bluuebunny/crossref_metadata_2025 huggingface dataset:
The 4th Aceh Surgery Update 2021
Authors: Habibie Yopie Afriandi
Published: February 2022

Assalamualaikum Wr.WbPraise and gratitude we pray the presence of Allah SWT for all His grace and guidance so we can still work to help in the fields of education and humanity. With greetings and prayers we praise the prophet Rahmatan lil alamin Rasulullah Muhammad SAW who has brought us from the realm of darkness to a realm full of knowledge.Â In the fourth year it was held during the Covid 19 pandemic, 4th Aceh Surgery Update International Conference in 2021 will be held virtually on February 26-28, with theme Current Update on Covid 19; Clinical and Surgery. This virtual science event will be attended by international and national speakers who have expertise in the field of surgery and the latest information regarding Covid 19 from the Indonesia government. This scientific event felt very special with the presence of the Bali Medical Journal indexed by SCOPUS and Web of Science in scientific publications for all topics presented, both in symposium and free paper sessions.I would like to welcome all experts who are willing to attend to be native speaker at this scientific even. I would like to thank all the committees and sponsors who have helped make this scientific webinar a success. Finally, I am also welcome all the participants and delegated, really hope you all get valuable scientific experiences in extra ordinary city of Banda Aceh.Â Sincerelly Yours,Yopie Afriandi Habibie, MD, Sp. BTKV (K)-D, FIHA, FICS, FACSChairman
Intravenous Wharton's Jelly stem cell increased the number of ? cells pancreas and reduced the fasting blood glucose level in diabetes mellitus Wistar rat male (Rattus norvegicus)
Authors: Permatasari Nadia , Pangkahila Wimpie , Budhiarta Anak Agung Gde , Pangkahila J. Alex , Aman I Gusti Made , Wihandani Desak Made , Bachtiar Indra
Published: February 2022

Introduction: Diabetes mellitus is a metabolic disease characterized by hyperglycemic and disorders of carbohydrate, protein and fat metabolism due to abnormalities in insulin secretion, insulin sensitivity or both. Based on previous research, Wharton's Jelly's mesenchymal stem cells have anti-inflammatory, immunoregulatory properties that can improve metabolic control and have the ability to differentiate into pancreatic lineage cells that function as insulin-producing cells in vitro culture. The purpose of this study was to prove that administration of mesenchymal stem cells Wharton's Jelly can increase the number of pancreatic beta cells and reduce fasting blood glucose levels in male rats (Rattus norvegicus) Wistar strain of diabetes mellitus.Methods: The research design used was pure experimental with post-test only control group design using 36 white male rats. All samples were induced with Streptozotocin and Nicotinamide. The selected samples were divided into two groups: the control group given glibenclamide + 0.9% NaCl, and the treatment group was given glibenclamide + mesenchymal stem cells from Wharton's Jelly. Calculation of the number of pancreatic beta cells and measurement of blood glucose levels were carried out after 14 days of treatment.Result: The results showed that the treatment group had a higher number of pancreatic beta cells than the control group (105.17 Â± 16.379 cells/field of view vs. 54.00 Â± 11.366 cells/field of view) (p <0.001). In addition, the treatment group had lower fasting blood glucose levels than the control group (109.06 Â± 16.71 mg/dl vs 122.78 Â± 10.14 mg / dl) (p <0.05).Conclusion: It was concluded that intravenous administration of Wharton's Jelly mesenchymal stem cells increased the number of pancreatic beta cells and decreased fasting blood glucose levels in male rats (Rattus norvegicus) Wistar strain of diabetes mellitus.
Risk assessment for surgeries during COVID-19 pandemic in Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia
Authors: Rahman Safrizal , Yusuf Muhammad , Rizal Syamsul , Rizal Syamsul , Amirsyah Mirnasari , Pratama Rovy
Published: February 2022

Introduction: Surgeries are potential procedures for Coronavirus Disease 2019 (COVID-19) transmission due to the presence of a multidisciplinary team and high-risk activities such as airway assessment and intubation. This study was carried out to assess risk of surgeries conducted at the main referral hospital in Aceh province, Indonesia during COVID-19 pandemic.Method: A Medical necessary, Time-Sensitive (MeNTS) score was used to assess risk of emergency and elective surgeries conducted at Aceh main referral hospital, Dr. Zainoel Abidin, from July to August 2020. In total, 463 surgeries were screened, consisted of 126 emergency surgeries and 337 elective procedures.Result: Orthopaedic department contributed the most with 129 patients (27.9%), while ear, nose, throat (ENT) departments contributed the least with only 16 patients (3.4%). Orthopedic surgeries had the lowest MeNTS score (36.23), while neurosurgeries had the highest MeNTS score (46.91). Most of the surgeries were elective (72.8%), and the MeNTS score for elective surgeries was higher than emergency procedures (41.0 to 39.6).Conclusion: Neurosurgeries were the highest risk procedures conducted in Aceh main referral hospital, Indonesia, followed by ENT, thoracic-vascular, and digestive surgeries. MeNTS scoring can be used as an additional screening tool in the Department of Surgery, Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia to minimize the risk of COVID-19 transmission during surgical procedures.
The differences of 25-Hydroxyvitamin D and malondialdehyde levels among thalassemia major and non-thalassemia
Authors: Caroline Poa Olivera Laurenzia , Widyastiti Nyoman Suci , Ariosta Ariosta , Pratiwi Rina , Retnoningrum Dwi , Ngestiningsih Dwi , Nency Yetty Movieta
Published: February 2022

Background: Patients with thalassemia major who require regular blood transfusions, have experienced a decline in the level of 25-Hydroxyvitamin D and an increase in oxidative stress biomarkers, one of which is Malondialdehyde (MDA). Both mechanisms are thought to be associated with iron overload seen in transfusion-dependent thalassemia patients. It is necessary to research the differences in 25-hydroxyvitamin D and malondialdehyde levels among thalassemia major and non-thalassemia patients along with the increasing prevalence of thalassemia. The study aims to prove the differences in 25-hydroxyvitamin D and malondialdehyde levels among thalassemia major and non-thalassemia patients.Methods: The study was an observational analytic study with cross sectional approach. Research subjects were 42 children consisting of 21 thalassemia major patients hospitalized at the Dr. R. Soedjati Grobogan Public Hospital and Dr. R. Soetrasno Rembang Public Hospital and 21 healthy children were matched for age. This study was conducted from March to September 2020. 25-Hydroxyvitamin D and malondialdehyde levels were examined using the enzyme-linked immunosorbent assay (ELISA) method and Thiobarbituric acid reactive substances (TBARS) method. Statistical analysis was done using Independent Sample T test and Mann-Whitney test, which p<0.05 was considered significant.Results: There was no significant difference in the level of 25-hydroxyvitamin D (p = 0.45) in thalassemia major and non-thalassemia patients (25.96 ± 6.36 ng/mL and 27.54 ± 7.09 ng/mL respectively). There was a significant difference in the malondialdehyde level (p = 0.00) in thalassemia major and non-thalassemia patients (0.43 µmol/L and 0.14 µmol/L respectively).Conclusion: Iron overload in patients with thalassemia major causes a decrease in 25-hydroxyvitamin D level. An insignificant difference in 25-hydroxyvitamin D level among thalassemia major and non-thalasemia indicates that other factors such as nutritional status, nutrient intake, and sun exposure also play an important role in 25-hydroxyvitamin D level. The formation of ROS triggered by iron overload also results in a significant increase of malondialdehyde level in thalassemia major.
Effect of glutathione administration as adjuvant therapy to NO and MDA level in Wistar rat peritonitis model
Authors: Korwa Ivani Yunita , Muniroh Mulflihatul , Kristina Tri Nur , Prasetyo Agung Aji , Mahati Endang
Published: February 2022

Background: Excessive amounts of free radicals beyond the antioxidant levels in the body will cause a condition called oxidative stress. Nitric oxide (NO) and malondialdehyde (MDA) are produced under conditions of oxidative stress. Glutathione (GSH) is the most endogenous antioxidant synthesized in humans. Therefore this study aims to prove whether the administration of glutathione as an adjuvant therapy can reduce levels of NO and MDA in peritonitis.Methods: This is an experimental study with a post-test-only control group design. Twenty-four Wistar rats were randomly divided into four groups (6 rats/group). The first group (C) was a control group. The second group (P) was induced by peritonitis. The third group (P+Cef) was peritonitis-induced groups with given Ceftriaxone injection as therapy. The fourth group (P+Cef+Glu) was peritonitis-induced groups with given Ceftriaxone injection and glutathione as adjuvant therapy. After 24 hours, blood samples were taken for examination of NO and MDA levels. Data is considered significant if the p-value <0.05.Results: There was a significant increase in NO level from Group 2 to Group 4 (P<0,05). There were no significant differences between MDA levels groups (P>0,05).Conclusion: Glutathione as adjuvant therapy is not adequate to reduce NO and MDA levels in peritonitis.
Prostate acinar adenocarcinoma: a comparative study of Her-2 and Ki-67 expression on Gleason patterns
Authors: Miranti Ika Pawitra , Istiadi Hermawan , Larasati Putri Ajeng Ayu , Wijaya Indra , Puspasari Dik , Karlowee Vega
Published: February 2022

Background: Prostate cancer is one the most common malignancy in men worldwide, and acinar adenocarcinoma is the most prevalent one. Gleason score and grade group is recently used to predict the therapy and prognosis based on Gleason pattern. Her-2 and Ki-67 are markers that are widely studied in breast cancer, but their role in prostate cancer is still unclear. Her-2 is a transmembrane protein involved in oncogenesis. We hope by using the basic determinant Gleason pattern to analyze the expression of these two markers, it will contribute to understand its carcinogenesis and prognosis. The aim of the study is to determine the expression of Her-2 and Ki-67 in Gleason grade of prostate acinar adenocarcinoma.Methods: An analytic observational study with cross-sectional design was done using 31 paraffin-embedded tissues of prostate acinar adenocarcinoma from the Anatomic Pathology Laboratory of Dr. Kariadi General Hospital, focusing on 48 areas classified into pattern 3, 4, and 5. Immunohistochemical staining was performed using Her-2 and Ki-67 antibodies to all tissues and the datas were analyzed using the Kruskal Wallis test and the Spearman test.Results: There are significant differences and correlations between the expression of Ki-67 and Gleason grade, but there are neither significant differences nor correlation between Her-2 expression and Gleason grade.Conclusion: Her-2 expression is almost the same among Gleason grade as basic determinant of prostate acinar adenocarcinoma
O6-Methylguanine-DNA Methyltransferase (MGMT) promoter methylation status of high-grade and low-grade gliomas
Authors: Ichwan Syaiful , Ningsih Hesty Lidya , Aman Renindra Ananda , Tandian David , Ashari Samsul , Gunawan Kevin , Nugroho Setyo Widi
Published: February 2022

Background: O6-methylguanine-DNA methyltransferase (MGMT) is a DNA-repair enzyme that correlates with tumor resistance mechanism to chemotherapy. Methylation of the MGMT promoter inhibits the cells from producing MGMT and is useful to predict chemotherapy's effectiveness with alkylating agents. This study aims to evaluate the MGMT promoter methylation of low-grade and high-grade glioma in the Neurosurgery Department of Cipto Mangunkusumo National General HospitalMethods: We evaluated MGMT promoter methylation status using methylation-specific polymerase chain reaction in low and high-grade glioma patients who underwent surgical resection in the Neurosurgery Department of Cipto Mangunkusomo Hospital Jakarta. The result then correlated with age, sex, Karnofsky Performance Scale (KPS), and glioma grading. Data were analyzed using SPSS version 20 for Windows.Results: MGMT promoter methylation was observed more often in patients diagnosed with age more than 40 years old than in patients less than 40 years old (85.7% vs. 50.0%), also more in men than women (77.7% vs. 50.0%). In patients with KPS more than 70 and KPS 70 or less, methylation of MGMT promoter was observed in 70.0% and 57.1%, respectively. Based on tumor grading, MGMT promoter methylation was observed more often in low-grade gliomas (WHO grade II) than high-grade gliomas (WHO grade II and IV) (85.7% vs. 50.0%). There was no significant relationship between gender, age, KPS, malignancy degree, and Overall Survival (OS) to the MGMT promoter methylation (p>0.05).Conclusion:  MGMT promoter methylation was observed less in the higher grade of tumors (grade IV), lower KPS, younger age at the time of diagnosis, and female patients, although the differences were not statistically significant. MGMT promoter methylation was observed more often in gliomas with oligodendroglioma components.
Antioxidant activity in red mulberries on sperm development exposed by cigarette smoke
Authors: Suryadinata Rivan Virlando , Sukarno Devitya Angielevi , Sardjono Stefani Cornelia , Adriani Merryana
Published: February 2022

Introduction: The adverse effects of exposure to cigarette smoke have been discovered for a long time. However, most people assume that exposure to cigarette smoke merely causes respiratory problems. The increase in free radicals from cigarette smoke will also affect sperm development, decreasing the number of sperm produced. The intake of antioxidants derived from red mulberry is expected to reduce cigarette smoke exposure on sperm count. The study aimed to analyze the antioxidant activity of red mulberries on sperm development exposed by cigarette smoke in experimental animals.Methods: This study employed experimental animals, Wistar Rats (Rattus norvegicus), divided into five groups with different treatments in each group. The treatment in the form of exposure to cigarette smoke and red mulberry was undertaken for 30 days. The parameters used were histological preparations from the testes by calculating the number of Leydig cells, spermatocytes, and spermatids in each tubule. Results: The results showed that the negative control group had the highest mean, while the positive control group had the lowest mean. The treatment group showed that the more red mulberry juice was given, the more sperm count was increased. The study group had a significant difference (p <0.05) and a strong relationship between groups (r> 0.80).Conclusion: In conclusion, consuming red mulberry juice can increase sperm quantity exposed by cigarette smoke.
Relationship red distribution width to platelet ratio with fibrosis degrees based on transient elastography in chronic hepatitis B patients
Authors: Yusuf Fauzi , Abubakar Azzaki , Maghfirah Desi , Baswin Ade
Published: February 2022

Introduction: Chronic hepatitis B virus infection is a major health problem in developing countries like Indonesia. A chronic HBV infection of approx. 40% leads to liver fibrosis and hepatocellular carcinoma. Furthermore, liver biopsy is the gold standard in diagnosing liver fibrosis, but this examination is invasive and has many complications. Transient elastography has been validated to assess fibrosis in several liver diseases including HBV infection. However, not all hospitals have temporary elastography facilities in such a way that cheaper and more affordable examinations are needed. This study aims to examine the relationship between Red cell distribution width to platelet ratio with the degree of liver fibrosis based on transient elastography in chronic hepatitis B patients.Method: This study was a cross-sectional examination, which involves 48 chronic hepatitis B patients receiving outpatient care from September to November 2020 at dr. Zainoel Abidin Banda Aceh. The routine blood tests were performed using the Sysmex XT 1800i. The red cell distribution width to platelet ratio value is calculated by dividing the Red Distribution Width value by the platelets, and the degree of liver fibrosis was assessed using TE (Fibroscan® 502 Echosens).Result: In the 48 patients, the mean value of Red cell Distribution Width to Platelet Ratio for various degrees of liver fibrosis F0-1, F2, F3 and F4 were 0.051; 0.050; 0.077 and 0.108, respectively. It was reported that red cell distribution width to Platelet Ratio levels also increased according to the increase in liver fibrosis degree and was statistically significant with a p-value of 0.002. Analysis of the relationship between red cell distribution width to platelet ratio with the degree of liver fibrosis using ordinal regression method, while the red cell distribution width to platelet ratio level variable has a fairly large estimate value that is 31098 with a p-value of 0.003. The p-value of the test of less than 0.05 proves that the red cell distribution width to platelet ratio level affects and has a relationship with the degree of liver fibrosis.Conclusion: Red cell distribution width to platelet ratio relates to the degree of liver fibrosis in patients with chronic hepatitis B.
Dual role of Cutibacterium acnes in acne vulgaris pathophysiology
Authors: Mawardi Prasetyadi , Ardiani Irene , Primisawitri Pratiwi Prasetya , Nareswari Adniana
Published: February 2022

Acne vulgaris (AV) is the most common and multifactorial skin disease in adolescents affecting the pilosebaceous unit that involves hormonal imbalance, increased sebum production, and bacterial colonization, which causes both physical and psychological disorders. Cutibacterium acnes is considered one of the key contributing factors even though many Cutibacterium acnes colonies are on healthy skin. Cutibacterium acnes induces lipogenesis and production of sebum. Through its production of porphyrins, it may act as a catalytic agent in squalene oxidation that is comedogenic, thus aggravating comedogenesis. We review the dual role of Cutibacterium acnes to provide an understanding of the pathophysiology of acne vulgaris.
Outcome of urinary tract infection caused by Extended Spectrum Beta-Lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae in Dr Zainoel Abidin General Hospital Aceh
Authors: Hayati Zinatul , Jamil Kurnia F. , Azhari Afrianda , Mahdani Wilda , Karmil Teuku Fadrial , Yossadania Asyriva , Dahril Dahril , Habibie Yopie Afriandi
Published: February 2022

Introduction : Extended-spectrum ?-lactamase (ESBL) is a mutated ?-lactamase enzyme that can hydrolyze beta-lactam antibiotics. The aim of this study was to determine the incidence rate, characteristics of patients, antibiotic use and outcome of urinary tract infections (UTIs) due to ESBL-producing Escherichia coli and Klebsiella pneumoniae at Dr Zainoel Abidin General Hospital Aceh.Method : The samples of this study were all Escherichia coli and Klebsiella pneumoniae isolated from urine culture of UTI cases. Patient characteristics and antibiotic use data were extracted from medical records. UTIs outcome was assessed as clinical improvement or death within a maximum of 30 days of treatment.Result : The results of this study obtained 63 patients with UTIs caused by E. coli and K. pneumonia of which 52.4% of them were ESBL producers. The incidence of UTIs due to E. coli was higher than that of K. pneumoniae, 63.5% and 36.5% respectively. E. coli ESBL producers were more in number than non-ESBL, conversely K. pneumoniae were mostly non-ESBL. The characteristics of patients with UTIs caused by E. coli and K. pneumoniae were predominant women 52.4%,  and most cases were at 56-64 years old. Antibiotic therapy that given before and after culture results to UTI patients were generally ceftriaxone. UTIs outcome due to ESBL producing Escherichia coli and Klebsiella pneumoniae showed that 26/33 (78.8%) patients experienced improvement, however, 7/33 (21.2%) patients died.Conclusion : The irrational use of ceftriaxone in patients with UTI caused by ESBL producing E. coli and K. pneumoniae has led to a poor outcome for the patient.
Acute subdural hemorrhage accompanied with rupture of the inferior vena cava: a case report
Authors: Risfandi Marsal , Musyari Sayed , Celia Celia
Published: February 2022

Introduction: One of the main causes of mortality and morbidity with physical and mental disabilities is traumatic brain injury (TBI). Apart from that, TBI also causes huge socio-economic burdens around the world. About 60% of TBI cases reported are caused by traffic accidents. Acute subdural hemorrhage (ASDH) is the main clinical finding in TBI cases. Blunt abdominal trauma associated with TBI accounts for 14% of cases. Inferior vena cava (IVC) injury is the most common vessel injured in a blunt (0.6-1%) and penetrating abdominal trauma (0.5-5%). Injury of the IVC can lead to a very high mortality rate.Case description: Male patient, 15 years old, presented to the emergency department 30 minutes after a traffic accident with decreased consciousness with the Glasgow Coma Scale score of 11. The patient’s chest was clear, abrasions were found on the left hypochondrium. Head CT scan represented acute subdural hemorrhage in the left frontotemporoparietal region was accompanied by midline shift more than 0,5cm. Hemicraniectomy decompression was performed. After decompression was done, the patient was unstable, blood pressure down to 70/50 mmHg and weak peripheral pulses with 140 beats per minute. Fluid and blood resuscitation have been performed but not responding. The patient remained hemodynamically unstable with minimal urine output. Physical examination reveals a tense abdomen. Diagnostic peritoneal lavage (DPL) was performed, blood was obtained. Exploration laparotomy was done by a midline incision, and IVC injury was found. The blood was removed, then packing on IVC with gauze, observation, and no blood comes out. The packing was opened, the patient stable, the operation was complete.Conclusion: Case of severe head injury with acute SDH, then a craniectomy was performed, in the abdomen had a ruptured inferior vena cava, an exploratory laparotomy was done. Currently, the patient has recovered well without deficits.
Nasal rinse and gargling as an effort in preventing COVID-19 infection with Islamic approach – a literature review
Authors: Yanti Budi , Maulana Imam , Sofiana Debby , Sufani Liesa , Jannah Noraliyatun
Published: February 2022

Due to the COVID-19 pandemic, the general public must comply with health protocols and adopt new habits as this disease spreads through droplets and enters the respiratory tract through the nose and mouth. Meanwhile, water penetration into the nasal cavity (istinsyaq) and out (istintsar) during ablution corresponds to the nasal rinse and gargling methods, which prevents the mechanical and chemical attachment of viruses. This article discusses the role of Islamic-based nasal rinse and gargling in the prevention of COVID-19 infection.Various solutions such as plain water, saline, povidone-iodine, and antiseptics have chemical effects. Gargling and nasal rinse mechanically and chemically wash the mucosal surface in the mouth and nose to prevent the attachment of virus and other pathogens. Mechanically, the difference in concentration causes water to move outside the cell by osmosis, reducing mucus secretion and releasing the virus. Meanwhile, a chemical mechanism occurs when the free iodine in povidone-iodine oxidizes fatty acids and damages the virus cell walls and the respiratory chain of cytosolic enzymes, hence preventing inflammation of the host cell. However, the choice of liquid type, concentration, duration, and frequency of use still need to be considered to prevent side effects.
Bladder stone in children: literature review
Authors: Dahril Dahril , Ismy Jufriady , Hasibuan Iman Akbar , Andreas Andreas
Published: February 2022

Bladder stones affecting children, especially in low-resource countries. Dietary, environmental, genetic inheritance, and socio-economic factors affecting the composition of bladder stones. Even though the etiology of bladder stones is unknown, recent research has identified many risk factors that may assist this pathological condition. Even though cystolithotripsy has now become the standard of care, many other approaches are indicated in specific conditions. Surgeons should diagnose and investigate the etiology of the diseases properly, thus a surgical approach is only used when it is needed. Therefore, this study aims to review bladder stones in children based on current literature to refer to other researchers and clinicians.
Chest therapy and breathing exercise in COVID-19 patient: a case report
Authors: Prabawa I Made Yoga , Silakarma Dedi , Manuaba Ida Bagus Amertha Putra , Widnyana M. , Jeviana Ariezta
Published: February 2022

Background: The coronavirus disease (COVID-19) pandemic has several clinical manifestations from asymptomatic to critical condition. Shortness of breath is one of the hallmark symptoms of COVID-19 infection. The main medical management for shortness of breath in COVID-19 infection is oxygen therapy. Physiotherapy and medical rehabilitation such as breathing exercise and chest physiotherapy can be adjuvant therapy that effectively improves breathing effort in COVID-19 patients. This case report will describe breathing exercises and chest therapy done in a patient with a COVID-19 infection.Case: In this study, we presented the case of a 53-year-old female patient with complaints of fever, cough, fatigue, anosmia, shortness of breath, and diagnosis with confirmed COVID-19 infection based on swab PCR result. On admission in the isolation ward, the patient was on non-invasive ventilation (NIV), medical medication, and physical therapy. The physical therapy done in this patient was breathing exercise and chest therapy once daily. After four series of chest therapy and breathing exercise, the shortness of breath and her breathing effort was improved. The patient was discharged after 15 days of hospitalization.Conclusion: This case shows the utility of chest therapy and breathing exercise as a physical rehabilitation treatment for the COVID-19 patient. This physical therapy helps to maximize lung expansion and improve the patient's breathing effort.
Primary amenorrhoea caused by Turner syndrome: A case series
Authors: Nora Hilwah , Maracilu Cut Nonda , Andalas Mohd , Priyanto Muhammad Hikmawan
Published: February 2022

Background: Amenorrhea is a condition where women do not experience menstruation or the cessation of menstrual cycles at reproductive age. Amenorrhea is divided into primary and secondary. Turner syndrome is one example of gonadal dysgensis that cause the most common primary amenorrhea. It is represented by the absence of all or part of the normal second sex chromosome and physical features including short stature, webbed neck, cubitus valgus, pterygium colli, low hairline, edema of the hands and feet, and shield chest. Clinical pictures and karyotype of Acehnesse patients with Turner syndrome are presented in this study. The patients involved in the study were those who came to an endocrinology clinic in a tertiary care center.Case Presentation: We reported four cases of Turner syndrome which were confirmed from anamnesis, physical examination and chromosomal analysis at the Department of Obstetrics and Gynecology in the Fertility, Endocrine and Reproductive Division of RSUD Dr. Zainoel Abidin Banda Aceh.Conclusion: All patients with Turner syndrome had amenorrhea,  short stature, bone deformity and underdeveloped primary dan secondary sexual characteristic. Only one case has monosomy X (45, XO), a mosaic chromosomal component was present in the rest of them (45, X with mosaicism).
A 10-day-old baby with "lightning-like" myoclonic limb jerks during sleep: a case report
Authors: Hastuti Sri , Maulana Imam , Sofiana Debby , Fathima Raisha
Published: February 2022

Background: Benign neonatal sleep myoclonus (BNSM) is a condition commonly mistaken for seizures. It is characterized by self-limiting "lightning-like" myoclonic limb jerks that occur primarily during sleep in the newborn phase but are not associated with epilepsy that suddenly stops when the infant is agitated. This condition is potentially resolved between the ages of 2 and 6 months.  The incidence of BNSM per 1,000 births is 0.8 to 3 cases. This case report aims to explain the findings of a neonate with multiple episodes of abnormal jerks affecting the entire limb, only during sleep.Case Report: We reported a 40-day-old baby boy with multiple episodes of abnormal jerks affecting the entire limb since 10-day-old only during sleep. The jerky body movements appeared six until nine times a day with approximately an hour interval between movements. The patient did not have any neurologic deficits, pathologic reflexes and vital signs abnormalities. Electroencephalogram (EEG) revealed the normal result. We diagnosed the patient with BNSM.Conclusion: The BNSM is a self-limiting disorder. For neonatal seizures or even neonatal status epilepticus, BNSM can be misinterpreted, recognizing childhood benign sleep myoclonus is important to prevent unnecessary diagnostic studies and treatments. The prognosis was good and the patient didn't need any medication and long-term follow-up.
Identification of the type of Human Papilloma Virus (HPV) in condyloma acuminata in the genital and/or anal areas in men who have sex with men (MSM)
Authors: Rohanda Boy Ardi , Hutapea Richard , Nadeak Kristina
Published: February 2022

Background: Condyloma acuminata is a sexually transmitted infection (STI) caused by the Human Papilloma Virus (HPV), marked by mucosal and skin hyperplasia, especially in the anogenital areas. HPV is transmitted by sexual intercourse. The incidence of condyloma acuminata in men who sex with men (MSM) increases due to the variations in genito-anal sexual intercourse. This study determined the type of HPV in condyloma acuminata in the genital and/or anal area in MSM.Methods: This study was a descriptive observational study with a cross sectional approach in 25 MSM subjects with condyloma acuminata at the Dermatology and Venereology outpatient clinic of Haji Adam Malik General Hospital Medan and Universitas Sumatera Utara Hospital from June 2020 to February 2021. Subjects were selected by consecutive sampling. The samples of condyloma acuminata were collected by a shave biopsy technique, followed by examining the DNA type of HPV using the PCR method. We collected the demographic data (age, education level, employment, condyloma acuminata location, and condyloma acuminata lesion shaped) and then presented it in the descriptive.Results: From 25 men who had condyloma acuminata in this study, most of them (14 people or 56%) were 19-26 years old and unmarried with homosexual orientation. Fifteen people (60%) graduated from high school, and 21 respondents (84%) worked as employees. The most locations of condyloma acuminata on the anal area as many as 16 people (64%), the most common characteristic of the lesion was acuminatum, found in 16 people (64%), and the most common type of HPV was HPV type 11 in 13 people (52%). In the genital areas and anal areas, the most common type of HPV was HPV type 11 in 4 people (44,4%) and nine people (56,2%). The most characteristic lesions in the genital area were papule in 7 people (77,8%), and in the anal area were acuminatum in 14 people (87,5%).Conclusion: The most common type of HPV in condyloma acuminata in the genital area and anal area in MSM were HPV type 11. The characteristic of condyloma acuminata lesions in the genital area in MSM was mostly papule, whereas in the anal area was acuminatum.
Analysis of vitamin A level in leprosy patients
Authors: Dalimunthe Dina Arwina , Hazlinda Cut Putri , Partogi Donna
Published: February 2022

Background: Leprosy or Morbus Hansen is a contagious, chronic, and infectious disease mainly caused by Mycobacterium leprae (M. leprae), affecting the skin and peripheral nerves. Vitamin A is an essential non-enzymatic antioxidant for the body, which regulates various immune response components. A decline in the levels of vitamin A was discovered in leprosy. This study determined the levels of vitamin A and its comparison in multibacillary (MB) and paucibacillary (PB) type leprosy patients, also the relationship between vitamin A levels with bacterial index.Method: This cross-sectional study included thirty-four leprosy patients, conducted at the Leprosy Division in Dermatology and Venereology Department of Haji Adam Malik General Hospital Medan, Pirngadi General Hospital Medan, Lau Simomo Leprosy Hospital, Sicanang Leprosy Hospital, and Belidahan Leprosy Hospital with consecutive sampling techniques from March to October 2018. We determined the levels of vitamin A and its comparison in multibacillary (MB) and paucibacillary (PB) type leprosy patients, also the relationship between vitamin A levels with bacterial index. A T test was then performed to compare vitamin A levels between PB and MB types of leprosy. The relationship between vitamin A levels and the bacterial index was tested using Pearson correlation.Results: Most of these subjects were MB, male sex predominance, in 16-35 years with 21 subjects. The bacterial index of 0 can be found in 16 subjects (47.1%), +1 in 8 subjects (23.6%), +2 in as many as 5 subjects (14.7%), and +3 in 5 subjects (14.7%). The vitamin A level in MB type leprosy was lower than PB type leprosy (p = 0.001). We also found a negative correlation between vitamin A levels and the bacterial index in leprosy patients (r = -0.632, p = 0.000).Conclusion: The higher the bacterial index value is, the lower the vitamin A level will be.
The effectivity of bovine colostrum and Mesenchymal Stem Cell (MSC) on the improvement of Alkaline Phosphatase (ALP) and Takeda G-Protein Coupled Receptor-5 (TGR5) level in post-hepatectomy Wistar rats
Authors: Hendrawijaya Albert Eko , Budiono Bernadus Parish , Riwanto Ignatius , Putra Agung , Prabowo Erik
Published: February 2022

Background: The factor affecting the liver's healing process after resection in liver malignancy is liver fibrosis. Bovine Colostrum (BC), as one of the anti-fibrosis products of the liver, improves hepatic fibrosis and reduces hepatocyte damage caused by carbon tetrachloride (CCl4). Meanwhile, Mesenchymal Stem Cell (MSC) is a new therapeutic source after resection. MSC is able to differentiate into specific cells in the healing process. This study aims to determine the effects of BC, MSC, and a combination of both in terms of increasing Alkaline Phosphatase (ALP) and Takeda G-Protein Coupled Receptor-5 (TGR5) levels in Wistar rats post hepatectomy 50% with liver fibrosis.Methods: This study is an experimental study with a randomized control trial design. Subjects were 25 Wistar rats (Rattus norvegicus) which were divided into 5 groups: Sham (surgery only), K (Control), K1 (CCL4 +BC), K2 (CCL4 + MSC), and K3 (CCL4 + MSC +BC). Blood was also taken to assess ALP and TGR5 at Day-3, Day-7, and Day-10 of treatment. Data were analyzed using SPSS version 25 for Windows.Results: A significant differences are found in ALP in the Sham group with K2 (p = 0.014) and the K2 group with K1 (p=0.026) on day 10. Significant differences in TGR5 are found in the Sham and K2 groups (p=0.009), control with K2 (p=0.014), K2 with K1 (p=0.007) on day 3. On day 7 in the control group with the combination (p=0.013). The test results showed that TGR5 on day 3 had a moderate significant strong correlation on ALP levels on day 10 (r=0.596; p=0.014).Conclusion: The combination of BC and MSC was not better than the administration of BC or MSC only in increasing ALP and TGR5 levels in rats with liver fibrosis after hepatectomy 50%.Based on this study, the administration of MSC is recommended.
A patient with obstructive hypertrophic cardiomyopathy: a case report
Authors: Rampengan Starry Homenta , Santoso Fery Budiman
Published: February 2022

Background: Hypertrophic cardiomyopathy (HCM) is a left ventricle hypertrophic condition related to genetic disorders involving the gene encoding protein from the cardiac sarcomere apparatus. The prevalence of this disease is relatively low, but various clinical presentations make underrecognized and underdiagnosed. We reported obstructive hypertrophy cardiomyopathy patients with an episode of unexplained syncope and malignant arrhythmia.Case Report: A 44 years old man came with the chief complaint of shortness of breathing. The patient felt the chief complaint since two years ago with getting worse during mild physical activity. The symptom got better during rest or slept with one pillow without complaining of dyspnea. One year ago, the patient started to feel palpitation disappear and arise with shortness of breathing. The patient got syncope two weeks ago during mild activities after a short period of breathlessness. For the vital sign, blood pressure was at 90/60 mmHg, blood pulse was 67 bpm irregular, breath frequency was 17x/min, and oxygen saturation was 99% room air. The electrocardiogram (ECG) showed atrial fibrillation with regular ventricular rate and left bundle branch block morphology of the QRS complex with Q wave at anterior precordial. The patient also checked for electrocardiography and ambulatory ECG monitoring using Holter. The patient was diagnosed with obstructive hypertrophy cardiomyopathy (OHCM), atrial fibrillation with regular ventricular rate and given Dabigatran 110 mg twice daily, metoprolol XL 12,5 mg once daily, and furosemide 10mg once daily for his medication.Conclusion: Theoretically, myectomy is the best option for this case; however, due to limited high-volume hospitals in Indonesia doing myectomy for hypertrophic obstructive cardiomyopathy, alcohol septal ablation may be an alternative option if the medication was no longer adequate to improve symptoms.
Relationship between skin hydration and stretch marks
Authors: Novita Mita , Jusuf Nelva Karmila , Putra Imam Budi
Published: February 2022

Background: Stretch marks are harmless skin disorders but can cause cosmetic and psychological problems. The mechanism in the pathogenesis of stretch marks is still not well known yet. However, it is most related to changes in the extracellular matrix components, including fibrillin, elastin and collagen. Skin hydration can affect the primary mechanism of its pathogenesis. This study determined the relationship between skin hydration and stretch marks.Methods: This was a cross sectional study with a total sampling method, involving 84 female residents from the Faculty of Medicine, Universitas Sumatera Utara batch 2020. The diagnosis of stretch marks is made through history taking and physical examination. The skin hydration checking was conducted on the right and left femur by using Corneometer CM 825 device. The data collected were analyzed by using the Kruskal Wallis test. The Ethical Committee of Universitas Sumatera Utara has approved this study.Result: The majority of ages ranged from 26-35 years (86,1%). Subjects who had a pregnant history with stretch marks were 44,6%. The majority of stretch marks located in the subjects were femur 45,5%. Skin hydration 65,5% of subjects was classified as dry. Skin hydration in subjects with stretch marks was lower than those without stretch marks with a p-value <0,001. There is a relationship between skin hydration and stretch marks with a p-value <0,001.Conclusion: There is a significant relationship between skin hydration and stretch marks.
A rare case of porokeratosis mibelli in 3-year-old boy
Authors: Lestari Wahyu , Hajar Sitti
Published: February 2022

Introduction: Porokeratosis mibelli is a rare, chronic, and slowly progressive genodermatotic characterized by abnormality of keratinization. The clinical manifestations are hyperkeratotic papules or plaques surrounded by a thread-like elevated border that widens centrifugally. Rarity of this case means the science behind it is underdeveloped. Thus, we present this case as an educational vehicle and to further develop the body of knowledge surrounding this disease.Case report: We reported a 3 years old boy, suspect of porokeratosis mibelli. His mother complained of a few reddish spots and patches that sometimes itchy, healed into white and brownish patches with atrophic centers in the last 5 months before admission. Physical examination: few lesions on the back, waist, left side of buttock, back of the neck, and lateral upper left arm. Hypopigmented and hyperpigmented patches with atrophic centers, and erythematous plaques with central erosion were found. No abnormality of internal organs or laboratory findings. Histopathology examination showed epidermis contains of invagination rete malpighia filled keratin. Slightly thinned stratum germinativum with corneum contains basket weave pattern. Topical therapy with 1% 5-fluorourasil cream twice daily showed mild improvement after 10 days.Conclusion: Although clinical examinations of the lesions on this patient did not fit the criteria of porokeratosis mibelli, however, the results of histopathology examination supported the diagnosis. Treatment with 1% 5-fluorourasil cream showed slow but progressive healing on the patient
How suited are the different commercially available archwires for the Egyptian dental arches?
Authors: Elhiny Omnia A. , Abou Elyazied Mohammed , Salem Ghada A.
Published: February 2022

Background: The purpose of this study was to investigate the suitability of the widths of some commercially available preformed NiTi arch wires to the dental arch widths of a sample of the Egyptian population.Methods: This cross-sectional study included 420 maxillary and mandibular pairs of casts for subjects with an age range of 10-16 years as part of project by the National Research Centre. The casts were traced using TracerNet; intercanine and intermolar widths were measured on the casts. Anterior and posterior arch lengths were measured to facilitates the measurements on the wires. The intercanine and intermolar widths of eight commercially available archwires were measured on a graph paper. Results: Regression analysis was performed to create a regression model for the predicted means of the intercanine and intermolar widths in different age groups. The mean square error (MSE) was calculated for all the available arch wires in relation to the dental arch. Ormco (Broad arch/small) had the lowest MSE; 1.55 for the upper intercanine width and 1.72 for the upper intermolar width. For the lower intercanine width its MSE was 0.30 for the Ormco and 0.31 for Ortho Technology, while for the lower intermolar width it was 0.78 for Ormco. Conclusions: The commercially available archwires were all considerably larger than the mean dental arch size of the majority of the population, except for the Ormco; thus, inviting potential relapse of treatment. It is necessary to produce a wider range of customized archwires that better suit the dental arch sizes of the Egyptian population.
The effectiveness of multiflora honey to prevent hepatotoxicity in invasive ductal breast cancer patients with FAC chemotherapy
Authors: Sidabutar Dwi Feris Martua , Budijitno Selamet , Prasetyo Awal
Published: February 2022

Background: Breast cancer is an epithelial malignancy of the breast duct, which chemotherapy is one of the treatment modalities. Hepatotoxicity is known as one of the side effects of chemotherapy. Multiflora honey provides hepatoprotective effects through its phenolic acid and flavonoid compounds. This study will evaluate the effect of Honey in preventing hepatotoxicity in ductal invasive breast cancer patients receiving FAC chemotherapy.Methods: An experimental study with double-blind, randomized pre and post-test with control group design. About 36 ductal invasive breast cancer patients were divided into 2 groups, the control group who received FAC chemotherapy and the treatment group who received chemotherapy and 90 ml/day honey consumption for 14 days. The patient's Aspartate Transaminase (AST), Alanine Transaminase (ALT), Alkaline Phosphatase (ALP), and Gamma-Glutamyl Transferase (GGT) enzyme levels before and after 14 days of the study were assessed. Data were analyzed using SPSS version 15 for Windows by Mann-Whitney test and Wilcoxon tests.Results: There was a significant difference in AST (33.72±44.35 U/L vs. 23.22±4.48 U/L; p<0.001) and ALT (29.72±16.96 U/L vs. 26.06±9.19 U/L; p=0.020) levels in the treatment vs. control group. In addition, a significant difference of ALP (107.00±65.89 U/L vs. 103.17±35.30 U/L; p=0.009) and GGT (56.61±58.16 U/L vs. 51.33±27.50 U/L; p=0.035) levels in the treatment vs. control group was also found in this study.Conclusion: Multiflora honey has a hepatoprotective effect for invasive ductal breast cancer patients receiving FAC chemotherapy.
Sclerosing rhabdomyosarcoma of the gingiva mimicking malignant peripheral nerve sheath tumor: a case report
Authors: Sumadi I Wayan Juli , Citra Dandy , Martadiani Elysanti Dwi , Christian I Nengah Wiadnyana Steven
Published: February 2022

Background: Spindle cell/Sclerosing rhabdomyosarcoma is the rarest variant of rhabdomyosarcoma, accounting for 5-10% of all rhabdomyosarcoma cases. Pathologically, these tumors can provide a variety of features and can resemble other tumors, thus often difficult to diagnose. We report a case of sclerosing rhabdomyosarcoma of the gingiva with histomorphology mimicking a malignant peripheral nerve sheath tumor. Case Presentation: The patient was a 39-years old Balinese male who noticed a lump on the left gum since 9 months ago. Head CT scan revealed a solid mass with soft tissue density at the left lower gingiva that extend superiorly and laterally, involving the left parapharyngeal and masticator spaces, infiltrated into the left mylohyoid muscle and left medial and lateral pterygoid muscles, and caused destruction of the left mandibular ramus and alveolar process of the left maxilla. The initial biopsy showed the proliferation of atypical spindle cells with a pattern resembling peripheral nerve sheath tumor and concluded as a low-grade malignant peripheral nerve sheath tumor. Wide excision specimen consists of proliferation of low-grade atypical spindle cells arranged in a fascicular pattern with foci of strap cells embedded in glassy eosinophilic sclerosis matrix. Some parts of the tumor showed palisading nuclei. The tumor cells were diffusely positive for desmin and negative for S100. This case was finally diagnosed as sclerosing rhabdomyosarcoma.Conclusion: Sclerosing rhabdomyosarcoma should be considered when atypical spindle lesions occur between the hyalinized stromal matrix of the head and neck in adults. Because of wide differential diagnosis, an adequate sampling, careful microscopic examination, and immunohistochemistry staining can avoid misdiagnosis.