bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Tourniquet Inflation on Blood Pressure, Mean Arterial Pressure, and Pulse Rate during the Maintenance of Anesthesia Using a Combination of Dexmedetomidine and Isoflurane for Patients Undergoing Lower Extremity Surgery
Authors: Wijanarko Bayu , Christrijogo Sumartono  , Belindo Wirabuana  , Hardiono  , Bambang Pujo Semedi  , Prananda Surya Airlangga
Published: May 2024

Introduction: The utilization of pneumatic tourniquets in surgery can help surgeons optimize the surgical field and reduce the amount of bleeding. It can also cause hyperdynamic cardiovascular responses, such as increased blood pressure, mean arterial pressure, and pulse rate, which the administration of analgesia, anti-hypertension, and increased depth of anesthesia cannot correct. Excessive hemodynamic responses can lead to complications due to the utilization of tourniquets, namely increased intracranial pressure and acute heart failure. This study aims to analyze differences in the effects of tourniquet inflation on blood pressure, mean arterial pressure, and pulse rate during the maintenance of anesthesia using a combination of dexmedetomidine and isoflurane compared to that using only isoflurane for patients undergoing lower extremity surgery.
Methods: This observational cohort study. The statistical test in this study was conducted using the Shapiro-Wilk test for normality and the Spearman test for correlation. The Chi-Square test was carried out to ensure the characteristics of patients in the two groups.
Results: The results showed no significant effects of tourniquet inflation on blood pressure, mean arterial pressure, and pulse rate during the maintenance of anesthesia using a combination of dexmedetomidine and isoflurane. Meanwhile, tourniquet inflation during the maintenance of anesthesia using only isoflurane resulted in significant effects on blood pressure, mean arterial pressure, and pulse rate. The results also indicated significant differences between the effects of tourniquet inflation during the maintenance of anesthesia using a combination of dexmedetomidine and isoflurane and that using only isoflurane on the blood pressure, mean arterial pressure and pulse rate of patients undergoing lower extremity surgery.
Conclusion: There are no significant effects of tourniquet inflation during the maintenance of anesthesia using a combination of dexmedetomidine and isoflurane on the blood pressure, mean arterial pressure, and pulse rate of patients undergoing lower extremity surgery.
Systematic review: andrographolide as a potential Anti-inflammatory treatment for psoriasis
Authors: Dharmasamitha Indira , Warditiani Ni Kadek , Rusyati Luh Mas , Wati DK , Gelgel Wirasuta Made Agus
Published: May 2024

A chronic inflammatory skin condition called psoriasis affects 1-3% of people worldwide. It will lead to other psychological, endocrine, and cardiovascular issues. It mainly affects the elbows, knees, scalp, back, umbilicus, and lumbar regions and is distinguished by well-defined crimson plaques and thick silvery white scales. Topical corticosteroid cream has been the main therapy in treating inflammatory skin in psoriasis vulgaris until now. Nowadays, andrographolide is an active compound of Andrographis paniculate, or the name in Indonesia is Sambiloto, which has been reported as a potential anti-inflammatory. Therefore, this study aimed to systematically review the published efficacy of andrographolide as an anti-inflammatory in an in vivo study and synthesize the available data. This study was a literature review searched using PubMed/ Medline, Science Direct, and Cochrane up to September 2022. The following search terms were used: (andrographolide or Andrographis paniculate) AND (anti-inflammatory) AND (animal study or in vivo). The bias in the research using the Newcastle-Ottawa quality assessment score was rated as low risk, of some concern, or high risk. A total of six in vivo studies were included in our analysis. Methotrexate and biologic agents are used for the systemic treatment of psoriasis. Topical corticosteroid therapy remains the first line of topical therapy but has some side effects. Specific reporting of andrographolide as a potential anti-inflammatory in other inflammatory diseases is necessary to support the possible treatment for psoriasis. There still needs to be further studies regarding the use of andrographolide as a topical psoriasis treatment.
Nursing education institutions' readiness to use online objective structured clinical examination scoring management system
Authors: Primanda Yanuar , Indarwati Ferika , Haris Fahni , Sutrisno Resti Yulianti
Published: May 2024

Introduction: The Objective Structured Clinical Examination (OSCE) is an acceptable measure to assess nursing students' skill competencies. To date, rapid changes in the education system, technology information, and pandemic enforced the need to develop and implement an online OSCE scoring management system, an online system to score the student during the OSCE. Although the satisfaction of the online OSCE scoring management system has been studied, the study to assess readiness to implement the online OSCE scoring management system is still lacking. This study aimed to identify the nursing education institution readiness level in implementing an online OSCE scoring management system named ON-OSCE.
Methods: The online survey involved 144 nursing lecturers across Indonesia. The survey consisted of 30 questions with a 5-point Likert scale that entails technology, innovation, people, and self-development dimensions. Each dimension was constructed by the questions related to resources, skills, and attitudes. The readiness levels were categorized into not ready (average score of 1-3.39) and ready (average score of 3.40-5.00).
Results: Mostly, the participants worked at a private institution (93%) with an accreditation level of B level (75.5%) and implemented an e-Learning system (85.4%). However, the common OSCE scoring management system was paper-based/hardcopy (73.2%). About two third of participants (67.4%) were ready to implement an online OSCE scoring management system (Mean = 3.57, SD = 0.57).
Conclusion: Most participants perceived that their institution was ready to implement an online OSCE scoring management system. Further study is needed to pilot an online OSCE scoring management system in a nursing education institution and explore the student and examiner's satisfaction before implementing an online OSCE scoring management system.
A successful pregnancy complicated with ovarian cyst torsion in the first trimester
Authors: Indirayani Ima , Nora Hilwah , Roziana  , Maharani Cut Rika , Jannah Rauzatul , Febrina Dara Meutia Ayu , Mulya Intan Chaharunia
Published: May 2024

Introduction: Ovarian cyst torsion is a rare gynecological emergency characterized by acute abdominal pain due to torsion of the ovarian vascular pedicle. Most cases are associated with several risk factors including pregnancy, ovarian cyst size, and pelvic organ anatomy. Despite the incidence of detected ovarian cysts during pregnancy increasing along with better antenatal care, the clinician needs to consider appropriate management for the safety of the mother and fetus.
Case description: A 25-years old woman who was pregnant with a gestational age of 10 weeks was referred to the Emergency Department of Zainoel Abidin General Hospital. The patient complained of sudden abdominal pain at the lower right abdominal quadrant within the last 5 hours before hospital admission. The patient stated the history of the ovarian cyst based on previous ultrasonography assessment on previous antenatal care. Abdominal tenderness on the relevant quadrant was positive during the physical examination. A vaginal examination revealed a regular non-tender cystic mass with a diameter of 5 cm on the right adnexa. The ultrasonographic finding showed the presence of a cystic mass on the right ovary with a size of 6.52 cm x 5.6 cm x 4.06 cm and a positive whirlpool sign. The patient was diagnosed with ovarian cyst torsion in the first trimester of pregnancy. Due to the patient refractoriness to conservative management, the patient was treated surgically by cystectomy laparotomy in an emergency setting. Histopathology examination of the intraoperative specimen revealed a luteoma. The pregnancy was successfully maintained until full-term pregnancy and the baby was delivered by caesarian section due to malposition.
Conclusion: Appropriate supportive management was required to maintain pregnancy and prevent fetal loss.
The relationship of the use of masks with the event of maskne on Universitas Sumatera Utara Hospital healthcare workers during the COVID-19 pandemic
Authors: Khairuni Raisa , Jusuf Nelva Karmila , Putra Imam Budi
Published: May 2024

Background: The COVID-19 pandemic mandated people to use masks to control the disease spreading. However, mask usage can cause skin-related problems such as acne, which is called maskne. This study aimed to find out whether there is a relationship between the use of masks and the event of maskne in Universitas Sumatera Utara (USU) Hospital healthcare workers during the COVID-19 pandemic.
Subjects dan Methods: This study was an observational analytic study with a cross sectional approach with consecutive sampling methods involving 100 healthcare workers at USU Hospital. Diagnosis of maskne was established through history taking and dermatological examination. The data collected was analyzed using Chi-square, Kruskal Wallis and Fisher Exact tests. This research has received approval from the Research Ethics Commission of the Faculty of Medicine Universitas Sumatera Utara and Universitas Sumatera Utara Hospital.
Results: Maskne was more common in women (84.9%) in the age group 26-35 years old (69.9%). Doctors and nurses (31.5%) had more maskne, polyclinic (23.3%) was the work location that often has maskne. The use of medical masks (74.0%) had a significant relationship with the event of maskne (p=0.002), while the duration of wearing masks was 36 hours/day (80.8%), frequency of masks replacement 2 times/day (52.1%) and using 1 layer of masks (74.0%) was more often found in subjects who has maskne but did not have a significant relationship with the event of maskne.
Conclusion: There is a relationship between the use of masks and the event of maskne based on the type of masks in healthcare workers Universitas Sumatera Utara Hospital during the COVID-19 pandemic.
Effect of isothiocyanate therapy on trophoblast cell culture-hyperglycemia atmosphere against Tumor Necrosis Factor- α (TNF-α) and Transforming Growth Factor- β (TGF-β) levels
Authors: Gondo Harry Kurniawan
Published: May 2024

Background: Diabetes mellitus is becoming a public health problem and can be found in every population, including a pregnant women. Hyperglycemia conditions in pregnancy can lead to gestational diabetes mellitus involving proinflammatory cytokines such as Tumor Necrosis Factor-Alpha (TNF-α) and Transforming Growth Factor- β (TGF-β). Isothiocyanate is a bioactive compound found in Moringa leaf extract with anti-glycemic activity and anti-inflammatory effects. This study aims to evaluate the impact of isothiocyanate therapy on trophoblast cell culture-hyperglycemia atmosphere toward the levels of tumor necrosis factor- α (TNF-α) and transforming growth factor- β (TGF-β).
Methods: An experimental study with a post-test-only control group design was conducted using trophoblast cell culture from placental tissue. To create a gestational diabetes event, glucose was administered into the trophoblast cell culture. The sample was divided into six groups: negative control without treatment, positive control by glucose administration, and treatment groups P1, P2, P3 and P4 with the treatment of isothiocyanate with doses of 0.1; 0.2; 0.4 and 0.8 mg/ml, respectively. The TNF-α and TGF-β levels in each group are quantified using immunoassay by ELISA method.
Results: The mean TNF-α in the negative control, positive control, P1, P2, P3, and P4 groups were 20.59, 43.54, 32.76, 30.15, 27.32, and 24.05, respectively. While the mean of TGF-β levels in the negative control, positive control, P1, P2, P3, and P4 groups were 15.76, 10.44, 11.05, 11.70, 12.46, and 14.32, respectively. The lowest TNF-α and the highest TGF-β levels were found in the treatment group (P4) that received isothiocyanate with a dose of 0.8 mg/ml.
Conclusion: The administration of isothiocyanates from Moringa leaf extract significantly lowered the level of TNF-α and increased the level of TGF-β in hyperglycemic trophoblast cell culture compared with the positive control group.
The effect of dietary antioxidant vitamins on malondialdehyde, white blood cells, and platelets
Authors: Andini Ary , Nuriannisa Farah , Nugraha Gilang , Sari Nathalya Dwi Kartika , Rhomadhoni Muslikha Nourma , Wirayudha Satya Nugraha , Sholeh Eka Apriliani Maisurotun , Faradita Audria Intan , Wahyuningtiyas Fika Dwi
Published: May 2024

Introduction: Vitamins have a main role in controlling metabolism in the body and the immune system. Vitamins A, C, and E are known as antioxidant nutrients and vitamin D is essential for innate and adaptive immune function. This study is aimed to analyze the effect of vitamin intake regularly on malondialdehyde (MDA) levels, white blood cell (WBCs) and platelet counts, and differences count of leukocyte
Method: The study used 6 groups including the control group without intervention and the intervention group intake of one tablet of vitamin a day for 7 days which were divided into groups of vitamin A 2000 IU, vitamin C 1000 mg, vitamin D 400 IU, vitamin E 100 IU and multivitamins C 1000 mg and D 400 IU
Results: Based on the study was explained that vitamins C, D, and E and multivitamins C and D were able to reduce MDA levels and leukocyte counts descriptively but not significantly. The differential leukocyte count has various levels depending on the type of vitamin.
Conclusion: Therefore, the consumption of vitamins A, C, D, and E and multivitamins C and D had no significant effect on MDA levels, WBCs count, platelets count, and differential count of leukocyte.
A case report of a woman with SLE and lupus enteritis as the first manifestation of active systemic lupus erythematosus
Authors: Yulistiawati Fitria , Awalia
Published: May 2024

Introduction: Lupus enteritis is a rare first manifestation of active systemic lupus erythematosus (SLE). diagnosis of this condition is hard, specially without other signs and symptoms associated with active SLE. this article will report a woman with SLE and lupus enteritis as the first manifestation of active systemic lupus erythematosus
Case presentation: A 25-year-old woman presented to the Emergency department complaining of abdominal pain and vomiting. From her medical history, four years in the past, she reported the same signs and symptoms as now and turned into identified with appendicitis. Her abdomen examination found out mild abdominal distention without a abdominal tenderness. Wall thickening and irregularity of small and big bowel loops were observed on the CT abdomen. She turned into given a excessive dose glucocorticoid as initial treatment and turned into maintained with low dose glucocorticoid and cyclosporin. After 6 months of follow-up, the patient did not have a recurrence of signs and symptoms.
Conclusion: A high index of suspicions is essential to differentiate lupus enteritis from other differential diagnoses. For lupus enteritis, excessive-dose steroids were an efficient initial treatment.
Medication adherence and visiting compliance: interventions self-management education based on health belief model
Authors: Joni Iskandar  , Setiyowati Eppy , Chilyatis Zahroh
Published: May 2024

Introduction: The large number of TB cases was  caused by the boredom of treatment for too long, the lack of knowledge of patients about pulmonary TB, the distance between the patient's home and public health services. The purpose was to analyze effect interventions of self-management education based on the health belief model on adherence medications and visiting compliance in pulmonary tuberculosis patients at Community health center Pamekasan Regency.
Method: This research is conducted using a quantitative approach, type of intervention research. Participants in this study were the >20 year old age group. This study has certain characteristics on the selection of subjects; therefore use purposive sampling techniques. Intervention Researchers gave treatment self-management education based on a health belief model. The collected data is then analyzed using a statistical test independent T-test with the level of significance α = 0,05.
Result: The average difference in drug administration adherence in the intervention group was 17.89 with a standard deviation of 9,650. The control group showed a difference in drug adherence value of 5.23 and a standard deviation of 3,456. The average difference in visiting compliance in the intervention group was 15.37 with a standard deviation of 6,130. In the control group it showed a visiting compliance difference value of 5.76 and a standard deviation of 4,162.
Conclusion: There was an influence of self-management education based on health belief model on increasing adherence to taking medications and increasing visiting compliance in tuberculosis patients at community health centers in Pamekasan Regency, East Java, Indonesia
The effectiveness of CRP and leukocyte examinations as a detection of risk factors for pre-eclampsia in pregnant women
Authors: Masruroh Nur Masruroh , Lailatul Khusnul Rizki  , Uliyatul Laili  , Dhifa Nur Alifah
Published: May 2024

Introduction: Preeclampsia is an important problem in obstetrics because it is a pregnancy complication often found and results in high morbidity and mortality in both mother and baby. Preeclampsia is one of the complications of pregnancy that needs to be detected or monitored for symptoms, because in addition to being risky for the mother, it will also have an impact on the occurrence of preterm birth and even further impact, namely fetal death in the womb. This study aimed to determine the effectiveness of CRP and leukocyte examination to detect preeclampsia.
Method: This research was conducted at the Jagir Health Center Surabaya in March-July 2022. The research used case control with 30 pregnant women as samples divided into 15 as a control group of normal pregnant women and 15 pregnant women with preeclampsia.
Result: The results showed that of the 15 respondents who had preeclampsia more than half (60%) had high leukocyte and CRP levels, the remaining less than half (40%) had normal CRP and leukocyte levels. While in the control group more than half (67%) had normal CRP and leukocyte levels and less than half (33%) had normal CRP and leukocyte levels. The results of data analysis showed p value 0.001 (<0.005), which means there is a relationship between the CRP and leukocytes on the incidence of preeclampsia.
Conclusion: Examination of CRP levels and leukocyte count proved effective for detecting the incidence of preeclampsia in pregnant women. It is expected that pregnant women carry out routine pregnancy checks and health workers are expected to routinely carry out early detection to prevent pregnancy complications such as preeclampsia
Histopathological findings of the liver and kidneys of wistar rat exposed to insect repellent
Authors: Ary Andini  , Lysa Veterini  , Edza Aria Wikurendra  , Achmad Syafiuddin  , Defi Rimasari  , Munifa Nur Aida
Published: May 2024

Introduction: The active substance of pyrethroids, especially dimefluthrin, in insect repellent not only plays a role in killing mosquitoes but is also toxic to human health. This study aims to analyze the effect of insect repellent exposure on the histopathological findings in the liver and kidneys of the Wistar rat.
Methods: This experimental study used 24 male wistar rats, which were divided into four groups, namely control, type of insect repellent, which included mat electric (dimefluthrin 0.566%), liquid electric (dimefluthrin 0.014%), and coil (dimefluthrin 0.031%), with a duration of exposure a day for 8 hours in 20 days.
Results: There was a significant effect of the type of insect repellent exposure on the histopathological findings of the liver and kidneys (p<0.05). This study also showed the highest rate of cell degeneration and necrosis in the liver and kidneys belonged to Mat electric repellent exposure in the liver and kidney. Higher concentrations of dimefluthrin in insect repellent have a significant effect on the histopathology of the liver and kidney.
Conclusions: The use of mosquito coils, electric mats, and liquid electricity for 8 hours over 20 days affects the histopathological evaluation of the liver and kidneys. The higher the concentration of dimetfluthrin in insect repellent, the higher the level of damage.
Antibacterial potential of Curcuma caesia Roxb ethanol extract against nosocomial infections
Authors: Siti Juariah  , Fazleen Izzany Abu Bakar  , Mohd Fadzelly Abu Bakar  , Susi Endrini
Published: May 2024

Introduction: Nosocomial infection is one of the infections that occurs in the hospital environment and can cause several diseases, but nosocomial infection can also cause the sufferer to experience sepsis and even die if they do not get treatment. This study aims to determine the active compound of black turmeric extract (Curcuma caesia Roxb) and measure the inhibitory ability of several bacteria that cause nosocomial infections.
Methods: The diameter of the inhibitory zone was evaluated using the Kirby-Bauer disk diffusion method in this investigation
Results: The results showed that black turmeric extract has the potential to act as an antibacterial against both gram-positive and gram-negative bacteria. The highest results were obtained at the highest concentration (80%) against Staphylococcus aureus bacteria with a 15.10 ± 6.95 mm inhibition zone.
Conclusion: Based on the results of this study, it can be stated that black turmeric extract (Curcuma caesia Roxb) has the potential to be an antibacterial control for nosocomial infections.
Effect of essential oil Citrus aurantium l var amara on menopause syndrome
Authors: Laili Uliyatul , Zuwariyah Nur
Published: May 2024

Introduction: Many therapies that have been done to overcome the problem of menopausal syndrome have been carried out using hormonal therapy or using drugs, but complementary therapies have not been carried out in Indonesia. The purpose of this study was to analyze the use of citrus aurantium l var amara to overcome the problem of menopausal syndrome.
Method: The data used in this study were data on menopausal syndrome experienced by respondents without giving therapy and after giving complementary therapy, as well as factors of occupation, age, and history of contraception of 42 respondents who had menopause. Data analysis was done by comparing the two groups of intervention (women who had been given the complementary therapy of aurantium l var amara) and control group (women who had not received the complementary treatment).
Results: Women in control group experienced no difference in terms of their menopause complaints (p = 0.206), while women in the intervention group showed improvement of their complaints after routine administration of aurantium l var amara therapy for 5 days (p=0.032).
Conclusion: Research conducted to analyze the use of citrus aurantium l var amara to treat menopausal syndrome problems proves that aurantium l var amara is effective in dealing with menopausal syndrome problems.
The effectiveness of triple elimination examination (HIV, syphilis, hepatitis), roll over test (ROT) and mean arterial pressure (MAP) and self hypnosis on emergency management of high risk pregnant women during pandemic
Authors: Mardiyanti Ika , Rahayu Esty Puji , Zuwariah Nur , Winoto Priyo Mukti Pribadi , Karmila Hartatiek Nila
Published: May 2024

Introduction: Screening in pregnant women by performing a triple elimination test to prevent transmission of HIV/AIDS, syphilis and hepatitis B, as well as a Roll Over Test (ROT) and Mean Arterial Pressure (MAP) to detect pre-eclampsia became really hard during the COVID-19 pandemic due to many restrictions on almost all routine health services. Adaptation is needed in responding to changes that can overcome physical and mental health problems in the community, one way to overcome this is through self-hypnosis. For this reason, there is a need for research on the effectiveness of triple elimination, ROT and MAP examinations as well as self-hypnosis in high-risk pregnant women in an effort to manage emergency pregnancy.
Method: A cross sectional design was used. All samples were selected by simple random sampling at PMB Ika Mardiyanti. Data were collected for completion of triple elimination, ROT, MAP, as well as the outcome of the emergency treatmentin the high-risk pregnant women.
Results: There were 30 pregnant women involved, in which 17 of them were at low risk and 13 of them at high risk. Most respondents with complete data of triple elimination, ROT and MAP had good emergency management (73.3%). Those who received self hypnosis seemed to have better emergency management compared to controls (p=0.001).
Conclusion: Doing the triple elimination examination, ROT, MAP and self hypnosis could be the strategies for handling emergencies and lead to better outcome in high-risk pregnant women.
Effect of COVID-19 pandemic large-scale social restriction to low back pain epidemiology, a single center study in Jakarta, Indonesia
Authors: Winaga Handriadi , Irfan Ario Stevanus , Gunawan Vincent , Andikusuma Samuel , Kennedy Dave
Published: May 2024

Link of Video Abstract: https://youtu.be/oyaEnUqaE9k
 
Background: With the increase in COVID-19 cases, Indonesia’s government enforced the Large-Scale Social Restriction (LSSR) that started on April 1st, 2020. Despite LSSR’s ability to decrease COVID-19 transmissions, LSSR also leads to an increase in depression disorder, change in dietary habits and lower physical activity, which are factors that affect low back pain (LBP) incidence. The objective of this study is to evaluate the incidence of LBP during LSSR in the COVID-19 pandemic, especially in Atma Jaya Hospital, Jakarta.
Methods: This study is a descriptive-analytic research. The data was taken from the medical records of patients whose ages are>18 years old and who complained of LBP symptoms. We divide our data into Pre- (July–December 2019) and during LSSR (July–December 2020). Statistical analysis is significant if α<0.05. Missing data will be excluded.
Results: Total orthopedics patients in Atma Jaya Hospital, Jakarta, in pre-and during LSSR were 1405 and 837, respectively. Only around 269 and 178 patients, respectively, had LBP complaints. There is a decrease of 5.2% in traumatic LBP complaints during LSSR compared with pre-LSSR (p=0.13). We found significant differences in number of subjects with HNP (20.1% vs 12.4%, p=0.034) and scoliosis (2.6% vs 8.4%, p=0.005). Pharmacological and physiotherapy were the mainstays of treatment for LBP complaints, with no significant difference in the number of patients who received them.
Conclusion: The LSSR does not significantly affect the number of LBP patients in an orthopedic clinic at Atma Jaya Hospital. LSSR might lower the prevalence of HNP with LBP and might increase the prevalence of scoliosis with LBP.
The roles of purple sweet potato anthocyanins in optimizing dietary intervention of metabolic dysfunction-associated fatty liver disease
Authors: Awan Syuma Adhy , Wibawa I Dewa Nyoman , Jawi I Made , Pinatih Gde Ngurah Indraguna , Mahendra Agung Nova
Published: May 2024

Link of Video Abstract: https://youtu.be/rRJRhubdmcM
 
Metabolic-associated fatty liver disease (MAFLD) is a multifactorial metabolic disorder with complex pathogenesis and a broad spectrum of disease. It is characterized by the accumulation of triglycerides (TG) in hepatocytes, which are associated with hepatic steatosis. Purple sweet potato (Ipomoea batatas L.) (PSP) tuber, is rich in anthocyanin contents. This review aims to discuss recent findings on the effects of purple sweet potato tubers and its potential therapeutic action on MAFLD. In various in vivo studies and limited clinical trials on patients, purple sweet potatoes have been shown to be beneficial not only in lipid metabolism but also in reducing liver fat deposition and insulin resistance. In addition to antioxidant, anti-inflammatory, and anti-hyperlipidemic effects, anthocyanins can be considered as important adjuvant therapeutic agents in the attenuation of inflammation, free radicals, insulin resistance, and hepatocyte injury.
The Impact of COVID-19 after one year on the orthopedic spine service at the Orthopedic Center Hospital in Indonesia
Authors: Utomo Pamudji , Santoso Hafizh Nur , Dykall Naf’an Dzikri
Published: May 2024

link of Video Abstract: https://youtu.be/-6sruWeh-_Q
 
Introduction: Coronavirus-2 (SARS-COV2) is the agent that causes Coronavirus Disease (COVID-19), an acute respiratory tract illness. Early in December 2019, COVID-19 was created in Wuhan, China. On March 11th, 2020, COVID-19 was classified as a pandemic by WHO. As a result, the Indonesian government enacted extensive social restrictions on March 31, 2021. This rule prohibits unnecessary public actions. This study aimed to ascertain how COVID-19 affected This study sought to ascertain how COVID-19 affected orthopedic treatments provided in the spine area at the Orthopaedic Center Hospital in Indonesia.
Methods: This research is cross-sectional and comparative. The population in Indonesia during the COVID-19 epidemic was compared to the same population one year earlier in the research. This report covers every patient who visited Prof. Dr. R. Soeharso Orthopaedic Hospital with a spine-related diagnosis from the emergency room, an outpatient clinic, or an inpatient setting. Patients with other orthopedic subspecialty diagnoses and those registered at orthopedic service support facilities like radiography, laboratories, or physiotherapy were excluded. SPSS version 26 was used to analyze the data.
Results: The overall number of spine patients decreased significantly (30%) from 2440 (pre-covid) to 1695 (during covid). Additionally, there was a significant decline in outpatient visits and surgical procedures (p≤0.05). Patients with trauma reported a crucial decrease during outpatient visits and during surgery (p≤0.05).
Conclusions: During the COVID-19 pandemic, the overall number of spine patients from outpatient visits and patient surgery decreased significantly. Additionally, orthopedic care provided during outpatient visits and surgeries decreased.
Endometrial thickness is a prognostic factor in endometrial carcinoma
Authors: Putra Very Great Eka , Iskandar Teuku Mirza
Published: May 2024

Background: Ultrasonography is a method that is commonly used today to measure endometrial thickness. It is useful as the initial step to detect endometrial hyperplasia or cancer in women with abnormal uterine bleeding. This study seeks to explore the predictive role of endometrial thickness in the development of endometrial cancer and identify the variables that affect endometrial thickness.
Methods: This study is a cross sectional retrospective analytical study of women with a history of endometrial cancer who underwent transabdominal ultrasonography or transvaginal ultrasonography (TVS) followed by complete surgical staging between January 2019 and December 2021 at Dr. Kariadi General Hospital Semarang. Patients were categorized by endometrial thickness into ≤8 mm and >8 mm. In order to compare the endometrial thickness and clinicopathology traits, a bivariate analysis was done. The study proceeded with multivariate analysis and logistic regression if more than one bivariate analysis revealed a significant correlation (p<0.25).
Results: This study involved 55 participants who had endometrial thickness measurements taken. Endometrial thickness was used to divide the patient population into two groups: ≤8 mm (n=28) and >8 mm (n=27). Tumor differentiation grading showed a significant difference between the two groups (p<0.001). The thickness of the endometrium is a significant prognostic of endometrial carcinoma based on the degree of tumor differentiation (p<0.001). With each millimeter increase in the endometrium, the likelihood of endometrial carcinoma increases significantly by 1,25 [p<0.001; 95%CI =1.112-1.404] times.
Conclusion: As a result, the degree of tumor differentiation on post-operative histological analysis is correlated with the thickness of the endometrium. The endometrium's thickness considerably increased as the tumor differentiation level deteriorated. These findings highlight the significance of endometrial thickness as a possible predictor of tumor differentiation and prognosis in endometrial cancer.
Posterior annulus elevation using pledget stitch: An adjuvant technique to improve the mitral valve coaptation in pediatric mitral valve repair
Authors: Rahmat Budi , Siswanto Bambang Budi , Fakhri Dicky , Sakidjan Indriwanto , Sulisetyowati Tri Wahyu Murni , Timan Ina Susianti , Kekalih Aria , Kurniawati Yovi , Wardana Putu Wisnu Arya , Fardhani Dwi Gunawan
Published: May 2024

Link of Video Abstract: https://www.youtube.com/watch?v=8PNO8KPQFTY
 
Purpose: Achieving an optimal result in mitral valve repair can be challenging in children due to the delicate nature of the mitral valve tissue, a wide range of pathologies, and a high incidence of co-existing cardiac anomalies. This study aimed to evaluate a novel adjuvant technique, posterior annulus elevation using pledget stitch, to improve mitral valve coaptation in pediatric mitral valve repair.
 
Patients and methods: A retrospective cohort study was conducted at the National Cardiovascular Center Harapan Kita. Patients with severe mitral regurgitation who underwent mitral valve repair with posterior annulus elevation using pledget stitch between January 2021 and October 2021 were included. Transesophageal echocardiography (TEE) at day-0 and transthoracic echocardiography (TTE) at day-5 and 3 months after surgery was performed to assess coaptation length and residual regurgitation.
 
Results: Twelve patients were included in this study with a mean age of 13.13 ± 2.98 years. The mean coaptation length was 6.94 ± 1.44 mm immediately after surgery. At day 5, 11 patients exhibited no or only trivial regurgitation (91.67%), with a mean coaptation length of 7.18 ± 1.72 mm. During a three-month follow-up period, 10 patients had no or only trivial regurgitation (83.33%) with the rest only developing mild regurgitation (16.67%), with a mean coaptation length of 7.60 ± 1.41 mm. No mortality or adverse events related to the procedure were observed during the follow-up.
 
Conclusion: Posterior annulus elevation using pledget stitch as a novel adjuvant technique during mitral valve repair showed promising results in improving leaflet coaptation in pediatric patients. This technique may provide an additional option for mitral valve repair when the conventional technique yields unsatisfactory results.
Complete recovery of interhemispheric subdural empyema extending to cerebellar tentorium treated with antibiotics as unimodal therapy: a case report and controversial literature review
Authors: Thohari Fadia Hasna , Sugianto Paulus , Ardiansyah Djohan
Published: May 2024

Link of Video Abstract: https://youtu.be/ep7OSDbighoBackground: Intracranial subdural empyema, although rare, represents an extreme medical and neurosurgical emergency. Multiple burr holes or a craniotomy for drainage and antibiotics are the treatment of choice. This case study aims to evaluate the complete recovery of interhemispheric subdural empyema extending to cerebellar tentorium treated with antibiotics as unimodal therapy.
Case Presentation: We present a case of a 40-year-old male with severe headache, a decrease of consciousness GCS E3V1M5, generalized onset tonic-clonic seizure, right abducens palsy, and right hemiparesis. Interhemispheric subdural empyema extending to cerebellar tentorium with associated intracranial abscess was seen from brain magnetic resonance imaging (MRI). Antibiotics were administered without surgical intervention due to the patient's family rejection. The patient regained full consciousness within 1 week and complete neurological function after 4 weeks of continuous use of antibiotics. The patient was discharged, and his recovery was uneventful on subsequent follow-up.
Conclusion: The use of antibiotics as monotherapy in subdural empyema is controversial, as it is widely accepted that surgery must be initiated as soon as possible in this pathology. It is indicated in small portions of cases without major neurological deficits or in particular conditions where surgery could not be performed. Still, more recent studies found it justifiable in patients with documented initial good responses. This case report highlights the complete recovery and the clinical outcome of antibiotics as monotherapy for subdural empyema.
Borderline type leprosy with variation of clinical manifestations and histopathology: two case reports
Authors: Karmila I Gusti Ayu Agung Dwi , Rusyati Luh Made Mas , Saputra Herman , Sari Luh Gede Melia Puspita
Published: May 2024

Link of Video Abstract: https://youtu.be/HgIJyHrxoOc
 
 
Background: Leprosy is a chronic disease caused by Mycobacterium leprae. This disease can be diagnosed if one of the four criteria is met. Histopathological examination can vary depending on the spectrum of the disease. The following describes two cases of borderline-type leprosy that aimed to increase understanding of the diagnosis and management of leprosy, especially the borderline type.
Cases: Both cases had complaints of numb spots on the body. The first case had more lesions than the second one with borderline-borderline histopathological examination results, while the second one had borderline lepromatous histopathological examination results. Both patients received the same therapy (multidrug therapy for multibacillary leprosy). During observation, there were no drug side effects that the patient could not tolerate. The prognosis in both cases is dubia, depending on the patient's adherence to treatment. 
Conclusion: The diversity of clinical and histopathological features can occur, including cases of leprosy. Early diagnosis and prompt treatment should be started as possible to prevent disabilities.
The role of the immune response in the development of pneumonia arising from oral periodontitis: a literature review
Authors: Hutomo Suryani , Denise Utami Putri
Published: May 2024

Link of Video Abstract: https://youtu.be/Cgi15seZAw4
 
A growing evidence links periodontitis, a chronic inflammatory disease of the oral cavity, to the development of systemic inflammation. One of the most commonly reported is pneumonia, arising from aspiration of the periodontal pathogens into the lung tissue. In high-risk individuals, the morbidity and mortality rate is high, raising the concern for prevention measures. Secondary systemic effects are proposed to arise from both direct periodontal pathogens spread and through leakage of bacterial byproducts and local inflammatory cytokines to the bloodstream. The association of periodontitis and systemic diseases is bi-directional, as systemic diseases may, in turn, increase the incidence and severity of periodontal diseases. Here, the conflicting roles of the immune system in both limiting pathogen growth and its potential catastrophic inflammatory activation is further discussed. In addition, possible approaches to prevent periodontitis from spreading into the respiratory organs are also proposed. Given the large number of the population affected by periodontitis, a comprehensive understanding of the pathomechanisms of the development of systemic diseases, notably pneumonia, as well as the discovery of prevention and therapeutic approaches, is urgently needed.
Characteristic of upper respiratory tract microbiota in severe covid-19 adult patients in Indonesia
Authors: Angky Budianti  , Dewi Beti Ernawati , Sudiro Tjahjani Mirawati , Nainggolan Leonard , Prihartono Joedo , Jauharoh Siti Nur Aisyah , Suwarto Suhendro , Sjahrurachman Agus
Published: May 2024

Introduction: Nowadays, new cases of COVID-19 have been found with severe cases and deaths. The upper respiratory microbiota has been associated with susceptibility to viral infection and disease severities. However, the association of respiratory tract microbiota with the modulation of COVID-19 outcomes still raises a question. Therefore, we examined the association between the diversity of upper respiratory microbiota and clinical manifestations of COVID-19.
Methods: This research is an observational cross-sectional study. We characterized the microbiota in the upper airway using the 16S ribosomal RNA sequencing method in 74 COVID-19 patients aged 18-64 years. We also examined the association between COVID-19 severities with alpha and beta diversity of upper respiratory microbiota. The alpha and beta diversity was analyzed by QIIME and shown by R software, AMOVA and MRPP testing was done with R software. The t test and diagrams were performed using R software. Bivariate analysis was carried out by t-test and Chi-square test. 
Results: The top five phyla in the upper respiratory tract of Indonesian COVID-19 patients with age 18-64 years old were Firmicutes (32,3%), Bacteroidota (27,1%), Fusobacteriota (15,2%), Proteobacteria (15,1%) and Actinobacteria (7,1%). Shannon and ACE index analysis showed no decline of microbiota diversity in the upper airway with increased disease severity. However, there were significant beta diversity differences in the upper airway microbiota between mild and severe COVID-19. The Firmicutes phylum and Oribacterium genus abundance were significantly higher in severe COVID-19 than in mild. The quantity of the Fusobacteriota phylum, Neisseria, and Fusobacterium genera was significantly higher in mild COVID-19 than in severe.
Conclusion: Our research supports the relationship between the severity of COVID-19 and the diversity of the microbiota in the upper airway in adults. Further studies are needed to examine how microbiota prevents COVID-19 severities.
Clinical presentation and outcome of perforated peptic ulcer patients at Dr. Soetomo Hospital Surabaya, Indonesia
Authors: Kurniawan Erwin , Danardono Edwin
Published: May 2024

Background: Perforated peptic ulcer often occurs in peptic ulcer disease. Identifying the clinical presentation before any operation is important to predict mortality and decision-making about management perforated peptic ulcers. Until to date, there is no report data of perforated peptic ulcer
characteristics at Dr Soetomo Hospital Surabaya.
Methods: This is a non-experimental study with descriptive retrospective design. Data were collected retrospectively from medical records all consecutive patients with diagnosis of perforated peptic ulcer at Dr. Soetomo Hospital 2020 - 2022.
Results: For three years, 97 patients were treated with perforated peptic ulcers with a high mortality of 48.5%. Patients were 67% male and 33% female with an average age of 61.4 ± 12.1 years old. There are two options for source control management: external drainage in patients with a Boey score of 3 with a mortality rate of 78.9% and definitive laparotomy repair perforation with a mortality rate of 28.8%. Patients with hemodynamic instability and sepsis have a high mortality rate. The most comorbid patients with perforated peptic ulcer are peripheral vascular disease, endocrine disorders,and lung disease.
Conclusion: Patients with perforated peptic ulcers at Dr. Soetomo Hospital have a high mortality rate. Treatment can be in the form of definitive surgery and external drainage. However, external drainage has a high mortality rate.
Relationship between transforming growth factor beta 1 (TGF-ß1) level and skin tag
Authors: Dewi Sisilia Kesuma , Putra Imam Budi , Jusuf Nelva Karmila
Published: May 2024

Background: Skin tag, also known as acrochordons, are benign neoplasms that look like a protrusion skin growth. Multifactorial causes of skin tags such as aging, obesity, metabolic and hormonal disorders. One of the mechanisms for the occurrence of skin tags by repeated scratching or friction trauma and continuously triggers an inflammatory response. During inflammation, TGF-ß1 has been activating to prevent the adhesion of neutrophils and T cells to endothelial cells, then limiting the recruitment of inflammatory cells. In addition, TGF-β1 expression is the main promoter in fibroblast proliferation and collagen synthesis as a response to cell repair function. This study aims to determine the relationship between TGF-ß1 level and skin tags.
 Methods: This observational study has a cross-sectional design of 39 skin tag patients and 40 non-skin tags. Each patient underwent history taking, dermatological examination, then took the blood sampling to analyze the TGF-ß1 level using the ELISA test. These data were statistically analyzed with the Mann-Whitney analytic test.
 Results: The average TGF-β1 level on skin tags group was 549.05±173.52 ng/ml. Most subjects with skin tags had 1–5 lesions, were 24 people (61.5%). The most common type of skin tag was pedunculated in 9 people (23.1%), followed by the drop form in 6 people (15.3%) and the spherical in 6 people (15.3%). The majority shows that 16 people (41%) have more than one type of skin tag in one region. The results of this study reveal that there is a relationship between TGF-β1 low level and skin tags.
 Conclusion: There is a significant relationship between TGF-β1 and skin tags.
Proceeding Article Annual Scientific Meeting of PAMKI in Conjunction with The 3rd Global health and Innovation Conference 2023
Authors: PAMKI
Published: May 2024

Dear Colleagues,
It was a true honor that we accept colleagues at the Annual Scientific Meeting of PAMKI in Conjunction with The 3rd Global health and Innovation Conference 2023 that was held on West Lombok, Indonesia on July 7-8th 2023.
The theme of this conference was "Combating Antimicrobial Resistance: Strengthening Collaboration and Nurturing Innovation". The event is expected to update and improve the knowledge in microbiology, particularly about antimicrobial resistance. This conference also contributed for the venue of reunion and brainstorming sessions with peers in arms. 
The proceeding article contains articles that were accepted for publication to Bali Medical Journal (BMJ).
Finally, we would like to thank the committee, reviewer, and another scientific team who dedicating to finalized this proceeding article. We hope to be able to meet with all of you soon on the next event.
A five-year study of Kikuchi Fujimoto Disease in Dr. Cipto Mangunkusumo National Central General Hospital
Authors: Naswa Syakira Maulana  , Agnes Stephanie Harahap  , Alif Gilang Perkasa  , Jonathan Ariel  , Salinah  , Maria Francisca Ham
Published: May 2024

Link of Video Abstract: https://youtu.be/4GFvBGh4sdI
 
Background: Kikuchi Fujimoto Disease (KFD) is a disease characterized by regional lymphadenopathy and fever. KFD is often misdiagnosed as tuberculosis because of the symptom’s similarities. Several studies have shown KFD prevalence in Asia, however, not much is known about KFD characteristics in Indonesia. This study aimed to determine KFD clinicopathological characteristics in an Indonesian National Central General Hospital and to determine the association between clinical characteristics and KFD histopathological features.
Methods: Samples were taken from the medical records of patients with KFD in the span of 2016–2020. The data collected includes age, gender, lymphadenopathy location, clinical diagnosis, clinical symptoms, lymph node size, number of lymph nodes involved, histopathology, and immunohistochemical examination. Data were analyzed using Chi-square and Fisher exact test.
Result: It was found that KFD mainly occurred in young women, mean age 25 years old, located in cervical lymphadenopathy, ≤ 2 cm size, and solitary. The main histopathological appearance is phagocytic subtype and necrotic phase, with < 50% coagulative necrosis area. It also appeared KFD with < 50% coagulative necrosis area was found significantly in ≤ 2 cm lymph nodes (p = 0.008).
Conclusion: Clinical characteristics and complete histopathological features are important to be assessed in KFD to achieve accurate diagnosis.