bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence factors and strategies for handling health workers’ anxiety in providing health services for COVID-19 variants
Authors: Firdaus  , Hasina Siti Nur , Setianto Budhi
Published: December 2022

Introduction: Analysis of health workers' anxiety in providing patient services towards the COVID-19 variant has never been done well. Therefore, this study analyzes factors that affect anxiety among health workers because it has the potential to interfere with health services. The purpose of the study is to analyze the factors that affect the prevalence of anxiety among health workers in providing patient services variant of COVID-19.
Methods: Participants involves health workers who handle patient variant of COVID-19. The data collection was approved by the research ethics committee of Surabaya Islamic Hospital A.Yani. Data source taken in Surabaya and surrounding areas in June 2021 namely N= 300-400 data breeding techniques is purposive sampling, research instrument is in the form of questionnaires by sharing to social media using a google form, data in the univariate analysis is done descriptively to see the respondents' characteristics and bivariate analysis is used to analyze factors affecting anxiety in statistical tests used is regression ordinal.
Results: The results of statistical analysis obtained factors that affect anxiety, namely: female sex obtained = 0.02), age 30 years obtained results= 0.00, working in public health center = 0.08, nursing profession= 0.25, unmarried= 0.00, works outside Surabaya= 0.00, has a child and 2-3 children= 0.00.
Conclusions: The study was conducted to analyze the prevalence factors of health care workers' anxiety in providing care for patients with COVID-19 variants and how the anxiety management strategies that resulted in this greatly contributed to the condition of health workers with psychological problems, namely anxiety.
The effectiveness of using peek acuity in vision screening for the admission of elementary school students
Authors: Aritonang Christina , Putri Salsabila Auliya , Utomo Budi
Published: December 2022

Background: Limiting close physical contact is key to helping reduce the spread of the coronavirus by using the portable eye examination kit (Peek Acuity), which has been recognized as a reliable and valid tool to measure visual acuity. This study is aimed to compare the effectiveness of the Peek Acuity and ETDRS (Early Treatment Diabetic Retinopathy Study) chart as the gold standard for screening in school-age students.
Methods: This study used an observational research design with cross-sectional data collection methods to compare the effectiveness of the Peek Acuity application diagnostic test and ETDRS chart for screening in school-age students. Sample collection was done by total sampling technique on students aged 6-12 from one of the elementary schools in Surabaya. The study was conducted from October 2019 to November 2019. OpenEpi analyzed the validity and reliability of the results to compare the effectiveness of Peek Acuity and the ETDRS chart.
Results: There were 231 students with details aged 6-9 years, as many as 150 students and aged 10-12 years, as many as 81 students. On examination of visual acuity using peek acuity and ETDRS chart, it indicated that the number of subjects with refractive errors was more than normal eyes. Peek acuity has been shown to have low sensitivity and high specificity. Higher specificity was found in children aged 10-12 years compared to 6-9 years.
Conclusion: The Peek Acuity application has higher effectiveness in screening than the ETDRS chart. It is practical, fast, and easy to use. The Peek Acuity application is considered effective for screening school-age students due to its high rate of specificity
Beliefs and acceptance of covid-19 vaccination among nursing students: a cross-sectional study
Authors: Yunita Rizka , Wahyusari Shinta
Published: December 2022

Introduction: COVID-19 is a disease that causes severe respiratory infections and has spread to various countries around the world, including Indonesia. The Indonesian government has made efforts to curb the spread of COVID-19 through vaccination. However, public acceptance of the vaccine varies among Indonesians related to COVID-19 vaccination beliefs. The purpose of this study was to assess the relationship between beliefs and acceptance levels of Covid-19 vaccination among nursing students.
Methods: This research used correlation analysis with a cross-sectional study involving 145 nursing students which selected by simple random sampling. This study used self-administered questionnaire to measure beliefs and acceptance of COVID-19 vaccination. Data were analyzed by Pearson’s Product Moment.
Results: The result showed that there is a high correlation between beliefs and acceptance of COVID-19 vaccination among nursing students with p value=0,000 and r=0,876.
Conclusion: Beliefs is one of the factors that influenced the acceptance of vaccination COVID-19 among nursing students, which can be used as a basis for providing future health education.
A patient with CD4+ T cells deficiency and HIV negative with pulmonary tuberculosis, tuberculous pleuritis and meningitis tuberculosis
Authors: Triwicaksana Anak Agung Fendy , Musofa Rusli  , M. Vitanata Arfijanto  , Bramantono  , Nasronudin  , Usman Hadi
Published: December 2022

Background: CD4+ T cells deficiency generally occurs in human immunodeficiency virus (HIV) patients, leading to some infections such as pulmonary and extrapulmonary tuberculosis. A rare case of decreased CD4+ T cells is idiopathic CD4+ T cell lymphocytopenia, a rare and unexplained immunodeficiency syndrome with no evidence of HIV infection. In this case report, we are reporting a patient with CD4+ T cells deficiency, pulmonary tuberculosis, pleuritis tuberculosis, and meningitis with HIV test negative.
Case Presentation: A 58-year-old male was referred to the Emergency Department of Dr. Soetomo General Hospital with a gradual decrease of consciousness following six days of hospitalization at a private hospital. During hospitalization, one liter of fluid was evacuated from the right lung and analyzed, revealing tuberculosis infection. History of diabetes, hypertension, stroke, hepatitis, and cardiovascular disease was denied. The patient also never had chemotherapy or radiation treatment. Based on history taking, physical examination, and laboratory results, this patient has been diagnosed new case of pulmonary tuberculosis with deficiency CD4+ T cells and altered consciousness et causes meningitis tuberculosis with pleurisy tuberculosis. After 32 days of hospitalization with anti-mycobacterium therapy, the patient was improved and was discharged.
Conclusion: This case highlights the challenges of having the definitive cause of CD4+ T cells deficiency either active tuberculosis infection or idiopathic CD4+ lymphocytopenia. Therefore, serial analyses of CD4+ T cells are advised on the patient during the treatment with anti-tuberculosis drug.
Omega-3 effectiveness against viability extended random skin flap in rats
Authors: Kurniawan Rifqi , Rizaliyana Sitti , Nata’atmadja Beta Subakti Nata’atmadja
Published: December 2022

Background: Grafts and flaps are commonly used for wound closure which can be caused by trauma, chronic disease, post excision tumors, burns, and infections. Reconstructive can fail because of the poor wound bed, radiation, vascular insufficiency and reperfusion injury (IR). EPA and DHA (omega-3) are new compounds that have a strong effect on controlling inflammation in the resolution phase. Some studies say that EPA and DHA (omega-3) are described not only to lower plasma triglyceride levels but also have anti-inflammatory effects and improve endothelial function, all of which mediate anti-atherogenic effects. This study aimed to prove whether preoperative omega-3 administration could increase the viability of extended random skin flaps
Method: This is an experimental post-test-only control group design. 24 rats were divided into 4 groups. The control group (I and II) only had an extended random skin flap, and the sample was taken on the 3rd day (Group I) and 7th day (Group II) and the treatment group (II and IV). Omega was administered according to the animal dose for 21 days. The extended random skin flap was performed, and the sample was taken 3rd day (Group III) and 7th day (Group IV) and the viability of the extended random skin flap in the study was assessed from the expression of VEGF, the number of capillaries and clinical examination assessed from survival area.
Results: Independent T test for each pair in groups I and III showed a significant difference between the mean number of blood vessels in group I and the average number of blood vessels in group III, P=0.000, p<0.005, a significant difference between the mean number of blood vessels in group II and the mean number of blood vessels in group II. group IV blood vessels obtained P = 0.000, p <0.005. Mann-Whitney test found a significant difference between the intensity of VEGF in groups I and III with a value of p=0.031 (p<0.05) and a significant difference in VEGF expression in groups II and IV with p=0.038 (p<0.05). The results of the statistical test of survival area independent T-test for pairs in groups I and III obtained p: 0.353 (p>0.05), and the Mann-Whitney test for groups II and IV obtained p: 0.749 (p>0.05).
Conclusion: Consumption of omega 3 oral before surgery increased the viability of the extended random skin flap by histopathologically increasing VEGF expression and capillary count, and omega 3 oral administration before surgery did not increase the viability of the extended random skin flap assessed from the survival area on the first week.
Comparison of the effectiveness between single and repeated administration of topical Tretinoin 0.05% on full-thickness acute wound healing
Authors: Surjantoro Abraham , Zarasade Lobredia , Hariani Lynda
Published: December 2022

Background: A wound is a discontinuity of any bodily tissue due to various causes. Every wound of any severity could result in problems related to its healing process, such as scar tissue formation. According to the duration of its healing process, wound is divided into 2 categories: acute wound that takes approximately 3-4 weeks to heal and chronic wound that needs 4-6 weeks and resulted from inappropriate healing of the acute wound. Tretinoin's use in wound healing has been controversial for more than 40 years. Topical Tretinoin has keratolytic effect that stimulates fibroplasia and epithelization on full-thickness wounds. On the other hand, single administration along with long-contact topical Tretinoin has an irritative effect that could delay healing due to continuous inflammation. This study aims to explore the effectiveness of single administration compared to repeated administration of topical Tretinoin in full-thickness acute wound healing on rats at Faculty of Veterinary Medicine, Airlangga University, Surabaya.
Methods: This experimental study involved 27 male rats which were randomly divided into 3 groups: control (A), single-administration (B), and repeated-administration (C). Full-thickness wound size 20 mm in diameter was made on the skin of each rat. On group A, wounds were covered with Tulle and transparent dressing. On group B, wounds were treated with lidocaine 2% and tretinoin solution 0,05% in single administration, while the same treatment was given repeatedly on group C for 4 days straight. Evaluation was done microscopically on day 5 according to epithelization phase on wound healing with hematoxylin and eosin (H&E) staining.
Results: The result from the calculation showed that group C obtained a significantly higher average number of fibroblast cells count compared to the treatment group A and B. The average number of fibroblast cells in treatment group B was three times higher than the number of fibroblast cells in treatment group A, while the average number of fibroblast cells in treatment group C was three times the number of fibroblast cells in treatment group B. From the statistic, it was proven that the regular application of 0.05% topical tretinoin solution in a full-thickness wound (Group C) has shown a significant increase in the number of fibroblasts during the proliferative phase.
Conclusion: A frequent administration of 0.05% topical tretinoin solution resulted in a higher number of fibroplasia improvements compared to once administered in full thickness acute wound healing, however it did not result in epithelialization on day 5.
A fatal case of Norwegian scabies in a patient with diabetes mellitus
Authors: Rahmawati Nur Atina , Chomariyati Alvi , Mudjanarko Sony Wibosono
Published: December 2022

Background: Diabetes mellitus (DM) is characterized by hyperglycemia due to a defect in insulin secretion, action, or both. Immunocompromised individuals such as those with DM tend to suffer from skin disorders, including crusted scabies (Norwegian scabies). However, studies regarding the incidence of Norwegian scabies are still limited. This article reports a case of an elderly diabetic patient suffering from crusted scabies.
Case Presentation: A 67-year-old male patient was referred to Dr. Soetomo Hospital with sepsis caused by suspected skin infection, hypertension, and type 2 DM. The patient presented with a chief complaint of recurrent skin diseases throughout the body and itching for the past three years. The itching became severe in the last three weeks prior to the hospital admission. The patient had a medical history of diabetes, tuberculosis, hypertension, and arrhythmia. Based on our assessments the patient was diagnosed with crusted scabies, septic shock, sepsis, pneumonia, pulmonary tuberculosis, hypoalbuminemia, type 2 DM, and erythroderma. The patient received oxygen, antibiotics, norepinephrine, albumin, ranitidine, metoclopramide, NovoRapid, ventolin nebules, rehydration, topical keratolytic cream, and scabicidal cream as therapies. However, on the 3rd day of the treatment, the patient suffered from type 1 respiratory failure and passed away the next day due to septic shock.
Conclusion: We reported a diabetic male patient suffering from crusted scabies, accompanied by pneumonia, pulmonary tuberculosis, hypoalbuminemia, and type 1 respiratory failure. Secondary infections had been developed at the time of presentation. Therefore, establishing an early diagnosis of Norwegian scabies will help prevent the disease's progression.
The correlation between cotinine levels in active smokers with color blindness
Authors: Prihatningtias Riski , Maharani  , Hendrianingtyas Meita , Amelia Rahma Athifah , Setiawan Limijadi Edward Kurnia
Published: December 2022

Introduction: Color blindness can be congenital or acquired due to certain diseases. One of the causes of acquired color blindness is due to toxic optical neuropathy. Tobacco consumption, assumed to be one of the risk factors, has been proposed to be associated with toxic optical neuropathy. Active smokers are subjects who are susceptible to the toxic effects of tobacco. This study aimed to analyze the correlation between blood cotinine levels in active smokers with color blindness.
Methods: This study was an observational analysis of 33 smokers and 35 non-smokers samples. Cotinine levels were examined from blood samples, which were then examined by Calbiotech reagent. Farnsworth Munsell 15 Hue was used to examine color vision. Statistical analysis was done using Shapiro-Wilk for normality distribution data, Mann Whitney and Independent T-test comparing data between two groups, and Spearman correlation test.
Result: There was a significant difference between the mean color blind error score in the smoker group (4.83 ± 6.27) and the non-smoker group (0.24 ± 0.65). Similarly, a significant difference was found between the blood cotinine level of the smoker group (64.59 µg/ml) and the non-smoker group (0.44 µg/ml). There was a significant correlation between the color blind error score and blood cotinine levels in the total sample.
Conclusion: There was a correlation in the total sample between blood cotinine levels and a color-blind error score. The higher the blood cotinine level, the higher the color blind error score.
TNF-α inhibitor administration in psoriatic arthritis patient with latent tuberculosis and cardiovascular disease as an extra articular manifestation
Authors: Nurrakhmadaniyah  , Rahmawati Lita Diah
Published: December 2022

Introduction: Psoriatic arthritis is a spondyloarthropathy subtype with a broad clinical spectrum and diverse symptoms. The use of biological disease-modifying antirheumatic medications (DMARDs), such as TNF inhibitors is recommended as pharmacological therapy for PSA in cases of axial involvement and high disease activity level. Since Indonesia has the second-highest tuberculosis (TB) cases globally, and patients receiving TNF inhibitors have an elevated risk of latent TB reactivation, evaluation of latent TB before starting TNFi is necessary and challenging.
Case Presentation: A 63-year-old male psoriatic arthritis patient with bilateral hip joint osteoarthritis, bilateral knee effusions and bilateral frozen shoulder. The patient also had coronary heart disease with a history of underwent coronary artery bypass graft (CABG), diabetes mellites type 2 and confirmed latent TB. Psoriatic arthritis had high activity based on the Bath Ankylosing Spondylitis Disease Activity (BASDAI) score and Ankylosing Spondylitis Disease Activity Score (ASDAS). TNF inhibitor treatment started a month after latent TB treatment. The patient responded satisfactorily to the TNFi treatment, as demonstrated by clinical evaluation and decreased disease activity. Latent TB treatment was continued for up to six months, followed by latent TB activity monitoring during TNFi administration to prevent latent TB reactivation.
Conclusion: This case highlights the challenges in management of axial psoriatic arthritis patients with high disease activity, concomitant latent TB infection, and early extra-articular symptoms of cardiovascular disease.
Comparison of acute appendicitis severity in pandemic and non-pandemic periods of COVID-19: a comparative study
Authors: Achmad Musa  , Marjono Dwi Wibowo  , Denny Septarendra
Published: December 2022

Background: Acute appendicitis is the most common cause of abdominal surgery. The delay of diagnosis and surgery increases the risk of perforated appendicitis, which is associated with increased morbidity and mortality. The COVID-19 pandemic has an impact on the delays in the diagnosis (time-to-diagnosis) and therapy (time-to-intervention). In this study, we aimed to analyze the profiles and characteristics of acute appendicitis patients in COVID-19 pandemic and non-pandemic periods in Indonesia.

Methods: We collected samples from all patients with acute appendicitis who visited the emergency department from November 10, 2018 – February 10, 2020 (non-COVID-19 pandemic) and March 11, 2020 – August 11, 2021 (COVID-19 pandemic). The data are secondary data taken from medical records. We collected the patient’s demographic data (e.g., age and sex), operation description, length of stay, and duration of the operation.

Results: We recruited a total of 121 patients, consisting of 56 patients during the non-pandemic period and 65 patients during the pandemic. Based on the severity, patients with grade 1 were the most common during the non-pandemic period, while patients with grade 4 were the most common during the pandemic. There was a significant difference between the severity of acute appendicitis during the non-pandemic and the pandemic (P < 0.0001). During non-pandemic periods, the majority of patients were hospitalized for 3-4 days, while during the pandemic, the majority of patients required hospitalization of up to 5-6 days.

Conclusion: There was a substantial difference in the severity of acute appendicitis patients during the COVID-19 pandemic and non-pandemic periods.
Correlation between hemolysis index and storage period to potassium levels of Packed Red Cell in Sanglah General Hospital, Bali, Indonesia
Authors: Clareza Arief Wardhana  , Anak Agung Wiradewi Lestari  , I Nyoman Wande  , Sianny Herawati  , Ni Nyoman Mahartini
Published: December 2022

Background: The quality of a blood product is determined by collecting, processing, storing, and transporting it. When blood is stored, there will be mechanical and biochemical changes. Mechanical changes consist of morphological changes and hemolysis, while one of the biochemical changes is increased plasma potassium levels. This study aimed to determine the correlation between the hemolysis index and the storage period to potassium levels of the packed red cell (PRC).

Methods: This study was a cross-sectional study at Sanglah Hospital. The sample was taken from the tube in the PRC blood bag and then a complete blood count and potassium analysis were performed. Data were analyzed using SPSS version 25 for Windows.

Results: From 70 subjects, the median hemolysis index was 0.15% (0-1.69%), the mean storage period was 12.06±4.95 days, and the mean potassium level was 12.06±3.92 mmol/L. The Spearman test results showed a positive weak significant correlation between the hemolysis index and potassium levels (r=0.360; p=0.002). The Pearson test results also showed a positive weak significant correlation between the parameter of the storage period and potassium levels (r=0.357; p=0.002).

Conclusion: There was a positive weak significant correlation between the hemolysis index and the storage period to potassium levels of the PRC.
Current surgical interventions of Charcot neuroarthropathy of the foot and ankle: a systematic review
Authors: I Wayan Subawa  , I Gusti Ngurah Bagus Andhika Pramana  , Adiet Wahyu Kristian  , Putu Bihan Surya Kinanta
Published: December 2022

Introduction: Charcot neuroarthropathy (CN), also known as Charcot's foot, is consequently causing a reduction in quality of life, high disability, and an increased risk of mortality that poses many clinical challenges in its diagnosis and management. Common surgical interventions typically include ulcer debridement, exostectomy, deformity correction, and minor and major amputations.
Methods: This systematic review was conducted using the PRISMA guideline. Literature research incorporating PubMed/ MEDLINE database for English language studies published in the last 5 years with the key terms defined using the PICO framework, which includes: Charcot, neuroarthropathy/arthropathy, neurogenic, and surgery, which were used interchangeably. A further set of keywords within the topic were then identified, including ankle, hindfoot, foot, fore-foot, and mid-foot.
Result: 221 feet undergone surgical reconstruction. Bony fusion occurred in 154 of 221 feet (71%), 79 of 128 feet (62%) in internal fixation, 47 of 58 feet (81%) in external fixation, and 29 of 34 feet (85%) in the utilization of both internal and external fixation.
Conclusion: Charcot neuroarthropathy poses many clinical challenges in its diagnosis and management. Many experts have proposed the implementation of different strategies to manage this complex condition depending on the acute and chronic phases of its nature. Delayed diagnosis can result in a severe deformity that can act as a gateway to ulceration, and infection and, in the worst case, can lead to limb loss. Further studies aimed at determining selection criteria and treatment algorithms are required for greater standardization of outcomes.
Factors associated with lymph node metastasis in endometrial cancer
Authors: Iskandar Teuku Mirza , Putra Very Great Eka , Ambari Ediwibowo , Cahyono Endy , Lubena
Published: December 2022

Introduction: Lymph node metastasis is considered one of the most significant prognostic markers in endometrial cancer, particularly in the initial stages. As the incidence rate of endometrial cancer increases, appropriate treatment is needed to increase the survival rate, including lymphadenectomy. This study aims to compare the characteristics of endometrial cancer with or without lymph node metastasis.
Methods: A retrospective analytical study of 155 women with a history of endometrial cancer
following complete surgical staging treatment from January 2017 to December 2021 at Dr. Kariadi General Hospital Semarang. All data were obtained using medical records.
Results: All 155 patients were divided into two groups, with and without lymph node metastasis. Of these, 19 patients have lymph node metastasis (12.25%). The body mass index is the only subject characteristic that is statistically significant between the two groups (p=0.024). In our multivariable risk analysis, three clinical variables were identified that might predict the probability of lymph node metastasis, including ovarian metastasis (OR=2.98, p<0.01) and cervical metastasis (OR=8.27, p=0.002), and tumor differentiation grading (OR=6,77, p<0,01).
Conclusion: The study results indicated ovarian metastasis, cervical metastasis, and tumor differentiation grading were independent prognostic factors for lymph node metastasis.
Mielopathy’s Like Symptom in Guillain Barre Syndrome: Case Report
Authors: Ahadiyati Ida , Ardiansyah Djohan , Fadil
Published: December 2022

Background: Guillain-Barré syndrome (GBS) is a peripheral nervous system inflammatory disease that is the most prevalent cause of acute flaccid paralysis, with an annual global incidence of 1-2 per 100,000 person-years. GBS typically appears with acute ascending flaccid paralysis and sensory abnormalities in anesthetic glove stockings; paralysis may extend to cranial muscles. Although the disease’s clinical presentation is diverse and there are multiple discrete clinical forms, myelopathy as a sign of GBS is a relatively unusual condition.
Case presentation: GBS is diagnosed in a 29-year-old woman with myelopathy symptoms such as tetraparesis, hypoesthesia below the level of second thoracal myelum, aberrant proprioceptive in lower extremities, retention of urine and anhidrosis. We perform a lumbar puncture, and a cerebrospinal fluid (CSF) examination reveals albumin-cytological dissociation. Cervico-thoracic magnetic resonance imaging (MRI) revealed no abnormalities. Demyelinating polyradiculopathy was discovered using electromyography (EMG) and nerve conduction studies (NCS).
Discussion: The classical presentation of GBS is progressive (ascending) limb weakness with decreased or absent physiological reflexes. Pharyngeal–cervical–brachial variation and face diplegia with paraesthesia are rare variations of GBS. Our patient presented with ascending limb weakness accompanied by a disturbance in the central nervous system but had similiar serological biomarker, which may be another rare variant of GBS.
Conclusion: Diagnosis of GBS is quite challenging. GBS has a wide range of clinical symptoms. EMG-NCV and lumbar puncture are still required in myelopathic individuals with normal MRI, and unusual GBS symptoms should be explored. As a result, the choice of therapy and management becomes more appropriate.
The effectiveness of the self-care management model in midwife care through android application as an effort to increase the ability of pregnant mothers in early detection of pregnancy at risk during the COVID-19 pandemic
Authors: Mardiyanti Ika , Munjidah Annif , Handayani Nanik , Abidah Siska Nurul , Novianti Hinda , Laili Uliyatul , Rizki Lailatul Khusnul
Published: December 2022

Introduction: The ability of pregnant women to detect early-risk pregnancies is still low, which is one of the causes of complications that can endanger the welfare of the mother and fetus. This research analyzed the effectiveness of the Self Care Model in Midwifery Care through an Android Application on the Ability of Pregnant Women to Early Detection of Risky Pregnancy During the Covid-19 pandemic.
Methods: The data of this study of pregnant women who conducted examinations at PMB Ika Mardiyanti in Maret-May 2021 involved a sample of 100 obtained by simple random sampling. This study uses an analytic design with a cross-sectional design. Data analysis using the Wilcoxon Signed Rank Test.
Results: The results show that Asym. Sig. (2-tailed) obtained < (0.0001 < 0.05), this means that the Self Care Model in Midwifery Care through the Android Application is effective for increasing the ability of pregnant women in early detect risky pregnancies during the COVID-19 pandemic.
Conclusion: The research conducted to analyze the self-care model in midwifery care through the android application contributes to increasing the efforts of pregnant women to care for their care during pregnancy to prevent the dangers of pregnancy.
The effect of oral phenytoin and vitamin C therapy on enterocutaneous fistula healing
Authors: Yohannes Sugiarto  , Ignatius Riwanto  , Trilaksana Nugroho
Published: December 2022

Introduction: Phenytoin is reported to heal the enterocutaneous fistula. Meanwhile, vitamin C is known to improve wound healing. The comparison of phenytoin and vitamin C in the treatment of enterocutaneous fistula is never reported.
Methods: A randomized controlled trial with a post-test-only group design using artificial enterocutaneous fistula Ratus Norvegicus male Wistar rats were reported. Rats were divided into four groups randomly, namely, Control (K), Treatment 1: combined phenytoin and vitamin C (P1), Treatment 2: phenytoin (P2), and Treatment 3: vitamin C (P3). Variables under study were a number of fibroblast and angiogenesis. One Way Anova test, followed by the Post-Hoc Test, was used to test the difference among and between groups.
Results: The mean value of fibroblasts in groups K (501.86 ± 107.10), P1 (861.53 ± 25.99), P2 (719.93 ± 24.61), P3 (781.46 ± 28.23). The mean value of angiogenesis in groups K (18.63 ± 4.24), P1 (48.86 ± 10.23), P2 (26.26 ± 1.64), P3 (31.96 ± 2.97). The Post-Hoc test showed that were significant differences in the number of fibroblasts and angiogenesis from the group given a combination of oral phenytoin and vitamin C therapy compared to the group given oral phenytoin, vitamin C, and control (p <0.05).
Conclusion: A combination of oral phenytoin and vitamin C therapy increased the number of fibroblasts and angiogenesis of enterocutaneous fistula in Wistar rats, better than single.
Exercise decrease the expression of MCP-1 in perivascular adipose tissue (PVAT) in obese mice
Authors: Salim Hotimah Masdan , Aisyah Aisyah , Shimabukuro Michio
Published: December 2022

Introduction: Exercise has been believed to prevent metabolic syndrome (Mets) from occurring.  Accumulation of inflammation factors such as monocytes chemoattractant protein-1 (MCP1) in adipose tissue is a factor in the development of MetS. However, the inflammatory mediators that play a role in the accumulation of macrophages are still unclear, so this study aims to determine the expression of MCP-1 in perivascular adipose tissue (PVAT).
Methods: Eight-week-old male wild-type mice, were divided into five groups. One control group was given a standard diet and four groups were given a high-fat diet (HFD) for 2 weeks. Exercise treatment was given to the HFD group by dividing HFD with exercise once a week, HFD with exercise three times a week, and HFD with exercise five times a week. As for the exercise, speed is given 10-18m/minute for 30 minutes. and this exercise is carried out for two weeks. Gene expression of MCP-1 in PVAT tissues was analyzed using quantitative chain reaction (PCR).
Results: The HFD group experienced an increase in body weight (P <0.01) and adipose tissue mass (P <0.01) compared to the control group. Furthermore, exercise decreased body weight (P <0.05) and adipose tissue in the HFD-Exc1 group (P <0.01). Furthermore, exercise tends to decrease the inflammatory mediator in macrophages MCP-1 in PVAT compared to the HFD group.
Conclusion: These results suggested that exercise partially reduces adiposity, tended to decreases MCP-1 in HFD-induced obesity.
A study of molecular docking of l-tryptophan ligand as a compound in pineapples and bananas binding with the human serotonin transporter (SERT)
Authors: Purnawati Susy , Wrasiati Luh Putu , Jaya Lesmana Cokorda Bagus , Sandra Megantara  , Lesmana Ronny
Published: December 2022

Introduction: Low mood condition is related to a low level of brain serotonin. An early sign of depression with low mood symptoms is generally treated with psychotropic drugs that work as selective serotonin reuptake and monoamine oxidase (MAO) inhibitors (one of which is sertraline), to increase serotonin levels in the brain. There are some concerns regarding side effects available medication like serotonin syndrome, suicidality and aggressive behavior. Thus, development of alternative herbal products made from a combination of pineapple and banana extract with less side effect and its potential affinity with serotonin regulation is important.
Aim of the study: To determine potential herbal rich (banana and pineapple) of L-tryptophan and potential active compounds interaction with the human serotonin transporter.
Method: In the present study, using in silico molecular docking techniques, the active compound of banana and pineapple and its potential interaction with human serotonin transporter were assed. Docking study explored the bioactive compounds interactions with specific target like catechin, dopamine, epigallocatechin, gallic acid, L-tryptophan, malvidin, norepinephrine, pelargonidin, peonidin, and serotonin. Molecular docking simulations were performed using AutoDock 4.2 software. The docking method was validated first by re-docking sertraline (nature ligand) in a complex with PDB ID: 6AWO against the target receptor (SERT).
Result: The molecular docking results had showed that L-tryptophan, peonidin, and catechin could bind to esential amino acid residues in the binding pocket, with binding affinity -5.69,  -8.63, -8.24 kcal/mol respectively.
Conclusion: L-tryptophan, peonidin, and catechin are the most promising compounds that have good potency as anti-depressant agents through SERT inhibitory activity. This compounds in bananas and pineapples have the potential to affect serotonin transporter receptors that play a role in mood and behavior.
Behavioral intervention on nonpharmacological pain management for child : a systematic review
Authors: Wesiana  , Ugrasena  , Yuni Sufyanti  , Nur Hidayah  , Resti Utami
Published: December 2022

Introduction: Children should not only be managed in high pain conditions; pain management in children should also involve moderate procedures, particularly invasive. Behavioral intervention is pain management for children since it is invasive action. The study's objective was to examine how behavioral therapies were used to treat children's discomfort without the use of drugs.
Method: We used PRISMA principles and conducted a systematic review. The original keywords utilized were "child," "behavioral treatment," and "pain management," which were further developed using "medical subject headings." Scopus, PubMed, and Research Gate were the three databases that were searched for prospective papers published between 2000 and 2020.
Results: Children can experience less pain by engaging in behavioral interventions like joyful pingu pain relief, cognitive behavioral therapy, positive reinforcement, graphic books about intravenous placement for training the desired behavior, and watching their favorite music videos.
Conclusion: Children can experience less pain with the help of behavioral therapies like happy pingu, cognitive behavioral therapy, picture books about intravenous placement, and watching their favorite music videos. These interventions train the desired behavior and can also be used to stop discomfort.
Phytochemical screening, antioxidant activity and cytotoxicity assay from noni juice and fermented noni (Morinda citrifolia L.)
Authors: Handayani  , Wulandari Devyana Dyah , Wulansari Devyani Diah
Published: December 2022

Introduction: Noni fruit is one of the plants that is often used in traditional medicine as a medicine for high blood pressure, beriberi, smooth urination, inflammation of the gallbladder, colitis, dysentery, constipation, spleen pain, liver disease, diabetes and back pain. This study aimed to analyze the content of bioactive compounds, antioxidant properties and cytotoxic activity of fermented noni juice and noni juice.
Method: Identification of the content of bioactive compounds was carried out using Gas Chromatography (GC), antioxidant activity testing using the DPPH method (2,2-Diphenyl-1 picrylhydrazine) and cytotoxic testing using the Brine Shrimp Lethality Test (BSLT) method.
Results: The results showed that the content of phenolic compounds contained in noni juice and fermented noni juice had strong antioxidant properties with the IC50 value for noni juice of 22.23 ppm and for fermented noni juice of 13.95 ppm. Meanwhile, the results of the cytotoxic test of noni juice and fermented noni showed that the LC50 values of 33.26 ppm and 2.25 ppm respectively.
Conclusion: It can be concluded that both of these materials have high antioxidant activity and potential as anticancer.
Effect of secretome of adipose stem cell (ASC) in photoaging skin
Authors: Winawati Eka Putri  , Anang Endaryanto  , Damayanti Tinduh  , Fedik Rantam  , Hari Basuki Notobroto  , Cita Rosita Sigit Prakoeswa
Published: December 2022

Introduction: UV light is the principal cause of photoaging, a kind of aging. The problem arises because it is less enjoyable. Utilizing the secretome of adipose stem cells (ASC), which is rich in growth factors, could be a novel anti-photoaging therapy. The secretome of ASCs has been extensively examined for their role in wound healing, but their function in photoaging has just lately been investigated. This study looked at changes in epidermal and dermal thickness, expression of MMP-1 and TIMP-1, as well as dermal collagen density to assess the influence of the secretome of ASC in photoaging treatment.
Methods: 28 male Wistar rats, 10-12 weeks old, were randomly assigned to one week of acclimation in each of four groups: UV-irradiated group with topical secretome of ASC (Group P1); UV-irradiated group with topical vehicle only (Group P2); only topical secretome of ASC, non-UV-irradiated (Group P3); and non-UV-irradiated and no topical treatment (Group P4) (Group P0). Prior to treating the rats, the UV exposure was administered for six weeks. Then, for a period of four weeks, the secretome ASC was administered as a treatment.
Results: The epidermal and dermal thickness were significantly improved after four weeks treatment compared to UV irradiated with topical vehicle only group (p<0.05). The expression of TIMP-1 and dermal collagen density were significantly increased (p<0.05).
Conclusion: Secretome of ASC may be a solution for photoaging skin.
The effect of syzygium polyanthum (wight) extract in histological changes of kidney in diabetic mice model
Authors: David Sajid Muhammad  , Hotimah Masdan Salim  , Cici Dita Virlliana  , Adyan Donastin  , Agus Aan Adriansyah
Published: December 2022

Introduction: Diabetes mellitus, or hyperglycemia, is one of the risk factors for atherosclerosis, causing disruption of blood flow through arterial plaque formation and atherosclerosis. Diabetic kidney disease (DKD) is the most common cause of chronic and end-stage renal disease (CKD and ESRD) worldwide and is a stronger predictor of mortality in people with diabetes. Although the concept that the kidney plays a key role in glucose balance is not new, it is only recently that this organ has been viewed as a potential therapeutic target. This study aimed to assess the potential effect of Syzygium polyanthum extract in DKD mice model.
Methods: We administrated Syzygium polyanthum extract for 2-weeks to alloxan-induced diabetic mice.
Results: Treatment with Syzygium polyanthum extract reduced blood glucose levels in dose dependency (2,62mg/20g/day, 5,24mg/20g/day, and 7,86mg/20g/day). Histological analysis showed that Syzygium polyanthum extract significantly (p<0,05) improved the kidney lesions in low dose, but did not show a significant effect on inflammatory cell at glomerulus.
Conclusion: Syzygium polyanthum extract has potential to improve the kidney lesion in low dose and showed therapeutic potential in DKD treatment.
Correlation of magnetic angiography with relative cerebral blood flow on arterial spin labeling using magnetic resonance imaging in acute ischemic stroke patients
Authors: Utami Ambarsari  , Arif Faisal  , Hari Basuki Notobroto  , Erna Furaidah  , Yunita Lestari Indrianto  , Naura Anindya Candini
Published: December 2022

Introduction: Acute ischemic stroke is one of the three main causes of death in developed countries. RISKESDAS data of 2013 depicted the fact that the prevalence rate of stroke was 12.1 per 1,000 population. CT protocol and magnetic resonance imaging (MRI) are excellent evaluations of acute ischemic stroke. Magnetic resonance angiography (MRA) is an MRI technique to delineate arteries and evaluate stenosis and occlusion. Arterial Spin Labeling (ASL) MRI is quantitative and non-invasive, does not require Gadolinium contrast, measures cerebral blood flow, is useful for performing perfusion-based functional MRI (fMRI), and is able to be reevaluated. The study aimed to analyze the correlation between MRA and the relative Cerebral Blood Flow on ASL in patients with acute ischemic stroke.
Methods: The study aimed to analyze the correlation between MRA and the relative Cerebral Blood Flow on ASL in patients with acute ischemic stroke.
Results: The patients with acute ischemic stroke were in the age category of 40 years or more (92.3%) with the average age of the patients was 56.96 years  14.05. The youngest patient was 8 years old and the oldest one was 79 years old. Most of them were women (56.5%) with the most comorbid hypertension (45.7%) and diabetes mellitus (34.8%). The results of the evaluation after agreeing the consent portrayed that MRA was normal in 10 patients (21.7%) and there was stenosis or occlusion in 36 patients (78.3%). ASL examination showed that 20 patients (43.5%) were normal, whereas 26 patients (56.5%) were decreased.
Conclusion: Phi value was 0.601 (p < 0.05), meaning that there was a strong relationship between the results of MRA examination and ASL.
Medico-socio-economic perspective of congenital hydrocephalus patients treatment in dr. Soetomo Academic General hospital, Surabaya, Indonesia
Authors: Heru Kustono  , Muhammad Arifin Parenrengi  , Arief Wibowo  , Agus Turchan  , Kurnia Kusumastuti  , Asra Alfauzi
Published: December 2022

Background: Hydrocephalus is a brain disease that requires prompt treatment. The outcome of hydrocephalus is dependent on early detection and treatment. This study was conducted to analyze the medico-socio-economic perspective on the delayed treatment of hydrocephalus patients, which aimed to advance the practice of neurosurgery in the socio-neurosurgery field, including both preventive and therapeutic aspects.
Method: This was an observational analysis study. The study subjects were all patients with congenital hydrocephalus treated in dr. Soetomo Academic General Hospital between January 2017 and December 2019. The study was carried out on January 2017 to December 2019 at the Inpatient Surgery ward, dr Soetomo Academic General Hospital, neurosurgery outpatient unit, and home visits. Research data consists of both primary and medical record data. Data on patient characteristics were obtained through direct interviews with the sample using prepared questionnaires, medical record data, and radiological data of both patients examined at dr. Soetomo Academic General Hospital and other health services. Bivariate correlation analysis was performed to assess the effect of each risk factor on the incidence of delay in treatment, and multivariate logistic regression analysis was performed to assess the magnitude of the effect of risk factors.
Result: The number of cases was 101 subjects. A total of 101 patients included as research samples were congenital hydrocephalus patients who received the first treatment at dr. Soetomo Academic General Hospital from January 2017 to December 2019. Up to 50 individuals (49.5%) were delayed in treatment. The data analysis with Chi-square did not reveal a statistically significant correlation between delay in treatment and level of parent's education (p=0.0951), delay in treatment and economic status ((p=0.4955). Delays in the treatment of congenital hydrocephalus were statistically significant and correlated with Posyandu's role (p=0.0012), health insurance ownership (p=0.0001), family support (p=0.0130), and professional medical decisions (p=0.0001). Health insurance ownership has the smallest p-value (0.000) and largest wald (16.545) in the multivariate logistic regression analysis calculation using the enter method. The insurance ownership variable has the most significant and largest partial influence on the delay in treating congenital hydrocephalus.
Conclusion: There were 101 patients included, and up to 50 individuals (49.5%) were delayed in treatment. Parents' education level and socioeconomic status were not associated with delayed treatment of congenital hydrocephalus. Delays in managing congenital hydrocephalus were influenced by Posyandu's role, health insurance ownership, family support, and professional medical decisions.
Serum ferritin level in pediatric patients with acute lymphoblastic leukemia (ALL) in the early stage of diagnosis and remission phase
Authors: Novia  , Rosdiana Nelly , Supriatmo
Published: December 2022

Background: Cancer cells increase iron absorption, interfere with iron storage, and reduce iron excretion. Acute lymphoblastic leukemia (ALL) condition may interfere with the iron synthesis, and the patients usually receive a blood transfusion which leads to iron buildup. Excess iron is linked to a poor prognosis and significantly becomes morbidity and mortality factors. Serum ferritin levels that can be assessed from complete blood count may become a low-cost and sensitive biomarker and prognostic marker for ALL. The aim of this research is to assess serum ferritin levels in pediatric patients with ALL in the diagnosis and remission phases.
Methods: An analytical observational cross-sectional study was conducted on pediatric patients with ALL in the pediatric ward Haji Adam Malik hospital Medan from July – October 2021. Physical examination and blood sampling for complete blood count and serum ferritin level assessment were carried out. Bivariate analysis using the Chi-square test was used to compare serum ferritin levels during early diagnosis and remission phases in ALL pediatric patients.
Results: Ferritin levels were higher in the newly diagnosed patient group with a median value of 951 µg/L (28.07-6632 µg/L) than the group in remission phase with a median value of 374.5 µg/L (29-2426 µg/L). There were no significant relationships between ferritin levels and BMI, SGOT, and SGPT in the newly diagnosed group. In contrast, the ferritin levels of the patients in the remission group were significantly correlated with SGOT and SGPT.