bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevention of post-ERCP pancreatitis using pancreatic duct stenting in difficult cannulation patients with calcular biliary bbstruction
Authors: Abdel Rahim Ali , Elrefaiy Mohamed A. , Morsy Shereif Ahmed , El Saadany Mariam Mosaad , Mashaal Ahmed R.
Published: February 2022

Background: Post-ERCP pancreatitis (PEP) has been the most frequent complication of Endoscopic Retrograde Cholangiopancreatography (ERCP). It has been documented to happen after 5–30% of ERCP procedures. PEP is new or exacerbated abdominal pain associated with a serum lipase or amylase concentration which is more than three times the upper limit of normal at 24 hours post-ERCP, requiring at least two days of prolongation of the planned admission. Following pancreatic sphincterotomy, pancreatic stenting is commonly used with the objective of decreasing both early restenosis and post-ERCP pancreatitis. Aim of the work: Evaluation of the pancreatic stenting technique as a preventive measure against post ERCP pancreatitis in calcular obstructive jaundice patients with difficult cannulation. Patients and methods: Forty Egyptian patients with calcular biliary obstruction with a difficult biliary cannulation who are at risk of developing PEP enrolled in a prospective randomized controlled comparative study. Group A: 20 patients with manipulation of pancreatic duct by guidewire without pancreatic stent insertion; Group B: 20 patients with manipulation of pancreatic duct by guidewire with pancreatic stent insertion.Results: The pancreatic duct stenting technique had reduced the risk of PEP significantly in calcular biliary obstruction patients with difficult CBD cannulation to 20?% (in group B) compared with 60?% in (group A).Conclusion: Prophylactic pancreatic stenting technique is a simple and easy procedure that showed to be efficient in decreasing cases of post ERCP pancreatitis in difficult cannulation patients. The endoscopists should be trained to practice the procedure safely.
Functional outcome of a patient with upper type brachial plexus injury treated by Saha and Steindler procedure: a case report
Authors: Syam Andi Dhedie Prasatia , Saleh M. Ruksal , Rante Indra Harianto , Kusmawan I Gusti Putu Yoga
Published: February 2022

Background: Upper type brachial plexus injury represents a major functional handicap. Secondary reconstruction was performed in neglected cases (>1 year without any attempt for reconstruction). The Saha procedure was commonly used for the reconstructive option for shoulder abduction, while the Steindler procedure for the reconstructive option for elbow flexion. We report a case in a patient with upper type brachial plexus injury treated by Saha and Steindler procedure.Case Presentation: We report a case presentation of an upper type brachial plexus injury in a 50-year-old man with a history of trauma when the patient climbed the roof and fell down with his right shoulder and hit the floor first. The patient underwent Saha procedure for shoulder abduction and Steindler for elbow flexion. Both of these operations were successful. After a follow-up of six months, the patient can perform the daily living activity.Conclusion: The Steindler procedure is one of the most common procedures and remains a powerful reconstructive option to restore elbow flexion. The Saha procedure was safe, easy, and significantly improved functional activity in a patient with upper-type brachial plexus injury.
Reliability of cerebral edema interpretation on head computed tomography scan in mild and moderate traumatic brain injury
Authors: Asih Made Widhi , Martadiani Elysanti Dwi , Laksminingsih Nyoman Srie , Sulaiman Yan William , Trisnawati I Gusti Ayu
Published: February 2022

Introduction: Cerebral edema could be caused by mild or moderate traumatic brain injury. The primary modality for cerebral edema is head computed tomography (CT), however the interpretation could be different between radiologists which could be due to subjectivity. The purpose of this study is to determine the radiologist interobserver and intraobserver reliability in the interpretation of cerebral edema on head CT of mild and moderate traumatic brain injury in Sanglah General Hospital, Denpasar, Bali.Methods: Retrospective study design with interobserver and intraobserver reliability test of two radiologists in interpreting cerebral edema on head CT of patients with mild and moderate traumatic brain injuryResults: 35 head CT scans of patients with clinical history of mild or moderate traumatic brain injury, shows that significant differences (bias) intraobserver and interobserver in the interpretation of cerebral edema.Conclusion: Head CT scan could not be reliable to determine cerebral edema in patients with mild and moderate traumatic brain injury due to high subjectivity between radiologists.
The importance of histological appearance in a preclinical test of the plant extracts effectiveness on dermal wound healing
Authors: Tjahyadi David , Parwanto Edy
Published: February 2022

N/A
Short cervix, wide anterior cervical angle and low cervical consistency index as a predictor of preterm birth: a case-control study
Authors: Susanto Andy , Wiradyana Anak Agung Gede Putra , Suwiyoga Ketut , Mayura I Gusti Putu Mayun , Manuaba Ida Bagus Fajar , Mahendra I Nyoman Bayu , Megadhana I Wayan
Published: February 2022

Objective: To determine and compare either change in length, anterior angle, and consistency of cervix can be used as the predictors of preterm labor or not.Methods: This case-control study involved 54 pregnant women with gestational age 20 - 37 weeks, which the case group is women in preterm labor and the control group were not in labor at Sanglah General Hospital, Bali, Indonesia from November 2018 to October 2019. The samples were examined using Transvaginal Sonography (TVS) to collect Cervical Length (CL), Anterior Cervical Angle (ACA), and Cervical Consistency Index (CCI) data.Results: Short CL could increase the risk of preterm labor by 9 times (OR = 8.80, 95% CI = 2.50-30.97, p-value 0.001). Wide ACA could increase the risk by 10 times (OR = 10.45, CI 95% = 2.92-37.39, p = 0.001). Low CCI could increase the risk by 7 times (OR = 7.43, 95% CI = 1.80-30.67, p = 0.003). Anterior cervical angle has the greatest role in the occurrence of preterm labor, followed by CL and CCI, although statistically insignificant (p=0.138; p=0.212= p:0.203).Conclusion: Performing cervical examination using TVS as the antenatal care routine can help predict and prevent preterm delivery.
RUMI DOPING application development as Anti-doping information media for Indonesian national paralympic comittee Athletes
Authors: Doewes Rumi Iqbal , Elumalai Gunathevan , Azmi Siti Hartini , Hendarto Singgih , Ramdhani Rina Nurhudi
Published: February 2022

Introduction: Doping is an invisible cheating act in a match; therefore, it is necessary to provide an anti-doping understanding to overcome doping behavior in a competition. The research purpose was to produce a product in the Rumi Doping application as a medium for anti-doping understanding in Indonesian NPC athletes.Methods: This research used R&D with the Agile Sprint planning model, which consists of (1) planning (planning for the preparation of software components); (2) developing (start software development); (3) testing (software testing); (4) delivering (present the software product); and (5) assessing (assess and provide feedback on the products that have been made). Data were collected by observation, interviews, and questionnaires. The testing stage used experts' product validation, and the assessment stage used product users (Indonesian National Paralympic Committee athletes). Aiken V Coefficient for validity testing and descriptive percentages to measure user ratings in the form of practicality and effectiveness of the Rumi Doping application.Results: The results showed that the average Aiken V value was 0.89 > 0.77, so it could be stated that the application developed was valid. The practicality assessment of the Rumi Doping application showed an average percentage of 80% (24/30) of athletes stated that it was practical to use. The effectiveness assessment of the Rumi Doping application showed that 90% (27/30) athletes disagreed about doping in sports, which means athletes have understood that doping is prohibited in sports. Conclusion: The research concluded that the Rumi Doping application is valid, practical, and effective in providing information about doping.
Antioxidants and immunomodulatory effect of black cumin seed oil in at-risk metabolic syndrome
Authors: Akrom Akrom , Darmawan Endang , Maulida Nuril , Syuhada Syuhada
Published: February 2022

Introduction: Black Cumin Seed Oil (BCSO) is a traditional medicine widely used as an antioxidant and immunomodulator. Objective: The purpose of this study is to investigate the effect of dose variation of BCSO (1.5 ml/day versus 3 ml/day) on IL-10 activity and MDA levels in patients at risk of MS at Jetis 1 Public Health Center (J1PHC), Bantul Regency, Yogyakarta, Indonesia.Methods: We conducted an analytical cross-sectional study. 66 patients at risk of metabolic syndrome (MS) were divided into two groups. In stage 1, group 1 received a 1.5 ml/day dose, and group 2 received 3 ml/day for 20 days. The clinical parameters of MS, IL-10 activity, and MDA levels were measured at the end of the study stages.Results: The mean activity of IL-10 in the 1.5 ml/day dose group was 4.83 and in the 3 ml/day dose group was 5.49, which showed an increase of around 13.66% (p = 0.300). The mean MDA level in the 1.5 ml/day group was 3.92 ?mol/L, which increased to 4.31 ?mol/L in the 3 ml/day group or approximately 9.95% (p = 0.802). Statistically, IL-10 activity and MDA levels in the two-dose groups did not differ significantly.Conclusion: The results of this study indicate that the administration of BCSO at doses of 1.5 ml/day and 3 ml/day for 20 days has the same effect on IL-10 activity and MDA levels in patients at risk of MS.
Chewing gum administration towards gastrointestinal motility on postoperative patients of PKU Muhammadiyah Gamping Hospital
Authors: Arianti Arianti , Annafi Imam
Published: February 2022

Background: Surgical procedures involving anesthetics could cause a complication of the digestive tract called postoperative ileus (POI). POI complicates the patient’s recovery and prolongs the stay period at the hospital. One of the most common interventions to prevent POI is early-postoperative feeding (EPF) to stimulate gastrointestinal motility that will prevent POI. Still, EPF is considered to be unsafe, according to several studies. Because of the disadvantage of EPF, some studies seek an alternative to EPF, one of which is postoperative chewing gum. The study aims to test the effectiveness of chewing gum to stimulate gastrointestinal motility in postoperative patients of PKU Muhammadiyah Gamping Hospital.Methods: The research utilized a quasi-experimental design with the post-test control group. The research’s samples are 30 postoperative patients of PKU Muhammadiyah Gamping Hospital. Samples were taken with probability sampling technique with purposive sampling approach. The effectiveness of chewing gum to stimulate gastrointestinal motility was determined by comparing the time record of the first bowel sound heard between the intervention and the control groups.Results: The result shows that there is a significance of chewing gum intervention to stimulate gastrointestinal motility. The Meantime of the first bowel sound heard of the intervention group (2.00 ± 0.07) is shorter than the control group (2.36 ± 0.33). Comparison between the intervention and control groups shows significance with p-value = 0.02 (p<0.05 indicates importance).Conclusion: Chewing gum intervention is effective in stimulating gastrointestinal motility in postoperative patients.
Online continuing professional development (CPD) for clinical nurse in the developing countries: a literature review
Authors: Sari Novita Kurnia , Prihatiningsih Titi Savitri , Lusmilasari Lely , Meliala Andreasta
Published: February 2022

Continuing education for nurses in the clinical setting is pivotal for their professionalism as well as the improvement of care delivery to the patient. While the traditional face-to-face method takes so many resources, online provision exists to bridge the gap. Therefore, this study aims to review the implementation of online CPD in developing countries where the characteristics of Indonesia are almost similar to these countries. Relevant publications were identified from Cochrane Trial, EBSCOhost, ProQuest, PubMed, ScienceDirect, and online manual resources from a search engine. Inclusion criteria included studies done in the low- and middle-income countries, full text, in English, peer-reviewed, and published in 2016-2020. A total of 17 articles were reviewed in this study resulting in several major themes including 1) barriers and facilitators of online CPD; 2) perception and expectation of nurses about online CPD; 3) model and development for online CPD. Study of needs and Indonesian nurse expectation and preparedness, a suitable framework to develop a more targeted and usable online CPD development plan in Indonesia can be done using pilot projects and other methods.
Community empowerment model to improve healthy living behaviors in rural areas: qualitative study
Authors: Kusumo Mahendro Prasetyo , Rosa Elsye Maria
Published: February 2022

Introduction: Limited knowledge is the leading cause of the high prevalence of type 2 diabetes (DM) in rural communities. Community empowerment is one strategy to increase knowledge regarding type 2 diabetes control. This study aims to design a rural community empowerment model to advance knowledge in controlling type 2 diabetes.Methods: The method used was qualitative with an action research design. Data collection included interviews, focused group discussions (FGD), and literature reviews. The participants of study involve the health office and cadres. The criteria for participants is to understand the procedures for preventing non-communicable diseases (NCD’s). Participants were selected using a purposive sampling method. Triangulation and member check to test the validity of the data. The analysis technique used was the N-Vivo software.Results: Four main themes related to the empowerment of rural communities to control type 2 diabetes were found: the DM control model based on community empowerment, cadres as health partners, types of health services in villages, and the families’ roles in increasing the success of controlling DM.Conclusion: Community empowerment can help in controlling type 2 diabetes in rural areas. Suggestions for next investigators is to evaluate the implementation of community empowerment programs in rural for clinical improvement.
The effect of knowledge on attitude of pregnant women in prevention of worm infections
Authors: Sulastri Sulastri , Triana Diah Ayu Agus
Published: February 2022

Introduction: Helminthiasis is an endemic and chronic disease caused by parasitic worms with a high prevalence rate and is non-fatal, but it affects the health of the human body by reducing the absorption of nutrients and proteins in infected individuals and reducing blood levels in the human body so that if it occurs in pregnant women, it can affect pregnancy and childbirth. This study aimed to examine the influence of findings on attitudes of pregnant women towards the prevention of helminthiasis in the work area of the Gatak Health Center, Sukoharjo. Methods: This study used a descriptive observational research method with a cross-sectional approach with 144 samples taken with an all-sampling technique. Results: Statistical test shows that the value of p 0.000 is less than alpha 0.05, which means there is a relationship between the knowledge the Pregnant women and the attitude of pregnant women insist the mother in preventing the occurrence of worms. Conclusion: The pregnant woman's posture is classified as functional because it influences the mother in the prevention and treatment of helminthiasis and affects her state of health.
Analysis of the quality of life of college students and students in Indonesia who were undergoing large-scale social restriction (LSSR) during the COVID-19 pandemic
Authors: Hadning Ingenida , Salsabila Anis Khoirul
Published: February 2022

Introduction: The Indonesian government's efforts to deal with the COVID-19 pandemic are implementing a Large-Scale Social Restriction (LSSR) policy. This LSSR policy becomes a problem for the quality of life of the people who carry out the policy, including college students and students. This research aims to determine the quality of life of college students and students in Indonesia who undergo LSSR during the COVID-19 pandemic.Methods: This research is a descriptive study with a cross-sectional approach. This research used accidental sampling methods by 30 days of distributing e-questionnaires. The samples used in this study were college students and students who were undergoing the LSSR in Indonesia. The instrument used for this research was WHOQOL-BREF. The quality of life was analyzed descriptively by calculating each domain's average transformed score.Results: Through this research, obtained 280 respondents consisting of 67 men and 213 women. Respondents aged 12-17 years were nine respondents, and 18-25 years were 271 respondents. The majority of respondents underwent LSSR for 9-12 weeks. Analysis of quality of life showed that the physical health domain had an average of 62.65 ± 0.87; psychological health of 62.58 ± 1.04; social relations of 53.76 ± 1.16; and the environment 61.53 ± 0.98.Conclusion: The conclusion in this study is that college students and students who undergo PSBB have good physical health, good psychological health, moderate social relationship quality, and good environmental quality.
Growth suppression of glioblastoma multiforme cell line response to the combination of Temozolomide and Nimotuzumab
Authors: Inggas Made Agus Mahendra , Miskad Upik Andriani , Islam Andi Asadul , Wahjoepramono Eka Julianta , Maliawan Sri
Published: February 2022

Background: Researches towards Glioblastoma multiforme therapy (GBM) has been performed, especially in finding the tumor’s genetic cellular expression. The overexpression of EGFR, frequently found in human malignancies, is known to significantly impact cancer cells hallmark traits, such as increased cell survival, proliferation and invasion. This research is performed to figure out the synergistic effect of temozolomide, the main chemotherapy regimen used, and the monoclonal antibody anti-EGFR nimotuzumab in inhibiting the growth of GBM cells in vitro.Methods: We performed cell cultures using GBM U87MG cells and administered nimotuzumab 1000µg/ml and temozolomide 20 µg/ml in different sequences and timings. Inhibition of GBM cell growth is evaluated by measuring Ki-67 and ?H2AX levels using flowcytometry and tested with one-way ANOVA. Data were analyzed using SPSS version 21 for Windows.Results: Levels of Ki-67 were in the control group (23.17±1.72), nimotuzumab monotherapy (15.43±1.70), temozolomide monotherapy (14.80±1.37), simultaneous therapy (10.73±1.19), nimotuzumab 24 hours before temozolomide (10.57±1.05), and nimotuzumab 48 hours before temozolomide (14.47±1.37). The level of ?H2AX is measured in the control group (11.90±1.25), nimotuzumab monotherapy (29.33±1.91), temozolomide monotherapy (28.13±1.58), simultaneous therapy (41.53±3.51), nimotuzumab 24 hours before temozolomide (39.56±2.06), and nimotuzumab 48 hours before temozolomide (35.93±3.56).Conclusion: This research shows that administration of nimotuzumab simultaneously with temozolomide and nimotuzumab 24 hours before temozolomide effectively inhibits the growth of U87MG GBM cells. Inhibition of EGFR expression before temozolomide administration is able to increase DNA damage and inhibit the proliferation of glioma cells.
The prominent factors of the selection of injecting contraception equipment in women of childbearing age in Yogyakarta
Authors: Indriastuti Nur Azizah , Oktafia Riski , Aviani Agista Wulan
Published: February 2022

Introduction: The increasing population growth has prompted the government to launch a family planning program. One of the family planning programs is the use of contraceptives. The government provides various contraceptives, one of which is injection contraception. Multiple factors influence the choice of injection contraceptives. The objective of this study was to analyze the factors that influence the choice of injection contraceptives for women of childbearing age (WCA).Methods: This study used a qualitative research method with a descriptive-analytic approach. The research respondents were nine people. The sampling technique was purposive sampling. This research was conducted on January 22 – February 06, 2021, in Brajan hamlet, Bantul. The instruments used in this study were interview guides, field notes and voice recorders.Results: There were six themes related to the factors influencing the choice of injection contraceptive methods for women of childbearing age in Brajan, Tamantirto, Kasihan, Bantul, Special Region of Yogyakarta. Mother's experience while using injectable contraceptives, mother's perception of injection contraceptive use, social support for mothers in choosing injectable contraceptives, advantages of injection contraceptives, sources of information related to injection contraception, mother's motivation to choose injectable contraceptives.Conclusion: The conclusion of this study is the mother's experience of using injectable contraceptives is comfortable and safe, mother's perception of injection contraceptives, mothers view that injection contraceptives have advantages, mild side effects, and easy installation methods, social support for mothers in choosing injection contraceptives is obtained from the help of their husbands, the experience of friends who use injectable contraceptives and the participation of midwives in choosing them, the advantages of injectable contraceptives include common side effects, low cost, easy installation, and safe breastfeeding, sources of information related to injection contraception are obtained from health workers, social media, relatives and friends, and than mother’s motivation to choose injectable contraceptives is to delay or regulate pregnancy spacing, provide comfort during use, and maintain a healthy body condition.
The effect of ACTH4-10Pro8-Gly9-Pro10 on neurotrophin-3 expression in Sprague Dawley rat on acute spinal cord injury
Authors: Maliawan Made Gemma Daniswara , Subagio Eko Agus , Utomo Budi , Parenrengi Muhammad Arifin , Al Fauzi Asra , Sudiana I Ketut
Published: February 2022

Background: Neurotrophic factors such as NT-3 play an important role in spinal cord regeneration, contributing to spinal cord regeneration assisting functional improvement in SCI. ACTH4-10Pro8-Gly9-Pro10, an analog of the N-terminal fragment (4-10) adrenocorticotropic hormone, is one of the neuroprotective compounds that can increase NT-3 levels in brain ischemia. Therefore, we conducted a study with experimental animals to determine the effect of NT-3 expression on ACTH4-10Pro8-Gly9-Pro10 administration in acute compression SCI.Method: We used Sprague Dawley rats with acute compression SCI model using 20 gr and 35 gr aneurysm clips. ACTH4-10Pro8-Gly9-Pro10 was administered intranasally to the treatment group, and 0.9% NaCl was administered intranasally to the positive control group. Both of the groups then terminated at 3 and 6 hours.Results: In rats with mild SCI that were given ACTH4-10Pro8-Gly9-Pro10, the NT -3 expression after 3 hours and 6 hours was 14 (12-17) and 10 (7-13). In rats with severe SCI given ACTH4-10Pro8-Gly9-Pro10, the NT-3 expression after 3 hours and 6 hours was 9 (6-11) and 8 (7-10). Intranasal administration of ACTH4-10Pro8-Gly9-Pro10 showed higher NT-3 expression than the group with 0.9% NaCl in mild and severe SCI.Conclusion: Intranasal administration of ACTH4-10Pro8-Gly9-Pro10 can increase NT-3 expression in mild and severe acute SCI at 3 and 6 hours. Expression of NT-3 in the group with ACTH4-10Pro8-Gly9-Pro10 mild acute SCI was higher than in the group with severe acute SCI. Further research needs to be done to determine the neuroregeneration effect of ACTH4-10Pro8-Gly9-Pro10 on SCI.
Correlation of bacterial index to zinc serum level in multibacillary type leprosy patient
Authors: Widasmara Dhelya , Wilanti Nesa Wike , SHW Tantari
Published: February 2022

Background: Leprosy Multibacillary type is the leading source of infection because total of bacteria is high. Zinc is an essential trace element of viability of host or pathogen. This research aimed to determine the relationship between bacterial index with zinc serum level in patients with leprosy multibacillary type.Methods: It was cross-sectional observational analytic research in 31 subjects selected using consecutive sampling and they met inclusion and exclusion criteria conducted in Outpatient Installation at RSUD Dr. Saiful Anwar Malang and RS Kusta Kediri in February to March 2019. Examination of acid-resistant bacteria used Ziehl Neelsen's staining method and measurement based on Ridley and Joplin. Test/examination of zinc serum level was conducted in Prodia Laboratory using Inductively Coupled Plasma-Mass Spectrometer (ICP-MS). data were analyzed statistically using program of Statistical Package for Social Sciences (SPSS) version 24.Results: From 31 research subjects, it was obtained that the lowest bacteria index of 1+ and the highest bacteria index of 6+ with median value of 3.5Â±2. the average of zinc serum level was 61.81Â±13.28 Âµg/dL with the lowest level of 37.00 Âµg/dL and the highest of 94.00 Âµg/dL. Based on Spearman correlation test, it was obtained correlation value of - 0.557 (55.7%) and value p = 0.001.Conclusion: There is a significant correlation between bacteria index and zinc serum level with strong closeness value. Correlation is negative, the higher bacteria index, the lower zinc serum level.
Prevalence of urogynecology fistula in Cipto Mangunkusumo National Hospital from 2011-2017
Authors: Rodjani Arry , Sandy Noffi Julia
Published: February 2022

Background: Genitourinary fistula is a condition that is quite common in developing countries due to the improvement of the health care system, especially the delivery service system and operating techniques. Vesicovaginal fistulas are the most frequently found type of fistula. In developing countries, the most common causes are gynecological surgery, radiotherapy, severe pelvic pathology events.Methods: This study is a descriptive observational study with a cross-sectional approach, namely by assessing age, etiology and the distinction between old cases or new cases. This study's data were secondary data from medical records collected retrospectively of all patients diagnosed with an urogynecology fistula at Cipto Mangunkusumo General Hospital in the period of 2011 to 2017.Results: From the data collected, there were 109 cases of urogynecology fistulas from year 2011 to 2017 in Cipto Mangunkusumo General Hospital with 46 years old. The most common type of urogynecology fistula is the vesicovaginal fistula where the majority are iatrogenic due to complications from gynecological obstetric surgery.Conclusion: Urologynecological fistula is still a matter that needs special attention, especially in obstetrics and urology.
A case of total atrioventricular (AV) block with acute coronary syndrome at a Negara tertiary care hospital: a diagnostic and therapeutic challenge in a resource-limited setting
Authors: Chandra I Made Anggita , Wirawan Narakusuma
Published: February 2022

Background: Total atrioventricular (AV) block describes a conduction disturbance from the atria to the ventricles via conduction through the atrioventricular node (AV node), acute coronary syndromes of mechanism, and being to cause mortality.Case Illustration: A 57-year-old man came with complaints of weakness two months ago, worsening for the last one week accompanied by left side chest pain. The patient is an active smoker without a history of chronic disease. ECG shows a total AV block with a junctional escape rhythm. Patients were treated with 1x75mg clopidogrel therapy, 1 x 80 mg aspirin, 3 x 5 mg ISDN, 5 mg / kg BW / minute, dopamine drip and 1 x 25 mg spironolactone. After being treated for three days with an increase in the maximum dopamine dose, the patient still felt weakness and chest pain on the left side, so the patient was referred to a tertiary hospital for echocardiography and percutaneous coronary intervention (PCI). Conclusion: a total atrioventricular (AV) block after an acute MI is a rare case. Clinical suspicion and proper evaluation of patients is essential for an early diagnosis, referral, and timely definitive treatment, to decrease the morbidity and mortality associated with this disease. Successful reperfusion at AV node is beneficial to the conduction system.
Anti-hyperurisemic Activity of Combination of Beetroot Powder (Beta vulgaris L.) And Allopurinol in Potassium Oxonate-Induced White Rats
Authors: Wulandari Anggraini , Dirgahayu Paramasari , Wiboworini Budiyanti
Published: February 2022

Introduction: Hyperuricemia is an abnormally high quantity of uric acid in the blood. Allopurinol is a type of xanthine oxidase inhibitor commonly used to lower uric acid levels in the general population. However, large doses of allopurinol can produce harmful effects, one of which being hepatotoxicity. The antioxidant activity of beetroot powder is high, and it has an antihyperuricemic effect. Giving beetroot powder and allopurinol together is intended to minimize allopurinol's adverse effects and give a positive increase in lowering uric acid levels. This study aims to evaluate the anti hyperuricemia effect of beetroot powder (Beta vulgaris L.) and allopurinol combination in white rats (Rattus novergicus strain Sprague Dawley) induced by potassium oxonate.Methods: This an experimental study with a randomized pre and post-test control group design. In this experiment, twenty rats were placed into four treatment groups; KP = Positive Control (hyperuricemic rats) + standard feed and drink; G1 = hyperuricemic rats + allopurinol 1,8 mg/Kg BW/day); G2 = Hyperuricemic rats + beet powder 1.56 g/Kg BW/day; G3 = hyperuricemic rats + allopurinol 1,8 mg/Kg BW/day and beetroot powder 1,56 g/Kg BW/day. On day 0 and day 28, the amounts of uric acid were measured. Data obtained were analyzed using SPSS version 23 for windows.Results: The mean pre-post changes in uric acid levels in each group were KP = 8.97 ± 0.48 mg/dl, G1 = 2.06 ± 0.15 mg/dl, G2 = 2.24 ± 0.10 mg/dl, and G3 = 2.11 ± 0.86 mg/dl. The mean pre-post changes in MDA levels in each group were KP = 8.14 ± 0.39 nmol/mL, G1 = 2.01 ± 0.38 nmol/mL, G2 = 3.13 ± 0.30 nmol/mL, and G3 = 2.35 ± 0.19 nmol/mL.Conclusion: Beetroot powder and allopurinol combination given for 28 days significantly reduced uric acid and MDA levels in potassium oxonate-induced white rats.
Analysis of Interleukin-6 level in Serum and Histopathology Changes of Cardiovascular Tissue on Male Wistar Rat with Nonalcoholic Fatty Liver Disease (NAFLD)
Authors: Ahmadwirawan Mylda Pratiwi , Cangara Husni , Santoso Arif , Hardjo Marhaen , Adnan Endy , Hamid Firdaus
Published: February 2022

Background: Nonalcoholic fatty liver disease (NAFLD) is the most common chronic hepatopathy and a global health issue. Interleukin-6 (IL-6) in liver pathology is very complex, and its participation in the development of NAFLD remains unclear. This study aimed to analyze the relationship between NAFLD and IL-6 as one of inflammaging biomarkers along with CVD histopathology.Methods: This study used a post-test control group design. The subject of this study was 14 male Wistar rats and divided into two groups. The control group was given standard diet and the NAFLD-modelling group was given 8 weeks high-fat-high-fructose diet. Both groups will be terminated at the 8th week for organ histopathological examination.Results: The IL-6 levels in NAFLD rats (16.14±6.46ng/ml) and non-NAFLD rats (11.28±3.49ng/ml). The blood vessel wall thickness of NAFLD (1.47±0.33 µm) and non-NAFLD rats (1.70±0.28 µm). The diameter of the blood vessels of NAFLD rats (14.06±3.30 m) and non-NAFLD rats (15.66±1.02 m). It was found that there were differences in cardiac histopathology (hemorrhagic (p:0.003), degenerated (p:0.036), and hyperemic(p:0.003)) between NAFLD and non-NAFLD modeling rats. As for IL-6 levels, blood vessel wall thickness, diameter, and heart histopathology (necrosis) there was no difference between NAFLD and non-NAFLD modeling rats (p>0.05).Conclusion: It has shown that NAFLD rats significantly caused cardiac histopathological changes. The levels of IL-6 tend to be higher in NAFLD rats but not significant, as well as the diameter of coronary artery shows a small tendency in NAFLD rats.
A discrepancy of blood group A with missing antigen in anorectal malformation patient at Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia
Authors: Atmanto Yohanes Kusumo Adi Arji , Samad Raehana , Muhiddin Rachmawati , Arif Mansyur
Published: February 2022

Background: Blood group discrepancy is a discrepancy in the results of the cell grouping with serum grouping examination. The source of discrepancy is from technical errors or a patient's medical status such as age, disease, history of blood transfusion and medication, pregnancy. This case study aims to evaluate a discrepancy of blood group A with missing antigen in anorectal malformation patient at Dr. Wahidin Sudirohusodo Hospital, Makassar, IndonesiaCase Presentation: A male baby, 6 months 19 days old, was unable to defecate since birth post-colostomy. Physical examination reveals anemia. A routine blood test showed a hemoglobin level of 8.8 g/dL. The diagnosis was high position anorectal malformation post colostomy suspect Hirschsprung Disease, with 110 cc Packed Red Cell (PRC) transfusion plan. A routine pre-transfusion procedure was performed. It was found a discrepancy of blood group A with missing antigen.  Crossmatching with blood groups O and A both gave compatible results. Examination of peripheral blood smear after PRC blood group A transfusion found no signs of hemolytic.Conclusion: Blood group discrepancy, in this case, was due to missing antigen, which was caused by the possibility of gastrointestinal bacterial infection.
The effectiveness of Triamcinolone Acetonide (TA) and Interleukin-6 (IL-6) levels in preventing intraperitoneal adhesion
Authors: Senjaya Yan , Rudiman Reno , Sulthana Bambang Am Am Setya
Published: February 2022

Background: Intraperitoneal adhesions are formed due to the inflammatory response in releasing proinflammatory cytokines such as IL-6. Triamcinolone Acetonide (TA) acts as an anti-inflammatory by inhibiting the production and release of IL-6 cytokines. This study aims to determine the effectiveness of triamcinolone acetonide in preventing intraperitoneal adhesions and its effect on assessing IL-6 levels in post-exploratory laparotomy in rats.Methods: An experimental study was conducted among 40 male Wistar rats from January and March 2021 in the Animal Laboratory of Universitas Padjadjaran, Bandung, Indonesia. Blood samples were taken before treatment and on the 14th day after treatment. In rats, laparotomy and cecum abrasion were performed with a needle. Rats in the treatment group were given triamcinolone acetonide at a dose of 0.1 mg, 0.3 mg, or 0.5 mg. On the 14th day, a microscopic examination of the degree of adhesion was performed. Data were analyzed using SPSS version 20 for Windows.Results: The results of the Kruskal-Wallis test analysis on the formation of intraperitoneal adhesions microscopically showed a significant difference between the control group and the treatment group (p < 0.001) with the lowest mean rank in the TA group of 0.3 mg (11.4), which stated that this dose was more effective in preventing intraperitoneal adhesions. The One-Way ANOVA test on IL-6 examination had a significant difference in postoperative IL-6 reduction between the control and treatment groups (p < 0.001).Conclusion: Triamcinolone acetonide was effective in preventing intraperitoneal adhesions and reducing IL-6 levels in post-exploratory laparotomy rats.
Leukocytospermia is related to total motile sperm counts in infertile men at Sadewa Maternal and Child Hospital, Yogyakarta, Indonesia
Authors: Rizal Dicky Moch , Hartanto Markus Christian , Septiyorini Nandia
Published: February 2022

Background: Leukocytospermia is defined as the presence of leukocytes in semen at the concentration of ? 1 x 106/mL according to World Health Organization (WHO) manual procedure. Leukocytes are the source of reactive oxygen species (ROS), which may lead to oxidative stress conditions and sperm damage. This study aims to evaluate the association between leukocytospermia, poor semen quality, and infertility at Sadewa Maternal and Child Hospital, Yogyakarta, IndonesiaMethods: This study was based on secondary data of semen analyses of males attending IVF clinics at Sadewa Maternal and Child Hospital, Yogyakarta, Indonesia, from May 2015 to November 2020. Variables assessed in this study were semen volume, sperm concentration, progressive motility, and Total Motile Sperm Count (TMSC). Data were analyzed using SPSS version 23 for Windows.Results: The median sperm concentration of the leukocytospermia group was higher than that of the non-leukocytospermia group. There is a relationship between the number of leukocytes in semen and TMSC, with the higher TMSC median in the leukocytospermia group.Conclusion: This is the first study to report a significant association between leukocytospermia and total motile sperm count (TMSC). The association is not expected with leukocytospermia patients who have better TMSC value.
Analysis of factors associated with the incidence of neonatal asphyxia in the neonatal intensive care unit (NICU) and perinatology unit in Wangaya Regional General Hospital
Authors: Astria Ni Kadek Risa , Suryawan Wayan Bikin , Sucipta Anak Agung Made
Published: February 2022

Background: Neonatal asphyxia is the second leading cause of neonatal death in Indonesia. According to the World Health Organization (WHO), neonatal asphyxia is the failure of neonates to begin and maintain normal breathing. Neonatal asphyxia can be caused by several factors, namely neonatal, maternal, placental, and delivery factors. This study is aimed to describe the factors associated with the incidence of neonatal asphyxia in Wangaya General Hospital.Methods: This study used an analytical method with a cross-sectional design. Data for the study were obtained from medical records. Study samples were selected using a simple random sampling technique, and the number of samples included was 170 neonates. The dependent variable was neonatal asphyxia, while the independent variables were preterm gestation, low birth weight baby, premature rupture of membrane, and delivery requiring the procedure. Data were analyzed with bivariate and multivariate analysis on SPSS.Results: The risk factors that showed association with neonatal asphyxia were preterm gestation (p=0.000; PR= 6.87; 95% CI: 3.19-14.79), low birth weight (p=0.000; PR=9.55; 95% CI 4.14-22.01), and premature rupture of membrane (p=0.002; PR=3.06; 95% CI: 1.48-6.3). while delivery requiring procedure was found to have no significant association with neonatal asphyxia (p=0.219, PR=0.64; 95% CI: 0.31-1.31). On multivariate analysis, it was found that preterm gestation, low birth weight, and premature rupture of membrane all showed significant association with neonatal asphyxia.Conclusion: There was a significant association between preterm gestation, low birth weight, and premature rupture of the membrane with neonatal asphyxia in Wangaya Regional General Hospital.
Aberrant expression of CD5 in a B-lineage Acute Lymphoblastic Leukemia (ALL): a case report
Authors: Sari Ni Ketut Puspa , Mahartini Ni Nyoman , Mulyantari Ni Kadek , Prawita Anak Agung Ayu Lydia , Krisnawati Ni Komang , Prabawa I Putu Yuda , Herawati Sianny , Dewi Made Minarti Witarini , Nabu Ekarini Katharina Yunarti
Published: February 2022

Background: CD5 is expressed in several B-lymphocyte malignancies, including Chronic Lymphocytic Leukemia (CLL), Mantle Cell Lymphoma (MCL), but CD5 positive B-cell lineage Acute Lymphoblastic Leukemia (ALL) is extremely rare. Aberrant T-cell antigen expression is associated with poor prognosis and is a useful marker to identify patients at increased risk. This case report aims to elaborate on the aberrant expression of CD5 in B-lineage ALL.Case Presentation: A 16-years-old male presented with a history of gum bleeding and abdominal pain of 7 days with associated fever, weakness and bone pain of 2-month duration. The bone marrow aspiration showed lymphoblast 30 % with the positive vacuole. In addition, the immunophenotyping test indicates for leukemia B-lineage with expression CD19, CD10, HLA-DR, CD 34, and there is the aberrant expression of CD5.Conclusion: Aberrant expression CD5 in cases of ALL B lineage is very rare. This can be associated with a poor prognosis.
Obesitas sebagai faktor risiko terjadinya peningkatan kadar trigliserida dalam darah: tinjauan pustaka
Authors: Salim Baiq Rissa Khaerawati , Wihandani Desak Made , Dewi Ni Nyoman Ayu
Published: February 2022

Obesity is considered a major factor in the emergence of various diseases such as coronary heart disease, stroke ischemia, and type 2 diabetes mellitus in developed and developing countries. Obesity is defined as an increase in body weight above 20% of normal limits and is associated with abnormal serum lipoprotein levels. Obese people are more at risk for diseases such as Diabetes Mellitus type 2, stroke and other diseases. Excessive fat accumulation in obese people results in increased amounts of free fatty acids hydrolyzed by endothelial lipoprotein lipases. This increase triggers the production of oxidants that have a negative effect on the endoplasmic reticulum and mitochondria. The free fatty acids released due to excessive fat accumulation also inhibit lipogenesis, resulting in an increase in triglyceride levels in the blood. This literature study aims to determine whether obesity is a risk factor for increased blood triglyceride levels based on the relevant literature.  Obesitas dianggap sebagai faktor utama munculnya berbagai macam penyakit seperti penyakit jantung koroner, stroke iskemik, dan diabetes mellitus tipe 2 yang terjadi di negara maju maupun negara berkembang. Obesitas diartikan sebagai peningkatan berat badan di atas 20% dari batas normal dan berhubungan dengan kadar lipoprotein serum tidak normal. Orang obesitas lebih berisiko untuk mengalami penyakit seperti Diabetes Mellitus tipe 2, stroke dan penyakit lainnya. Penumpukan lemak yang berlebihan yang terjadi pada orang obesitas mengakibatkan meningkatnya jumlah asam lemak bebas yang dihidrolisis oleh lipoprotein lipase endotel. Peningkatan ini memicu produksi oksidan yang berefek negatif terhadap retikulum endoplasma dan mitokondria. Asam lemak bebas yang dilepaskan karena adanya penimbunan lemak yang berlebihan juga menghambat terjadinya lipogenesis sehingga mengakibatkan peningkatan kadar trigliserida dalam darah. Tinjauan pustaka ini bertujuan untuk mengetahui apakah obesitas sebagai faktor risiko peningkatan kadar trigliserida dalam darah berdasarkan pada studi literatur yang relevan.
Kesesuaian pewarnaan gram dengan kultur darah sebagai prediktor nilai kritis kasus bakteremia di Rumah Sakit Umum Pusat Sanglah, Denpasar
Authors: Harindana Putu Yoska Arya , Iswari Ida Sri , Setyojatmiko Indramawan , Fatmawati Ni Nengah Dwi
Published: February 2022

Background: One of the considerations for giving empiric antibiotics in bacteremia cases is gram staining (GS) results. Accurate and fast results are required in distinguishing infection-caused bacteria. However, the data on how much the corresponding gram stain results with bacterial growth in blood cultures are still insufficient.Aim: The study aims to compare Gram stain results with bacterial growth in positive blood cultures.Methods: A cross-sectional analytic study obtained data from the VITEK® 2 Compact (bioMérieux) results for six months (January - June 2020). Data involved all blood cultures examined as many as 509.Results: Of the 509 blood samples, 46 were reported as critical values for bacteremia. Gram-negative bacillus bacteria were identified in 39.13% of the gram staining (GS) and 45.65% of the blood culture (BC) samples. Gram-positive bacteria appeared in 56.52% of GS and 52.17% of BC. MBRO (multidrug-resistant organisms) bacteria were identified in the proportion of 11%, then 13% from ESBL (extended-spectrum beta-lactamase) bacteria, and they remain as 4% MRSA (methicillin-resistant Staphylococcus aureus) bacteria. The higher result, 76% of the data was confirmed from the non-ICU patients.Conclusion: GS can be used as a reference for empiric antibiotic therapy due to its effectiveness, and it has a high degree of similarity with positive blood culture results.  Latar belakang: Salah satu pertimbangan pemberian antibiotika empiris pada kasus bakteremia adalah berdasarkan hasil pewarnaan gram. Dibutuhkan hasil yang akurat dan cepat dalam membedakan bakteri penyebab infeksi. Namun sedikit data tentang berapa besar kesesuaian hasil pewarnaan gram dengan pertumbuhan bakteri pada kultur darah. Untuk membandingkan hasil pewarnaan gram dengan pertumbuhan bakteri pada kultur darah yang positif.Metode: Penelitian ini merupakan penelitian analitik cross-sectional. Data diperoleh dari hasil VITEK® 2 Compact (bioMérieux) selama enam bulan (Januari – Juni 2020). Sampel penelitian adalah semua kultur darah yang diperiksa pada periode penelitian berjumlah 509.Hasil: Dari 509 sampel spesimen darah, 46 sampel dilaporkan sebagai nilai kritis prediktor bakteremia. Bakteri batang gram negatif teridentifikasi pada 39,13% sampel pewarnaan gram dan 45,65% sampel hasil kultur darah. Bakteri gram positif muncul pada 56,52% sampel pewarnaan gram dan 52,17% sampel hasil kultur darah. Bakteri MDRO (multidrug resistant organisms) teridentifikasi sebanyak 11%, 13% bakteri ESBL (extended spectrum beta lactamase), dan 4% bakteri MRSA (methicillin-resistant Staphylococcus aureus). Proporsi 76% sampel berasal dari pasien non-ICU.Simpulan: Hasil pewarnaan gram dapat digunakan sebagai acuan terapi antibiotika empiris karena memiliki tingkat kesesuaian yang tinggi dengan hasil kultur darah positif.
Neutrophil-Lymphocyte Ratio (NLR) as an output-outcome predictor in moderate-severe head injury at Sanglah General Hospital, Denpasar, Indonesia
Authors: Krisanty Melissa , Mahadewa Tjokorda Gde Bagus , Niryana I Wayan , Semadi I Nyoman , Suwedagatha I Gede , Wibawa I Gusti Agung Bagus Krisna
Published: February 2022

Background: This prospective cohort study aims to determine the best cut point value and the ability to predict Neutrophil Lymphocyte Ratio (NLR), analyze the most dominant factors, and the direct influence of the NLR to output and outcome in moderate and severe trauma to the head injury at Sanglah General Hospital, Denpasar, Indonesia.Methods: This study was an observational analytic with a prospective cohort design. The subjects of this study were head injury patients over 16 years old with Glasgow Coma Scale (GCS) ? 12 who visited and were treated at Sanglah General Hospital, Denpasar, Indonesia. Patients less than 16 years old, history of alcohol intoxication, stroke, metabolic disease, and multiple traumas were not included as research subjects. Data were analyzed using SPSS version 20 for Windows.Results: The research conducted on 49 respondents found that the best cut-off point of NLR was 6.05 has the most significant predictor (OR=7.6; p=0.001) and dominant (OR=64.97; p=0.002) factors to the output-outcome predictor in moderate-severe head injury. In addition, this cut-off value (6.05) also has a direct influence (x-value=0.523) in the occurrence of output and outcome unfavorable in moderate-severe head injury.Conclusion: the cut-off NLR values of 6.05 became the dominant predictor that directly affected the output and outcome unfavorable in moderate-severe head injury.