bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Aerobic Walking on Maximal Oxygen Consumption and Serum Vitamin D Levels in Patients with Mechanical Chronic Low Back Pain in Office Workers at Dr. Soetomo Hospital Surabaya
Authors: I Nengah Bagus Surianta  , Damayanti Tinduh  , Andriati  , Meisy Andriana  , Sony Wibisono Mudjanarko  , Soenarnatalina Melaniani
Published: May 2024

Background: Sedentary behavior is a common risk factor for mechanical chronic low back pain. Functional capacity and serum vitamin D levels are associated with low back pain intensity. The aim to analyze the effect of aerobic exercise walking on maximal oxygen consumption and serum vitamin D levels in patients with mechanical chronic low back pain.
Method: true experimental with pre and post-test randomized control group design. Each group consisted of 16 respondents. The treatment group received additional aerobic exercise walking 3x/week, intensity 40-50% HRR (weeks 1-3), 50-60% HRR (weeks 4-6) and 60-80% HRR (weeks 7-8), 30 minutes per session for 8 weeks. The control group only received conventional training 3x/week for 8 weeks. The parameters evaluated were VO2 max and 25(OH)D. Measurements were taken before and after 8 weeks of intervention.
Results: The VO2 max values of both groups increased with a significant difference after the intervention (p < 0.001) and there was a difference in the difference (p < 0.001). 25(OH)D levels in both groups increased with no significant difference after the intervention (p = 0.720) and no significant difference in the difference after the intervention (p = 0.662)
Conclusion: There is a difference in the addition of walking aerobic exercise to conventional exercise compared to conventional exercise alone on maximal oxygen consumption, but there is no difference on serum vitamin D levels in mechanical chronic low back pain patients.
Current insight flavonoid quercetin in epithelial maturation vagina for menopause treatment: a narrative review
Authors: Andini Sarah Fitria , Kurniawati Eighty Mardiyan , Hardianto Gatut , Setyohadi Tri Hastono
Published: May 2024

Background: Menopause affects all parts of the women's body system, especially in the genitourinary area. The impact on the genitourinary system causes post-menopausal women to complain of menopause-related genitourinary syndrome due to vaginal atrophy, sexual dysfunction, and pelvic organ prolapse in the long term. Various research has been conducted to find alternative therapy, especially flavonoid quercetin, due to its phytoestrogen characteristic.
Methods: This review article assembles much literature to highlight the menopause effect on the vagina and the phytoestrogen effect of flavonoid quercetin as a potential alternative therapy. This study aims to develop future experimental studies of quercetin's effect on the vagina.
Results: Hypoestrogenic condition affects all vaginal layers. This is due to estrogen receptors distributed in the epithelial lining, lamina propria, and muscular layer of the vagina. In vitro studies showed quercetin induces cell proliferation by activating signal pathway b-catenin/c-Myc/cyclin A2, mediated by estrogen receptor. The signal pathway increases the cell cycle transition to the G1 phase. It also increases keratinocyte proliferation and migration, proliferating cell nuclear antigen, and positive a6 and b1 integrin cells in the basal layer of the epidermis, which causes thickening of the epidermis.
Conclusion: Flavonoid quercetin is a promising alternative for menopause therapy in the vagina. Further, in vivo studies are needed to confirm the result of in vitro study and as basic data for comparison with other potent phytoestrogen.
Maternal distress during pregnancy related to preeclampsia
Authors: Khalida Siti Nur , Erry Gumilar Dachlan  , Gatot Soegiarto
Published: May 2024

Introduction: Maternal distress related to the occurrence of preeclampsia. The distress condition may disrupt the neuroendocrine and immune systems, activating the maternal HPA axis and increasing serum cortisol levels. The latter may affect the placental cortisol lvel, may alter the trophoblast invasion, which is the main pathology of preeclampsia. This study aims to assess the correlation between maternal distress and the incidence of preeclampsia using PSS and DASS-21 questionnaires.
Methods: We conducted a cross-sectional study at two secondary hospitals in Surabaya, East Java, Indonesia from December 2022 until February 2023. Twenty women with preeclampsia and seventeen non-preeclamptic women as control were included in this study. Maternal distress was measured using self-reported PSS and DASS-21 questionnaires.
Results: Preeclamptic women were significantly more depressed and stressed than the control group, while there was no significant difference in anxiety scores between groups. Maternal distress measured by PSS score positively correlated with the occurrence of preeclampsia (p<0,05; β-value 0,742).
Conclusion: Maternal distress conditions were correlated with the occurrence of preeclampsia. Further research still needs to be done to unravel the mechanisms by which maternal distress can induce preeclampsia.
Effect of Blood Flow Restriction in Low-Intensity Resistance Training of the Quadriceps Femoris Muscle on Joint Position Sense and Threshold to Detect Passive Motion in Patients with Knee Osteoarthritis
Authors: Sri Wulandari Pramana I Gusti Agung Ayu , Subadi Imam , Wardhani Indrayuni Lukitra , Andriana Meisy , Utomo Dwikora Novembri , Melaniani Soenarnatalina
Published: May 2024

Backgrounds: The functional ability of knee OA (KOA) patients is mainly affected by muscle weakness and poor proprioception function. Quadriceps femoris strengthening exercises can improve proprioceptive function in patients with KOA, whereas low-intensity resistance exercises with Blood Flow Restriction have been shown to produce hypertrophy and increase muscle strength equivalent to high-intensity resistance exercises. However, prescriptions for exercise with BFR are still very diverse, and only a few studies show the effects of BFR training on proprioceptive function in patients with KOA. This study aims to determine the impact of BFR in LI-RT of the quadriceps femoris muscle on joint position sense and threshold to detect passive motion in patients with KOA.
 Methods: This randomized control trial study designed a clinical experiment with a before and after test. The research enrolled 28 people with KOA grades 2 and 3. The JPS and TTDPM, which reflect proprioceptive function, were measured before and after 6 weeks of exercise. This study's statistical analysis utilized the Monte Carlo test, independent t-test, and paired t-test. The effect size was noticed using Cohen's-d calculation to investigate the statistical influence of alterations further. The significance level was less than 0.05.
Results: The mean age of the control group was 61.43 ± 5.70 years old, and the treatment group was 57.71 ± 5.25 years old. There were significant improvements in JPS and TTDPM results before and after training in each group (p < 0,05). There was no significant difference in JPS and TTDPM results between the two groups on the post-test on delta values (p> 0,05).
Conclusions: The addition of BFR in LI-RT for 6 weeks did not affect JPS and TTDPM in patients with KOA.
Clinical research capacity evaluation at Prof. I.G.N.G Ngoerah General Hospital, Denpasar: Teaching general hospital, Indonesia
Authors: Agustini Tri Fajari , Sjaaf Amal Chalik , Sulistiadi Wachyu , Hendrawan Harimat
Published: May 2024

Link of Video Abstract: https://youtu.be/0zW7g_T0heE
 
Introduction: Applying research activity in hospitals in Indonesia is a kind of challenge. This study aimed to assess the research’s capacity in Prof. I.G.N.G Ngoerah General Hospital. It is related to the indicators and cultural analysis at the team, organization, and individual levels in Prof. I.G.N.G Ngoerah General Hospital.
Methods: A cross-sectional study and qualitative analysis using Focus Group Discussion (FGD) were conducted in July-August 2022 at Prof. I.G.N.G Ngoerah General Hospital. The Research Capacity and Culture (RCC) validated survey measured self-reported research capacity at leadership, individual, team, and organization levels. Additionally, this study explored barriers and motivators. The rate of research capacity decisions and the domains in this study use the ROC curve. This statistical analysis used chi-square with a significance of p-value < 0.05.
Results: One hundred and thirty respondents were analyzed. The individual characteristics were 45-54 years old, male, medical specialist, clinician without structural position, with a master’s degree or specialist, internal medicine department and pediatric department, 0–10 years of work history, 1–10 journal publications, and having a research history. In leadership and team capacity, most have low scores, and in individual capacity, organization and research capacity have high scores. There is a statistically strong relationship between each domain and research capacity.
Conclusions: High research capacity in a hospital is very important. Evidence-based research can be used to support the services and progress of the hospital itself, especially as a teaching hospital.
Progesterone Serum Level on HCG Trigger Day among Frozen Embryo Transfer IVF Patients and Pregnancy Outcomes: A Systematic Review and Meta-Analysis
Authors: Herida Alifia Ramadhani , Muhamad Faza Soelaeman
Published: May 2024

Abstract: The association between progesterone serum levels on the day of hCG administration and IVF pregnancy outcomes has been the subject of numerous studies and clinical investigations. We aim to conduct a systematic review and meta-analysis to explore the influence of progesterone serum levels on hCG trigger day on pregnancy outcomes in vitro fertilization (IVF) cycles. Through a comprehensive search of the PubMed and Embase databases, eight studies were identified for inclusion. The analysis revealed a risk ratio for live birth rate of 0.91 (95% CI 0.79-1.06), clinical pregnancy rate of 1.01 (95% CI 0.89-1.15), miscarriage rate: 0.98 (95% CI 0.80-1.21), implantation rate 0.81 (95% CI 0.49-1.35), and mean difference for endometrial thickness -0.01 (95% CI -0.16, 0.14). This study showed insignificant progesterone serum levels on the day of hCG administration and IVF pregnancy outcomes. However, the heterogeneity across studies emphasizes the need for larger, standardized investigations to elucidate the nuanced associations between progesterone levels and IVF success. This study contributes to our understanding of the role of progesterone in IVF outcomes and provides a basis for future research to optimize fertility treatment protocols.
Telemedicine for the management of Behavior and Psychological Symptoms of Dementia (BPSD) during the COVID–19 pandemic
Authors: Harikha Igha Vinda , Erikavitri Yulianti
Published: May 2024

Background: The majority of dementia patients exhibit behavior and psychological symptoms of dementia (BPSD). It is extremely painful for both patients and caregivers. Following the COVID-19 epidemic, it is necessary to strike a balance between social distance and isolation, because the loneliness created by quarantine can have harmful psychological implications, particularly for the elderly. BPSD patients and carers require greater health services in the setting of a pandemic. Telemedicine has the potential to lessen the likelihood of unfavorable outcomes in mental health treatment. We hope to highlight how BPSD does not worsen in patients during the pandemic and how telemedicine can be a significant option in the current scenario in this post.
Case illustration: The older woman aged 76 years, came to the psychiatric polyclinic at RSUD Dr. Soetomo with complaints that he often forgets for 2 years, counting money over and over again, and is angry if not given money, but if given money the patient will distribute it to neighbors, and some will be spent. Patients often talk slurred, talk to themselves, talk dirty, and do violence, such as hitting and throwing things. During the COVID-19 pandemic, the family did not bring patients for control to the hospital. The family came to Poly to collect medicine. When the family arrived, the doctor communicated with the patient via video call.
Conclusion: The use of telemedicine allows patients and caregivers to get access to mental health services easily.
Analysis of CYP17 gene polymorphism on increasing androstenedione levels in polycystic ovary syndrome women with obesity in Surabaya
Authors: Muarrofah  , Santoso Budi , Tirthaningsih I Wayan
Published: May 2024

Introduction: CYP17 gene polymorphism causes susceptibility, can interfere with the enzyme biosynthesis mechanism in steroidogenesis, and becomes a possible genetic factor for hyper-androgen in PCOS. The study aimed to analyze the relationship between CYP17 gene polymorphism and increased androstenedione levels in PCOS women with obesity.
Methods: This study is an observational case-control analytic. The sample is 23 obese PCOS women and 23 obese non-PCOS women, using a purposive sampling technique. CYP17 gene polymorphism examination with PCR and RFLP. Examination of androstenedione hormone by ELISA. The examination results were tested using a logistic regression statistical test with α = 0.05, the hypothesis being accepted if p-value <0.005.
Results: The study subjects were 20-30 years old, 50-60 kg body weight, with BMI more than 25%. The distribution of CYP17 gene genotypes in the case group was TC, 47.8%, while in the control group, it was TT, 100%, Chi-Square test on CYP17 gene polymorphism in PCOS and control groups showed significant differences (P 0.000). Wilcoxon-Mann Whitney test of androstenedione levels in cases compared to controls P = 0.000, eta CYP17 correlation test with androstenedione levels P = 0.061.
Conclusion: There is a difference in CYP 17 gene polymorphism in obese PCOS women compared to obese non-PCOS women. Androstenedione levels are higher in PCOS women than in obese non-PCOS women and there is no association of CYP17 with Androstenedione levels in PCOS women with obesity.
Effect of epigallocatechin gallate (EGCG) on neutrophils count and interleukin-6 (IL-6) expression in Pseudomonas aeruginosa keratitis: an experimental study on Rattus norvegicus rat
Authors: Karima Annisa , Indriaswati Luki , Fatmariyanti Susy , Kurniasari Nila
Published: May 2024

Link of Video Abstract: https://youtu.be/pCACVaojEVMBackground: Pseudomonas aeruginosa keratitis is a prevalent ocular illness that carries the potential risk of endophthalmitis and corneal perforation. The use of antibiotics effectively eradicates the bacteria; nevertheless, the corneal damage caused by toxins remains unresolved, resulting in the thinning of the cornea, which can ultimately lead to corneal perforation or the development of corneal fibrosis. This study aims to analyze the quantification of neutrophils and the expression levels of interleukin-6 in the Pseudomonas aeruginosa keratitis model.
Methods: The study used an experimental research design. The research utilized a Rattus norvegicus corneal preparation to establish a keratitis model. Each test group consisted of six samples, including a negative control (solvent), moxifloxacin 0.5%, and a combination of moxifloxacin 0.5% and EGCG at a concentration of 50 µg/mL.
Results: The combined group of 0.5% moxifloxacin and epigallocatechin gallate (EGCG) 50 µg/mL exhibited a reduced count of neutrophils compared to the group treated with 0.5% moxifloxacin alone. The findings indicated a statistically significant disparity in the neutrophil count across the various treatment groups (p<0.05). No significant distinction was observed in the neutrophil count between the moxifloxacin 0.5% group and the combination group (p>0.05). The average percentage of IL-6 expression level in the group treated with a combination of 0.5% moxifloxacin and 50 µg/mL EGCG was found to be lower compared to the group treated with only 0.5% moxifloxacin. There was statistically significant variation in the expression of IL-6 across the three treatment groups (p<0.05). There was no statistically significant difference in the level of IL-6 expression between the moxifloxacin 0.5% group and the combination group (p>0.05).
Conclusion: The results of this investigation demonstrated that EGCG possesses the capability to serve as an adjunct treatment for the suppression of inflammation in cases of Pseudomonas aeruginosa keratitis.
Matrix metalloproteinase-1 serum level in association with the occurrence of striae distensae
Authors: Wiryadana Michelle , Jusuf Nelva Karmila , Putra Imam Budi
Published: May 2024

Introduction: Striae distensae are fine atrophic scar tissue on the skin. They are formed on areas with dermal collagen rupture due to excessive stretching of the skin. Matrix metalloproteinase-1 (MMP-1) is an enzyme that degrades collagen types I and III. An imbalance in the expression of MMP-1 and transforming growth factor-beta (TGF-β), cytokine that trigger the synthesis of new collagen, leads to imperfect dermis remodeling process in atrophic scar tissue, which is a clinical appearance of striae distensae. This study aimed to determine the association between serum MMP-1 level and striae distensae.
Methods: We conducted an observational cross-sectional study on 40 females with striae distensae and 40 controls. History taking, physical and dermatological examination, followed by blood sampling analysis of serum MMP-1 level with ELISA method were conducted in all subjects.
Results: The mean serum MMP-1 levels in the striae distensae group were 51.54±28.03 ng/dL. All subjects in the striae distensae group had striae albae and only 7 subjects (17.5%) had striae rubrae. The most common location of striae distensae is the combination of femoral and gluteus regions (25%). The results of this study showed a relationship between high MMP-1 levels and the risk of striae distensae by 4.89 times (p = 0.002).
Conclusion: There was an association between serum MMP-1 levels and striae distensae.
Case report of a person with diabetes mellitus who has tropical diabetic hand syndrome
Authors: Choirunnisa Miftahani Leo , Wironegoro Rio
Published: May 2024

-Introduction: Diabetes mellitus (DM) is a chronic systemic disease that causes morbidity and mortality. Diabetes often increases the incidence and severity of various infections, especially those caused by bacteria and fungi, where patients have hyperglycemia and poor blood sugar control. Tropical diabetic hand syndrome (TDHS) is a specific hand complication experienced by people with DM in tropical countries. The syndrome involves localized cellulitis, which can be progressive and fulminant to hand sepsis and gangrene. Management of patients with TDHS requires a comprehensive strategy and management to reduce mortality and morbidity. This study aimed to report a rare case of a patient with T2DM who experienced TDHS.
Case Presentation: A 45-year-old man came to the emergency department of RSUD Dr. Soetomo, with a chief complaint of a wound on his right hand caused by a rusty nail that had not healed for three days. The patient said that he had uncontrolled DM for six years. In manus dextra examination, an ulcer measuring 0.5x 0.5 cm was found on the back of the hand on the ulnar side, with edema, hyperemia, and active pus discharge. The patient was hospitalized for nine days and discharged when the complaints and the blood sugar level were improved. On the seventh day after discharge, the complaints felt significantly reduced, the wound improved with granulation tissue appearing, and the blood sugar level was within normal limits. The patient was given insulin aspart injection of 10 units thrice daily, basal insulin of 16 units, ciprofloxacin 500 mg twice daily, ibuprofen 400 mg thrice daily, and cilostazol 100 mg twice daily.
Conclusion: In this case report, we presented a case of a 45-year-old man with manifestations of TDHS as a complication of uncontrolled DM for six years and delay in obtaining medical services. Management of patients with TDHS includes hospitalization, elevation of the affected hand, optimal blood sugar control, administration of antibiotics, and wound care. Education for T2DM complications remains the most important preventive measure in developing countries.
Exploring rutinoside's impact on inflammation in a rat knee OA model induced by monosodium iodoacetate (MIA)
Authors: Normasari Rena , Purwanto Bambang , Tinduh Damayanti
Published: May 2024

Link of Video Abstract: https://youtu.be/Dl8sYvPfd6o
 
Introduction: Osteoarthritis (OA) is a common joint disease characterized by persistent inflammation and cartilage breakdown. Monosodium iodoacetate (MIA) is often used to generate OA in rats. This study aims to explore the anti-inflammatory benefits of rutinoside, a natural flavonoid glycoside, in rats with MIA-induced knee OA.
Methods: The male Wistar rats were divided into five groups (n = 6) and randomly allocated to one of five treatments: control, OA, rutinoside, glucosamine sulfate, and sodium diclofenac-treated group. 3 mg of monosodium iodoacetate (MIA) was injected intra-articularly into the knee joints of rats to induce osteoarthritis. Rutinoside, glucosamine sulfate, and sodium diclofenac were given daily for four weeks. Body weight, joint swelling, knee bend score, interleukin-1 (IL-1) levels, interleukin-8 (IL-8) levels, and C-terminal telopeptide type II collagen (CTX-II) levels were all assessed.
Result: Rutinoside significantly decreased body weight loss, joint edema, and knee bend test scores compared to the untreated OA group. Furthermore, rutinoside was equally effective as glucosamine sulfate and sodium diclofenac in these parameters. The rutinoside, glucosamine sulfate, and sodium diclofenac groups had significantly lower IL-1, IL-8, and CTX-II levels than the untreated OA group.
Conclusion: Rutinoside reduced inflammatory responses, lowered joint edema, and improved knee bend test scores in a rat model of MIA-induced osteoarthritis. Its efficacy in preventing illness was comparable to glucosamine sulfate and sodium diclofenac. More study is needed to better understand rutinoside's underlying mechanisms and long-term consequences for treating osteoarthritis.
The effect of ascorbic acid on leukocyte reduction in burns injury patient: A short communication
Authors: Wahdono Muhammad Ihsan , Saputro Iswinarno Doso , Budi Agus Santoso
Published: May 2024

Link of Video Abstract: https://youtu.be/-_-efYtOGxk
 
Introduction: Challenges in managing burn injury include a high risk of sepsis and mortality. The study aimed to determine the effect of ascorbic acid on leukocyte reduction in burns injury patients.
Methods: The design of this study was a case series reported using retrospectives. Data collection was carried out from January to December 2020. All participants were diagnosed with burn injuries. Participants received burn wound care with and without ascorbic acid or Vitamin C (Vit. C). Participants measured leukocyte levels on the first and fifth days.
Result: The mean age of the participants was 32.08 ± 17.78 years, of which most of the participants were men (59.38%) with an average age of 35.21 ± 13.45 years, while the average age in women was 27.51 ± 22.52 years old. The mean TBSA of participants was 34.20 ± 21.21%, of which the mean TBSA for males was 39.45 ± 20.01% and for females 26.54 ± 21.32%. The mean participant leukocyte value on the first day was 21.49 ± 9.55 × 103/µL and on the fifth day, it was 11.26 ± 3.86 × 103/µL (z = -4.507; p <0.001). There was a significant difference in the leukocyte participant values on days 1 and 5 of -10.23 ± 9.77 × 103/µL (t = -2.504; p = 0.018).
Conclusion: Use of Vit. C in the management of burn injury has been shown to significantly reduce the number of leukocytes on the fifth day and reduce the risk of sepsis and mortality.
Risk factors for increasing leprosy treatment dropout cases reported in specific areas in Tangerang District
Authors: Sity Kunarisasi  , Jatty Puspaningtias  , Farah Segeir
Published: May 2024

Link of Video Abstract: https://youtu.be/WPu8KQqNFNM
 
Introduction: In 2020, Indonesia announced the elimination of leprosy in the whole country, including the Banten Province, with new cases detected 568 cases (4.8 per 100,000 population), higher than the national average of 4.12 per 100,000 population. Although information on the percentage of dropouts in Indonesia is not known, it still occurs in the field, If the case is cleared out unchecked, it will become a source of transmission of wellbeing problems in the community. This study aims to determine the influence of socio-demographic factors, leprosy patients, and health services on leprosy dropout rates and detect new cases in the Panongan Community Health Center working area.
Methods:  Secondary data on leprosy patients at the Panongan Community Health Center during 2019-2022 and primary data from cross-sectional surveys through home visits, interviews, face-to-face, and screening. Screening for leprosy symptoms in close contact with the patient's family using a questionnaire that includes independent variables of socio-demographic, patient, and health center with the dependent variable of treatment dropout. Purposive sampling technique in 5 villages with leprosy cases. The total sample size was 79 people. Data were processed and analyzed using STATA 14.0.
Results: The logistic regression test was found to be significant (p-value < 0.05) including age, (p=0.003), occupation (p=0.002), stigma (p=0.001), family of leprosy patients (p=0.003), close contact (p=0,000), healthy eating habits (p=0.002),  perception of taking medicine (p=0.000) and a woman, 60 years old, was found to be infected with leprosy within the family of a drug withdrawal patient who was in near contact for 1 year, although multivariate testing was not statistically significant (p-value: > 0.05).
Conclusion: Increasing compliance through health education and motivation of patients and families, also monitoring medication taking by health service staff, groups of former patients, and cadres.
Pregnancy with uterine didelphys and history of recurrent pregnancy loss: Case report
Authors: Pratama Dito Oktawijaya , Wicaksono Budi
Published: May 2024

Link of Video Abstract: https://youtu.be/H7Y7XoPOUAw
 
Background: Uterine didelphys is an embryologic disorder that arises from the failure of Mullerian duct fusion. It is characterized by the presence of two distinct cervices, two vaginas, and two uterine horns. Obstetric complications may arise during pregnancy when uterine didelphys is present; these may include spontaneous abortion, premature labour, and fetal malpresentation. 
Case Presentation: A 25-year-old woman has been married for three years and had history of six gravid, zero parity, and five abortion. The patient had uterine didelphys. A fully septated uterus with double cervices and vaginas was found on pelvic magnetic resonance imaging. The patient arrived at the hospital at 27/28 weeks. Periodic sonograms demonstrated breech presentation and no (Intrauterine Growth Restriction) IUGR evidence. At 38/39 weeks, the patient was scheduled for cesarean surgery. Uterine didelphys morphology, pregnancy on the left side of the uterus, and the septum separating the left and right uterine cavities were all observed during the caesarean section. The newborn had three umbilical cords wrapped around his neck. The infant was female, 2800 grams, 48 cm, Apgar score 7-8, Ballard score (BS) 38 weeks, Lubchenco score (LS) p25-50. 
Conclusion: Antenatal care is required for investigating risks of uterine didelphys, including cervical incompetence, spontaneous abortion, and preterm birth, using serial sonograms to assess fetal well-being and cervical length.
Analysis of eosinophil count as a predictor of Acute Lymphoblastic Leukemia (ALL)
Authors: Nurue Nefie Ilona , Muhadi Darwati , Arif Mansyur
Published: May 2024

Background: Acute lymphoblastic leukemia (ALL) is a malignancy of blood cells in many children. Predicting the severity of ALL is important for treatment. An easy and cheap marker is eosinophil count. This study aims to analyze eosinophil count as a predictor of ALL severity.
Methods: Retrospective study using medical record data of 76 ALL patients from January 2020 to September 2021 was conducted at RSUP Dr. Wahidin Sudirohusodo Hospital. Patients are classified as ALL remission and relapses. Eosinophil Count based on routine blood test results using Sysmex XN-1000. Statistical Test using Kolmogorov-Smirnov test to assess data normality, Mann-Whitney test, eosinophil count diagnostic values analyzed with ROC curve to assess AUC and determination of cut-off value. The test results are significant if p<0.05.
Results: The sample consisted of 59 ALL remissions and 17 ALL relapses. The mean eosinophil was found to be significantly lower in the relapse patient (0.19) than in the Remission patient (0.47) (p<0.05). Based on the ROC curve, the value AUC = 0.660 and significant (p<0.05). This shows that the cut-off value of eosinophil count can be used as a prognostic value for the status of ALL patients. ROC curve shows the sensitivity and specificity of the eosinophil count is 70.6% and 54.2% at a cut-off of 0.15.
Conclusion: Eosinophil Count can be used as a prognostic value for the status of ALL patients with a cut-off value of 0.15. The eosinophil count was lower in the relapse patients than in the remission patients.
The impact of formula-fed feeding in comparison with breastfeeding to the infant’s intestinal microbiota: a literature review
Authors: Andri Adrianus
Published: May 2024

Child health outcomes are related to the mother's nutrition during pregnancy and the baby's diet throughout infancy. The child's intestinal microbiome is the main source of postnatal immunological activation, which is linked to both health and disease in children. Nursing exclusively is advised for the first six months of a baby's life; otherwise, dairy-based infant formula is a supplement to breastfeeding. Numerous studies have shown that breastfed newborns have a different makeup of gut flora compared to infants fed formula. To highlight the important differences between human milk and infant formula in the development of the early intestinal microbiota and immune system, this study attempts to ignore any plausible explanations for some of the risks and benefits associated with human milk and infant formula. The approach was a literature review. A comprehensive search was done on the Pubmed Central® search engine. Using the Boolean operators "AND" and "OR," the search terms used are "breastfeeding," "formula," "microbiota," "intestinal," "human milk," and "infant." Among all the publications purchased, articles comprising various types of studies relevant to the literature review topic were picked. Breastfeeding is the preferred baby-feeding strategy. If exclusive breastfeeding is not preferred, infant formula prepared from cow's milk should be altered to promote the development of the infant's gut flora. Formulations could be modified by adding probiotic or prebiotic oligosaccharide agents.
Characteristics of pregnancy with placenta previa in Prof. Dr. I. G. N. G. Ngoerah General Hospital, Bali, in 2017
Authors: Jaya Kusuma Anak Agung  Ngurah
Published: May 2024

Introduction: Cesarean sections (CS) are rising annually worldwide. Globally, based on data from 121 countries, from 1990-2014, the number of CS increased by 12.4%, with an average increase of 4.4% per year. The high rate of CS increases the risk of complications in subsequent pregnancies, including placenta previa. In a study conducted in England with nearly 400,000 women with a second pregnancy, the incidence rate of placenta previa was 8.7 in 1000 births in women with previous CS history and about 4.4 in 1000 births in women with previous vaginal delivery. This study aimed to determine pregnancy characteristics with placenta previa at Prof. Dr. I. G. N. G. Ngoerah General Hospital in 2017.
Methods: This study is a cross-sectional study with a retrospective descriptive approach using medical records of patients admitted from 1st January-31st December 207. This research was conducted at Prof. I. G. N. G. Ngoerah General Hospital, Bali, from February 1 to April 1, 2018. All data from medical records were collected and processed to describe pregnancy characteristics with placenta previa.
Results: There were 49 (4.89%) cases of placenta previa from 1001 deliveries in 2017. This number was higher than the placenta previa case in other countries, around 0.3-0.5%. There were 2 cases excluded, and 47 cases were processed for data presentation. Pregnancy characteristics that dominated placenta previa cases in this research were aged 30-34 years old, second to third pregnancy, age of gestation ≥ 37 weeks, no history of vaginal bleeding, no history of curettage, and no history of CS
Conclusion: The characteristics of pregnancy in this study which dominated placenta previa cases were aged 30-34 years old, second to third pregnancy, age of gestation ≥ 37 weeks, no history of vaginal bleeding, no history of curettage, and no history of CS Further investigation is required.
The urgency of arrangement legal facilities for health workers in public health emergency
Authors: Parwati Ni Made , Rwa Jayantiari I Gusti Agung Mas , Purwani Sagung Putri M.E , Kuswardhani RA Tuty
Published: May 2024

Background: The public health crisis that all countries around the world have experienced is the corona virus disease 2019 (COVID-19) pandemic. The COVID-19 pandemic exposed strengths and weaknesses in many legal frameworks. A public health emergency (PHE) is carried out quickly by health workers to save lives. This study intends to analyze legal certainty in adequate norms in the Health Law to fill the void in norms regarding guarantees of legal protection and access to government legal facilities for health workers related to PHE.
Methods: Using normative legal research methods with a statutory approach (statue approach) and a conceptual approach towards PHE.
Results:  The results of this study indicate that the Health Law only regulates legal protection guarantees in general and does not regulate in detail the legal facilities that can be accessed by health workers when dealing with legal cases, so this will result in non-optimal legal protection guarantees.
Conclusion: In formulating future policies to help health workers resolve legal issues in PHE, the government must be able to develop provisions by adapting and adopting the guidelines of the International Federation of Red Cross and Red Crescent Societies for future legal framework readiness in public health emergencies and preparing institutions lawfully appointed to accommodate the government's responsibility for legal certainty for health workers. Keywords: legal facilities, public health emergencies, health workers
The potential of plant extracts containing flavonoids as anti-hyperlipidemia: A literature review
Authors: Lukas Lisye Marrilyn
Published: May 2024

One of the risk factors that cause cardiovascular disease is hyperlipidemia. Hyperlipidemia is a condition of increased plasma fat levels consisting of increased cholesterol, triglycerides and LDL levels and decreased HDL levels. The existence of side effects on the body from antihyperlipidemic drug treatment makes herbal medicine one of the alternatives chosen as a treatment for hyperlipidemic patients. Antihyperlipidemic activity testing was carried out on various herbal plants that contain antioxidants. There are 6 types of plant extracts with activity test results that have potential as antihyperlipidemic. The literature study used a search method on the internet related to the keyword "Plants that contain flavonoid compounds and have the potential as antihyperlipidemic" on the Google Scholar page. Primary data is obtained with sources of research results that have been published in national and international journals. The result of our literature review shows that plants that have flavonoids have the potential for antihyperlipidemic. More investigation is required to determine what kind of plants, dose and side effects can improve the herb plants as a substitute for anti-hyperlipidemia treatment
The efficacy of pumpkin (Cucurbita sp.) on inflammaging
Authors: Novianri Citra , Wahyuniari Ida Ayu Ika
Published: May 2024

The aging process can be delayed by antioxidant supplements such as pumpkin. It is useful for reducing oxidative stress, inflammation, and cellular aging so that older people will be fitter and happier. This literature review will investigate the effect of pumpkins on inflammaging. Google Scholar, Researchgate, and Mendeley were used as the search engine. The keywords were pumpkin & inflammaging. The effect of pumpkin on geriatric beta-endorphin was analyzed from fourteen articles. Body homeostasis, organ systems, and other changes will reduce the functional capacity from the cellular to the individual level in the inflammaging process. To delay the physiological process of aging, pumpkin has the potential to improve the cognitive, endocrine, musculoskeletal, cardiovascular, and immunological organ systems. The inflammaging can be improved by the effect of pumpkin for a better quality of the aging process.
Patterns of germs before, during and after the COVID-19 pandemic in Intensive Care Unit (ICU) patients at Dr. Wahidin Sudirohusodo, Makassar, Indonesia
Authors: Mustamsil  , Handayani Irda , Kadir Nursin Abdul
Published: May 2024

Background: The intensive care unit (ICU) is a unit that cares for patients with a high risk of infection, while viral infections are one of the predisposing factors for someone being easily infected with bacteria. This research aims to see a picture of germ patterns before, during and after the COVID-19 pandemic.
Methods: This research is descriptive with a retrospective approach. The research sample used secondary data from microbial culture results of clinical specimens (blood, sputum, pus, urine, etc.) from ICU patients for the period 2019-2022 at the Clinical Pathology Laboratory of Dr. Wahidin Sudirohusodo Hospital, Makassar. Data is grouped into Gram-positive and Gram-negative bacteria, based on the highest order, and presented as tables and graphs.
Results: There were 440 isolates, 80 Gram-positive isolates (18%) and 360 Gram-negative isolates (82%). The five most common types of isolates were dominated by the Gram-negative group in the last 4 years, respectively: Burkholderia cepacia 92 (21%), Acinetobacter baumannii 89 (20%), Klebsiella pneumoniae ss. pneumoniae 58 (13%), Pseudomonas aeruginosa 37 (8%), Escherichia coli 37 (8%), and Staphylococcus aureus ss. aureus was the 6th most common, with 20 (5%) isolates. The majority of isolates identified were obtained from blood, as many as 192 (44%), sputum 136 (31%), pus 52 (12%) and urine 8 (2%). Bacteremia was the largest cause of infection by Burkholderia cepacia, 91 (47%), while sputum was dominated by Acinetobacter baumannii 49 (26%).
Conclusion: The germ pattern in the ICU before, during, and after Gram-negative bacteria dominated the COVID-19 pandemic. Bacteremia is the largest proportion of causes of infection.
Nutritional status of digestive surgery treated in Wahidin Sudirohusodo Hospital, Makassar
Authors: Warsinggih Warsinggih , Faruk Muhammad , Sinangka A. Arief Munandar , Abdi Amirullah , Shanaya Shandy , Mayidah Maryam , Mangiwa Ingrid Gloria , Munaqisah Munaqisah , Buana Desi Vera
Published: May 2024

Introduction: One way to assess nutritional status is to use a more comprehensive subjective global assessment (SGA) format and a structured clinical approach that reflects metabolic and functional changes. Knowing the nutritional status of patients with digestive surgery is essential for comprehensive patient therapy. In this study, we used the SGA assessment to compare the nutritional status of digestive surgery patients treated at the admission and discharge time.
Methods: This research is an observational analytic study with a cross-sectional research design. The population of this study was digestive surgery patients at Dr. Wahidin Sudirohusodo Hospital for the period August-September 2022. Univariate analysis and Wilcoxon test were carried out to compare the nutritional status outcomes at admission and discharge in digestive surgery patients at our institution.
Results: It was found that 101 patients were mainly in the old adult age group (40-59 years) of 46 patients, most of whom were male, the most diagnosed with colorectal cancer, and 81 patients were sent home. Based on SGA at discharge, the most were SGA B with 46 patients, SGA C with 30 patients, and SGA A with 25 patients. The Wilcoxon statistical test was carried out, and statistically, there was no significant difference between the nutritional status at admission and discharge (p=0.162).
Conclusion: Malnutrition or nutritional risk was present in a large percentage of hospitalized patients upon admission. These patients' nutritional risk and status remained low upon discharge, highlighting the need for follow-up monitoring and the application of suitable nutrition interventions to enhance patients' quality of life and long-term health outcomes. In general, there was no statistically significant difference between nutritional status assessed by SGA at the time of admission and discharge from the hospital.
Magnetic Resonance Imaging Features of Spinal Tumor: A Case Series
Authors: Nugraha Wilson , Widhi Asih Made , Anandasari Pande Putu Yuli
Published: May 2024

Background: Spinal tumors are one of the rarest tumors from the Central Nervous System. The location is essential in determining the differential diagnosis of a spinal tumor. MRI plays a central role in the imaging of spinal tumors and makes it easier to classify spinal tumors as extradural, intradural-extramedullary, or intramedullary. Thus, in this study, we provided several cases that had spinal tumor and MRI role in diagnosing the disease
Case Description: This study had four cases with similar chief complaints of weakness in the lower extremity. The first case was a woman, 42 years old, with lower limb weakness for four years, without a history of trauma. The second case was a woman 26 years old with a chief complaint of weakness in her right leg over two years and a history of trauma. The third case was a man, 41 years old, with lower back pain and weakness in both of his legs since two years ago. The last case was a man, 51 years old, with lower limb weakness since eight days ago without a history of trauma. According to the physical examination of all of the patient, there was a decrease in motor strength in their lower limb, followed by sensory problems from hypoesthesia, paresthesia, anesthesia, and numbness. All of the cases underwent the Spine MRI examination. We found a solid mass in extra and intra-medullary that cause compressions to the spinal cord the spinal canal.
Conclusion: In spinal tumours, a radiology examination is crucial in determining the mass's location, size, and extent. MRI is the best imaging modality because it can identify and localise tumours and classify spinal tumours as extradural, intradural-extramedullary, or intramedullary, thereby narrowing the differential diagnosis.
A patient with suspect of Fahr syndrome caused by secondary hypoparathyroid after total thyroidectomy
Authors: Widiada Putu Amanda , Saraswati Made Ratna
Published: May 2024

Background: Hypoparathyroid is an endocrine disorder that is characterized by hypocalcemia and hyperphosphatemia due to insufficient secretion of parathyroid hormone. Mostly, this disease is secondary caused by neck surgery and it is responsible for almost all cases of hypoparathyroid. Parathyroid hormones responsibles for maintaining homeostasis of calcium. Fahr syndrome is a neurodegenerative disorder characterized by bilateral basal ganglia calcification that is caused by endocrine disorder such as hypoparathyroid.
Case Presentation: In this case report, we reported a 70 years old woman with secondary hypoparathyroidism presenting with Fahr's syndrome after total thyroidectomy. Besides hypocalcemia and hyperphosphatemia as signs of secondary hypoparathyroidism, specific clinical signs with Fahr's syndrome in this case is presence of multiple calcifications in several parts of the brain and specifically in the bilateral of basal ganglia. Management of this disease mainly focused on supplementation of calcium and vitamin D.
Conclusion: Fahr syndrome is a rare, genetically dominant, inherited neurological disorder that should be considered as the main problem in several patients with post total thyroidectomy.
Kawasaki disease in an infant: a case report
Authors: Norberta Jesslyn , Muhammad Ali  , Chandra King
Published: May 2024

Background: Kawasaki disease is an acute systemic vasculitis of childhood, with a predilection of the main coronary artery. This disease is the most frequent cause of acquired heart disease in developed countries. This report is aimed to describe the diagnosis and treatment of Kawasaki disease in an infant.
Case description: A 4-month-old boy came to the emergency room on November 21, 2021, with a chief complaint of high fever for three days. His appetite has decreased since he got sick. Other complaints, such as red eyes, red lips and red rashes overall his body, occurred two days before the admission. Physical examination: the child's nutritional status was good, with bilateral non-purulent conjunctivitis, erythema and cracked lips, and polymorphous rash on the body, back, and legs. We found enlarged cervical lymph nodes and reactivation of Bacillus Calmette-Guerin (BCG) scars. The laboratory findings were as follows:  HGB  10.6gr/dL, WBC 11.570/µL, PLT 335.000/µL, CRP 84mg/dL, Antigen NS-1 dengue test negative, and SARS-COV2 Antigen test negative. The echocardiography results were minimal pericardial effusion and normal coronary size. With a Harada score of 4, he was diagnosed with Kawasaki disease. Management of the patient includes breastfeeding, infusion of dextrose 5% with sodium chloride (Na Cl) 0.22%, Paracetamol infusion, Intravenous Immunoglobulin (IVIg) single dose, and Acetylsalicylic acid orally. After being discharged from the hospital, he was advised to control his condition routinely to a pediatrician.
Conclusion: Kawasaki disease has been reported in a 4-month-old boy with typical clinical manifestations and successfully treated with good results.
A rare case report: compartment syndrome after brachiocephalic arteriovenous fistula formation in a hemodialysis patient
Authors: Aksar Syahrun Mubarak , Usman Umar
Published: May 2024

Introduction: Acute compartment syndrome is a condition in which increased pressure in the tight fascia space reduces capillary perfusion below the level required for tissue viability. Very few cases of acute compartment syndrome associated with dialysis have been reported. It can lead to severe damage to the tissues of the arm.
Case Illustration: A 47-year-old woman with end-stage renal failure presented to the emergency room with swelling and pain in the right upper extremity and has lasted for a day. Three days before admission, the patient underwent right brachiocephalic arteriovenous (AV) fistula surgery. Physical Examination showed a blackish bruise at the fossa cubiti, radial and ulnar artery were not palpable, but there is trill at AV fistula. Decreased motoric strength, reduced hand sensation and decreased capillary return in fingers. Oxygen blood saturation of the right fingers could not be read. Diagnosis of acute compartment syndrome was made. The patient was immediately taken to the operating room for decompression surgery. Emergency compartment fasciotomy was performed. After fasciotomy, necrotomy was performed. Furthermore, brachiocephalic AV fistula was ligated. Postoperative evaluation obtained good radial and ulnar artery. Six months after the surgery, the wound was fully healed and no sign of neuromuscular or vascular deficit.
Conclusion: Compartment syndrome is a possible complication after AV fistula formation that can have disastrous consequences. However, it can be effectively treated if detected and treated early. Prognosis of compartment syndrome after fasciotomy depends on how quickly the condition is diagnosed and treated.