bluuebunny/crossref_metadata_2025 huggingface dataset:
The Risk Factor Associated with Stress Urinary Incontinence (SUI) Severity: a Cross-Sectional Multi-centered Study
Authors: Hakim Surahman , Santoso Budi Iman , Rahardjo Harrina Erlianti , Setiati Siti , Kusumaningsih Widjajalaksmi , Prihartono Joedo
Published: May 2024

Background: Stress urinary incontinence is defined as involuntary loss of urine on effort or exertion or with coughing or sneezing. SUI affects as many as 75% of older women, 44-57% of middle-aged, and 25% of young women. Risk factors include age, parity, vaginal birth, menopause, obesity, body mass index, diabetes, hysterectomy, chronically increased abdominal pressure, genetic factors, physical activity level, smoking, diet, and family history. Our purpose was to determine which risk factors are associated with the severity of stress urinary incontinence using a 1-hour pad test.
Method: This cross-sectional multicentered study was performed on 178 women who complained of incontinence and had completed QUID for SUI. We collected data using a pad test, and we classified those women into two main groups, women with mild SUI with 1-hour pad test results 1-10 g and women with moderate and severe SUI with 1-hour pad test results more than 10 g. We use Phi and Cramer’s V to calculate the effect size of each risk factor.
Results: There were 20 women with moderate and severe SUI, and 158 had mild SUI. We analyzed the risk factors associated with moderate-severe SUI women and found that age (p=0.03), perineometer result (p = 0.04), and level of education (p=0.02) are statistically significant.
Conclusion: The severity of stress urinary incontinence is related to age, perineometer result, and level of education.
The association between neutrophil to lymphocyte ratio (NLR) with mortality in patients with perforated peptic ulcer at Dr. Soetomo Hospital in Surabaya, Indonesia
Authors: Istimansyah Arifin Perdana , Septarendra Denny , Wibowo Marjono Dwi
Published: May 2024

Background: Perforated peptic ulcer is the most dangerous complication of peptic ulcer.  Neutrophils and lymphocytes are crucial in the inflammatory process. A simple and effective biomarker to assess systemic inflammation is the neutrophil-lymphocyte ratio (NLR). This study aims to ascertain the connection between NLR and mortality in peptic ulcer patients.
Methods: This study was a cross-sectional observational analytic study. Data were obtained from medical records in Dr. Soetomo General Hospital from January 2018 to December 2022. The dependent variable was patient mortality, while NLR value served as the independent variable. NLR cutoff value calculated using the Receiver Operating Characteristic (ROC) curve. The collected data was tested using the Chi-square test and the Spearman rank correlation test integrated in the SPSS software.
Results: There were 109 patients, consisting of 74 male and 35 female patients. There were 29 patients with the Boey Score category 1, 54 patients with the Boey score category 2, and 25 patients with the Boey score 3. Using a cutoff of 15.60, the NLR values were separated into low and high NLR groups. There were 56 patients with high scores and 53 patients with low scores. A significant relationship was found between NLR values and mortality (p <0.0001). The results of Spearman's analysis revealed a strong correlation between the incidence of mortality and an increase in the NLR value (p<0.0001; r = 0.500).
Conclusion: There is a significant relationship between NLR and mortality in patients with perforated peptic ulcers.
The effectiveness of roll-on aromatherapy of calamansi orange peel essential oil (Citrofortunella microcarpa) on reducing anxiety and pain in labor
Authors: Purnama Yetti , Dewiani Kurnia , Rahmawati Suci , Yusanti Linda , Yulyani Linda
Published: May 2024

Purpose: To determine the effectiveness of calamansi orange peel aromatherapy in reducing pain and anxiety in the active first stage of labor.
Patients and methods: This research is a quasi-experimental pre-posttest control group design. The number of samples was 60 people, 30 mothers for each intervention and control group. Samples were obtained by accidental sampling from 10 independent Privat Midwifery Clinics in Bengkulu and divided into 2 groups randomly. Pain level was assessed by VAS, and anxiety level was measured by HARS. Data were collected before the intervention (pre-test and after the intervention (post-test) 1 (dilatation 4), post-test 2 (dilatation 7-8 cm), and post-test 3 (dilatation 9-10). Meanwhile, the level of anxiety was only measured 2 times during the pre-test and post-test (dilatation 4). The results were analyzed using the Wilcoxon signed rank test and the Mann-Whitney U test.
Results: The results showed that in the intervention group, it was known that there was an effect of giving calamansi orange peel aromatherapy on pain (0.001) and anxiety (0.001) in mothers in the active phase of the first stage of labor. In the control group given orange aromatherapy, the results also showed an effect on pain (0.005) and anxiety (0.046). The results of the Mann-Whitney U test showed that there was a significant difference between the intervention and control groups in post-test 1 (0.000) and post-test 2 (0.004), but there was no significant difference in post-test 3 (0.121). Meanwhile, for the level of anxiety, it is known that there is a difference between the intervention and control groups (0.042).
Conclusion: Using aromatherapy of calamansi orange peel essential oil as a complementary therapy effectively reduces the level of pain and anxiety in mothers during the active phase of the first stage of labor.
The relationship of biofilm Staphylococcus aureus with degree of severity and infection in patients of chronic rhinosinusitis
Authors: Husni T.R Teuku , Siagian Karina Witary Ayu , Kurnia Benny
Published: May 2024

Background: Staphylococcus aureus is the main pathogen infect chronic rhinosinusitis (CRS) and the biofilms play an essential role in the pathophysiology of infection and treatment of patients. However, research on clinical conditions is still limited. This study aimed to evaluate the relationship between S. aureus biofilms with severity and infection degree in CRS patients.
Methods: A post-test-only study was conducted at Dr Zaionel Abidin Hospital in Banda Aceh, Indonesia from January to April 2022. Thirty-five CRS patients, classified according to the disease severity and infection degree, were included and followed in the study. A mucosal swab on each patient was collected and biofilm formation analyzed quantitatively and qualitatively using a spectrophotometer and scanning electron microscope (SEM), respectively. The relationships between the bacterial growth, biofilm formation and mass of biofilms with the disease severity and degree of infection were assessed statistically.
Results: More than half of the patients (54.3%) were aged younger than 40 years, and 51.4% were male. Nasal congestion and rhinorrhoea were the most common reported obligate symptoms (78.2%) and 82.9% patients have additional symptom on facial pain. There was the relationship between bacterial growth and disease severity (p=0.046) and infection degree of CSR cases (p=0.031). Our data showed a significant association between biofilm formation and the disease severity (p=0.022) and infection degree of CSR patients (p=0.020). The mass of the biofilm was also associated significantly with disease severity (p=0.029) and degree of infection (p=0.018).
Conclusions: Our study shows that the formation and mass of biofilm associated with the disease severity and degree of infection in CSR. Biofilms may contribute to the clinical condition and also be considered during management of CRS patients.
Profiles of patients with maxillofacial fractures in emergency department of head and neck surgery division of Dr. Soetomo General Hospital Surabaya in 2021 during COVID-19 pandemic
Authors: Adrian Kevin , Wibowo Marjono Dwi
Published: May 2024

Background: Maxillofacial fracture is the most common injury in head and neck trauma patients. The Coronavirus disease 2019 (COVID-19) pandemic affects many sectors including restrictions on community mobility. This study aims to determine the profile of patients with maxillofacial fractures during the COVID-19 pandemic.
Methods: This descriptive observational study will evaluate the profile of maxillofacial fracture patients who came to the Emergency Department of Head and Neck Surgery Division of Dr. Soetomo General Hospital Surabaya in 2021.
Results: Subjects were grouped by gender, age, month of visit and trauma mechanism. The ratio of prevalence between males and females was 5.7:1. The highest age distribution was in the range of 21-30 years (29.8%). Based on the month, the highest number of patients was in January (19.1%). Traffic accidents are the most frequent mechanism of injury by 85.1%. Isolated maxillofacial fractures occur mostly in the mandible by 47.6% and in multiple maxillofacial fractures on the maxillary bone by 76.9%. Associated trauma was found in 78.7% of the subjects, with the highest pattern being intracranial trauma as much as 34.1%.
Conclusion: There was a decreasing incidence of maxillofacial fracture cases in 2021. The highest prevalence was in males and most of the patients were in 21-30 years age group.
Prevalence and susceptibility profile of carbapenem-resistant pseudomonas aeruginosa (CRPA) at Dr. Soetomo Public Hospital, Surabaya, from January to December 2021
Authors: Andritta Febriana  , Widodo Agung Dwi , Muhammad Vitanata Arfijanto
Published: May 2024

Introduction: Pseudomonas aeruginosa is a pathogen that frequently causes healthcare-associated infections (HAI), which has also been associated with high mortality and morbidity rates. Carbapenems have been widely utilized as empiric therapy for P. aeruginosa infections since these organisms have intrinsic resistance to various antibiotics. Therefore, the high rate of CRPA infection became the reason for conducting this study to determine the prevalence and susceptibility pattern of CRPA in Dr. Soetomo Public Hospital, Surabaya, from January to December 2021.
Method: The researcher employed descriptive observational study from secondary data with the first isolate sample of P. aeruginosa per specimen per patient that has been identified by the BD Phoenix™ automated identification and susceptibility testing system from specimens of urine, blood, sterile fluid, pus, tissue, and sputum that are phenotypically resistant to meropenem or imipenem antibiotics, examined at the Clinical Microbiology Unit of Dr. Soetomo Public Hospital, Surabaya, from January to December 2021.
Result: Of the total P. aeruginosa isolates, 149 CRPA isolates were obtained. The researcher conveyed that the majority of the samples were male (59.1%); the most comorbid cases were diabetes mellitus with complications (22.4%) found in the intensive care unit (40.3%); the majority of specimens were from the respiratory tract (43%); the highest antibiotic susceptibility was amikacin (62.4%); the prevalence of CRPA in Dr. Soetomo Public Hospital, Surabaya, from January to December 2021 reached 21.25%.
Conclusion: In this study, CRPA isolates showed the highest sensitivity to amikacin, and the highest distribution of CRPA events was found in the intensive care unit.
Diabetic ulcers prevention in the elderly for improving blood circulation of lower extremities with combination foot exercise therapy and electrophysical therapy
Authors: Dewi Astuti Agnes , Utama Nang Randu , Aridamayanti Bernadetta Germia
Published: May 2024

Background: Diabetic foot ulcer is one of the complications of diabetes. The intervention for diabetic foot examination is the Ankle Brachial Index (ABI). Decreased ABI scores indicate decreased peripheral blood circulation in the extremities. An increase in ABI can be done by combining foot exercise therapy with electrophysical therapy. This study aims to analyze ABI scores in patients with type II diabetes performing a foot exercise combined with electrophysical therapy.
Method: The research design is quasi-experimental, with a pretest-posttest comparison group used. The sampling method used was purposive sampling. A total of 120 respondents were divided into 2 groups: intervention and control. The intervention group was given diabetic foot exercises with a combination of electrophysical therapy, while the control group was given a standard intervention. The diabetic foot exercise was conducted daily in the morning for 4 weeks and lasted 20-30 minutes. Subsequently, the ABI score was assessed. Prior to the intervention, respondents’ ABI scores were measured. Data were analyzed using SPSS version 26.0 for Windows.
Result:  We found that an increase in the ABI score by 0.113 was statistically significant at a p-value <0.05. After a month of the initial state, the ABI score by 0.758, and the p-value shows significance at <0.05. In comparison, an increased ABI score was observed after a month of the first intervention. There was an increase in the ABI score by 0.654 (p<0.05).
Conclusion: Foot exercise therapy combined with electrophysical therapy was shown significantly increased repetitive muscle contractions and improve blood circulation, thus increasing the ABI score, which was ​​higher than the control group.
Palliative management of a patient with gastric outlet obstruction (GOO) due to caput pancreatic cancer during COVID-19 pandemic
Authors: Rettobyaan Fitria , Widodo Budi
Published: May 2024

Background: Pancreatic cancer is associated with a poor prognosis and high cancer-related deaths in developed and developing countries because most of the patients are symptomatic until the advanced stage. A small percentage of pancreatic cancer could develop gastric outlet obstruction (GOO) when the tumor causes intestinal obstruction. This case report aimed to highlight the palliative management of GOO due to caput pancreatic cancer.
Case presentation: A 48 years-old male was admitted to Dr Soetomo General Academic Hospital in Surabaya during coronavirus disease 2019 (COVID-19) pandemic with complaint of severe heartburn and pain for the last two months with lump around the upper right abdomen. The pain was not related to diet and only slightly relieved by pain relievers and ulcer medication. The patient also complained of nausea and vomiting after eating and drinking with significant weight loss. Unclear borders mass was palpable. The magnetic resonance imaging (MRI) of upper abdomen yielded the mass of head pancreatic that invaded the duodenum, the involvement of the superior mesenteric artery and multiple lymphadenopathies in the paraaortic. Pathology examination confirming the malignant, ductal adenocarcinoma. With other examinations, the patient was diagnosed as GOO due to T4N1M0 head pancreatic cancer. The tumor was unresectable. The patient underwent urgent double bypass biliodigestive laparotomy as part of palliative management. loop gastrojejunostomy, cholecystectomy and choledocujejunostomy Roux en Y was performed. Celiac plexus block was performed to reduce the cancer pain in the patient.
Conclusion: This case highlights that the GOO case's selected management depends on the stage disease and evaluation of multidisciplinary involvement even in the COVID-19 pandemic. Therefore, collaboration between surgeons, medical oncologists, gastroentero-hepatologist, radiologists, and supportive and palliative care specialists is required to reduce mortality.
Association between serum homocysteine levels and the frequency of epilepsy-related cognitive dysfunction: a cross sectional study in patients with epilepsy in Mataram, Indonesia
Authors: Harahap Herpan Syafii , Rizki Mohammad , Indrayana Yanna , Rianawati Sri Budhi
Published: May 2024

Background: In patients with epilepsy (PWE), cognitive dysfunction becomes an important comorbidity. In PWE, cognitive dysfunction is thought to be linked to the processes of neurodegeneration that are triggered by the rise in homocysteine levels.
Objective: To determine whether PWE in Mataram, Indonesia, have a higher prevalence of cognitive dysfunction and higher serum homocysteine levels.
Methods: 81 PWE were recruited for this cross-sectional study from Mataram's three primary referral hospitals. The patients' serum homocysteine levels were measured by ELISA using five milliliters of fasting blood. The patients' sociodemographic (age, gender, and educational level) and clinical (etiology of epilepsy and treatment duration) characteristics were also gathered. Indonesian version of The Montreal Cognitive Assessment (MoCA-Ina) was used to evaluate the cognitive status. The association between homocysteine, clinical, and socio-demographic data, as well as the cognitive dysfunction frequency in PWE was determined with final logistic regression model.
Results: The patients’ age was 33 years old on average. PWE had a cognitive dysfunction prevalence of 76.5 percent. PWE's high prevalence of cognitive dysfunction was not associated with serum homocysteine levels in the final logistic regression model (p > 0.05). Patients' clinical and sociodemographic characteristics were also not associated with a high prevalence of cognitive dysfunction (p > 0.05).
Conclusion: In Mataram, Indonesia, the high prevalence of cognitive dysfunction among PWE was not linked to serum homocysteine levels.
Microbiology diagnostic approach in identifying Streptococcus pneumoniae: Case report of Streptococcal meningitis
Authors: Andaru Dahesihdewi  , Girsang Tama Sari
Published: May 2024

Introduction: Bacterial meningitis remains a serious global health problem. Streptococcus pneumoniae as the causative organism, is fastidious. Microbiology diagnostic approach is needed to identify S.pneumoniae and antimicrobial susceptibility tests (AST). This study aims to report S. pneumoniae meningitis has been successfully cured strongly related to diagnostic stewardship.
Case: A 1 year old child who fell, suffering from vomiting, fever and seizures was brought to the Emergency Department. Multi-slice Computerized Tomography shows cerebral edema and intracerebral hemorrhage. Laboratory blood tests and cerebrospinal fluid analysis strongly indicate bacterial meningitis. Presumptive Gram microscopy of Cerebrospinal Fluid (CSF) and initial identification of CSF cultures on lysed blood agar under microaerophilic conditions, consistently showed lancet-shaped and encapsulated Gram-positive diplococci. Our Clinical Microbiology Laboratory finally identified the growth of S.pneumoniae from blood and CSF cultures. Patients were treated with cefepime 50 mg/kg body weight/8 hours in the first 10 days as empirical and switched later definitively to ciprofloxacin 10 mg/kg body weight/12 hours according to the AST result on day 11 to day 26. On the 31ˢᵗ day, the patient recovered and was discharged.
Conclusion: The case of a 1 year-old child with S. pneumoniae meningitis has been successfully cured strongly related to diagnostic stewardship by the Clinical Microbiology Laboratory. Supplementation media with sodium bicarbonate can improve S. pneumoniae recovery as a basis for identification and AST. Proper inoculation and AST need to be accelerated because S.pneumoniae easily undergoes autolysis.
The evaluation of Acehnese people's health insurance from the welfare perspectives
Authors: Yani Muhammad , Suhanda Rachmad , Iqbalawati Indrita , Puspandari Diah Ayu , Hafasnuddin  , Candra Aditya , Ilzana Teuku Muhammad , Khaled Teuku Muhammad , Cut Rizka Rahmi
Published: May 2024

Link of Video Abstract: https://youtu.be/UEJWESqCEvo
 
Introduction: Indonesia has tried to implement the UHC system by implementing the National Health Insurance (JKN) program since 2014. To extend the coverage of JKN, the government of Aceh, one of the poorest provinces in Indonesia carries out Acehnese People's Health Insurance (JKA), which aims to improve the health and welfare of the people of Aceh. However, there has never been an evaluation of the usefulness of JKA related to the welfare of the Acehnese people. Therefore, this study aims to evaluate the impact of JKA on the level of welfare of the people of Aceh.
Methods: This was an ecological study with a cross-sectional approach to evaluate the correlation between welfare indicators (education, health, and housing) and Community Coverage Levels and Capitation Costs on Acehnese People's Health Insurance. All study data were taken from the Acehnese public health insurance accountability report and the people's welfare statistics report from the Central Statistics Agency. All data collected were analyzed using SPSS ver. 25.
Results: JKA has an average community coverage of about 2 million people with an average capitation payment of around 139 billion rupiahs from 2015 to 2021. Immunization coverage was significantly correlated with community coverage, non-capitation fee, and drug cost. In addition, drug costs are also significantly related to formal school coverage. Meanwhile, medical equipment cost was correlated with sanitation and internet coverage. However, other welfare indicators did not find a correlation between community coverage and capitation costs.
Conclusion: Some indicators of JKA were significantly correlated with several indicators of welfare in Aceh.
Placental apoptotic index on COVID-19 and non-COVID-19 cases: a cross sectional study
Authors: Shahnaz Almira Aulia , Manggala Pasca Wardhana  , Ernawati  , Grace Ariani  , Budi Utomo
Published: May 2024

Backgrounds: Rare cases of COVID-19 vertical transmission are reported, even though abnormal findings on placenta histopathology are frequently reported on SARS-CoV-2 infected pregnancies. However, no publications report the impact of COVID-19 infection on the placental apoptotic index. Apoptosis is a physiological process of cell regeneration. SARS-CoV-2 infection during pregnancy may disturb the respiration system, causing hypoxia, thus altering placental perfusion. COVID-19 infection also increases inflammatory mediators, producing reactive oxygen species and affecting placenta tissue in viremia cases. These processes can cause caspase cleavage, resulting in programmed cell death and apoptosis. This study aims to know whether COVID-19 infection with various degrees of symptoms affects placental apoptosis.
Methods: This is a retrospective, cross sectional study. We conduct a study on 34 placenta blocks of COVID-19 pregnancy and 31 placenta blocks of non-COVID-19 pregnancy. The PCR of nasopharyngeal swabs performed on third-trimester patients in Dr. Soetomo Hospital meets the inclusion and exclusion criteria. Those placenta samples were processed into slides and painted with a TUNEL assay kit. Slides are then examined and rated for apoptotic index.
Results: The majority of these patients are multiparous women. Sixty-five patients were included in the study, 2 died, and 63 others lived. Comparison between COVID-19 positive and non-COVID-19 placental apoptotic index shows a significant difference between both groups (p=0.001).
Conclusion: From this study, we can conclude that there is a significant difference in the apoptotic index of the placenta between COVID-19-positive and negative pregnancies.
Mozart music stimulation effect on wistar rats’ neurogenesis
Authors: Anak Agung Ngurah Krisna Putra  , Irwanto  , Reny I’tishom  , Bagus Setyoboedi  , Muhammad R. D. Mustakim
Published: May 2024

Introduction: Optimal brain development is required to achieve optimal health. Therefore, stimulation is needed to achieve optimal development, and one of the stimulations which can be provided is music stimulation. Several prior investigations have been completed to prove the impact of music stimulation on brain development, whose results still showed both pros and cons. This investigation had the intention of determining musical stimulation's impacts on neurogenesis.
Method: Thirty 30 days old male Wistar rats were grouped randomly but equally into experimental and control groups, with 15 rats in each group. The experimental group was exposed for 90 minutes twice a day in 30 constitutive days to Mozart music (Mozart Sonata for two pianos K. 448) with sound pressure levels between 60 and 80 dB. After 30 days, the rats were euthanized. The neurogenesis parameters, such as plasma corticosterone level, Brain-Derived Neurotrophic Factor (BDNF) and Insulin-like Growth Factor 1 (IGF-1) concentration, and cerebral cortex thickness, were assessed.
Result: Rats with Mozart music exposure had considerably lower plasma corticosterone. They had substantially higher BDNF concentration in the hippocampus compared to the control group (p-value 0.049 and 0.040, respectively). Still, no significant effect was found on IGF-1 concentration and cerebral cortex thickness (p-value 0.148 and 0.094, respectively).
Conclusion: The brain development process requires stimulation, and Mozart's music is proven to be an alternative to stimulations provided for brain development.
Activity of enzyme Esterase, Glutathione S Transferase and Inorganic Substance of Dengue vector Aedes aegypti larvae against Lansium domesticum leave extract and fractionation
Authors: Putri Devita Febriani , Husna Ismail , Kurniati Mala , Primadiamanti Annisa
Published: May 2024

Backgound: Dengue vector control using chemical insecticides for a long time on the same target encourages the rapid development of a resistant dengue vector population of Aedes aegypti. Therefore, an alternative method is needed in the form of the use of plant-based insecticides, Lansium domesticum or duku has been proven to contain secondary metabolites that have the potential as insecticides. This study was conducted to measure the activity of enzyme esterase and glutathione S-transferase, as well as to observe the concentration of inorganic substances such as Fe, Mg, Na, and K in Ae. aegypti larvae exposed to L. domesticum extract using methanol as the solvent and fractionation using hexane, butanol, and ethyl acetate as the solvents.
Methods: This study used Ae. aegypti larvae and L. domesticum leaves extract and fraction. Esterase activity was measured using a spectrophotometer at λ = 490 nm and obtained as light absorption per minute per mg protein. GST activity was measured using a spectrophotometer at λ = 340 nm and expressed as light absorption per minute per mg protein. Inorganic substance level was evaluated by the absorbance of the atoms using an atomic absorption spectrophotometer which was analyzed at certain wavelengths of each atom according to Beer's law equation
Results: The results showed LD50 and LD90 of the crude extract of L. domesticum were 2200ppm and 3200ppm after 24 hours of observation. Crude extract and the fraction of L. domesticum leaf influenced the development of Ae. Aegypti. It reduced the activity of the esterase enzyme. Meanwhile, it increased the GST enzyme activity of Ae. aegypti larvae as well as affects the levels of inorganic substances in Ae. aegypti larvae.
Conclusion: Thus, L. domesticum as a plant-based insecticide is an alternative to control the vector whose target is more selective and safe.
The effect of giving extract of Giwang ferns (Euphorbia milii) cactus leaves on the number of fibroblast white rats burn infected with Pseudomonas aeruginosa
Authors: Putra I Made Agus Sunadi , Udayani Ni Nyoman Wahyu , Winatra I Made Yoga
Published: May 2024

Background: Burns is one of society's most common types of trauma. It is estimated that around 1.2 million people experience burns each year and 100,000 of them require hospitalization. The giwang fern cactus leaf (Euphorbia milii) extract contains many antimicrobial compounds in almost all plant parts. This study determined the effect of giwang fern cactus leaf extract (Euphorbia milii) on the number of fibroblasts in burnt white rats infected with Pseudomonas aeruginosa.
Methods: This experimental study uses a randomized post-test research design with a control group using three groups of rats. The data results were analyzed statistically using a parametric test with Anova (One Way Anova). Data were analyzed using SPSS version 20.0 for Windows.
Results: This study showed that the 50% giwang fern cactus leaf (Euphorbia milli) extract had the highest average number of fibroblasts (38.3±8.77), compared with the control (23.3±1.86) and P1 group (25%) (27.6±6.65). Based on the analysis test, it is known that there is a significant comparison between groups (p<0.05).
Conclusion: There is a significant difference in the number of fibroblast cells among groups after providing giwang fern cactus leaf (Euphorbia milii) extract.
Sinonasal inverted papilloma extirpation by endoscopic approach: a case report
Authors: Husni TR Teuku , Mulya Ridha Chaharsyah
Published: May 2024

Introduction: Inverted papilloma is a benign tumor that generally arises from the lateral wall of the nasal cavity and mostly grows on the middle meatus.The incidence is rarely found in the ear, throat, nose, throat, head and neck, which is around 0.5% -4% of all nasal and paranasal sinus tumors.The etiology of inverted papilloma remains unknown.Clinical features of inverted papilloma are unilateral nasal obstruction, rhinorrhea, epistaxis, anosmia, tinnitus and some other symptoms.The diagnostic examination are histopathological examinations, CT scans and magnetic resonance imaging (MRI). Histopathology is the gold standard in diagnosing of inverted papilloma.Management of inverted papilloma is carried out with surgical approach including lateral rhinotomy, maxillectomy, degloving, and non-invasive surgery via endoscopy depending to the krouse classification.
Case description: A 44-year-old female patient diagnosed with inverted papilloma was reported.The patient complained of progressive right nasal obstruction appeared two years ago which turned into total obstruction and rhinorrhea in the last 6 months.A biopsy was done with the result of inverted papilloma. CT scan of the paranasal sinuses showed a mass filling the right nasal cavity, right maxillary sinus and right ethmoid sinus. Patientwas diagnosed with sinonasal inverted papilloma with Krouse 2 classification based on clinical examination, radiological findings and preoperative endoscopy. The patient was treated with sinonasal inverted papilloma extirpation via endoscopic approach.
Conclusion: Inverted papilloma is a benign tumor of the nasal and paranasal sinuses in which biopsy is the gold standard for diagnostic test while the main treatment is done by surgical approach depending on the krouse classification.
Topical nonsteroidal anti-inflammatory drugs in the prevention of pseudophakic cystoid macular edema following phacoemulsification: A systematic review
Authors: Arista Dewi Ni Putu Ayu Pande , Pemayun Cokorda Istri Dewiyani
Published: May 2024

Introduction: The goal of surgeons to avoid Pseudophakic Cystoid Macular Edema (PCMO) has led to the widespread use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) after cataract surgery, although current research into the best anti-inflammatory drugs to avoid PCMO is still underway. This review aimed to determine the efficacy of topical NSAIDs in preventing PCMO following phacoemulsification.
Methods: This systematic review was built on the recommended reporting items for systematic reviews and meta-analyses (PRISMA) and PICO criteria for papers during the previous 10 years. The keywords was searched by Boolean operator: “NSAIDs” AND “Prevention” AND “Cystoid Macular Edema” AND “Optical Coherence Tomography” AND “Phacoemulsification”. According to  STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist, the quality of each chosen article was evaluated.
Results: We have selected five articles of prospective cohort studies, which involved 756 patients whom received topical NSAIDs (Nepafenac 0.3%, Ketorolac Tromethamine 0.4%Nepafenac 0.1%, , and Diclofenac 0.1%) in treatment group and 700 patients received Placebo (Artificial tears) in control group. There was significant difference of central macular thickness based on OCT results between NSAIDs and control (placebo) group after uneventful phacoemulsification. Additionally, NSAIDs used as a preventative before phacoemulsification procedure exhibited a significantly reduced rise in central foveal thickness compared to placebo. There were changes of central macular thicknes postoperatively, and were significantly different from preoperative.
Conclusion: It has been demonstrated that topical NSAIDs successfully lower the incidence of Pseudophakic Cystoid Macular Edema following phacoemulsification.
Prediction of criminal profiles based on forensic medical investigations in Banda Aceh, Indonesia
Authors: Suryadi Taufik , Kulsum
Published: May 2024

Background: Criminal profiles are also often referred to as psychological profiles or engagement profiles. Profile means a description the term profile to be discussed when discussing techniques and determining the possible characteristics of the debate about the results of research on crime itself. The following paper aims to present the case in predicting criminal profiles in Banda Aceh Indonesia based on forensic medical investigations.
Case presentation: The victim is a male 16-year-old which is conducted a forensic medical examination. The result of forensic medical autopsy findings is the destruction of face-forming bones and skull fractures in the victim. According to the autopsy finding, the doctor concluded that the violence was carried out by someone who is powerful. The doctor states that the alleged criminal's profile consists of someone close to the victim, someone likely to be male, and someone who engaged in violence by using blunt objects. The police investigator is an Indonesian National Police in Banda Aceh district who has done the interview. The discussion with police investigators was conducted to predict the alleged perpetrator's profile. Based on the doctor's statement, the police conducted an investigation looking for the suspect, and the doctor's prediction was correct about the criminal profile of the perpetrator. During the trial, the panel of judges stated that the perpetrators used blunt objects to attack the victim.
Conclusion: There is an association between the results of forensic medical examination, police investigations and facts at the trial in predicting the profiles of criminals.
The comparison of effects of iron supplementation since pre-pregnant and during pregnant period on reducing iron deficiency anemia in pregnant women with mild anemia in Bali
Authors: Ani Luh Seri , I Made Bakta  , Made Ayu Hitapretiwi Suryadhi  , Bagiada Nyoman Agus
Published: May 2024

Introduction: Iron deficiency anemia (IDA) is still a problem of pregnant women's health related to its high prevalence and its negative effects on health. Prevention efforts have been carried out through administration of oral iron tablets to women during their pregnancy; however, the expected results have not been satisfied yet. This failure is probably due to the assumption that, especially in developing countries, the iron store in pre-pregnant women is very low or may be empty, so that iron supplementation during pregnancy is not enough to prevent IDA. The aim of study is to know the difference of effect of iron supplementation in treated and control groups in terms of hemoglobin concentration, serum ferritin level and prevalence of IDA.
Method: A quasi-experimental study was conducted on 99 non-pregnant new couple women. Iron tablets were administered to the treated group from the beginning of pre-pregnant period, continuing until the first 3 months of pregnancy, while in the control group iron tablets were only given during the first 3 months of pregnancy.  IDA was measured by serum ferritin and hemoglobin concentration using WHO’s criteria, the benefit of iron tablet was measured by BCR technique.
Result: The administration of an oral iron tablet from the prepregnant period (treated group) could decrease prevalence of IDA higher than the administration of oral iron tablet during pregnancy only (control group) (0% vs 38.46%, p<0.05). A significant difference was also observed on mean serum ferritin concentration at the end of observation (the third month of pregnancy) 33.45±14.12 µg/dL in the treated group, and 19.65±8.99 µg/dL in the control group. This difference was statistically significant (p<0.05). Meanwhile, the hemoglobin concentration was 12.25±1.20 g/dL in the treated group and 10.91±0.67 g/dL in the control group. This difference was also statistically significant (p<0.05). Benefit analysis showed that administration of an oral iron tablet starting from pre-pregnancy is more advantageous (BCR >1) compared to oral administration of iron tablet during the pregnancy period only. There were no significant differences in side effects and compliance of the patient to consume iron pills in both treated and control groups.
Conclusion: The administration of oral iron tablets (iron supplementation) to pregnant women starting from pre-pregnant period results in a better effect compared to oral iron supplementation during pregnancy only. This program is feasible to be implemented in a community setting because its compliance is good.
The immune response of SARS-CoV-2 vaccine in population with obesity: a systematic review
Authors: Arafah Nur , Soegiarto Gatot , Wulandari Laksmi
Published: May 2024

Link of Video Abstract: https://youtu.be/rXb-E8We3vU
 
Background: COVID-19 vaccines involve a humoral response to produce a neutralizing antibody that could protect subjects from severe COVID-19 infection. However, obesity tends to lower the immune response to the COVID-19 vaccine. Therefore, we conducted a systematic review to determine the immune response of various types of COVID-19 vaccines in a population with obesity.
Methods: We conducted a systematic review based on The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. Using keywords, we search studies from Taylor & Francis, PubMed, ScienceDirect, Cochrane, and EBSCOHost.
Results: We included eight cohort studies with 21,280 subjects after thorough selection and appraisal. Four studies stated that obesity was related to lower antibody titer post-SARS-CoV-2 vaccination, even though one study stated that obesity was not associated with long-term immune response. Another prospective cohort study involving approximately nine million populations stated that SARS-CoV-2 vaccination provided similar protection against COVID-19 compared to normoweight when underweight was a risk factor for lower protection. One study found that antibody titer wanes faster in obesity compared to normoweight. In addition, another study found lower antibody titer in obese men, whereas no significant findings were found in obese women.
Conclusion: Therefore, it should be noted that COVID-19 vaccination in an obese population tends to provide a lower immune response regardless of vaccine type and doses are given. This should inform clinicians who want to administer the COVID-19 vaccine to obese populations.
Whole-genome-scale analysis of circulating SARS-CoV-2 during the first COVID-19 wave in an international tourist destination, Bali, Indonesia
Authors: Masyeni Sri , Sumohadi Duwi , Duta Krisna , Mahayani Ida Ayu , Parwata Komang , Darwinata Agus Eka , Harapan
Published: May 2024

Background: The emergence of severe acute respiratory syndromes coronavirus 2 (SARS-CoV-2) variants such as B.1.17 (alpha), B.1351 (beta), and B.1.617.2 (delta) have caused a significant rise in coronavirus disease 2019 (COVID-19) cases worldwide. In response, the Indonesian government imposed restrictions on international and domestic travel, especially in areas with a high number of COVID-19 cases including Java Island and Bali. The aim of this study was to investigate the mutation patterns of indigenous SARS-CoV-2 strains in Bali.
Methods: We conducted whole-genome sequencing on isolates collected from COVID-19-confirmed patients at the end of the first wave (January – March 2021). The sequencing was carried out at the 1st BASE Pte Ltd Laboratory (Singapore) using Oxford Nanopore Platform (GridION) using IDT ARTIC nCoV-2019 V3 Panel. The phylogenetic tree was constructed on MEGA 7.0 with hCoV-19/Wuhan/WIV04/2019 as the genomic reference.
Results: Our data revealed that none of the isolates were variants of concern. Among the five lineages tracked, the viral isolates were most likely from B.1.466.2 (n=4). All viruses had D614G mutation in the spike protein with clade GH being most predominant (n=10) and followed by GR (n=1) and O (n=1). Additionally, mutations at NS3, NSP3, NSP12, and NSP6 were found.
Conclusion: At the end of the first COVID-19 wave in Bali, variants of concern were not detected which could be attributed to the heavy mobility restrictions.
Diagnostic and predictive value of hematological parameters of COVID-19 patients: a retrospective study
Authors: Kiriwenno Estie Ludi , Indrasari Yulia Nadar
Published: May 2024

Link of Video Abstract: https://youtu.be/K2R3dfdvi20
Background: Simple, cost-effective, and practical laboratory indicators are required to diagnose and evaluate COVID-19 disease severity. This study assessed the diagnostic value and predictor of severity and outcome parameters of NLR, d-NLR, MLR, PLR, and ALC in COVID-19 patients.
Methods: A retrospective study used medical record data from 100 COVID-19 patients from November 2020 to March 2021. SPSS version 22 was used to analyze the data. The severity of COVID-19 was predicted using a ROC curve. Kaplan-Meier analysis was employed to evaluate the ability of various inflammatory markers to predict COVID-19 prognosis. A multivariate analysis with logistic regression was conducted to assess the ability of an independent predictor of COVID-19 severity. A p-value of <0.05 was considered significant.
Results: ALC values were lower in the severe-critical COVID-19 group, whereas NLR, d-NLR, MLR, and PLR values were higher. The NLR, d-NLR, and ALC parameters had sufficient accuracy, whereas the MLR and PLR parameters had low accuracy. NLR, d-NLR, MLR, PLR, and ALC had optimal cut-off values of 7.865, 4.82, 0.455, 235.000, and 0.895, respectively. The multivariate odds ratio for ALC was 7.348 (95% CI = 1.914-28.214; p = 0.004). Kaplan-Meier analysis revealed differences in survival time based on the optimal NLR, MLR, d-NLR, and ALC cut-offs obtained.
Conclusion: NLR, d-NLR, MLR, PLR, and ALC are all potential predictors of COVID-19 severity and prognosis. ALC is a reliable predictor of COVID-19 severity.
Profile of tracheotomy patients at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
Authors: Amalia Siska Citra , Romdhoni Achmad Chusnu
Published: May 2024

Link of Video Abstract: https://youtu.be/YsAWA4NoiPw
 
Background: The tracheotomy profile, including the degree of airway obstruction, underlying disease, following procedures, and complications, is important. The latest data regarding the profile of tracheotomy patients at ORL-HNS Dr. Soetomo General Academic Hospital has not been published yet. This research to describe the profile of tracheotomy patients at ORL-HNS Department Dr. Soetomo General Academic Hospital, Surabaya
Methods: A retrospective descriptive study with total sampling covering tracheotomy patients in 2015-1019 at ORL-HNS Department Dr. Soetomo General Academic Hospital, Surabaya. Data were analyzed using SPSS version 23.0 for Windows.
Result: There were 590 tracheotomy patients consisting of 452 men and 138 women, with the largest age group of 51-60 years with 167 patients (28.31%). Jackson 1 in 306 (51.86%), impending upper airway obstruction in 209 (35.42%), Jackson 2 in 38 (6.44%), Jackson 3 in 31 patients (5.25%), Jackson 4 in 3 patients (0.51%). The diagnosis includes tumors (87.29%), especially laryngeal carcinoma, then infection, neurological, trauma, and others. Procedures following tracheotomy are biopsies (11.19%), tumor surgery, and abscess incision and drainage. Complications were found in 65 patients (11.02%). Subcutaneous emphysema in 45 patients (7.63%), followed by bleeding and pneumothorax with subcutaneous emphysema (1.02%), 5 died (0.85%). Subcutaneous emphysema and bleeding in 2 patients (0.34%). Pneumothorax without subcutaneous emphysema in 1 patient (0.17%).
Conclusions: There were more male tracheotomy patients than female. The age group of most patients was 51-60 years. The majority were Jackson 1, and most were diagnosed with tumors. A biopsy is the most following procedure in tracheotomy. Complications were found in 11.02% of tracheotomy patients; the most common is subcutaneous emphysema.
Effect of probiotics as adjuvant therapy of antidepressants in male Wistar rats with anhedonia behavior
Authors: Evilia Wati , Wahyuni Anak Ayu Sri , Ida Aju Kusuma Wardani  , Putra I Wayan Gede Artawan Eka , Lely Setyawati Kurniawan  , Diniari Ni Ketut Sri , Ardani I Gusti Ayu Indah , Arijana I Gusti Kamasan Nyoman
Published: May 2024

Link of Video Abstract : https://youtu.be/umLlj1K4l2w
 
Background: Depression is one of the most common causes of disability in the world, and one third of patients do not respond to currently available antidepressants, so a strategy is needed in its management. There have been many studies looking for a relationship between the role of the gut and mental health. Probiotics are the focus of much research in the field of psychiatry today due to their alleged role in improving mental health through gut health.
Methods: This research was a true experimental study with a posttest-only design with a control group design. Brain-derived neurotrophic factor (BDNF) plasma levels, serum serotonin (ST) serum levels, and sucrose preference test (SPT) values were analysed in 39 male Wistar rats with anhedonic behavior.
Results: Average BDNF plasma level in treatment group was 1.63 ng/mL with a standard deviation of 0.56 ng/mL, while the mean BDNF plasma level in control group was 0.89 ng/mL with a standard deviation of 0.46 ng/mL. There was a significant difference in that the BDNF plasma levels in the control group were lower than in the treatment group, with a p<0.001 (CI = 95%). The median ST serum level in the treatment group was 25.78 with an IQR of 9.61 ng/mL, while the median ST serum level in the control group was 7.5 with an IQR of 0.38 ng/mL. Statistically, the difference is significant from the p value <0.001. The median SPT score in the treatment group was 84.5 with an interquartile range (IQR) of 12%, while the median SPT value in the control group was 67 with an IQR of 8%.
Conclusion: There was an effect of probiotics as an adjuvant antidepressant therapy in male Wistar rats with anhedonic behavior.
Successful coronary artery fistula closure using Amplatzer duct occluder II device in a 10-months-old infant
Authors: Faisal Aulia , Hidayat Taufiq , Rahman Mahrus Ahmad , Umayasa Alit
Published: May 2024

Link of Video Abstract: https://youtu.be/ZYpxn1S7yjwBackground: Coronary artery fistula is a rare entity of cardiovascular anomaly. The etiology is often congenital due to malformation of coronary artery vessels. They are mostly asymptomatic, while some cases may be present with complications such as congestive heart failure, myocardial infarction, or pulmonary hypertension. This case study aims to evaluate the Successful coronary artery fistula closure using Amplatzer duct occluder II device in a 10-months-old infant.
Case Presentation: The 10-month-old female infant was present with a coronary artery fistula diagnosed at three months old. The echocardiography revealed a right coronary artery fistula to the right atrium with an ampulla size of 7.29 mm, waist of 3.11 mm, and length of 4.71 mm. The patient underwent cardiac catheterization and coronary artery fistula closure with a transvenous technique approach using Amplatzer duct occluder II. The procedure was successful, and the echocardiography examination found no residual flow from the fistula. This is the first reported case of successful coronary artery fistula closure using the Amplatzer duct occluder II device.
Conclusion: Fistula closure using the Amplatzer Duct Occluder II device, in this case, is preferred because it is safe and efficient to use in small infants due to its small sheath delivery catheter caliber.