bluuebunny/crossref_metadata_2025 huggingface dataset:
Nasopharyngeal histopathology of Wistar rats induced by formaldehyde with tiered concentration
Authors: Wedayani Anak Agung Ayu Niti , Abdul Qadar Punagi  , Pieter Nova Audrey Luetta , Muhammad Husni Cangara  , Kristin Erna , Kadriyan Hamsu , Rohadi  , I Made Tobias Abdiman
Published: January 2025

Link of Video Abstract: https://youtu.be/XDoTlhAvGKo
 
Background: Formaldehyde is a substance that can damage cell structures because it has irritant and carcinogenic effects. Formaldehyde can cause several adverse effects by injuring various tissues, impairing the regulation of energy metabolism, and reducing the body's antioxidant capacity. This study aims to assess the severity of cellular changes and the time required for the occurrence of nasopharyngeal dysplasia after formaldehyde induction over a different period.
Methods: Twenty Wistar rats were divided into control and three treatment groups with 20, 30, and 40 ppm formaldehyde concentration induction. Every sample in the group will be terminated every four weeks for sixteen weeks. Nasopharynx samples were examined under the light microscope with H&E staining to identify severity differentiation between the control and treatment groups. We used the cellular and architectural dysplasia grading system as the reference for histopathological results.
Results: There was a significant difference between the treatment groups and the severity of dysplasia (p=0.007) but an insignificant difference between the week of termination and the severity of dysplasia (p=0.407). Histopathological results showed no specific mark of cellular changes from every degree of dysplasia.
Conclusion: This study showed that a higher formaldehyde concentration could cause more damage to cellular morphology. The longer formaldehyde is exposed in any dose, the more cellular damage occurs in the nasopharynx of Wistar rats.
Model prediction formulation of antibiotic type and length of treatment for pediatric typhoid fever patients at Cut Mutia General Hospital, North Aceh, Indonesia
Authors: Yuziani  , Sofia Rizka , Utariningsih Wheny , Adri  , Faddhillah Siti Ghina
Published: January 2025

Link of Video Abstract: https://youtu.be/Tnam4IeVlsc 
 
Introduction: Aceh Province is one of the provinces that has the highest typhoid fever cases in Indonesia and North Aceh district is also the number one highest district in Aceh province, this is certainly a special concern in dealing with the problem of appropriate antibiotic use and has effectiveness in predicting length of hospitalization. Antibiotics are drugs of the antimicrobial compound class that are generally used for bacterial infections. The use of antibiotics with good effectiveness can further shorten the length of hospitalization. This can save costs and time in the length of hospitalization, researchers want to see the effectiveness of antibiotics as a predictor of the length of treatment of pediatric typhoid fever patients at Cut Mutia General Hospital, North Aceh. This study aims to assess the effectiveness of antibiotics as a predictor of the length of treatment of pediatric typhoid fever patients at Cut Mutia General Hospital, North Aceh.
Patients and methods: The method researchers took data sources from the medical records of typhoid fever patients in children who fit the inclusion criteria, the data amounted to 160 samples and then analyzed univariate and bivariate data. All analyses considered significant if p<0.05
Results: The results showed that the characteristics of patients with typhoid fever were mostly female (63.8%) and had an age mostly in the school-age category (66.9%). The length of treatment in pediatric typhoid fever patients is mostly less than 7 days (84.4%) and the type of antibiotic used most widely used is Ceftriaxone (59.4%), more toddlers have a length of treatment of fewer than 7 days (92.3%) compared to pre-school age and school age, While school age has more length of treatment more than 7 days (18.7) than a toddler and pre-school age and female gender has more length of treatment less than 7 days (86.3%) than male, while men have more length of treatment more than 7 days (19%). Patients who used Ceftriaxone antibiotics had a longer stay of less than 7 days (87.4%) compared to other types, while patients who used Ciprofloxacin antibiotics had a longer stay of more than 7 days.
Conclusion: The type of antibiotic has a significant relationship with length of stay where Ceftriaxone antibiotics have a 2 times risk of having a length of stay of less than 7 days and age and type of antibiotic can predict the length of stay in typhoid patients.
Pediatric neuromyelitis optica spectrum disorder: Case report of postrema syndrome
Authors: Puspitasari Vivien , Goenawan Vonny Fibrianty , Solansa Tracy , Cenweikiawan Anderson
Published: January 2025

Link of Video Abstract: https://youtu.be/w-yWNre4RNg
 
Introduction: Neuromyelitis Optica Spectrum Disorders (NMOSD) is an inflammatory disease of the optic nerve and spinal cord characterized by severe immune mediated axonal damage and demyelination. Optic neuritis, transverse myelitis, or combination of both are common first clinical attack symptoms. Area postrema syndrome was infrequently described as an initial presentation of pediatric NMOSD.
Case Presentation: We present the case of 10-year-old male presents with fever, nausea, vomiting, hiccups, and vertigo suggesting an Area Postrema Syndrome. Brain Magnetic Resonance Imaging (MRI) with contrast shows a pathological lesion without contrast enhancement on the periventricle of the 3rd ventricle extends to the bilateral optic tracts. Whole spine MRI showed no abnormalities. Aquaporin-4 was found seropositive on lumbar puncture examination. He was treated with intravenous methylprednisolone for 5 consecutive days followed by IVIG for 5 days and mycophenolate mofetil as maintenance therapy. Patient then showed a significant improvement in symptoms.
Conclusion: Pediatric NMOSD with core criteria of area postrema syndrome as the first clinical attack is rare. Relapse may occur, requiring further follow-up and maintenance therapy. We should raise awareness on the possibility of postrema syndrome in pediatric NMOSD cases that are intractable with medication.
Admission C-reactive protein, D-dimer, IL-6 and XCL1/lymphotactin levels as predictors of 28-day mortality in COVID-19 patients: a prospective cohort study
Authors: Susilo Adityo , Pohan Herdiman Theodorus , Rumende Cleopas Martin , Rengganis Iris , Harahap Alida , Kekalih Aria , Wulandari Dewi , Sahbandar Ivo Novita , Suwarto Suhendro
Published: January 2025

Link of Video Abstract: https://youtu.be/cQUhwa50jAM
 
Background: Predictors of mortality in COVID-19 patients, which are essential factors in guiding patient management, are poorly understood. In Indonesia, several inflammatory markers have been utilized to evaluate the severity of COVID-19. This study aimed to determine the role of C-reactive protein (CRP), D-dimer, interleukin-6 (IL-6), and XCL1/lymphotactin levels in predicting 28-day mortality in patients with COVID-19.
Methods: A prospective cohort study was conducted with COVID-19 patients admitted to the emergency department at Cipto Mangunkusumo Hospital and Medistra Hospital, Jakarta, Indonesia, from June 2020 to February 2021. The predictors of 28-day mortality in COVID-19 patients in this study included CRP, D-dimer, IL-6, and XCL1 levels at admission. Cox proportional hazard regression analysis was used to determine the independent predictors of 28-day mortality in the study population.
Results: A total of 120 patients with COVID-19 were enrolled in the study; 21 (17.5%) died within 28 days after admission. According to our multivariate analysis, a CRP level (HR, 8.55; 95% CI, 3.310-22.088) ≥ 110 mg/L and a D-dimer level (HR, 20.642; 95% CI, 6.909-61.667) ≥ 4640 ng/mL were identified as independent predictors of 28-day mortality in COVID-19 patients.
Conclusion: A C-reactive protein level ≥ 110 mg/L and a D-dimer level ≥ 4640 ng/mL can be used to predict 28-day mortality in COVID-19 patients.
Safety and efficacy holmium laser lithotripsy for bladder stones: Initial experience at a single center in Koja General Hospital
Authors: Wijaya J Rahendra , Hariwibowo Rinto , Sutarto Waluyo Eko , Akbar Nurul
Published: January 2025

Introduction: Bladder stones, a common urological condition, can significantly impact a patient's quality of life, leading to symptoms such as obstructive lower urinary tract symptoms (LUTS) and hematuria. In recent years, the utilization of laser lithotripsy has emerged as a promising technique for the removal of bladder stones, offering potential advantages in terms of efficacy and safety.
Methods: Data obtained from the medical record was collected retrospectively since the use of laser lithotripsy in 2019. Patients who fulfilled the inclusion and exclusion criteria were included. Data on patients’ age, sex, symptoms, maximum stone diameter, operation duration, complications, and length of in-hospital duration were gathered and analyzed. The primary endpoint was to assess the stone size being successfully removed and procedure duration.
Results: We recruited 46 participants (40 men and 6 women) with a mean age of 55.5 years old. In 18 (39%) participants, obstructive LUTS was the main presenting symptom, followed by hematuria in 9 (19%) patients. In 10 (28%) of cases, work-up was done by plain abdominal x-ray, while the remaining 36 (72%) underwent CT-scan. The mean surgery duration was 57.2 ± 22.3 minutes. Out of subjects, 3 (6.5%) experienced hematuria as a side effect while 1 (2.1%) patient had a fever.
Conclusion: Our data demonstrated a safe and effective result of laser lithotripsy used for bladder stones removal. More research is warranted to compare the current modality applied  in Indonesia general hospitals along with cost analysis to provide the best treatment option for the patients.
Correlation Between Serum Calcium and Parathyroid Hormone in Chronic Kidney Disease Patients
Authors: Harli Wahyudi Pratama , Hasyim Kasyim  , Pendrik Tandean  , Syakib Bakri  , Nur Ahmad Tabri  , Arifin Seweng
Published: January 2025

Introduction:  Chronic kidney disease (CKD) is commonly associated with secondary hyperparathyroidism. Elevated phosphorus concentrations and decreased synthesis of active vitamin D (calcitriol) as a direct result of impaired renal function induce a cascade of symptoms, including decreased calcium absorption and increased parathyroid hormone (PTH) secretion. This study aimed to assess the association between calcium levels and PTH levels in patients diagnosed with CKD.
Methods:   A cross-sectional observational study was conducted involving a cohort of 80 individuals diagnosed with CKD who met the established criteria. The statistical tests employed in this study were Pearson's correlation. Statistically significant findings are obtained from these tests when the p-value is below 0.05.
Results: This study demonstrates a correlation between decreased levels of calcium in the blood and increased levels of PTH in persons with impaired kidney function.   In eighty patients with CKD stages 3 to 5, regardless of dialysis status, a clear inverse correlation (-0.328, P = 0.000) was observed between parathyroid hormone and serum calcium levels.
Conclusion: Patients with CKD showed a significant inverse correlation between their blood serum calcium levels and PTH levels.   Hence, it is imperative to assess the concentrations of blood calcium and PTH in individuals with CKD and a glomerular filtration rate below 60 ml/min/1.73 m2.
Propolis effects on dysbiosis of polycystic ovarian syndrome (PCOS) induced Wistar rats
Authors: Puspitasari Vannya Dewi , Lestari Endang Sri , Pramono Noor
Published: January 2025

Introduction: Polycystic ovarian syndrome (PCOS) is an endocrinopathy that has two major risk factors, genetics and environment. Tremellen and Pearce proposed a new theory of Dysbiosis of Gut Microbiota (DOGMA) as an environmental factor that can modified by probiotics. Propolis acts as a probiotic in diabetic rats and has been proven to change gut microbiota dysbiosis. This study evaluated whether propolis extract can modify dysbiosis in PCOS animal models compared to metformin.
Methods: This was a post-test-only control group design randomized control trial with 30 Wistar rats divided into five groups: control, PCOS, PCOS with metformin, PCOS with propolis extract, and PCOS with metformin plus propolis extract. PCOS induced by daily 100 mg/kg.bw testosterone propionate injection intramuscularly for 28 days. The feces in the caecum were extracted after the rats were sacrificed and analyzed for Firmicutes/Bacteroides ratio, alpha diversity, and beta diversity.
Result: Firmicutes abundance in the control group was the lowest, and Bacteroidetes abundance was lowest in the propolis group, although it’s not significantly different. Between groups, Firmicutes/Bacteroidetes ratio, alpha diversity, and beta diversity were not significantly different. Testosterone concentration and preantral follicle count in the propolis and metformin groups improved compared to the PCOS group (p=0,01 and p=0,025, respectively).
Conclusion: Propolis cannot modify dysbiosis in PCOS-induced rats, but it reduces total testosterone concentration and preantral follicle counts.
The Effect of Erythropoietin on Cerebral Palsy Prevention in Hypoxic Ischemic Encephalopathy (HIE): A Systemic Review and Meta-Analysis
Authors: Nur Fadhilah Tia , Salimo Harsono , Pusponegoro Hardiono D , Probandari Ari , Purwanto Bambang , Soetrisno  , Nuhriawangsa Naili Nur Sa’adah
Published: January 2025

Introduction: HIE plays a significant role in global disability, with 60% of newborns with severe HIE passing away or becoming severely disabled. Since there is still debate over the impact of EPO on HIE, we conducted a thorough analysis of the literature to determine whether erythropoietin may prevent cerebral palsy in HIE patients.
Methods: Database search included Cochrane Library, ProQuest, PubMed, ScienceDirect, and Scopus. RCTs reporting cerebral palsy, neurodevelopmental impairments, seizures, brain injury on MRI, or death were included. Qualitative studies were excluded. Critical appraisal was assessed using JBI while the I2, forest plot, and sensitivity analysis were performed on meta-analysis. The funnel plot and Egger’s test were used to assess bias. The GRADE method was used to assess the LOE independently.
Results: A total of 812 infants were included in 6 eligible articles. For the infant with HIE, EPO alone was statistically significant to prevent cerebral palsy in HIE patients (OR=0.90, p = 0.038, 95% confidence interval [95% CI] was 0.57-1.44). Erythropoietin administration also significantly reduced the risk of neurodevelopmental impairments (OR 0.50, p = 0.014, 95% CI 0.36-0.70) and risk of death (OR 0.81, p = 0.018, 95% CI 0.54-1.20). The event rate, which compared EPO vs. control, of cerebral palsy (13.03% vs. 13.43%, p <0.001), neurodevelopmental abnormalities (19.76% vs. 51.86%, p <0.001), seizures (26.75% vs. 37.52%, p <0.001), brain injury on MRI, which divided as white matter, subcortical, cortical, brainstem, and cerebellar (28.55% vs. 68.33%, 25.63% vs. 31.58%, 6.85% vs. 14.53%, 4.73% vs 29.01%, respectively, p <0.001), and death (14.31% vs 20.67%, p <0.001) was reduced.
Conclusion: With only 6 trials included, it is essential to do clinical trials with sufficient power to evaluate erythropoietin further. Researchers and clinicians must collaborate with specialists and form interest groups to define primary and secondary outcomes and acceptable guidelines for using erythropoietin in future trials.
Effect of scalp block with 0.5% ropivacaine on interleukin-6 and neutrophil lymphocyte ratio in elective craniotomy
Authors: Desiree Pricilia , Airlangga Prananda Surya , Kriswidyatomo Prihatma , Waloejo Christrijogo Soemartono , Hamzah  , Santosa Dhania A. , Semedi Bambang Pujo , Susila Dedi , Komarulloh Noor Syamsu , Karamoy Ovi Octavia , Lestari Pudji , Pandi Moses Glorino Rumambo
Published: January 2025

Background: In recent decades, the study of immunology has evolved rapidly, elucidating the cellular and molecular mechanisms underlying human immunity. Recent studies have shown that high levels of cytokines correlate with the degree of manipulation of brain tissue and lower levels of inflammation in brain tumor surgery are associated with higher safety rates. The use of scalp block in craniotomy surgery is associated with the modulating effect of both local and systemic inflammatory responses. This study aims to analyze the effect of scalp block with 0.5% ropivacaine on IL-6 and NLR in elective craniotomy surgery.
Method: A randomized controlled trial (RCT) was conducted at Dr. Soetomo General Hospital Surabaya with a total of 40 patients who underwent elective craniotomy from September to November 2023. Patients were divided into two groups: the scalp block (SB) group and the non-scalp block (non-SB) group. All patients were under general anesthesia and a scalp block was added to the SB group after general anesthesia. IL-6 concentration and NLR count were assessed after general anesthesia (T0), 6 hours after incision (T1), and 24 hours after surgery (T2).
Results: IL-6 and NLR levels increased over time and reached their peak at 24 hours after surgery in both groups with IL-6 SB: 83.50 ± 2,289 pg/mL and IL-6 non-SB: 84,638 ± 2.25 pg/ml. NLR SB: 6.80 ± 1.17 and NLR non SB: 7.33 (5.83-8.09). In the comparative test, there was a significant difference in IL-6 and NLR levels at 6 hours after incision (p:<0.001 and p=0.0015), and significant differences in changes IL-6 baseline and 6 hours after incision (∆T0-T1)  (P:<0.001). However, there was no significant difference in IL-6 and NLR levels at 24 hours after surgery and no significant difference in the changes between IL-6 baseline and 24 hours after surgery (∆T0-T2), NLR baseline, and 6 hours after incision (∆T0-T1), NLR baseline and 24 hours after surgery (∆T0-T2) between two groups.
Conclusion: Scalp block suppresses pro-inflammatory mediators for only 6 hours after incision. It is most effectively used in short procedures, as an adjuvant for the head pinning procedure or incision.
Relationship of antenatal care visit, emesis gravidarum, and dietary habit against anemia in pregnant women: A case study at Sentosa village, Seberang Ulu II district, Palembang city, South Sumatera province in 2023
Authors: Yanuarti Tuty , Anggraeni Linda Luciana , Damayanti Sapera , Syafithrie Millah , Yanti Hesti , Larasati ,Nina Ayu , Astuti Ika Putri , Hadijah Siti , Novita Novita
Published: January 2025

Introduction: The adverse effects of anemia during pregnancy have been associated with increased antenatal care (ANC) visits, emesis gravidarum, and nutritional factors, all of which may contribute to the incidence of anemia in pregnant women. This study aimed to examine the relationships between ANC visits, emesis gravidarum, and dietary factors in anemia among pregnant patients.
Methods: This cross-sectional study was conducted in 2023 at the Rabiah Midwife Practice, Sentosa Village, Seberang Ulu II, Palembang, South Sumatra. Independent variables included ANC visits, emesis gravidarum, and diet, with anemia in pregnant women as the dependent variable. Data were analyzed in SPSS version 25 with a p-value <0.05 is considered significant.
Results: This study of 35 respondents found that 85.7% were aged 20-35 years, 77.1% were unemployed, and 60.0% had moderate anemia. Significant associations were observed between anemia severity and several factors. Fewer ANC visits were linked to more severe anemia (p<0.001), with 48.6% of those with fewer visits having moderate anemia. A strong relationship was also found between emesis severity and anemia (p<0.001), with 51.4% of those with mild emesis having moderate anemia. Dietary habits significantly impacted anemia severity (p<0.001), with 54.3% of those with an adequate diet experiencing moderate anemia.
Conclusions: There is a significant relationship between ANC visits, emesis gravidarum, and diet against anemia in pregnant mothers.
Assessment of hemoglobin levels on the physical condition of adolescent girls in Denpasar City, Bali, Indonesia
Authors: Manuaba Ida Bagus Amertha Putra , Made Violin Weda Yani  , I Putu Gede Septiawan Saputra  , Ida Ayu Widya Anjani  , Gede Setula Narayana  , I Gede Putu Supadmanaba
Published: January 2025

Background: Anaemia is currently one of the global health problems affecting adolescent girls, women of childbearing age, pregnant women, and children in both developing and developed countries. The prevalence of anemia, according to RISKESDAS 2018, is 32%. It was indicated that 3-4 out of 10 adolescents suffer from anemia. Low levels of hemoglobin can affect psychiatric and physical conditions in adolescents. This study assesses hemoglobin levels in adolescent girls' physical condition in Denpasar City, Bali, Indonesia.
Method: This study is an analytical observational study with a cross-sectional design to determine the relationship between hemoglobin levels and the physical condition of adolescent girls in Denpasar City, Bali, Indonesia. The inclusion criteria in this study were all female students (junior and senior high school) who attended schools in Denpasar, Bali, were not on a special diet, and were willing to become research respondents by signing informed consent. The instrument used is the Indonesian version of the WHO QOL-BREF questionnaire.
Result: The study included 354 female adolescents aged 12-16 years. No participants were found to have severe anemia. Most respondents had mild anemia (49.2%), followed by those with no anemia (36.7%).Anemia status had a significant relationship with the physical health domain (p<0.001) and overall quality of life (p=0.001). Female adolescents without anemia had higher quality-of-life scores than those with mild or moderate anemia.
Conclusion: Anemia was significantly associated with physical health dan psychological condition. Adolescent girls who were not anemic had higher quality of physical condition scores compared to girls with mild and moderate anemia.
The effects of Epigallocatechin-3-Gallate (EGCG) to the expression of Basic Fibroblast Growth Factor (bFGF) and detection of cell apoptosis in Human Pterygium Fibroblast (HPF) cells
Authors: Ayunda Astry , Indriaswati Luki , Firmansjah Muhammad , Purwanto Djoko Agus , Utomo Budi
Published: January 2025

Link of Video Abstract: https://youtu.be/tiaUvh3apW8Background: Pterygium is a prevalent ocular health issue. The efficacy of surgical procedures as the primary therapeutic approach has been limited, particularly in preventing its recurrence. Basic Fibroblast Growth Factor (bFGF) plays a significant role in the progression of chronic inflammation and DNA damage, leading to the invasion of pterygium cells. Epigallocatechin-3-gallate (EGCG) demonstrated the ability to decrease recurrence of human pterygium fibroblast (HPF) and inhibit cell migration in vitro, while preserving the integrity of conjunctival cells. This study aimed to examine the impact of EGCG on the expression of bFGF and cell apoptosis in HPF.
Methods: The experimental study with a randomized posttest only control group design was used to examine the expression of bFGF and cell apoptosis on HPF across 5 treatment groups. These groups included a control group (-), treatment groups receiving Mytomicin-C 0.4 mg/ml, as well as EGCG 50 µM, 100 µM, and 150 µM. Cell apoptosis was assessed by a flow cytometry instrument, while bFGF was accomplished by immunofluorescence staining.
Results: The results showed a significant decrease in bFGF expression in HPF cells among the control group (-), Mitomycin-C group and EGCG 50, 100, 150 µM group (p<0.01). The mean apoptosis induction of HPF cells after 72 hours in the control group, EGCG 50, 100, and 150 µM and MMC 0.4 mg/ml were respectively 6.1 (SD±0.08); 4.63 (SD±0.91); 20.70 (SD±1.46); 16.20 (SD±0.47); 98.81 (SD±0.16). ANOVA and Tukey posthoc tests showed a significant increase in apoptosis of HPF cells among treatment groups: the control group (-), EGCG 50,100, 150 µM, and MMC 0.4 mg/ml (p<0.01), whereas EGCG 50 caused a decrease of apoptosis compared to control group (-).
Conclusion: There is a significant difference in the expression of bFGF and apoptosis in HPF after administration of EGCG compared to negative controls
Effect of Vitamin C on Malondialdehyde (MDA) and Nitric Oxide (NO) Levels in Paraquat-Induced Sprague Dawley Rats
Authors: Yulianti Maria Eka Patri , Utami Putri , Permatasari Dinda , Suzery Meiny , Susilaningsih Neni , Suhartono  , Mahati Endang , Suwondo Ari , Sadhana Udadi
Published: January 2025

Link of Video Abstract: https://youtu.be/mtlaCUH5TegBackground: Paraquat can induce toxicity in the human body because of its ability to affect the redox cycle and form reactive oxygen species (ROS). Malondialdehyde (MDA) and Nitric Oxide (NO) are formed in the body as a result of oxidative stress, namely an imbalance between the formation of reactive oxygen species (ROS) and antioxidants in the body, where free radical levels are higher than antioxidant levels. Vitamin C acts as an antioxidant and anti-inflammatory to inhibit oxidative stress. This study aims to analyze the effect of vitamin C on MDA levels and NO levels in paraquat-induced Sparaque Dawley rats.
Methods: This type of research was an experimental posttest-only control group design, with a sample of 12 male white rats (Rattus norvegicus), Sprague Dawley strain, aged 8-10 weeks, and a body weight of 200-300 g. Mice were divided into 2 treatment groups. Each group consisted of 6 rats. Mice were acclimatized for 7 days, then given paraquat induction intraperitoneally once after 24 hours, followed by treatment according to the group for 6 days. Group P1 was given paraquat and vitamin C 0.075 g/kg/rat/day. On the 8th day, the rats were euthanized, blood was taken from the orbital sinus and the heart, the blood serum was separated, and then the MDA level of the rat blood serum was examined using the Thiobarbituric Acid Reactive Substance (TBARS) using a spectrophotometer and assay NO rat blood serum by method Colorimetric using a spectrophotometer. Data were analyzed using SPSS version 25.0 for Windows.
Results: The results of the analysis showed that the average MDA level of the negative control group (P0) was 2.68 μmol/L; the P1 group was 2.96 μmol/L and the average NO level in the negative control group (P0) was 31.99 μmol/L; the positive control group (P1) was 33.91 μmol/L.
Conclusion: In this study, it can be concluded that vitamin C 0.075 g/kgBW/rat/day can reduce MDA and NO levels in paraquat-induced Sparaque Dawley rats.
The relationship between characteristics and prognostic index of follicular thyroid nodule
Authors: Permana Agung , Wibowo Marjono Dwi , Susilo Dwi Hari
Published: January 2025

Link of Video Abstract: https://youtu.be/Hb9slIAm55g
 
Introduction: Determining the risk of recurrence and categorizing patients according to their risk groups is a milestone in managing thyroid nodules. The AMES score is a good prognostic index widely used because it is easy for clinicians to remember. Risk groups for thyroid nodules, according to ATA guidelines for nodule characteristics, are closely related to patient prognosis. The specific use of the AMES score to determine suitability for risk groups and prognostic survival rates has not been widely studied. This study aims to find the relationship between the ATA risk stratification of follicular thyroid nodule characteristics and the AMES prognostic index score and prognostic survival rates in follicular thyroid nodules.
Methods: This study is a retrospective cohort using patient medical record data at Dr. Soetomo General Hospital, Surabaya, during the 5-year research period (2013-2017), followed by 5-year monitoring to determine overall survival and disease-free survival.
Results: AMES scores have a strong relationship with ATA classification ultrasound results. A high-risk AMES score in follicular-type thyroid nodules has a 64x probability of being in the ATA high suspicion category. Overall survival and disease-free survival were higher for lower AMES scores and ATA classifications.
Conclusion: The AMES score can be used to predict prognosis and estimate classification ultrasound results in cases of follicular thyroid nodules.
Analysis of plasma atherogenic index in predicting major cardiovascular events in patients with very high risk of cardiovascular disease receiving high-intensity statin therapy
Authors: Kusyanto Fahmi Abdullah , Heriansyah Teuku , Zulkarnain  , Punawarman Adi , Munirwan Haris
Published: January 2025

Background: Abnormal Lipid levels have a very strong correlation with ASCVD in relation to atherosclerotic plaque formation. Elevated serum triglyceride levels are also associated with residual risk of ASCVD events.  The residual risk of ASCVD is the majority result of elevated TG and low HDL-C levels. Another study, further revealed that metabolic HDL-C levels also play an important role in ASCVD. The triglyceride to HDL cholesterol ratio or paslma atherogenix index (AIP) is proposed as a marker of plasma atherogenicity and a predictor of cardiovascular risk. Giving statins is one of the standard therapies to lower triglyceride concentrations in sufferers of atherosclerotic cardiovascular disease (ASCVD) to reduce major adverse cardiovascular events (MACE). This study aims to determine changes in AIP after administration of high-sensitivity statins in ASCVD sufferers with and without MACE.
Method: This research is an observational study with a cohort design involving 70 ASCVD sufferers who were given high-intensity statins with an evaluation of the incidence of MACE for 3 months. AIP assessment was carried out before and after administration of high-intensity statins. Mann-Whitney U test analysis and Wilcoxon rank test were used with a confidence level of 95%.
Result: A total of 70 research subjects experienced MACE with an average AIP of 0.48 and there was no difference in the score for patients without MACE (p = 0.947). The AIP value in patients without MACE (n = 27) before therapy was 0.51 and decreased to 0.46 after 3 months of high-intensity statin therapy (p = 0.130).
Conclusion: The AIP value in ASCVD sufferers did not decrease significantly with high-dose statin therapy for 3 months and did not prevent MACE events.
The management of anorectal abscess during pregnancy: a case report
Authors: Albar Heky  , Khanisyah Erza Gumilar
Published: January 2025

Introduction: Perianal and perirectal abscesses are rare in pregnant women and typically cause severe, constant pain, often accompanied by purulent rectal drainage. Diagnosis can be aided by digital rectal examination and magnetic resonance imaging (MRI). This report discusses the management of a pregnant patient with an anorectal abscess, which is a rare condition during pregnancy.
Case Presentation: We present a case of a 25-year-old pregnant woman (G1P0A0) at 37-38 weeks of gestational age with a history of sepsis due to a perianal abscess before her last menstrual period. She presented to the emergency room of Dr. Soetomo General Hospital, Surabaya, with a three-day history of fever and painful anal discharge. Magnetic resonance fistulography revealed a perianal fistula measuring 33.6 mm in length and 3.7 mm in width at the six o'clock position on the right side. The obstetric evaluation showed no uterine contractions cephalic presentation, and the fetus was at a high position. Laboratory tests indicated anemia and leukocytosis. A cesarean section was performed, delivering a male infant weighing 3,305 g with Apgar scores of 8 and 9. Subsequently, the surgical team performed drainage and debridement of the abscess.
Conclusion: Anorectal abscesses causing anal pain in pregnant women are uncommon. Timely clinical assessment and management are crucial to prevent adverse maternal and fetal health effects. Further prospective studies are warranted to evaluate the outcomes of different delivery methods in pregnant women with anorectal abscesses.
Accuracy of 2-phase abdominal ultrasound for diagnosing biliary atresia
Authors: Anindita Adecya Nararia , Bagus Setyoboedi  , Sjamsul Arief  , Rendi Aji Prihaningtyas
Published: January 2025

Background: Biliary atresia is a dangerous neonatal disorder characterized by an inflammatory and fibrotic obliteration of the extrahepatic biliary tree, which results in progressive hepatic failure and, if ignored, death from end-stage liver disease. Due to clinical similarities that distinguish biliary atresia from other causes of neonatal cholestasis, early identification is often challenging. Ultrasound is recommended in screening for infantile cholestasis because it is inexpensive, non-invasive, safe from radiation and does not require anesthesia. It is hoped that abdominal ultrasound can be an alternative for diagnosing biliary atresia. This observational design analyzes abdominal ultrasound diagnostic tests for biliary atresia.
Method: This study uses medical data records of children who were diagnosed with biliary atresia and underwent liver biopsy and 2-phase abdominal ultrasound. Statistical analyses using the Kruskal-Wallis and Mann-Whitney U-test. The chi-square test was employed in qualitative data to establish the significance of differences between groups. The results were considered significant if the p-value was less than 0.05. Diagnostic performance was measured using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
Results: With a liver biopsy investigation, there were 89 participants with biliary atresia and 71 subjects without. Abdominal ultrasonography had a sensitivity of 77.5%, a specificity of 69%, a positive predictive value of 78.4%, a negative predictive value of 71%, and an accuracy of 73.7%.
Conclusion: Two-phase abdominal ultrasonography can help diagnose biliary atresia early.
Intrauterine nephro-amniotic shunt insertion for fetal bilateral hydronephrosis and urinoma: a case report
Authors: Safinaz  , N.I.  Cininta  , Manggala Pasca Wardhana
Published: January 2025

Introduction: Prenatal obstructive uropathy identified during pregnancy is mostly caused by unilateral or bilateral stenosis of the pelvic ureteric junction that can lead to the development of lung hypoplasia, cystic kidney dysplasia, and urinoma as a rare case. Intrauterine shunting intervention can prevent uropathy, but there are limited references to support the use of stent insertion for urinoma drainage.
Case Report: This study presents a case of a fetus with bilateral renal pelvic dilatation, hydroureter, unvisualized bladder, and anhydramnion at 26/27 weeks gestation. Amnioinfusion was done to aid in further evaluation and found unvisualized right renal parenchyma and bladder, bilateral urinoma, and scalp edoema. Bilateral nephro-amniotic shunting was performed at 29 weeks of gestation. Following the procedure, the fetus was evaluated with serial ultrasounds. The left kidney parenchyma was visible on day one, the right-sided urinoma had resolved, the left-sided urinoma was not getting bigger, and the urinary bladder had not been visualized with enough amniotic fluid. On day 10, there was anhydramnion, enlarging bilateral renal urinoma, and the two nephro-amniotic shunts were visualized. The pregnancy was terminated two weeks after the procedure, as indicated by fetal distress. The baby was male, weighed 2100 grams, and had asphyxia and anuria as the outcome. Following a postnatal ultrasound evaluation that revealed severe right renal hydronephrosis and mild left renal hydronephrosis, the urologist performed a percutaneous nephrostomy the day after birth with suspicion of ureteropelvic junction obstruction. An ultrasound revealed bilateral parenchymal kidney disease. Sepsis worsened his condition, and the baby died at the age of 26 days.
Conclusion: The nephro-amniotic shunting is a viable treatment option for severe bilateral and unilateral urinary tract obstruction that results in renal impairment in fetuses. However, using good stent material and time to do stent insertion is recommended to ensure more effective fixation in the fetal kidney cavity system, which can lead to improved perinatal outcomes.
Primary source of Vitamin D: sunlight or nutrition?
Authors: Fikri Bahrul , Juliaty Aidah , Engels Sam , Putera Azwin Mengindera , Hikmah Zahrah , Febriani Andi Dwi Bahagia , Putri Sri Hardiayanti , Ridha Nadirah Rasyid , Alasiry Ema , Endaryanto Anang , Massi Nasrum , Yusrawati  , Irawati Deasy , Kadrian Hamsu
Published: January 2025

Link of Video Abstract: https://youtu.be/w3EhDrNg4ts 
 
This study reviews the existing literature on whether sunlight or nutrition is the main source of vitamin D and explores the factors contributing to vitamin D deficiency in tropical regions. The key findings include urbanization, ethnicity, sun-avoidance, religion, and nutrition as causes for the high prevalence of vitamin D deficiency in tropical areas. While sunlight is considered the main source of vitamin D, factors such as air pollution, sun-avoidance behaviors, and the clothing style of certain religions can limit sunlight absorption. Moreover, limited access to vitamin D-rich foods and low consumption of fortified foods contribute to the deficiency. The study suggests further research on the role of nutrition as a potential main contributor to vitamin D deficiency in tropical areas.
Comparison outcomes of miniplate and wire cerclage fixation in traumatic sternal fracture: a retrospective multicenter study
Authors: Yasa Ketut Putu , Jiwangga Dhihintia , Sarwono Antonius , Kartika Ronald , Dandanah Maulidya Ayudika , Hatta Hariadi , Sudarma Wayan , Hakim Arif Rahman , Dharmawan Tommy , Ibnu Syahroni
Published: January 2025

Introduction: The management of traumatic sternal fractures is quite heterogeneous and still has controversies. Open surgical fixation is occasionally indicated for intractable pain, and unstable motion of sternum as a risk factor for respiratory distress. This study aimed to compare the outcome of miniplate and wire cerclage fixation in traumatic sternal fractures.
Methods: A cross-sectional retrospective multicenter study was carried out during 2015 - 2020 in traumatic sternal fracture patients who were undergoing open surgical fixation. Data collection was carried out such as demographic characteristics, associated injury, mechanism of injury, site and type of sternal fracture, the fixation method. Exclusion criteria were sternal fractures due to non-trauma, incomplete data, and patient death or referral to other facilities The primary outcomes endpoints of this study were duration of ventilator after surgery, intensive care unit (ICU) length of stay, hospital length of stay (LOS), and complications of blood loss requiring transfusion.  Patients were divided into a miniplate fixation group and wire cerclage fixation group. The comparison outcome between two groups was statistically analyzed using the Mann-Whitney test and Chi-square / Fisher Exact test from numerical and categorical data.
Results: During 2015-2020, 47 traumatic sternal fracture patients were included, but 34 patients were included. Mean age 37 – 42 years, majority of patients were male 31 (91%), 25 (73%) fracture site at corpus sternum, with associated injury 27 (79%) mostly rib fracture (47%) and hemothorax or pneumothorax (56%), mechanism of injury was 30 (88%) of patients were traffic accident. There were 15 (44%) patients who underwent a miniplate fixation and 19 (56%) patients who underwent wiring cerclage fixation. From statistical analyses in both numerical and categorical data showed there was no significant difference outcome between two groups in terms of the length of ventilatory support, ICU LOS, Hospital LOS and blood loss requiring blood transfusion (p>0.05), although that all variables were higher in wire cerclage groups. However, there was a significant difference in the intubation before surgery (p<0.05), this is probably related to the associated injury and presence of displaced and multiple fractures of sternum in wiring group.
Conclusion: There was no significant difference outcome between miniplate compared to wire cerclage fixation in traumatic sternal fractures in duration of ventilatory support, ICU LOS, Hospital LOS and blood loss requiring transfusion, although that all variables were higher in wire cerclage groups. There was a significant difference in intubation before surgery, this is probably related to the associated injury and presence of displaced and multiple fractures of sternum.
Immune responses of COVID-19 vaccines in older adults: a systematic review and meta-analysis
Authors: Hayati Taureni , Kartinah Neng Tine
Published: January 2025

Introduction In the wake of the unprecedented global COVID-19 pandemic, the development of effective vaccines is crucial. While multiple vaccines have been developed, evidence suggests that immune response may vary especially in older adults. Evaluation of COVID-19 immunogenicity in this vulnerable population needs to be explored.
Methods Literature search was performed in databases including PubMed, ScienceDirect, and Scopus. The quality of studies was evaluated using the Cochrane Risk of Bias 2.0 and Newcastle Ottawa Scale for Cohort Studies.
Results There are 10 studies included in this review. Two doses of the COVID-19 vaccine showed a significant increase in antibody titers (MD 221.48 AU/mL; 95% CI 109.16-333.80; p=0.0001). Subgroup analysis showed a dose-dependent relationship, with the highest amount of increase in MVC-COV19 at 25 mcg. The increase in anti-RBD IgG was also significant (MD 3.355 log 10 AU/mL; 95% CI 3.03-4.08; p=0.00001). S1 reactive T cells and anti-S1 IgG was not significantly increased after 2 doses of the vaccine.
Conclusion Our study found that in general, the COVID-19 vaccine is effective in increasing several immune parameters. Measures to increase efficacy in this population such as a third dose or vaccine booster are needed to overcome age-related changes in immunity, thus enhancing the health of the elderly.
Barriers to rabies prevention through canine vaccination in Payangan tourism destination, Bali
Authors: Wijaya Made Indra , Pradnyawati Luh Gede , Juwita Dewa Ayu Putu Ratna , Kartinawati Komang Triyani , Pratiwi Anny Eka
Published: January 2025

Link of Video Abstract: https://www.youtube.com/watch?v=TjSFVNybRS8&ab_channel=BaliMedicalJournal
 
Introduction: Rabies was first reported officially in Bali, The Republic of Indonesia, in November 2008. In 2022, primary preventive strategy is implemented through mass canine vaccination, combined with door-to-door canine vaccination. However, until the end of 2022, the outbreak had not been well controlled and unmet canine vaccination coverage is suspected as the culprit of continuing transmission. This study aimed to identify facilitators and barriers to rabies prevention through canine vaccination during mass campaigns in Payangan tourism destination.
Methods: This is a qualitative study. Purposive sampling was used to select informants to be interviewed. Data were collected within 2-30 March 2023 period. The analysis was carried out by inductive coding process. Themes emerged during analysis were categorized into the social ecological model.
Results: We found various barriers in preventing rabies through rabid canine vaccination at the individual, interpersonal, institutional and community levels from a social ecological model.
Conclusion: Our findings revealed that risk communication should be emphasized on improving knowledge about rabid canine. The canine mass vaccination promotion should be conducted in a timely manner. To comprehensively address the barriers to rabies prevention through canine vaccination in tourism destinations, future studies should focus on multifaceted research.
Risk factors for vasoplegic syndrome in post-isolated coronary artery bypass grafting surgery patients using cardiopulmonary bypass machine: a literature review
Authors: Nurdiansah Henderik Agus , Sembiring Yan Efrata , Pribadi Oky Revianto Sediono
Published: January 2025

Background: Vasoplegic syndrome is a state of low tissue perfusion despite normal or high cardiac output, characterized by hypotension, tachycardia, and low systemic vascular resistance (SVR). Multiple conditions can result in vasoplegia, but cardiac surgery patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) and other circulatory alterations are at increased risk for this condition due to their unique position. The aim of this study is to determine the risk factors for vasoplegic syndrome in patients undergoing isolated coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB).
Method: Vasoplegic syndrome and isolated CABG-related books, journals, and articles were used as data sources to address research questions as part of this study's library research methodology, which is based on online and offline data sources. The use of literature focuses on fundamentals. The use of vasoplegic syndrome following cardiopulmonary bypass was examined using articles from a variety of sources. The search phrase is "Vasoplegic syndrome AND Coronary Artery Bypass Grafting" and "Vasoplegic syndrome AND Cardiopulmonary Bypass". The research is a literature review, so article queries are chosen solely on the basis of the articles' compatibility with the research objectives.
Result: We obtained a total of 5 articles that met our review criteria. Many articles excluded by the year of publication criteria are out-of-date according to our review method considerations. This is due to the lack of publication of research articles related to the topic of our review.
Conclusion: Vasoplegic syndrome is a common complication of cardiopulmonary bypass that has a substantial influence on main clinical outcomes. It is of particular concern in patients with left ventricular dysfunction or chronic renal failure, and it occurs more frequently in patients with a higher BMI following pre-operative administration of an ACE inhibitor, intravenous heparin, a lengthy CPB procedure, and blood transfusion.
A literature review of primary screening tool for biliary atresia using web-based stool color card
Authors: Arianti Novi Rahayu , Prihatiningtyas Rendi Aji , Setyoboedi Bagus , Ranuh Reza Gunadi
Published: January 2025

Prompt diagnosis and appropriate Kasai Procedure (KP) are crucial for improving patients' long-term prognosis who have BA. The notion that KP at ≤30 days of age considerably increases the native liver survival rate is becoming more widely acknowledged. It appears that screening by SCC and DB/CB is maybe possible, according to published assessments in both English and Japanese. In Tochigi Prefecture, Japan, screening with SCC has been in place since 1994. Japan introduced the idea of SCC to Taiwan, and in 2004 Taiwan became the first country to use SCC for statewide screening; Japan followed suit in 2012. SCC home-based screening is simple and affordable, but in the event that stools have an intermediate hue, it may present challenges for families and the medical community. Consequently, a training approach appropriate for both parents and healthcare professionals is required. It has been demonstrated that case-based learning produces good training outcomes for the medical field. This work will provide a solid theoretical basis for creating online case-based learning stool color cards.