bluuebunny/crossref_metadata_2025 huggingface dataset:
Emergency immune reconstitution inflammatory syndrome (IRIS) in HIV drug discontinued with tuberculous meningoencephalitis: a case report
Authors: Retnaningsih Retnaningsih , Udji Muchlis Achsan , Anandika Danar Dwi
Published: February 2022

Background: Immune reconstitution inflammatory syndrome (IRIS) is a paradoxical condition in which the administration of ART (antiretroviral therapy) to human immune virus (HIV) patients causes a deterioration in clinical situations. This article describes IRIS in an HIV patient who discontinued the drugs and was accompanied by opportunistic infection with tuberculous meningoencephalitis.Case Presentation: A 40-year-old male complained of high fever and severe headache for 1 week, then the patient had general tonic-clonic seizures twice and less than 5 minutes. After seizure, patient experiences a loss of consciousness with the only response to pain stimuli. He was diagnosed with HIV since 3 years ago and only taking ART 2 months after being diagnosed. The physical examination revealed neck stiffness with a positive Brudzinski I and Kernig Sign, as well as lateralization to the right side. Oral candidiasis was found. HIV screening tests were reactive with CD4 65 cells/mm3. Cerebrospinal fluid (CSF) examination showed 172.8 mg/dL protein, 23 mg/dL glucose, MN 13/mm3 dominant cells, clear CSF fluid and colorless, supporting tuberculous meningoencephalitis (METB). Multi sliced CT-Scan (MSCT) head contrast shows enhancement of the basal cistern. The patient received the ART tenofovir-lamivudine-efavirenz. Then he has experienced a deterioration in clinical condition. He had ARDS, respiratory failure and was intubated, but failed resuscitation attempts.Conclusion: The patient was diagnosed with HIV 3 years ago but discontinued the treatment. HIV causes diffuse inflammation throughout the body including the cardiac, where myocarditis cannot be ruled out as a cause of death. IRIS may occur when the patient has risk factors for not getting previous ART (withdrawal of drugs) and has a low CD4 count. According to the criteria proposed by Robertson, there were worsening clinical symptoms, associated with initiation of ART administration, not explained by the presence of previously acquired infection, we suggest IRIS as causes of death in this patient.Â
Mentalization-based psychotherapy practices in patients with borderline personality disorder
Authors: Wardani Natalia Dewi , Suromo Lisyani
Published: February 2022

Introduction: Mentalization-based psychotherapy (MBT) develops with the importance of establishing attachment relations with patients. MBT focuses on internal mental processes that occur in the therapeutic process that actively improve patient-therapist relationships.Methods: A woman with preoccupied/anxious attachment is given mentalization-based psychotherapy. The goal of psychotherapy based on mentalization is to develop secure attachment relationships in therapy, use empathy and validation in reciprocal relationships, strengthen the patient's capacity to reduce emotional dysregulation and impulsive behavior, increase self-awareness, control of attention and flexible thinking in the context of emotions and relationships.Results: The patient has begun to form a secure base attachment. Patients' mentalization has improved along with the formation of secure base attachments, patients are better able to do self-soothing and regulate emotions properly.Conclusion: In the early years of life, patients have a pattern of interaction with caregivers who lack the need for mirroring. Furthermore, the patient develops into an insecure self and has an inherent preoccupied/anxious attachment. It has an effective representation and attention regulation system that is not functioning so that patients use existing stimuli as the basis of an insecure sense of self. Fonagy termed this condition with incoherent, disruptive "alien self" through controlling and manipulative behavior. The patient externalizes the alien self against the attachment figure. This externalization appears as a countertransference experience in a therapy session, if it can be appropriately managed it will emerge a feeling of coherence in the patient's internal world.
The association between tension-type headache (TTH) and the severity of insomnia
Authors: Asmarani Runi , Suryawati Herlina , Husni Amin , Bintoro Aris Catur , Muhartomo Hexanto , Rahmawati Dani , Suryadi Suryadi
Published: February 2022

Introduction: Sleep can reduce headaches, but on the other hand, sleep disturbances can provoke the onset of headaches. Research showed that sleep quality was a complex interaction of people with Tension Type Headache (TTH), due to depression and emotional burden with sleep quality. The study aims to determine the association between the type of tension-type headache and the severity of insomnia.Methods: This was a cross sectional observational study. The subjects were tension-type headache patients who went to the neurological clinic of dr. Kariadi Hospital and Puskesmas (Primary Healthcare Facility) Pandanaran Semarang who met the inclusion and exclusion criteria. It was conducted from February to July 2020. Insomnia examination was carried out using the ISI questionnaire. Data were analyzed using chi-square significant test. The result was considered significant if the p-valueÂ  <0.05.Results: From 29 TTH patients, 5 (17.2%) subjects experienced rare ETTH, 18 (62.1%) had frequent ETTH, 6 (20.7%) had CTTH, and 2 (6.9%) subjects with depression. There was a significant association between TTHÂ  type andÂ  the degree ofÂ  insomnia (p 0.034) and between depression and the degree of insomnia (p 0.041). The regression analysis reported that depression and chronic TTH caused an increase in insomnia by 0.366 and 0.410, respectively.Conclusion: There was an association between the type of TTH and the severity of insomnia, also between depression and the severity of insomnia. Moreover, depression increases the incidence of insomnia in TTH
Factors related to the level of prisonerâ€™s participation in implementing the voluntary counseling and testing program in penitentiary Semarang, Indonesia
Authors: Sujianto Untung , Aisyiyah Laura Ayudina Nasyiatul
Published: February 2022

Introduction: Voluntary Counseling and Testing (VCT) is one of HIV screening programs to detect HIV infection earlier by counseling before and after doing blood test. During implementation of this program, there were various factors influenced prisoners to do VCT. The purpose of this research to determine factors influenced the participation of prisoners to do VCT.Method: This research was an analytical research with cross sectional design. A total of 145 respondents have filled questionnaire distributed by researcher The result showed that 73 respondents (50.3%) have followed VCT and 72 respondents (49.7%) did not VCT yet. Factors related prisonerâ€™s participation (WBP) towards VCT program were education level, perception of needs about VCT service, prison support, health workers support, support by family and people around them.Result: The result showed that there are two types of support related with prisonerâ€™s participation: prisonâ€™s support which is among 104 respondents (71.7%) who have high support, 62 respondents (42.8%) have followed VCT with p-value = 0.000. According to health workers support, 114 respondents (78.6%) who have high support, there are 64 respondents (44.1%) have followed VCT with p-value = 0.007.Conclusion: The counselorâ€™s ability must be improved to perform good VCT and the prison was expected to give more information about HIV/AIDS and VCT program to increase prisonerâ€™s knowledge to follow VCT.
A new hope of CD133+ bone marrow stem cell for functional exercise capacity improvement in low ejection fraction coronary artery bypass graft patients: a clinical trial
Authors: Soetisna Tri Wisesa
Published: February 2022

Background: Patients with low ejection fraction who are undergoing coronary artery bypass graft (CABG) only have an insignificant improvement in ejection fraction. This condition will make a little hope to achieve an improvement in physical performance. But now, from a view study, CD133+ stem cells offer new hope for this situation. This study evaluates CD133+ bone marrow stem cells' role for functional exercise capacity improvement in low ejection fraction coronary artery bypass graft patients.Methods: Thirty patients with ischemic heart disease who had ejection fraction <35% at the National Cardiovascular Center were randomized into 2 groups. The treatment group undergoes the CABG + CD133+ procedure and the control group undergoes the CABG only. All research subjects underwent follow-up before and 6 months after the procedure. Fraction ejection, scar size, wall motion score index, ventricular dimensions, myocardial perfusion measured by cardiac MRI, 6 Minutes Walking Test (6MWT) and Minnesota Living with Heart Failure Questionnaire (MLHFQ) as an additional parameter for physical performance and quality of life. Data was analyzed using SPSS version 21 for Windows.Results: The results of the fraction ejection parameters showed a significant improvement in the treatment group, from 25.88Â±5.66% to 34.57%Â±11.31% compared to CABG only 30.18Â±3.85% to 31.61Â±7.89% (p=0.040), in the perfusion defect showed improvement but not significant, left ventricular end-systolic volume and left ventricular end-diastolic volume showed improvement with no significant result, scar size was found to be an improvement in the treatment group 10 persons (76.92%) compared to the control group 5 persons (38, 46%) (p=0.040), the wall motion score index and 6MWT showed a significant improvement in the treatment group (p=0.003 and p=0.03, respectively). The MLHFQ parameter showed improvement but not significant.Conclusion: CD 133+ stem cell implantation in patients with low ejection fraction who undergo CABG provides improved myocardial function and indirectly improves functional exercise capacity and patients' quality of life.
An overview of overactive bladder
Authors: Gunawan I Putu Gde Fredy , Suarjana I Nyoman , Wulandari Kadek Frida
Published: February 2022

Overactive bladder (OAB) is a common multifactorial disease that can cause a burden to the patient. Despite being a symptomatic diagnosis, several urological examinations need to be done to rule out other possible causes. The management of OAB is specific to each individual, from the very first line of behavioral therapy to surgical for an extremely rare case of OAB. This overview will look out for OAB thoroughly from the epidemiological burden, pathophysiology, clinical presentation and diagnosis, and the current treatment of OAB.
The difference in the prevalence of periodontitis degrees between ischemic stroke with diabetes mellitus and prediabetes mellitus
Authors: Sulistyowati Nanik , Retnaningsih Retnaningsih , Widiastuti Widiastuti , Sumali Rendy , Husni Amin , Kustiowati Endang , Hartono Jimmy Eko Budi , Pudjanarko Dwi
Published: February 2022

Background: Stroke is a cerebrovascular disease caused by atherosclerosis. Oral health and atherosclerosis may be associated with cerebrovascular disease. Some studies proved the association between chronic infectious diseases, including periodontal tissue disease with stroke risk factors. Diabetes Mellitus has a risk of microvascular complications that are pathologically related to periodontal disease. This study compares the degree of periodontitis between ischemic stroke with diabetes mellitus and ischemic stroke with prediabetes mellitus.Methods: This study is an observational analytic study with a cross-sectional design. The subjects of this study were infarct stroke patients with diabetes mellitus and prediabetes mellitus in the inpatient ward of Kariadi Hospital Semarang, who met the inclusion and exclusion criteria. The study was conducted from January to March 2020. Infarct stroke was assessed by using head CT scan, while diabetes mellitus using blood glucose with 2 hours postprandial blood glucose and HbA1c, and periodontal disease using MMI (Millerâ€™s Mobility Index). The data were analyzed with chi-square correlation test and logistic regression test. The results were significant if the p-value <0.05.Results: This study was conducted to 42 ischemic stroke patients with diabetes mellitus and prediabetes mellitus. All of the cases also had hypertension. The prevalence of severe periodontitis in DM-hypertension was (OR=0.66; 95% CI=0.12-0.354) compared to prediabetes-hypertension. The chances of severe periodontitis in the age of 61-70 years (OR=2.626; 95% CI=0.473-14.587) compared to the age 51-60 years, dyslipidemia (OR=0.392; 95% CI=0.076-2.016) compared to non dyslipidemia, obesity (OR=2.346; 95% CI=0.382-14.428) compared to non-obesity, smoking (OR=1.768; 95% CI=0.371-8.425) compared to non-smokers.Conclusion: in this study, all cases of diabetes mellitus and prediabetes mellitus were suffered along with hypertension. The prevalence of severe periodontitis in prediabetes-hypertension patients increased compared to hypertensive-DM patients. There was an increased possibility of severe periodontitis in the risk factors groups of age 61-70 years, obesity, and smoking.
Blood pressure difference between regular hemodialysis and hemodialysis with hemoperfusion at Haji Adam Malik Hospital, Medan-Indonesia
Authors: Fachrianda Situmorang Dedy Shauqi , Nasution Alwi Thamrin , Nasution Syafrizal
Published: February 2022

Background: The differences of Hemodialysis and Hemoperfusionâ€™sÂ  combination can increase of Uremic Toxin clearance, average creatinine clearance, and Angiotensin elimination optimally. The hemodialysis and hemoperfusionâ€™sÂ  combination also can decrease blood pressure and reduce the use of Anti Hypertension drugs so that the number of cardiac events in CKD patients may decrease. The use of ABPM is chosen because this is the best method of automatic blood pressure which has the most accurate blood pressure measuring periodically.Objective: This study aims to determine the difference of regular Hemodialysis and Hemodialysis with Hemoperfusion on blood pressure measured by using ABPM in Medan, North of Sumatra.Methods: This study was a pre-experimental study which conducted since December 2013-March 2014 to the 20 regular hemodialysis patients. The measurement included anamnesis, height, weight, systolic and diastolic blood pressure among patients with regular hemodialysis and hemodialysis with hemoperfusion. Results: The study found that about 3 of 20 subjects were out of the study. There was no significant difference found in systolic and diastolic blood pressure between regular hemodialysis and hemoperfusion group (P = 0.807 and 0.906, respectively) based on the T-paired test and Wilcoxon test. Conclusion: There was no significant difference between blood pressure measured using ABPM on the combination of hemodialysis and hemoperfusion compared with regular hemodialysis
The potential effect and delivery of piperine on breast cancer
Authors: Wihandani Desak Made , Saputra I Putu Gede Septiawan , Remitha Ni Putu Sri Indrani , Indrakusuma Anak Agung Bagus Putra , Adiputra Putu Anda Tusta , Supadmanaba I Gede Putu
Published: February 2022

Breast cancer is the most common malignancy in women worldwide. Breast cancer is associated with a high mortality rate and health-related economic burden. Breast cancer patients have a low 5-year life expectancy when diagnosed at advanced stages. Besides, the emergence of chemoresistance in breast cancer has led to an intense search for alternative anticancer agents. One of the potential anticancer compounds is Piperine. Several studies had found that Piperine has anticancer effects such as anti-proliferation, induces apoptosis, anti-migration or anti-metastasis, chemo-enhancer or chemosensitizer, cytotoxic agents, anti-angiogenesis, immune response modulators, and self-renewal inhibitor for cancer stem cells. Several delivery agents such as PLGA, PEG-PLGA and liposomes have been studied to improve Piperine's delivery and have shown good results. Therefore, the combination of Piperine and nanoparticles is a potential anticancer agent, especially in breast cancer.
Effectiveness of nanosilver collagen cream for healing deep dermal burns in Sprague Dawley rats: an overview of neutrophil counts and angiogenesis
Authors: Muhammad Krisna , Prasetyo Awal , Prajoko Yan Wisnu , Najatullah Najatullah , Susilaningsih Neni
Published: February 2022

Background: Burn injuries remain the third cause of death in the world. The treatment, management of deep dermal burns is by applying topical medications like nanosilver collagen cream. Collagen is widely used for wound healing, cell development, angiogenesis, and platelets' activation. This study observed the effectiveness of the drug administration of nanosilver collagen cream compared to the silver sulfadiazine cream against the healing of deep dermal burns reviewed based on neutrophils counts and angiogenesis.Methods: This study represents an experimental study of a laboratory with a randomized post-test with a control group design. The study used the Sprague Dawley mice to be divided equally into four randomly generated groups. Data were analyzed using SPSS version 20 for Windows.Results: The Post-Hoc Mann Whitney test shows there is a significant difference in the angiogenesis between the 3rd and 6th-day groups such as group I (p = 0.034), II (P = 0.009), III (P = 0.009), and IV (P = 0.009). Kruskal-Wallis test also obtained that neutrophil counts decrease but not significant (p=0.159) on day 3rd and (p = 0.315) dan day 6th administration of nanosilver collagen.Conclusion: The administration of nanosilver collagen creams cannot decrease neutrophils counts significantly and administration of nanosilver collagen 2% increase angiogenesis compared to the silver sulfadiazine cream against the healing of deep dermal burns reviewed from the Sprague Dawley mice.
Chronic limb-threatening ischemia, successful infra popliteal endovascular revascularization: a case report
Authors: Kleruk Dawar Sitaba , Habibie Yopie Afriandi
Published: February 2022

Introduction: Chronic limb-threatening ischemia (CLTI), a manifestation of peripheral arterial disease (PAD) that is characterized by chronic ischemic pain in the foot, inadequate tissue perfusion at rest more than 2 weeks, non-healing wounds, or gangrene that is attributable to objectively proven arterial occlusive disease. Endovascular surgery has played an important rules for revascularization in limb saving.Case description: 57-years-old man came to the Zainoel Abidin General Hospital emergency room, with a chief complaint of ischemic pain at the right foot since 3 months ago, and being extremely progressive for 10 days. He has no history of smoking and 10-year history of controlled type 2 diabetes mellitus. On the physical examination revealed a stable hemodynamic, an unhealed wound in the right lower limb as well as an open wound size 10cm x 6cm x 4cm. He has palpable femoral pulses but not distal pulses. Peripheral CT angiography obtained a total occlusion at the right anterior tibialis artery (ATA), and no flows at the right dorsalis pedis artery (DPA). Performed a revascularization procedure with endovascular therapy using 3 mm balloon angioplasty with good results along the ATA and DPA. The patient was discharged on the 4th day after surgery. Clinical Evaluation after 2 months showed improvement on pain, good ulcer healing and ready for skin grafting.Conclusion: The goal of treatment for CLTI is to relieve pain, heal wounds, and preserve a functional limb, with a cornerstone of treatment is timely arterial revascularization Endovascular surgery in one of the best revascularization techniques for CLTI.
Neurological manifestation as an implication of COVID-19 pandemic at a hospital in Aceh, Indonesia
Authors: Syahrul Syahrul , Emril Dessy Rahmawati , Mutiawati Endang , Farida Farida , Imran Imran , Musadir Nasrul , Lestari Nova Dian , Astini Nur , Fajri Nurul , Nurfida Ellya , Mulyana Rita , Rahayu Nona Suci , Syahrul Faza Nabila
Published: February 2022

Introduction: Coronavirus disease 19 (COVID-19) has quickly spread to more than 200 countries as a global health pandemic. The outbreak of the COVID-19 infection in Wuhan (China) has brought its clinicians to investigate different manifestations, including neurological presentations of this novel infection. As of 12 October 2020, the number of deaths due to COVID-19 is 1.08 million worldwide, with 11,935 cases in Indonesia and 209 cases in Aceh. This study aimed to determine the neurological manifestations in patients confirmed with COVID-19.Methods: A Retrospective cross-sectional study design from neurology patients who diagnosed with COVID-19 and were hospitalized at the Dr. Zainoel Abidin Hospital from March to September 2020. COVID-19 diagnosis was confirmed with polymerase chain reaction (PCR) swab test that met the inclusion and exclusion criteria.Results: We collected 36 cases, consisting of 19 males (53%) and 17 females (47%) with a mean age of> 60 years 47%. According to the comorbidities data, 53% of patients were smoking, 47% had hypertension, 8% had diabetes mellitus, 8% had a history of stroke, and 8% had malignancy. Neurological manifestations included limbs weakness and cranial nerve paresis (55%), decreased consciousness (39%), and headache (22%). At admission, several patients had stroke (47%), cephalgia (14%), metabolic encephalopathy (8%), and vertigo (5%). Finally, 16 patients died during the period of observation.Conclusion: Patients with COVID-19 commonly have neurological manifestations such as limb weakness, cranial nerve paresis, decreased consciousness, headache, dizziness, olfactory disturbances, and seizures.
Amino acid methionine, lysine and vitamin choline: A potential feed supplement to reduce mortality, improve immunity, and health of Bali pigs in the growth phase
Authors: Ardana Ida Bagus Komang , Sumadi Ketut , Budiasa Ketut , Dhamayudha Anak Agung Gde Oka , Suhasono Hamong , Gunawan Nico Fajar
Published: February 2022

Introduction: Balinese piglets, separated from the mother and given traditional feeding, can cause prolonged growth. So, it is necessary to provide feed with a complete formula to support the growth process. Previous studies reported that Balinese piglets fed with a mixture of yellow corn, pollard, Aminovite, table salt, and minerals with several formulations and a metabolized energy (ME)/crude protein (CP) ratio 2800 kcal/kg/12% significantly increased body weight. However, his health status has not been reported, both the hematological profile and antibody titer. The purpose of this study was to determine the effect of the amino acid methionine, lysine, and choline (Aminovite) on health, hematological profile, and antibody titer as immunomodulatory effects.Methods: This study used 72 Balinese piglets after being separated from the mother, divided into four groups of 18 piglets each. The first group (P0) was given basic feed mixtures of corn and pollard as a control. The second group (P1) was fed P0 + 0.5% Aminovite. The third group (P2) was fed P0 + 1.00% Aminovite. The fourth group (P3) was fed P0 + 1.50% Aminovite. Bali piglets are vaccinated with the Hog Cholera vaccine. Furthermore, on the 12th day of the week after treatment (aged 80-90 days), a hematological profile examination will be carried out, and the antibody titer of Hog Cholera will be examined. The data were analyzed using the One Way Anova test and Duncan's Multiple Range Test. The p-value <0.05 is significant.Result: There was no mortality of piglets in all groups, but the control group had a high morbidity rate (22.2%) than the other groups. Aminovite mixed in the feed significantly increased WBC, total RBC, Hb levels, and PCV values compared to control (p<0.05). Aminovite can also increase neutrophils and monocytes and significantly reduce lymphocytes compared to control (p<0.05).Conclusion: The addition of Aminovite as a feed supplement in Balinese piglet feed improved the health of Bali piglets seen from the blood profile and increased Antibody titers resulting from Hog Cholera vaccination.
The relationship between CT scan and incidence of intrathoracic thymoma metastases in Dr. Moewardi General Hospital, Surakarta
Authors: Nikita Sekar Mayang Octarina , Widiastuti Widiastuti , Rima Ana , Sarwono Prasetyo , Wujoso Hari , Rosati Ari
Published: February 2022

Background: Intrathoracic metastases are the most common form of metastasis in thymoma patients that influences the patient's life expectancy. Observing the tumor profile based on CT scan images is one of the ways that can be used to predict the presence of intrathoracic metastases in thymoma patients. However, there are not many studies reported.Methods: This observational analytic study with a cross-sectional approach was conducted on 60 thymoma patients who had undergone a chest CT scan at Dr Moewardi General Hospital Surakarta and held from September 2020 to February 2021. Two research variables were used: the incidence of intrathoracic metastases as the dependent variable and the thymoma CT scan image as the independent variable. Data analysis was performed using SPSS 25.0 software, including hypothesis testing and Chi-Square test with a 95% confidence level.Results: Intrathoracic metastases were found in 78.3% of the thymomas patients. Based on the analysis between chest CT scan findings and the presence of intrathoracic metastases in thymoma patients, it was found that a significant association between tumor density and the incidence of intrathoracic metastases with heterogeneous density increased the risk of intrathoracic metastases 6.72 times higher with a form of subpleural nodules and pleural effusions with a p-value of 0.037 and 0.027.Conclusion: There is a significant relationship between thymoma density based on a chest CT scan and the incidence of intrathoracic metastases in Dr. Moewardi General Hospital Surakarta.
Comparison of angle, length, and diameter of the eustachian tube of safe and unsafe CSOM based on CT scan in Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia
Authors: Ridwan Azwar , Husni TR T. , Machilah Nurul , Aria Zona
Published: February 2022

Introduction: Damages in middle ear structures correlated with tubal dysfunction and impaired drainage; thus, it's associated with changes in angle, length, and tubal diameter. This study aimed to determine the ratio of angle, length, and diameter of Eustachian tube with safe and unsafe types of chronic suppurative otitis media (CSOM).Methods: Cross sectional analytical retrospective design, CT-Scan assessment for angle, length, the diameter of the tube on safe and unsafe type CSOM from January to December 2019 Angle is assessed using Reid's line, tube length by a tympanic orifice to pharyngeal orifice line, Tube diameter is measured from anteroposterior pre-tympanic line diameter. Results: From 61 CSOM patients, 70.5% safe type, 29.5% unsafe type. Safe type tube angle mean is 29.120, unsafe type 29.950, normal ear 28.230, thus no significant difference. A significant difference in the tube length (P = 0.001) is that the mean normal ear is 35.39 mm, smaller on safe type 33.58 mm, and unsafe type 29.53 mm. A significant difference in tubal diameter ratio (P = 0.001), normal diameter 2.19 mm, on safe type is 2.02 mm smaller, unsafe type 1.86 mm.Conclusion: The smaller length and diameter of the Eustachian tube will lead to unsafe type CSOM.
Complete tubular duplication of colon presenting as rectovestibular fistula: A case report
Authors: Isa Muntadhar Muhammad , Thayeb Amir , Meildi Maria , Hutagalung Muhammad Bayu Zohari
Published: February 2022

Background: Duplication of the gastrointestinal tract is a rare congenital disorder in pediatric patients.  Complete resection in case of a total tubular duplication that requires total or subtotal colectomy is undesirable in children.Case Presentation: This case presented a simple surgical technique for treating complete colonic duplication without colonic resection. A 2 months old female baby with abdominal distention and stool complaint came out from her vaginal vestibular and normal anus. A digital rectal exam showed a palpable mass in the posterior region. Abdominal CT Scan showed a rounded mass with size 2x2 cm in the left posterolateral of rectum region. The initial diagnosis was suspected sacrococcygeal tumor type 4 with rectovestibular fistula. Intraoperative findings showed duplication of the caecum, appendix, total colon (ascending to sigmoid) and rectum (one directed to the vagina and the other to anus). The ileostomy was done 20 cm from the ileocaecal junction as a temporary treatment to relieving distention with definitive repair planned in the following months. The second stage repair was performed after 1-year-old with posterosagital anorectoplasty followed by distal separation of the duplicated colon using a 12 cm linear stapler. For this case, the third stage repair was done one year after the previous surgery to close the remaining ileostomy. The patient’s outcome showed good results with normal defecating function and no complication.Conclusion: Complete tubular duplication is a rare case without specific clinical symptoms, but the assessment of the diagnosis can be assisted by radiology such as abdominal CT and barium enema. We hope this article could illustrate management for complete tubular duplication of colon presenting as rectovestibular fistula, thus reflect how important clinical judgment and initial diagnostic in our health care system.
Role of exercise training in pulmonary hypertension: a review article
Authors: Ridwan Muhammad , Dimiati Herlina , Putri Cut Jaswanita Eka , Habibie Yopie Afriandi , Sariningrum Hesti Anandini
Published: February 2022

Pulmonary hypertension is a cardiovascular disease with high mortality and morbidity affecting various aspects, including prognosis and quality of life. Limiting physical exercise in patients with pulmonary hypertension was initially suggested because it worsened the patient's clinical condition.  Recently clinicians have begun to focus on the role of physical activity in patients with pulmonary hypertension. Despite limitations of literature that describe the role of physical exercise in pulmonary hypertension,  this paper is expected to provide an overview and the extent of implementing physical exercise in health centers. In our review, the data collection for eligible articles was conducted from 1st January 2011 until 4th January 2021 using the PubMed database undertaken English language. The search algorithm used in this paper is "Exercise" OR "Physical Activity" AND "Pulmonary Hypertension." Manual search methods were also has been used to find the topic-related articles. According to our synthesis of physical exercise in patients with pulmonary hypertension, it is safe to apply under the supervision of cardiac rehabilitation experts. Initial assessment, exercise capacity adjustment, and monitoring during physical exercise are essential to avoid adverse events during exercise. Regular physical exercise over 12 weeks can increase exercise capacity, improve quality of life, improve prognostic and life expectancy. Otherwise, the application of physical exercise under ten weeks does not always show significant results, and the application for less than eight weeks shows unsatisfactory results. In conclusion, the use of physical exercise in pulmonary hypertension has not been optimally utilized in cardiac rehabilitation centers
Colorectal cancer in pediatric with obstructive symptoms: a rare case report
Authors: Agustina Flora , Felicia Felicia
Published: February 2022

Introduction: Colorectal cancer or known as CRC, is rare among adolescents younger than 20 years old. CRC diagnosis in children is commonly delayed until it reaches the advanced stage due to the nonspecific symptoms mimicking other gastrointestinal disorders. Most CRC in children is poorly differentiated mucinous adenocarcinoma, in contrast to CRC in adults, mostly moderately or well-differentiated adenocarcinoma. The delay in diagnosing CRC in children leads to an extremely poor prognosis rather than adults. Thus, this article aimed to report a rare case related to the CRC in pediatric.Case presentation: A rare case of a 14-year-old male present with abdominal distention since a month before presented to the emergency department. He also complained of bilious vomiting and not passing stool for three days, there was decreased body mass of about 15 kilograms since a year ago, and a family history of malignancy was refused. There was a distended abdomen, arm contour and metallic sound. The full blood count showed no significant results. We found a dilated prominent bowel filled with air in the entire abdomen from plain abdominal radiography that led us to suspect total bowel obstruction. We decided to do an emergency exploratory laparotomy. Intraoperatively, we found multiple masses look like polyposis in the intraluminal of a descending colon ranging about 10 centimeters long. The histopathological finding showed adenocarcinoma well-differentiated colon T3N0. Postoperatively, there were no complications from the surgery until a month after surgery, and we suggested our patient continue his treatment with adjuvant chemotherapy.Conclusion: The treatment of colorectal cancer in pediatric is complete surgical resection of the tumor and chemotherapy. Early detection of colorectal cancer is required to prevent further morbidity and mortality.
Rehabilitation-related knowledge correlate to visit compliance in post-ischemic stroke patients in an outpatient rehabilitation clinic
Authors: Nadila Islah , Syahrul Syahrul , Suherman Suherman , Mamfaluti Teuku , Firdausa Sarah
Published: February 2022

Background: Stroke is a serious medical condition potential that affects humans and requires special attention. The treatment of stroke is highly dependent on patients' knowledge and adherence in undergoing rehabilitation. Knowledge about medical rehabilitation will determine the level of patients' adherence undergo medical rehabilitation. The study aimed to find the correlation between patients' knowledge and adherence to chronic stroke patients undergoing medical rehabilitation.Methods: This is an observational analytic study conducted in the executive medical rehabilitation policlinic at dr. Zainoel Abidin Hospital. Seventy-four respondents were selected by the non-probability sampling technique and accidental sampling method. Two questionnaires were used, namely the "Overview of Familial Behaviour towards Stroke Patients in Rehabilitation Efforts" questionnaire and the "Correlation of Family Support with Stroke Patients Rehabilitation Adherence" questionnaire. Data were analyzed using Chi-Square statistical test.Results: 45.9% of respondents had good knowledge and compliance, 23% of respondents had average knowledge and compliance, and 9.5% of the respondents had poor knowledge and compliance.  Data analysis showed a significant correlation between patients' knowledge and level of adherence in undergoing medical rehabilitation.Conclusion: Increasing patients' knowledge about medical rehabilitation is crucial to improve patient's adherence in undergoing medical rehabilitation.
Bizarre parosteal osteochondromatous proliferation (Nora’s lesion) of the talus: a case report
Authors: Rante Su Djie To , Sugiarto Jordan , Nugraheni Tri , Norahmawati Eviana
Published: February 2022

Introduction: Bizarre Parosteal Osteochondromatous Proliferation (BPOP), or Nora’s Lesion, is a very rare condition, with less than 200 documented cases that exist in the literature. BPOP / Nora’s Lesion of the talus has not been reported in any literature in Indonesia. Therefore, this study aim to present a unique and rare case of BPOP (Nora’s Lesion) of the talus.Case: An eighteen-year-old male patient admitted to hospital with a complaint of palpable lump at his front right ankle region since seven years ago with the size of a marble. On physical examination, there was a swelling of the anteromedial aspect of the ankle, hard in consistency, well-defined, immobile, and without neurovascular impairment. There was pain exacerbated by sports activities. There was a history of trauma at the located lump; he was fell while running on the ground a few years before the lump first arose with no fracture, wound, or swelling at that area. The range of motion (ROM) of the right ankle was less than the left ankle. The operation was performed under general anesthesia. After an incision was made, the mass was exposed and we did an osteotomy and a complete surgical excision. Conclusion:  In this case, the radiographic imaging showed well-defined exostosis arising from the anteromedial aspect of the talus bone cortex, but not in continuity with it. Histopathological examination consistent with BPOP. We suggest a surgical “En-bloc” (complete surgical excision) as a recommended treatment for BPOP.
Correlation between post-traumatic amnesia with behavioral disorders in the mild- and moderate-traumatic brain injury patient
Authors: Arifin Muhammad Zafrullah , Setiabudi Adolf , Faried Ahmad
Published: February 2022

Introduction: Traumatic brain injuries (TBIs) could have short and long-term sequelae, including cognitive and behavioral changes and physical impairments. This study aimed to determine the correlation between post-traumatic amnesia and neurobehavioral disorders in mild and moderate TBI patients.Methods: A cross-sectional study was conducted on 75 patients with mild or moderate TBI who had or didn't have a period of post-traumatic amnesia during their hospital stay in the Department of Neurosurgery Dr. Hasan Sadikin Hospital (RSHS), Bandung, from January to August 2019. The Galveston Orientation Amnesia Test (GOAT) was performed, and neurobehavioral functions were examined in post-TBI patients (mild or moderate) using the neurobehavioral rating scale (NRS), which was performed at the time of hospital discharge.Results: The subjects were predominated with male patients (76%) with a mean age of 25 years old (15 â€“ 35 years old). The analysis showed that the patients with post-traumatic amnesia had a higher median total NRS score (10.4 [5.0-18.0]) compared to those who didn't have any neurobehavioral disorders (2.6 [1.0-12.0]). The statistical analysis showed that the difference was statistically significant (p-value: 001; r: -0.776).Conclusion: According to the result, it can be concluded that post-traumatic amnesia was significantly associated with neurobehavioral disorders. However, further study is needed to confirm this finding and assess the other potential factors that may affect both variables.
Prebiotic supplementation supports immunity & growth-development in preterm infants: a review and expert perspectives
Authors: Rohsiswatmo Rinawati , Widodo Ariani Dewi , Munasir Zakiudin , Medise Bernie Endyarni
Published: February 2022

Preterm birth still causes significant mortality and morbidity in newborns, despite modern advancements in preterm care. The gut microbiota is the most significant microbial colonization in the human body and plays a significant role in supporting a healthy body. Preterm infants are susceptible to gut dysbiosis, which is thought to contribute to the many adverse outcomes of prematurity, such as necrotizing enterocolitis (NEC), late-onset sepsis (LOS), and developmental delays. Human breast milk is considered the ideal nutrition source for newborns and can help create ideal microbiota in preterm infants. Breast milk contains human milk oligosaccharides (HMO), prebiotics that promote beneficial bacteria growth, absent in cow's milk. Supplementation of non-milk oligosaccharides such as long-chain fructo-oligosaccharides (lcFOS) and small-chain galacto-oligosaccharides (scGOS) in formula milk for preterm infants is found to be beneficial with a favourable safety profile. This review discusses gut microbiota in preterm neonates, its role in developing immune systems, growth and development, and the benefits of prebiotic supplementation.
Patent foramen ovale and cryptogenic stroke: still needs a complete study
Authors: Dimiati Herlina , Rasaki Rico
Published: February 2022

Patent foramen ovale (PFO) is a residual of normal fetal anatomy. More than half of babies will develop PFO at six months of age. PFO may cause shunts from right to left, and the possibility for shunting from venous thromboembolism into the arterial circulation. Since then, many idiopathic stroke studies have been conducted, in which PFOs are often found. PFO does not require follow-up treatment in infants and children, and venous thromboembolism should also be evaluated for idiopathic stroke in young patients to assess the trend of thromboembolism associated with PFO, which affects morbidity and mortality. The decision to treat depends on the presence, size and presence of complications.
Serum neutrophil gelatinase-associated lipocalin and decreased kidney function as predictor of mortality and major adverse cardiac events during acute heart failure hospitalizations
Authors: Maliawan Rani Paramitha Iswari , Nadha I Ketut Badjra , Widiana I Gde Raka , Gunadhi I Gusti Ngurah Putra , Iswari Ida Sri , Wita I Wayan
Published: February 2022

Introduction: Decreased renal function is associated with a poor prognosis in acute heart failure (AHF). The current standard for assessing the decline in kidney function, creatinine, has several limitations. Serum Neutrophil gelatinase-associated lipocalin (NGAL) is one of the predictive biomarkers that was shown better at indicating an early AKI. Although several studies have examining the role of NGAL as a predictor for poor prognosis in various medical conditions, the result in AHF condition is still inconsistent. This study aimed to determine the role of serum NGAL and decreased renal function (estimated using serum creatinine) in predicting the mortality and major adverse cardiovascular (MACE) events during hospitalization in acute heart failure patientsMethods: Prospective cohort study with consecutive sampling was conducted in AHF patients who were treated at Sanglah General Hospital from July to September 2017. Serum NGAL and creatinine levels were measured at the onset of hospital admission and observed for mortality and MACE during hospitalization.Results: Seventy-seven patients were involved in this study. We found hazard ratio (HR) serum NGAL to mortality was 7.8 (p = 0.009) and increased to 18,9 in multivariate analysis with cox proportional hazards regression model (p = 0.002). There were significant differences in survival (p = 0.002) between patients with high serum NGAL (424 hours survival rate, 95% CI 296-552) than low serum NGAL (baseline survival 680 hours; 95% CI 584-775) after log rank test. Meanwhile, the effect of serum NGAL on MACE and decreased of kidney function on mortality or MACE did not yield significant result.Conclusion: High serum NGAL is an independent predictor of in-hospital mortality among AHF patients.
Skin barrier before and after topical Adipose Stem Cell-Conditioned Medium (ASC-CM) treatment in photoaging
Authors: Putri Winawati Eka , Endaryanto Anang , Tinduh Damayanti , Rantam Fedik , Notobroto Hari Basuki , Prakoeswa Cita Rosita Sigit
Published: February 2022

Background: Photoaging is a type of aging mainly caused by ultraviolet irradiation. The skin barrier is affected in photoaging and it will result in coarseness, roughness and dry skin. It is probably because Ultraviolet (UV) affects the extracellular matrix in the skin. Adipose Stem Cell-Conditioned Medium (ASC-CM), which contains many growth factors, becomes a potential agent as a novel anti-photoaging treatment by repairing the skin barrier. This study aims to evaluate the skin barrier function before and after treatment with ASC-CM in photoaging skin by evaluating changes in Transepidermal Water Loss (TEWL) and skinfold thickness.Methods: A true experimental study was conducted among 28 male Wistar rats aged 10-12 weeks. They were acclimated for 1 week and randomly divided into 4 groups: UV irradiated group with topical ASC-CM (Group P1); UV irradiated group with topical vehicle only (Group P2); only topical ASC-CM, non-UV irradiated (Group P3), and non-UV irradiated and no topical treatment (Group P0). The ASC-CM was given twice a day for four weeks and the total irradiance dose for 6 weeks was 4,2 J/cm2. Data were analyzed using SPSS version 20 for Windows.Results: There was a statistically significant difference of TEWL between pre-and post-treatment in group P3 (p=0.043) and P0 (p=0.018). In addition, a statistically significant difference in skin thickness was also found between pre-and post-treatment in group P2 (p=0.005) and P3 (p=0.003). There was a statistically significant difference in skin thickness post-treatment (p=0.000); however, there was no statistically significant difference of TEWL post-treatment by One-Way ANOVA test (p=0.138).Conclusion: ASC-CM could be a potential option for photoaging skin based on the TEWL and skin thickness evaluation. However, a longer study period was needed to know the further effect of ASC-CM.
The effect of cutaneous candidiasis toward skin moisture in Haji Adam Malik Central Hospital in Medan
Authors: Armayanti Ira , Wardani Meidina Kusuma , Nasution Lukmanul Hakim
Published: February 2022

Background: Cutaneous candidiasis is the second most common fungal infection. One of the predisposing factors for candidiasis is moisture. Excess moisture will cause skin damage related to skin moisture or also known as Moisture-Associated Skin Damage (MASD) is defined as inflammation and erosion of the skin caused by prolonged exposure to various sources of moisture. This study aimed to determine the comparison of skin moisture in patients with cutaneous candidiasis and without cutaneous candidiasisSubjects and Methods: This study was an observational analytic test with a cross sectional approach on 32 subjects with cutaneous candidiasis and 32 subjects without cutaneous candidiasis. The diagnosis was confirmed by clinical examination, skin scraping with 10% KOH and fungal culture. Check skin moisture using a scalar moisture checker on the volar lower arm.Results: The majority of the subjects' age ranged from 40-49 years (28.1%). The majority of gender is female (62.5%). The majority of body mass index is overweight (46.9%). The majority of occupations are service and sales personnel consisting of traders and employees (43,8%). The majority have middle education level is senior high school/equivalent (43.7%). Distribution of cutaneous candidiasis by location. Majority was  intertriginous candidiasis (50.0%). The degree of skin moisture in candidiasis subjects was wet as many as 19 people (59.4%) and subjects without candidiasis were normal as many as 21 people (65.6%). Humidity in cutaneous candidiasis subjects compared with subjects without cutaneous candidiasis showed a significant difference (p = 0.001).Conclusion : Subjects with cutaneous candidiasis had a wetter level of skin moisture than subjects without cutaneous candidiasis.