bluuebunny/crossref_metadata_2025 huggingface dataset:
The effectiveness of Barbagli technique compared to Kulkarni technique for urethral strictures: a systematic review and meta-analysis
Authors: Ishaq Muhammad Rozaqy , Yogiswara Niwanda , Rahman Ilham Akbar , Febriansyah Nafis Audrey , Renaldo Johan , Wirjopranoto Soetojo
Published: May 2024

Introduction: Urethroplasty is one of the management of urethral stricture. Various studies reported that urethroplasty procedures have a higher long-term success rate than urethrotomy for treating urethral stricture. We aim to compare the efficacy and safety of urethroplasty using the Barbagli and Kulkarni approaches.
Materials and Methods: This systematic review and meta-analysis were performed in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We systematically searched for relevant articles through several databases. The outcomes evaluated in this study were success rate, mean operative time, and complication rate. Outcomes with dichotomous data were analyzed using odds ratio (OR). Continuous data will be analyzed using mean difference (MD) and standard deviation (SD). Statistical analysis using RevMan 5.4 for Windows.
Results: Three studies were evaluated involving 272 urethral stricture patients. Urethroplasty procedure using the Barbagli technique had a success rate that was not significantly different from that of the Kulkarni technique (OR 0.55, 95% CI 0.28-1.08, p = 0.08). The Barbagli technique had a significantly longer duration of operation (MD 10.34, 95% CI 3.83-16.85, p = 0.002). The incidence of surgical wound infection was not significantly different in both groups (OR 2.13, 95% CI 0.46-9.83, p = 0.33). There was no significant difference in overall complication rates between patients undergoing urethroplasty using the Barbagli and Kulkarni technique (OR 1.52, 95% CI 0.42-5.55, p = 0.52).
Conclusion: This SRMA found that the success rate in the Barbagli technique urethroplasty procedure was not significantly different from the Kulkarni technique. However, the operation duration was significantly longer in the Barbagli technique. Complication rates were minimal in both groups.
The validity and reliability of various footprint analysis in flatfoot diagnosis of competitive athletes
Authors: Juniartha I Putu , Tinduh Damayanti , Nugraheni Nuniek , Pawana I Putu Alit , Setiawati Rosy , Melaniani Soenarnatalina
Published: May 2024

Background: Foot morphology is an essential intrinsic factor in athlete performance. Therefore, abnormality of the foot morphology, such as flatfoot, can affect the foot biomechanics, reduce motor performance, and increase the risk of injury. Assessment of flatfoot in the competitive athlete is essential to decide on the appropriate management; however, the imaging evaluation method needs special equipment and experience. Footprint analysis using Clarke's angle (CA), Chippaux Smirak Index (CSI), and Staheli Index (SI) offers a cheaper, faster, more effective, and easier method for flatfoot diagnosis. This study aims to determine the validity and reliability of various footprint analysis with calcaneal inclination angle (CIA) from the radiographic image as the standard examination.
Method: This is an analytic observational study with a retrospective cohort design. The data of CIA, CA, CSI, and SI were collected from 70 athletes' medical records from 6 different sports that met inclusion criteria. The validity, reliability, diagnostic performance, and determination of the cut-off point were performed.
Results: The correlation test and intraclass correlation coefficient showed that CSI and SI were valid and reliable in diagnosing flatfoot, while CA was invalid but reliable in diagnosing flatfoot. Area under the curve of the ROC curve and the cut–off point of CA were 0.427 (p=0.403) and 39.32o; CSI was 0.446 (p=0.537) and 33.58; and SI was 0.418 (p=0.347) and 73.59, respectively. The sensitivity and specificity of CA were 26.78% and 100%; CSI was 10.71% and 100%; and SI was 78.57% and 78.57%, respectively.
Conclusion: Footprint analysis using CA is not valid but reliable in diagnosing flatfoot, while CSI and SI are valid and reliable in diagnosing flatfoot. The Staheli Index has the best diagnostic performance compared to others.
Norepinephrine modified the interaction between Escherichia coli and levofloxacin, potentially affecting clinical outcomes and increasing the risk of bacterial colonization
Authors: Thayyiba Amina , Wasito Eddy Bagus , Alimsardjono Lindawati
Published: May 2024

Background: Norepinephrine is the most used vasopressor in intensive care units. It can modulate gene expressions and metabolism pathways in Escherichia coli. As fluoroquinolone’s bactericidal activity is affected by bacterial metabolism and growth rate, simultaneous exposure to these medications might alter the interaction between E. coli and levofloxacin. This study aims to investigate the effect of norepinephrine and levofloxacin given simultaneously on the in vitro growth of E. coli.
Methods: Ten clinical isolates of E. coli were grown in minimal nutrition media with and without norepinephrine, levofloxacin, or both. Bacterial growth was observed for 20 h, and viable cell count was done every 2 h. Growth curves and generation times for each study group were calculated. Statistical analysis compared the viable cell counts on the 4, 14, and 20 h observation time points and the generation times.
Results: Temporary inhibition of E. coli growth was observed until 4h of incubation when therapeutic concentrations of norepinephrine and levofloxacin were given simultaneously, followed by regrowth. The viable cell count of the norepinephrine–levofloxacin group was significantly lower than the control group by the 14 h and 20 h time points. Interestingly, the study group's average generation time of regrowth was 19.3 min, which was significantly faster than the control group (p < 0.05).
Conclusion: Norepinephrine caused alterations in the interaction between E. coli and levofloxacin, which may affect clinical outcomes and increase the risk of bacterial colonization in patients receiving simultaneous norepinephrine and levofloxacin therapy.
Septorhinoplasty in an Asian-Caucasian pediatric patient with neglected nasal deviation from previous traumatic injury: a case report
Authors: Nataatmadja Beta Subakti , Lumintang Loelita Marcelia , Widiartha Nyoman Bayu , Yasa Nyoman Wawan Tirtha , Suriana Sang Nyoman
Published: May 2024

Background: Numerous studies present evidence of the association between nasal-septal deviation and impaired breathing that led to a multisystem disorder, nasal-midface growth alteration, and gets worse with facial growth. However, the extent of the traumatic septal injury is often neglected. Here, we summarized the clinical experience in treating a pediatric patient with those problems.
Case Presentation: A case of a 10-year-old girl with type C-IIB nasal deviation and type IVb septal deviation with left obstructive nasal breathing and snoring is presented. A nasal injury history at the age of four was reported. She had divergent dorsal lines, hump irregularity, lower lateral cartilage (LLC), columella/septum deviation, drooping-indented-boarded tip, asymmetrical nostrils, and internal valve incompetence. We conducted corrections on nasal bones by bilateral osteotomies, c-shaped anteroposterior caudal septum by scorings, mattress suture techniques and batten grafts, upper lateral cartilage by dorsal septal manipulation, tip/columella by LLC manipulation, dorsal long spreader graft, columellar strut grafts, and septum repositions. A crushed cartilage was placed on the hump. Improvements, complications, and patient satisfaction were documented. No complications were reported after the surgery. The patient was satisfied with the final result. Snoring and left nostril breathing obstructions no longer existed. Corrections on dorsal, columella and septal deviation, hump, nasal tip shape and projection, and asymmetrical nostril were observed.
Conclusion: Septorhinoplasty's philosophy on pediatric patients highlighted the importance of weighing its risks. Findings suggest studies of the pediatric anatomy and surgical technique to minimize the risks. Thorough observation is also advised until the cessation of facial growth.
Association between polymorphism loci rs7041, rs4588 in vitamin D-binding protein receptor gene with comorbid with mortality sepsis patients in intensive care unit General Hospital M. Djamil Padang, West Sumatra
Authors: Ananta Kahar Liliriawati , Yusrawati  , Jamsari  , Tinni Maskoen  , Delmi Sulastri  , Yusticia Katar  , Raveinal  , Fika Tri Anggraini  , Kornelis Aribowo  , Wiwi Monika Sari
Published: May 2024

Background: Many factors influence the disease, one of which is comorbidity. Comorbid is a condition in which a person simultaneously suffers from two or more diseases. The disease is generally chronic. Patients with comorbid diseases are more at risk of experiencing increased healthcare costs, experiencing obstacles in the healing process, and even death. Loci rs7041 and rs4588 polymorphism of VDBP receptor gene contributed to the pathogenesis of sepsis patients. According to several previous studies, Vitamin D levels and comorbidities affected the mortality of sepsis patients. Several previous studies had linked VDBP with mortality in sepsis. This study aimed to determine the relationship between the loci rs7041 and rs4588 polymorphism and comorbidities with the mortality of sepsis patients.
Method: This research was a descriptive observational study with a prospective cohort design. The total data for this study were 80 samples, consisting of 40 samples of Vitamin D deficiency and 40 samples of non- deficiency Vitamin D. Data were analyzed using the Chi-Square test or the fisher test.
Result: The average age of patients with vitamin D deficiency was 56 years, for females (77,5%), mean APACE II score (20), and mean SOFA score (7). Non-deficient vitamin D with an average age of 50 years, males (70,0%), mean APACE II score (18) and mean SOFA score (5). Diabetes mellitus was the highest comorbidities in rs7041 locus polymorphism (80,0%), underweight in rs4588 locus polymorphism (66,7%) and obesity for non-survival events (64,3%). There was no significant association between comorbidities and rs7041 locus polymorphism, rs4588 locus polymorphism and severity sepsis patients with pValue > 0,05.
Conclusion: Obesity is the highest comorbid for mortality in sepsis patients, but loci rs7041 and rs4588 polymorphisms have no relation to comorbidities.
Correlation between the number of Interstitial cells of Cajal (ICC) and defecation pattern in patients with Hirschsprung's disease after Duhamel's surgery at General Hospital Dr. Soetomo
Authors: Honggowarsito Yohanes Santosa , Hariastawa Adria , Matulatan Fendy , Rahniayu Alphania
Published: May 2024

Background: Hirschsprung is a congenital disorder of the distal bowel caused by the absence of a ganglion in the Aurbach and Meissner plexuses. Definitive treatment of the disorder is operative, namely by resection of the aganglionic segment of the intestine and performing a pull-through on the ganglionic segment. It cannot be denied that there are still disturbances in the pattern of defecation after definitive surgery, even though the pull-through segment has enough ganglion cells. Interstitial cells of Cajal (ICC) are the pacemaker in smooth muscle contraction in the intestine. In several studies, the number of these cells decreased in Hirschsprung's disease (HD), and it is not known with certainty the effect on the occurrence of defecation pattern disturbances.
Methods: Data were collected retrospectively from all patients with Hirschsprung’s Disease (HD) who underwent Duhamel Procedure in Dr. Soetomo General Hospital, starting January 2016 – December 2021. Correlation analytic research with a cross sectional design was performed to analyze the correlation between the number of ICC and the defecation pattern of patients at Dr. Soetomo after Duhamel surgery.
Results: From this study, it was found a decrease in the number of ICC in the ganglionic segments of the resected specimens from pull-through surgery. From the results of the correlation test, it was found that the p-value was 0.49 for the defecation pattern of postoperative Duhamel patients at Dr. Soetomo for the period January 2016 – December 2021.
Conclusion: In this study, a significant correlation was found between the number of ICC and definitive pull-through postoperative defecation pattern.
The compliance of Pasar Raya Padang merchants in implementing health protocol
Authors: Sri Siswati  , Vebi Adiva  , Ahmad Hidayat
Published: May 2024

Introduction: COVID-19 cases in Indonesia continue to grow, including in Padang, 48% of the largest contributors to cases in West Sumatra. The distribution cluster occurs in the economic center of Pasar Raya market Padang. Traders are very at risk of contracting COVID-19 because of the dense market activity and interaction between sellers and buyers. The first survey by the COVID-19 Task Force showed that 40% were reprimanded for not implementing health protocols. This study aims to determine the factors related to the compliance of Pasar Raya Padang traders in implementing health protocols.
Methods: The type of research conducted is analytical with a quantitative approach to prove the existence of a statistical correlation between the variables studied. The total sample in this study amounted to 103 respondents. The sampling techniques used in this study are a proportional random sampling.
Results: 103 respondents showed that most respondents were female 52.4%. Respondents were dominated by the elderly age group aged 45 years 39.8%, 26-45 years were 31.1% and the young group 29.1 %. Variable dependent obedience 53.4% or 55 people. Independent variables, knowledge, attitude, and environment. Respondents have high knowledge 60.2%, positive attitude 51.8% and a supportive social environment 53.4%. Bivariate analysis showed a significant relationship between knowledge, attitude, and environment with compliance with health protocols. Based on qualitative results, the inconvenience of wearing a mask is the main priority of the obstacles found.
Conclusion: There is a significant relationship between knowledge, attitude, and environment with compliance with health protocols. Education about implementing health protocols and the vulnerability of traders to COVID-19 infection, as well as strict monitoring of effectiveness to improve merchant compliance with health protocols.
Development of social skill training design for preschool in social distancing pandemic COVID-19
Authors: Machmudah  , Sa’dun Akbar  , Nur Eva  , Ika Andrini Farida  , Fifi Khoirul Fitriyah  , Siti Nurjanah  , Nafi’ah
Published: May 2024

Introduction: The low level of social skills during the social distancing period triggers high levels of aggression in children. Teachers and parents find teaching difficult because of their limited knowledge and the pandemic situation. Therefore, teachers and parents must be trained to develop children's social skills proportionally. Training children's social skills should be done face-to-face because it is related to the ability to modify behaviour. Of course, this cannot be done, so it is necessary to design training designs in such a way as to deliver digital-based learning, namely virtual learning. This research aims to develop a social skills training design for preschools during the social distancing pandemic of COVID-19.
Methods: The research method using Research and Development (R&D) refers to the ADDIE research development model: analysis, design, development, implementation, and evaluation, which aims to produce an effective training design to develop early childhood social skills for teachers and parents through digital-based learning, namely virtual learning.
Results: The design has been tested and validated by 3 experts; experts in the field of character education, linguists, and experts in educational technology both quantitatively and qualitatively and has met the acceptability criteria. Therefore, design training has proved effective in improving the competence of teachers and parents in developing the social skills of children ages early during social distancing. These results can be seen from the activities of the trainers and trainees on the implementation of the training in the very good category, said to be practically based on the positive responses of the trainees (teachers and parents) in the very good category, can increase the knowledge and competence of participants based on the results of the learning evaluation.
Conclusion: The design training has proved effective in improving the competence of teachers and parents in developing the social skills of children ages early during social distancing.
Administration of mesenchymal stem cell derivate secretome causes lower levels of Matrix Metalloproteinase-13, Aggrecanase-2, and Interleukin-1β than hyaluronic acid in rabbit knee osteoarthritis
Authors: Dharmayuda Cokorda Gde Oka , Kawiyana I Ketut Siki , Bakta I Made , Astawa I Nyoman Mantik , Astawa Putu , Manuaba Ida Bagus Putra , Suyasa I Ketut , Subawa Anak Agung Ngurah , Suroto Heri , Maker Luh Putu Lin Indrayani
Published: May 2024

Link of Video Abstract: https://youtu.be/XrtI29YbnTs
 
Background: Osteoarthritis (OA) is the most common form of arthritis, which cause pain and disability that can affect the quality of life. The inflammation in OA is chronic and characterized by the infiltration of immune cells and the secretion of cytokines. Previous OA treatment used hyaluronic acid intraarticular injection, but several studies show no satisfactory clinical outcome. This study aims to determine and compare the anti-inflammatory and anti-catabolism effects of stem cell-derived secretomes versus hyaluronic acid as the gold standard for the treatment of OA.
Methods: This research was conducted using an experimental randomized post-test-only control group design. According to veterinarians, the population in this study were local rabbits, aged 6-8 months, weighing > 1,500 grams, and healthy. Data were analyzed using SPSS version 22.0 for Windows.
Results: Twenty-two subjects were included in each treatment and control group. From the descriptive analysis, it was found that MMP-13 levels were 7.55 ± 0.23 (Treatment) (ng/mL) and 8.36 ± 1.04 (Control) (ng/mL), ADAMTS-5 levels were 0.83 ± 0.08 (Treatment) (ng/mL) and 1.14 ± 0.33 (Control) (ng/mL), and levels of IL-1β 23.0 5± 2.48 (Treatment) (ng/mL) and 26.81 ± 5.57 (Control) (ng/mL). From the inferential test, it was found that all research results were statistically significant (MMP-13= 0.81; p = 0.021; 95%CI = -1.48 – (-0.13)) (Agrekanase 2 = 0.32; p = 0.006; 95% CI = -0.53 – (-0.09)) (IL-1β = 3.76; p = 0.023; 95% CI = -7.59 – (-0.08)).
Conclusion: Administration of mesenchymal stem cell-derived secretomes resulted in significantly lower levels of MMP-13, Agrekanase 2, and IL-1β compared to administration of hyaluronic acid in rabbit knee osteoarthritis
Relationship between age at repair surgery and growth and development of children with acyanotic congenital heart disease: a cross-sectional study
Authors: Nuralim Muhammad Zulfadli , Soebroto Heroe , Irwanto  , Puruhito Ito
Published: May 2024

Background: The survival of children with congenital heart disease (CHD) has increased drastically in the last few decades. However, in children with the acyanotic type of CHD, it is often accompanied by symptoms of failure to thrive. This study aims to assess the correlation between age at repair surgery and the growth and development of children with acyanotic CHD.
Method: A cross-sectional study was conducted on eligible patients with acyanotic CHD who had undergone heart repair procedures. Age was taken when the patient was preoperatively repaired and categorized based on the age range of 3 months to 5 years. According to the WHO curve (weight/height), growth is assessed from nutritional status. Development was assessed from the category of height (cm) after surgery. Differences in growth and development before and after repair surgery were tested using the Wilcoxon method.
Results: Of the 40 samples analyzed, there were 20 males and 20 females, the majority aged 3-4 years (25%) followed by ages 2-3 years (10%). There was an effect of repair surgery on growth when surgery was performed at 2 to 3 years with a p-value of 0.016 (<0.05). In the development category, there was no effect of surgery on development in all age categories, with a p-value of 0.424 (>0.05).
Conclusion: Surgery at an early age has better growth outcomes, especially at 2-3 years, but is unrelated to developmental aspects.
Characteristic profiles of patients with diabetes mellitus and COVID-19 during the second epidemic wave in East Java, Indonesia: a retrospective study
Authors: Minanti Batari Retno , Soelistijo Soebagijo Adi , Pranoto Agung
Published: May 2024

Background: The transmissibility and severity of coronavirus disease 2019 (COVID-19) are higher in the delta variant (B.1.617.2) infection responsible for Indonesia's second epidemic wave. This study aimed to establish an epidemiological profile of COVID-19 in patients with diabetes mellitus, a comorbid that has been widely suggested for its association with increased severity and mortality.
Methods: This study employed a retrospective observation on medical records from May to December 2021. Patients (n=115) aged >18 presented with COVID-19 and diabetes mellitus were enrolled. The SARS-CoV-2 infection was confirmed by a pharyngeal swab sample's reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The diabetic condition was determined by previous medical records and persistent level of random blood sugar (RBS) of >200 mg/dL. Demographic, clinical characteristics, COVID-19 symptoms, radiological findings, and hematological and coagulopathy markers were collected from the medical records. The data were presented as frequency (%) assigned based on severity levels: mild, moderate, severe, and critical COVID-19.
Results: A group of patients aged 50—59 years had higher prevalence of severe COVID-19 (n=14; 28.6%) than the other groups. Severe cases were relatively more common in a group with body mass index (BMI) ranged from 30—<35 kg/m2 (n=13; 27.1%). Notably higher number of severe cases was recorded in patients having <3.5 mg/dL albumin (n=11 out of 50), >200 mg/dL RBS (n=22 out of 93), and ≥1 μg/mL D-dimer (n=18 out of 73). Critical COVID-19 cases were found in those with C-reactive protein levels of <5 mg/L (n=6; 6.8%) and procalcitonin levels of ≥0.05 ng/mL (n=6; 7.1%). Patients who had stage 1 and 3 chronic kidney disease (CKD) were found to develop critical COVID-19 with a frequency of 5.9% (n=2) and 10.5% (n=4), respectively.
Conclusion: The severity of COVID-19 in diabetic patients is indicatively associated with the age, BMI, hematological and coagulopathy markers, and CKD. Active monitoring of these parameters in diabetic COVID-19 patients is encouraged.
Clinical manifestations of allergic reactions and immunoglobulin E levels on allogeneic freeze-dried platelet-rich plasma (PRP) application
Authors: Bernadetta  , Hutagalung Magda Rosalina , Hariani Lynda
Published: May 2024

Link of Video Abstract: https://youtu.be/yS431sCL3VQ
Background: Several studies have reported that modern wound dressings offer better results. Allogeneic PRP products in the form of injections and gels are available in the market, which helps accelerate wound healing without triggering an immunological reaction. Meanwhile, this study was carried out to investigate the Allogeneic Freeze-Dried PRP form, which is more practical, efficient, and safer. This study aims to determine the effect of Allogeneic Freeze-Dried PRP on human split-thickness skin graft donor wounds on clinical manifestations of allergic reactions and levels of Immunoglobulin E (IgE).
Methods: A randomized Pre- and Post-test Control-Trial Group Design was conducted on patients with split-thickness skin graft donor wounds using Allogeneic Freeze-Dried PRP dressings at Dr. Soetomo General Hospital, Surabaya. Allergic manifestations were reviewed during the observation period of up to 4 days, and IgE levels were measured pre-test and 60 minutes post-application. A statistical comparison of results was carried out between the trial and control groups that used paraffin dressings.
Results: A total of 36 patients were used as subjects, with 19 (52.78%) in the trial group and 17 (47.22%) in the control group, and their parameters were generally homogeneous. There were no clinical manifestations of allergic, changes in vital signs, and significant differences in IgE levels before and after application statistically in all study subjects (p>0.05).
Conclusion: Application of Allogeneic Freeze-Dried PRP to human split-thickness skin graft donor wounds did not generate clinical manifestations of allergic reactions and an increase in IgE.
Regional recurrence of malignant peripheral nerve sheath tumor in upper extremity – a rare case report
Authors: Sudarsa I Wayan , Putu Anda Tusta Adiputra
Published: May 2024

Introduction: Malignant Peripheral Nerve Sheath Tumor (MPNST) are aggressive soft tissue sarcoma (STS), originally arising from neural cell components. MPNST had a relatively high local recurrence rate of 22% and a disease survival rate of 45 - 60%. In this study, we would like to report a rare case of recurrent MPNST affecting the upper arm region, with a history of previously resected MPNST at the patient's ipsilateral elbow.
Case Presentation: A 38-years old male patient complained of an enlarging mass in his left anterior axilla Patient had a history of left elbow mass 2 years before and had resected twice. Eight months afterward, a new tumor grew from his left axilla. From the physical examination, the mass was fixated and firm with an oval shape, size 8 x 6 cm. From chest CT scan examination, it appeared a soft tissue mass surrounded with stranding fat had infiltrated his left teres major muscle. The mass was removed successfully and the pathology result revealed a grade 2 MPNST. Post-operative radiotherapy was then scheduled. Among many STS, MPNSTs are notorious for having a high recurrence rate. NF1 mutation, tumors deeper than fascia, large tumors, high-grade tumors, and tumors arising from the trunk, head, and neck are related to poor prognosis in MPNST. Surgeons' inadequate knowledge, unplanned resections, and their dependency on radiotherapy are other iatrogenic factors for recurrences.
Conclusion: MPNST has high recurrent risk, especially in high-grade tumors, large or deep tumors, surgery with positive resection margins, and NF1 mutations. The primary option for treatment is surgery and radiation therapy.
Evaluation of the Implementation of Objective Structural Clinical Examination (OSCE) in the Faculty of Medicine: a Literature Review
Authors: Manuaba Ida Bagus Amertha Putra , Yani Made Violin Weda
Published: May 2024

Medical educators always want the best method for conducting formative and summative student evaluations. The Objective Structured Clinical Examination (OSCE) is an assessment that evaluates aspects of clinical competence in a comprehensive, consistent and structured manner with due observance of objectivity. Clinical skills assessment in OSCE includes history taking, physical examination, communication skills, professionalism, technical skills, problem-solving, decision-making, and time management. However, OSCE is currently one of the exams that students are afraid of, causing sleep disturbances and anxiety. In addition, OSCE involves many personnel in its implementation, so good coordination is needed to create a conducive exam situation. Therefore, evaluation is very important to measure student competency or capability, determine goals that have been and have not been achieved, and get feedback to improve OSCE implementation in the future.
Transverse vaginal septum: a case report
Authors: Nora Hilwah , Indirayani Ima , Rusnaidi  , Mutyara Heyza Damara
Published: May 2024

Introduction: Transverse vaginal septum or known as partial vaginal agenesis, is a rare case. The most frequent causes are defects or fusion disorders of the Mullerian Ductus and defect formation of the urogenital ducts of the urogenital sinuses. The septum may obstruct the entire vaginal opening and cause hematocolpos. The diagnosis is based on a detailed physical and gynecological examination supported by ultrasound and magnetic resonance imaging (MRI). The management option is surgery which is performed as soon as possible.
Case Report: An 11-year-old girl came with lower abdominal pain and amenorrhea, diagnosed with a transverse vaginal septum complicated with hematocolpos based on anamnesis, physical and gynecological examination, and imaging study by ultrasound and MRI. The management includes excision and cross-incision of the septum followed by diagnostic laparoscopy. Endometriosis was found at the broad ligament during laparoscopy and continued with endometriosis resection.
Conclusion: The transverse vaginal septum is still one of the rare anomalies of the Mullerian Duct. The diagnosis was made from a history of low abdominal pain, primary amenorrhea, and a pelvic examination that revealed the vaginal septum. MRI is a gold standard examination procedure of anomalies or abnormalities involving the vagina. The management of the transverse vaginal septum is a surgical approach involving drainage of hematocolpos.
Prevalence and characteristics of Postoperative Cognitive Dysfunction (POCD) in on-pump cardiac surgery patients at Dr. Kariadi General Hospital Semarang
Authors: Nurcahyo Widya Istanto , Adhyatmoko Ginanto Auzan , Kurniawan Muhammad Farhan , Manapa Chandra Hermawan , Wicaksono Satrio Adi , Boom Cindy Elfira , Muttaqin Zainal
Published: May 2024

Background: Postoperative Cognitive Dysfunction or POCD is a reversible decline in the cognitive function of patients after surgery. The risk factors for POCD are age, comorbidities, duration of CPB, intraoperative hypoperfusion, duration of ventilator use, and postoperative sedation are risk factors of POCD. This study aims to determine the prevalence and characteristics of postoperative cognitive dysfunction (POCD) in patients who undergo on-pump cardiac surgery at Dr. Kariadi General Hospital.
Methods: This study's population was all patients undergoing on-pump cardiac surgery at Dr. RSUP. Kariadi in July 2021-December 2021. The study subject was 97 patients, obtained by total sampling technique. The study subjects were examined for cognitive function with MoCA-INA one day before surgery and the third day after surgery. Data were analyzed using SPSS version 23 for Windows.
Results: There were 68 (70.1%) patients who experienced POCD and 29 (29.9%) patients who did not experience POCD. The median age of patients with POCD is 50 (18-68) years and 36 (18-63) years for patients without POCD. Based on MAP during CPB, patients with POCD had a median of 64 (51-80) minutes. In patients with POCD, the median length of CPB was 53 (22-92) minutes, and the median length of the aortic cross-clamp clamp was 35 (11-69) minutes.
Conclusion: We found a high prevalence of POCD patients after on-pump cardiac surgery, as many as 70.1% at Dr. Kariadi General Hospital.
Description of screen time and dry eye syndrome in medical students of UIN Alauddin Makassar
Authors: Rimayanti Ulfah , Yustika Gita , Jamaluddin Sri Rezki Wahdania
Published: May 2024

Link of Video Abstract: https://youtu.be/-B5Z8H6e4o0
 
Background: During pandemic, the amount of screen time in individuals is tremendously expanding. Excessive screen time may result in eye blinks reduction, tears evaporation, and eventually dry eye syndrome (DES). This study aims to show the descriptions of the duration of screen time and dry eye symptoms in medical students during the pandemic.
Methods: This study uses a descriptive and cross-sectional methods.  The subjects were students of The School of Medicine at UIN Alauddin Makassar, who were undergoing online learning. The data were collected through a questionnaire containing subjects' activities using gadgets per day and the Ocular Surface Disease Index (OSDI) to assess dry eye symptoms. Ophthalmological examinations for DES (blink rate, tear meniscus height, tear break-up time, Schirmer test) were also performed on the study subjects.
Results: Most of the subjects are female and 22 years old. The average screen time of the subjects was 17.7 hours per day. Two subjects (4.55%) had mild dry eye symptoms, 14 subjects (31.82%) had moderate dry eye symptoms, and 28 subjects (63.64%), had severe dry eye symptoms. This study also found that the average blink rate of the subjects was 11.36±7.45 times per minute, and the average TBUT value was 10.58±2.69 seconds. Schirmer 1 examination showed a value with a mean of 23.67±12.76 mm, and Schirmer 2 examination showed a value of 20.21±11.64 mm.
Conclusion: The average screen time of the subjects was 17.7 hours. Most subjects had severe dry eye symptoms (63.64%) and low blink rate (59.09%).
Correlation between sebum level and severity of male androgenetic alopecia
Authors: Tambunan Regina Maharani , Jusuf Nelva Karmila , Putra Imam Budi
Published: May 2024

Background: Androgenetic alopecia is the main concern hair problem in the male which is characterized by progressive miniaturization of hair follicles. One factor which contributed in androgenetic alopecia progression is sebum level. This study determined the correlation between sebum level and the severity of AGA in men.
Patients and methods: This study was an observational analytic study with a cross sectional method involving 50 male androgenetic alopecia (AGA) patients based on inclusion and exclusion criteria. Recorded age, education, occupation, family history and duration of illness. AGA severity was determined by the Hamilton- Norwood classification I–VII. Sebum levels were measured using Sebumeter® SM 815. The correlation between sebum level and severity of AGA was analyzed using the Gamma correlation test and significant if p-value<0.05.
Results: Most AGA patients were found in the 36–45 age group, had a diploma/bachelor education level, worked in business services and salespeople, had a family history of their father suffering from AGA, and had suffered from AGA for >20 years. Most AGA patients were found in Hamilton-Norwood III (50%) with the most sebum levels were found to be normal (60%). The results of this study showed a positive correlation (p<0.01) with a very strong strength between sebum level and severity of AGA (r=0.94).
Conclusion: There is a very strong correlation between sebum level and severity of AGA.
Progressive ovarian sertoli – leydig cell tumor: case report
Authors: Raynaldi Juanda , Hasanuddin  , Nainggolan Sarah Ika , Munizar
Published: May 2024

Introduction: Ovarian Sertoli – Leydig Cell Tumor (SLCT) are one of sex cord tumor that has incidence rate less than 0,2% of all ovarian tumors. It occurs predominantly in second and third decades of lifetime. It has characteristics mostly low–grade malignant although poorly differentiated type may behave more aggressively. Clinical characterstic of ovarian SLCT usually hormonal changes, nevertheless in patients without hormonal changes, the manifestation of the disease consists of abdominal pain and abdominal enlargement, and palpable adnexal mass on physical diagnostic.
Case: a 52 years woman that has been undergo right salpingooforectomy 5 months prior with PA result shows poorly differentiated sertoli – leydig cell tumor, and refusing to chemotherapy. She came with chief complaint of abdominal enlargement since 3 months accompanied with lower abdominal pain 2 weeks prior. Ultrasound examination shows cystic ovarian neoplasm with solid part size 9 x 9 x 9 cm from left adnexa. Tumor markers that arise are Alpha–Fetoprotein (AFP)  52 ng/mL and Lactate Dehydrogenase (LDH) = 432 U/mL which correspond to sex cord tumor. She has undergone Laparotomy Total Abdominal Hysterectomy Left Salpingooforectomy and chemotherapy afterward.
Conclusion: Ovarian Sertoli – Leydig Cell Tumors (SLCT) are a rare sex cord ovarian tumor that may behave more aggressively as it poorly differentiated. It has manifestations of hormonal changes and also abdominal enlargement.
Efficacy of 1064nm neodymium-doped yttrium aluminum garnet (Nd: YAG) laser and 2940nm fractional erbium laser for severe acne with acne scar: a case report
Authors: Sari Ninda , Salim Fitria , Sara Meutia , Fitri Elfa Wirdani , Bulqiah Mikyal
Published: May 2024

Introduction: Pharmacological therapy is not always desirable because of the development of antibiotic resistance or the potential risk of adverse effects. Non-pharmacological therapies can be viable alternatives to conventional therapies. Recently, laser therapy has been widely used in the treatment of acne vulgaris due to its effectiveness and safety as it provides a more rapid response with less rate of recurrence, specifically 1064nm Nd: YAG laser. Few studies have investigated laser combinations. Combination 1064nm Nd: YAG and 2940nm fractional erbium laser for severe acne with acne scar has not been reported.
Case report: We report a case of severe acne with acne scars in a 21-year-old female, skin type IV, treated using 1064nm Nd: YAG laser in five sessions and 2940nm fractional erbium laser two sessions. Reduction of acne lesions counts and acne scars improvement prominent after Nd:YAG laser at least four sessions. Our patient's acne scars improved not significantly after 2940nm fractional erbium laser. Acne remission was sustained through the follow-up period. There were no post-inflammatory hyperpigmentation and no exacerbation of acne lesions after the procedures.
Conclusion: 1064nm Nd: YAG laser is very effective for mild to severe acne and improves new acne scars. While 2940nm fractional erbium laser is more effective for mature scars.
The role of mean platelet volume (MPV) and platelet distribution width (PDW) pre-operating as sepsis indicators in laparotomy patients in Dr. Zainoel Abidin Hospital Banda Aceh, Indonesia
Authors: Ilham Darul , Syahputra Dian Adi , Yusuf Muhammad
Published: May 2024

Background: Sepsis has become the most common postoperative complication caused by major surgery. Early diagnosis of sepsis is very important to know the patient's prognosis and survival. Changes in mean platelet volume (MPV) and platelet distribution width (PDW) were assessed to have a relationship with the incidence of sepsis. The use of MPV and PDW platelet preoperative indicators is expected to help predict sepsis so that appropriate interventions can be given immediately.
Methods: A total of 50 patients who met the inclusion criteria became the subjects of this study to determine the potential of MPV and PDW preoperative biomarkers for predicting sepsis in laparotomy patients. All blood tests for the diagnosis of sepsis were examined. Spearman's test and ROC curve were performed for statistical calculations to determine the cut-off point for MPV and PDW.
Results: Analysis of the relationship between PDW and MPV values ​​as an indicator of sepsis using the Spearman test found a significant relationship between MPV and PDW ​​on the incidence of sepsis (p<0.05). Furthermore, statistical tests using the ROC area under the curve (AUC) curve, MPV levels were 0.968, which indicates that if MPV were examined in 100 patients, it would predict sepsis in 96 patients. Meanwhile, the AUC of PDW is 0.770, which shows that if MPV examination is performed in 100 patients, it will predict sepsis in 77 patients. . The best cut-off point ​​that the researchers got in this study was MPV levels 9.8 fL (sensitivity 93.3% and specificity 85%) and PDW levels 9.45 fL (70% sensitivity and 70% specificity).
Conclusion: Preoperative MPV and PDW can be predictive indicators of sepsis in laparotomy surgery, with MPV sensitivity and specificity of 93.3% and 85% and sensitivity and specificity of PDW of 70% and 70%, respectively.
The role of stem cell secretome on spinal cord injury regeneration: a systematic review and meta-analysis
Authors: Semita I Nyoman , Utomo Dwikora Novembri , Suroto Heri
Published: May 2024

Background: The treatment of spinal cord injuries (SCIs) is a controversial topic and is not yet effective. Stem cell secretome is an emerging alternative treatment that uses the paracrine effect of stem cells. Although there have been many studies on this subject, there are still differences regarding the origin, dose, route of secretome administration, type of experimental animal, phase of the SCI, and outputs evaluated. The topic needs a systematic review and meta-analysis.
Methods: This systematic review and meta-analysis were reported based on criteria from Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The authors searched PubMed, ScienceDirect, Cochrane Library, and Google Scholar with multiple electronic databases until October 2021.
Results: Twenty-eight studies that met the inclusion criteria were included in this research. The stem cell secretome was very beneficial as the axonal regeneration agent (n=12); it increases the locomotor recovery (n=28) and growth factors (n=2) and reduces the size of the cystic cavity (n=1) and lesion extension (n=14). We recognized 28 studies that met our inclusion criteria. Stem cell secretome therapies showed improvement in the locomotor score (standard mean difference [SMD]: 0.94; 95% confidence interval [CI]: 0.75–1.13, p<0.000001, I2=90%) and reduction in the lesion size (SMD: 5.06; 95% CI: 3.44–6.67, p<0.00001, I2=94%).
Conclusion: The stem cell secretome greatly affects treating SCI rodent models. Future studies should focus on chronic SCIs in the primary research, translational research, and neurological research stage of stem cell secretome.
Effect of mini low carbohydrate diet and eating speed in obese adults on fasting blood glucose
Authors: Yaqiin Muhammad Aldhi Ainul , Lestari Anik , Sumardiyono
Published: May 2024

Link of Video Abstract: https://youtu.be/FcVVr3DoiOs
 
Background: Obesity is an issue with public health that affects people worldwide and raises morbidity and mortality rates. In addition to dietary factors, non-nutritional factors like meal frequency and duration also contribute to the increased risk of obesity. This study aims to evaluate the duration of meals that will be compared between obese subjects who receive a mini low carbohydrate diet and those who do not.
Methods: Used a cross-sectional, quasi-experimental design in this study. Seven days of testing on 70 obese subjects who met the inclusion criteria for this study were conducted in November at the Palangka Raya city health center. Using a stopwatch to time the length of each meal in seconds and fasting blood glucose tests. Paired T-test and Independent Sample T-test are used in statistical analysis, while Wilcoxon and Mann-Whitney tests are used in the non-parametric analysis. Data were analyzed using SPSS version 20.0 for Windows.
Results: Blood glucose levels and eating speed did not correlate significantly in the mini low carbohydrate diet (M-LCD) group (p>0.05), but they correlated significantly in the control group (CG) (p<0.05). There was a significant difference in fasting blood glucose of the M-LCD and CG groups (p<0.05).
Conclusion: There was no correlation between meal speed and fasting glucose levels in the M-LCD group, but there was a significant difference between the M-LCD and CG groups' fasting blood glucose levels.
Mirror therapy combined with flashcards on the extremity function and stages of self-acceptance of stroke patients
Authors: Purba Maria Magdalena , Aden Christine , Kusfriyadi Mars Khendra
Published: May 2024

Link of Video Abstract: https://youtu.be/u6GkzKfCplE
 
Background: Psychological changes such as body image are important factors that need to be considered to boost the positive sense of self-acceptance in stroke patients with hemiparesis. One measure that can be taken to minimize the incidence of disability, both physically or psychologically, in stroke patients is mirror therapy (mirror therapy combined with flashcards). This study aims to determine whether mirror therapy combined with flashcards can improve the upper limb muscle strength function and the stages of self-acceptance of stroke patients with hemiparesis.
Methods: This study was quantitative, with an experimental research design. The design used was a quasi-experiment with a pre-test-posttest control group design involving 60 respondents with consecutive sampling techniques for 5 months in the Nusa Indah Ward of the Dr. Doris Sylvanus Palangkaraya General Hospital. Upper extremity/arm muscle strength was measured using the muscle strength scale from the Medical Research Council, while self-acceptance stages were measured using a stage questionnaire adapted from Kubler Ross. Data were analyzed using SPSS version 20.0 for Windows.
Results: Our results showed there was a significant increase in the mean value of muscle strength and self-acceptance stages of the treatment group from the control group (p<0.05). The results of the Mancova test showed that gender affects the intervention given (p<0.05).
Conclusion: Our study provided information for nurses in nursing care to stroke patients with hemiparesis on the upper arm and motivation to improve the patient's self-acceptance stages.
Efficacy of topical medroxyprogesterone acetate 1 % and topical doxycycline reduce MMP-9 and TGF-β1 expression as corneal ulceration due to alkali burn: literature review
Authors: Juwita Anindita , Agustini Lukisiari , Loebis Rozalina , Zuhria Ismi , Ridholia  , Ardianto Chrismawan
Published: May 2024

Link of Video Abstract: https://youtu.be/rypOUr0MPxA
 
Corneal alkali burn is a typical ophthalmology emergency which requires immediate management and treatment. Alongside conventional treatment, medroxyprogesterone and doxycycline are considered potent add-on treatments. This literature review was conducted to determine their impact towards corneal wound healing after an alkali burn. It was proven from studies extracted from literature searching among various databases that medroxyprogesterone and doxycycline proven to reduce the inflammatory condition of corneal wounds after alkali trauma. In addition, they are subjected to reduce matrix metalloproteinase (MMP-9) and transforming growth factor (TGF-β1), which are abundant and over-expressed in a corneal wound and could cause excessive inflammation and neovascularization of cornea, which results in hazy and disintegrated corneal tissue after recovery. Therefore, the usage of topical medroxyprogesterone acetate 1% and doxycycline is proven beneficial for patients with corneal wounds after being exposed to alkali burns.
A comparison of otoacoustic emissions examination results as early hearing screening in normal and infants at risk of hearing loss
Authors: Falerina Rosa , Nugroho Puguh Setyo , Purnami Nyilo , Salsabila Fatimah Azizah
Published: May 2024

Link of Video Abstract: https://youtu.be/fvbkSDEVY3Q
 
Background: A child's ability to speak must be supported by a good hearing function. With early detection of hearing loss, it is hoped that intervention can be made promptly, thus improving the quality of life (QOL) of children with hearing loss at birth. The purpose of this study was to compare the otoacoustic emissions (OAE) examination results in infants with and without risk.
Method: The OAE examination was conducted on 60 newborns with and without risk factors in the nursery room and ORL-HNS outpatient unit. For all the newborns aged > 24 hours and before being discharged from the hospital with inclusion criteria, the OAE examinations were performed and repeated when they were 1 and 2 months old. Furthermore, the comparison of OAE results on newborns with and without risk factors aged > 24 hours, 1 month, and 2 months were statistically analyzed.  
Results: A Friedman statistical analysis test was then conducted to examine the correlation between the results of the first, second, and third OAE examinations. The first, second, and third OAE examination results of newborns with and without risk factors were compared, significant differences were found with a p-value of 0.0111 (p < 0.05).
Conclusion: The newborn hearing screening using OAE should be performed for all newborns (Universal Newborn Hearing Screening) and serially to minimize the number of higher referrals to health facilities to improve an individual's quality of life in the future.