) was higher compared to patients without a family history (11,82 Â± 8,48 nmol/ml). The mean of MDA level was significantly higher in the skin tags group (15,81 Â± 8,23 nmol/ml) than the control group (8,86Â± 7,02ng/ml) with p = 0.032.Conclusion: There were higher significant differences in serum MDA levels in the skin tags patients than in control.
The correlation of blood thiamine concentrations with lactate acidosis in peritonitis patients with sepsis
Authors: Sinaga Maria Meilita , Budipramana Vicky Sumarki , Nugraha Jusak
Published: February 2022

Background: Vitamin B1 (Thiamine) functions as a pyruvate dehydrogenase cofactor to produce acetyl Co-A and activate the Krebs cycle in cellular metabolism. The hypermetabolic state in septic condition requires excess thiamin to keep the Krebs cycle functioning well. The thiamin level in the blood decreases and causes mitochondrial dysfunction and vice versa results in an increase in lactate levels. This study aims to evaluate the correlation of blood thiamine concentrations with lactate acidosis in peritonitis patients with sepsisMethods: Prospective observational study in 65 adult septic patients who came to the hospital with peritonitis and underwent laparotomy. Thiamine concentration was assessed on days 1, 3, and 5 by liquid chromatography-mass spectrometry (LC-MS). The primary outcome was lactate levels. Data was analyzed using SPSS version 23 for Windows.Results: The incidence of thiamine deficiency (TD) was 61.5% of patients. Specifically, 29 cases (44.6%) had absolute thiamine deficiency (TD) on presentation, 4 patients (6.1%) developed it on day 3, and another 7 patients (10.8%) on day 5. Thiamine was negatively correlated with lactate levels (r=-0.600; p=0.020). The relationship appeared after multivariable regression analysis controlling for sex, septic shock, and malnutrition. Overall, for the TD group, there was a significant association with septic shock, malnourishment, and Mortality (p<0.05). Conclusion: Thiamine deficiency had significantly raised lactate levels, which might increase the risk of Mortality.
Anti-diabetic properties of Stevia rebaudiana Bertoni as sugar substitute: a mini-review
Authors: Kristanto Yudi , Hartono Angeline Rosa
Published: February 2022

The incidence of obesity, type II diabetes mellitus, and metabolic syndrome in children and adults show an alarming increase worldwide. This increase was supported by one factor: the increasing availability of high-calorie foods and beverages, thus increasing the need for sweeteners. Researchers are driven to find a sweetener that can replace sugar. One of the natural sweeteners that can be used is the Stevia plant. Stevia contains stevioside, which is a natural sweetener with 300 times sweetness compared to sucrose. Besides, stevioside can reduce blood sugar levels and show benefits for people with diabetes.
Purple sweet potato extract and vitamin C increase the proliferation of endothelial progenitor cells from stable coronary artery disease patients
Authors: Suastika Luh Oliva Saraswati , Oktaviono Yudi Her , Soemantri Djoko , Sandra Ferry
Published: February 2022

Introduction: Endothelial progenitor cell (EPC) numbers are reduced in stable coronary artery disease (CAD), partly due to oxidative stress. This study aimed to evaluate the effect of different antioxidants, purple sweet potato (PSP) extract and vitamin C, on EPC proliferation in stable CAD patients.Methods: Peripheral blood mononuclear cells were isolated and cultivated on fibronectin-coated plates with the colony-forming unit (CFU)-Hill medium for three days. Non-adherent cells were divided into control, PSP extract (1, 5, 25 Î¼g/ml), and vitamin C (10, 50, 250 Î¼g/ml) groups; then cultured for two days. EPC proliferation was assessed with MTT Cell Proliferation Assay Kit. EPCs were identified by detecting the expression of CD34. Resulted CFU-Hill colonies were counted under an inverted light microscope.Results: EPC proliferation was increased in low, moderate, and high doses of PSP extract and vitamin C compared to control (all groups vs. control, p<0.001). The high dose of PSP extract increased EPC proliferation non significantly compared to the moderate dose (p=0.289). Vitamin C increased EPC proliferation better than PSP extract in moderate and high dose groups (p=0.042 and p<0.01, respectively). Meanwhile, the low dose of both treatments increased the EPC proliferation equally (p=0.353). CFU numbers, representing EPC differentiation capability, were highest in the groups given PSP extract compared to control and vitamin C groups.Conclusions: PSP extract and vitamin C increased EPC proliferation dose-dependently. Vitamin C induced EPC proliferation better than PSP extract. Furthermore, PSP extract was presumably a better EPC differentiation inducer.
Evaluation of patient's daily activities with Free Non-Vascularized Fibular Head Graft (FNVFHG) as a treatment after resection of proximal humeral tumors
Authors: Johan Muhammad Phetrus , Yurianto Henry , Firdaus Roichan Mochammad , Mubarak Andi Firman , Putra Luky Tandio , Kurniawan Tri
Published: February 2022

Introduction: Free non-vascularized fibular head graft (FNVFHG) is a method in handling bone defect after wide resection of the tumor.Methods: This study used descriptive research with the sample of three cases of proximal humeral giant cell tumor that underwent bone resection and reconstructed with a free non-vascularized fibular head graft. The outcomes were measured by the Musculoskeletal Tumor Society (MSTS) score, range of motion of the shoulder, and activity of daily living.Results:Â  The overall MSTS score of 3 patients was 73%. Two patients were able to perform all the shoulder motions, including flexion, extension, abduction, external rotation, internal rotation with limited range of motion, while the other patient could only perform restricted internal rotation. Two patients performed all of their daily activities with the affected extremity, including personal hygiene (tooth brushing), writing, eating, holding a glass, dressing, and riding a motorcycle. In contrast, the other patient encountered difficulty performing tooth brushing and self-feeding with the affected extremity, using the contralateral upper extremity.Conclusions: Free non-vascularized fibular head graft may serve as an option in handling bone defect after wide resection of musculoskeletal tumor at the proximal humerus. This method can be safely performed with an acceptable functional outcome.
The dynamic of Soluble Vascular Cellular Adhesion Molecule -1 (sVCAM-1) level in Overnutritious children with Dengue Infection
Authors: Elmy Saniathi Ni Kadek , Juffrie Mohammad , Rianto Bambang Udji Djoko , Soetjiningsih Soetjiningsih
Published: February 2022

Introduction: Dengue infection is still posed a significant medical challenge for pediatric population in developing countries. However, increased prevalence of overweight and obesity among children in those countries increased the possibility of the coexistence of these conditions. However, their interaction is still under investigated. Therefore, this study was aimed to study the dynamic of sVCAM-1 level as the known predictor of the severity of dengue infection with over nutritional status in children with dengue infection.Method: An analytic observational nested case-control study was conducted in Paediatric Division Sanglah General Hospital, Bali. The children with DHF between 6 months old to 12 years old were included as the case group while control groups consisted of pediatric patients with just Dengue Fever (DF) with the same age range. The diagnosis of dengue was established using 1997 WHO criteria while nutritional status was assessed using WHO curve. The sVCAM-1 was evaluated using ELISA technique.Results: The level of sVCAM-1 was significantly higher in patients with DHF than patients with DF only. The level was also fluctuated more in DHF patients. Likewise, the sVCAM-1 level was also significantly higher in DHF patients with overnutrition compared to normal DHF patients with a more fluctuated pattern over the course of 3 days (starting from day 4 to day 7). Finally, no significant finding was observed in sVCAM-1 level in DSS patients albeit the difference in concentration pattern.Conclusion: Overnutrition is seems to be associated with higher concentration of sVCAM-1 and higher fluctuation of its concentration in children with DHF.
The role of psychosocial stressors, carbohydrate and protein intake on serum serotonin and cortisol levels in patients with depression: a preliminary evaluation
Authors: Fitrikasari Alifiati , Wardani Natalia Dewi , Sumekar Tanjung Ayu , Saktini Fanti , Asikin Hang Gunawan , Sulchan Mohamad
Published: February 2022

Introduction: Depression is a mental disorder associated with biological, environmental and psychological factors. Depression is estimated to be a disease that requires the second largest expense on treatment. Chronic stress will reduce serotonin activity and storage and also stimulate the adrenal cortex to release cortisol and other glucocorticoid hormones. Nutritional intake such as carbohydrates and protein also plays a role in depression with various mechanisms. The study aims to investigate the role of psychosocial stressors, carbohydrate and protein intake on serum cortisol and serotonin levels in patients with depressionMethods: The study used an analytic observational approach with a cross sectional design. Subjects were selected by consecutive sampling and were asked to fill out the general characteristics questionnaire, Beck Depression Inventory (BDI) - II to determine depression levels, Holmes Rahe scale to measure psychosocial stressors, food frequency questionnaires to measure carbohydrate and protein intake. Subjects who met the inclusion criteria were taken blood samples to measure the cortisol and serotonin levels.Result: Of the 79 subjects, 57 (72%) women and 22 (28%) men with an average age of 43 Â± 3 years. A total of 64 (81%) subjects were with mild psychosocial stressors and 5 (6%) were severe. Psychosocial stressor were not significantly correlated with either serotonin (p=0.479), nor cortisol level (p=0.625) Carbohydrate were not significantly correlated with serotonin level (p=0.628) and cortisol level (p=0.252). Protein was not significantly correlated with serotonin level (p=0.688) and cortisol level (p=0.110).Conclusion: There was no correlation between psychosocial stressors, carbohydrate and protein intake with serum cortisol and serotonin levels in depressed patients.
The role of epidermal growth factor receptor as progression factor in cervical intraepithelial neoplasia and squamous cell carcinoma
Authors: Dewi I Gusti Ayu Sri Mahendra , Sriwidyani Ni Putu , Ekawati Ni Putu
Published: February 2022

Background: Cervical carcinoma is the most common cancer with a prevalence of 28.6% of all cancers in women in Indonesia and is one of the leading causes of death among gynecologic malignancies. Prevention and understanding are needed in terms of initiation and development of precancerous lesions into cervical cancer. About 90% of cervical cancers are squamous cell carcinomas that develop from intraepithelial neoplasia. Epidermal Growth Factor Receptor (EGFR) is an expression product of the proto-oncogene c-erbB-1 (HER-1), which plays a role in the proliferation, differentiation and acceleration of the transformation of malignant cells. This study aimed to prove the role of EGFR as a progression factor of cervical intraepithelial neoplasia and cervical squamous cell carcinoma.Methods: The study design was a cross-sectional analytic observational study, with a total sample of 36, which was taken from biopsy or surgery from patients with cervical intraepithelial neoplasia (CIN) and cervical invasive squamous cell carcinoma (SCC), whose tissues were examined at the Anatomical Pathology Laboratory, Faculty of Medicine, Universitas Udayana/Sanglah General Hospital. Histopathological diagnosis and determination of the type of malignancy were carried out by staining with Hematoxylin and Eosin (H & E). The immunohistochemical stain evaluated EGFR expression.Results: The age range of CIN was 21-48 years and SSC 33-61 years, mean age 41.8 Â± 10.55 years. A total of 16 (44.4%) showed CIN namely 9 (25%) low-grade CIN, 7 (19.4%) high-grade CIN, and 20 (55.6%) SCC. There was a significant difference in the expression of EGFR at low-grade CIN, high-grade CIN and SCC (p = 0.004). There was a significant difference in EGFR expression between low-grade CIN and high-grade CIN (p = 0.035) and between low-grade CIN and SCC (p = 0.003). There was no significant difference in EGFR expression between high-grade CIN and SCC (p = 0.441). Conclusion: EGFR has a role as a progression factor in CIN and SCC. There was no difference in the expression of EGFR between high-grade CIN and SCC, probably because in this study, carcinoma in situ was also included in high-grade CIN.
Prevalence of stress, anxiety and depression among Indonesian immigrant workers in Malaysia
Authors: Siregar Pinta Pudiyanti , Sutan Rosnah , Baharudin Azlin
Published: February 2022

Introduction: Being apart from family to work in a new environment requires sacrifice and endeavor to adapt to the foreign surroundings and, therefore, may cause perturbation and tension. The present study aimed to assess mental health problems among Indonesian women migrant workers in Peninsular Malaysia and their associated factors.Method: A cross-sectional study was conducted in three representatives of the Indonesian Government in Peninsular Malaysia: Indonesian Embassy in Kuala Lumpur and the Indonesian Consulate General in Johor Baharu and Penang. The target population was every Indonesian women worker who fulfils the inclusion criteria: reproductive age (18-45 years), legal workers, and stay in Malaysia for 12 months. A validated Indonesian Depression Anxiety Stress Scale (DASS21) questionnaire used has Cronbach's alpha of 0.95. Result: A total of 589 respondents participated with granted consent. The measurement of the prevalence of stress, anxiety and depression among workers was reported to be 151 (25.6%), 308 (52.3%) and 139 (23.6%), respectively. The multivariate logistic regression analysis found that younger age, longer working hours a day, and having reproductive health problems were significant predictors of negative emotional states.Conclusion: Early screening to identify risk groups at works helps reduction of mental health incidence.
The trend analysis of COVID-19 cases before and after the Large-Scale Social Restriction (PSBB) in four provinces in Indonesia
Authors: Saputri Rosalina Intan , Setiawan Winardi Emmanuel
Published: February 2022

Purpose: As the intervention of COVID-19 pandemic, Indonesia implemented Large Scale Social Restriction (PSBB). The aim of present research was to evaluate daily new cases, active cases, and daily death of COVID-19 before and after the implementation of PSBB in 4 provinces: Jakarta, West Sumatra, Gorontalo, West Java.Methods: Each parameter observed on four different time P0 (14 days before PSBB), P1 (0-13 days after PSBB), P2 (14-27 days after PSBB), and P3 (28-41 days after PSBB) from March 27, 2020 until May 22, 2020. Polynomial model was used to construct the trend of new cases and predicted active cases. The difference of the increase of new cases and the mean of death rate between periods was analysed using dependent T-test. The difference between predicted and measured active cases was analysed by independent T-test.Results: COVID-19 daily new cases increased at P1 in Jakarta and West Sumatra and differed at P2 and P3, while declined since P1 in Gorontalo and West Java. There was significant higher of COVID-19 active cases compare to predicted active cases at P1 in all provinces, except West Java. The trend of declining daily death after PSBB implementation was observed in all provinces.Conclusion: Different trends were observed in four provinces after the implementation of PSBB, which showed random trend of daily cases, mainly increase trend of active cases, and decrease trend of daily death. However, the length of PSBB implementation also differ, therefore prolonged observation was needed to evaluate the consideration of PSBB program continuation.
Radiological union analysis of femoral shaft aseptic nonunion after failed plate and screw convert to reaming intramedullary solid locking nail
Authors: Lengkong Andriessanto Ceelvin , Saleh M. Ruksal , Yurianto Henry , Putra Luky Tandio
Published: February 2022

Background: Non-united fracture shaft of the femur after plate fixation is a common problem. Management of this problem is still controversial. There are many methods for treating femoral shaft aseptic nonunions with a broken implant which conversion to reaming solid intramedullary nail is one of the procedures. However, the reported success rate varies. This study aimed to evaluate bone healing, especially callus formation, radiologically after nonunion reconstruction using intramedullary nailing reamingMethod: This study is a cross-sectional retrospective case analysis presenting 22 patients with the patient's age was 15 to 50 years old who underwent operation procedures managed by removing the hardware and converting to reaming solid intramedullary locking nail with or without autogenous iliac bone graft for at least six months. The bone healing process was assessed by serial plain radiography every six weeks using the Callus Index method.Results: Conversion to reaming solid intramedullary nailing after nonunion with broken implant gives union rate 95%. Among 22 patients, one patient persisted in nonunion, and two patients experience delayed union. The Callus index of Fracture location (P=0,043)      significantly affected index callus formation (P<0.05); The fracture location, whereas fracture classification (P=0,365), nonunion type (P=0,398), and bone graft (P=0,510) did not significantly affect index callus formation (P>0.05). There was no significant difference in time to the solid union between patients with or without iliac autogenous bone graft. Proximal third nonunion affects the time to solid union. No significant complications were noted.Conclusion: Nonunion reconstruction using solid reaming nail at both types nonunion gives a solid union. Solid union achieves with or without bone graft.
Staged modified Charles procedure on stage III lymphedema of lower limb: safe and effective: a case report
Authors: Yasa Ketut Putu , Ningrum Nurmalia Fitria , Samsarga Gde Wara , Hamid Agus Roy Rusly Hariantana
Published: February 2022

Introduction: Lymphedema of lower limb or elephantiasis is debilitating condition causes quality of life impairment, physical, mental, and social burdens. Surgical techniques of lymphedema are physiologic therapy and excisional procedure, one of them is Charles procedure. Currently, surgical approach controversies remain. This case report aims to present Staged Modified Charles Procedure on stage III lymphedema of lower limb, other excisional procedure techniques. Case description: A Male, 43 years old, complain enlargement of left leg since 18 years ago, his leg was bigger and heavier gradually with intermittent pain until he got difficult to walk. History of trauma, or previous surgery was denied. There were lymphostatic elephantiasis, non-pitting edema with skin changes (acanthosis, increase in thickness, fat deposition, and fibrosis) on physical examination. The patient was diagnosed as lymphedema stage III. Modified Charles's procedure consisted of two-stage tissue excision, negative pressure wound therapy, and delayed skin graft. There were no fluid or blood loss, and infection, obtained 95% of skin graft take, good wound healing, and maximum soft tissue reduction. Histomorphologically supports the  diagnosis of elephantiasis. Conclusion: Staged modified Charles procedure on stage III lymphedema of lower limb are safe and effective treatment, provide maximum tissue reduction, with excellent skin graft and wound healing, without fluid and blood loss, or infection.