bluuebunny/crossref_metadata_2025 huggingface dataset:
Hubungan Platelet- Lymphocyte Ratio (PLR) dan Neutrophil-Lymphocyte Ratio (NLR) Terhadap Terjadinya Sindrom Koroner Akut di RSUD Sanjiwani Gianyar Tahun 2020
Authors: Putra Dwi Masu , Pranata Bagus Gita , Bagiari Ketut Erna
Published: December 2022

Background: Inflammatory processes in atherosclerosis play an important role of the acute coronary syndrome (ACS). Inflammatory markers such as platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) are known to provide a progressivity of the worsening atherosclerosis process rapidly and simple. This study aims to evaluate the relationship of PLR and NLR in ACS.
Method: This is a retrospective study with a total of 102 ACS patients during 2020. PLR and NLR are calculated based on the ratio of absolute platelet, neutrophil, and leukocyte values from the results of regular blood tests. The ACS samples were divided into three groups UAP, NSTEMI, and STEMI.
Result: Based on a total of 102 patients, 66.7% of men and 33.3% of women with the most age ranges of 50-59 years (52%). One-Way Anova Test showed significant differences between PLR (p = 0.002) and NLR (p = 0.017) against ACS. The Posthoc test showed meaningful results in most test groups (p< 0.05). Spearman's correlation test showed positive coleration of PLR (r = 0.508) and NLR (r = 0.500) against the diagnosis of ACS (p = 0.000).
Conclusion: PLR and NLR can be used as a simple hematological marker in determining the severity of atherosclerosis in ACS.
 
Latar Belakang: Proses inflamasi pada aterosklerosis memiliki peranan penting terhadap terjadinya sindrom koroner akut (SKA). Marker inflamasi seperti platelet-lymphocyte ratio (PLR) dan neutrophil-lymphocyte ratio (NLR) diketahui mampu memberikan gambaran progresifitas keparahan aterosklerosis dengan cepat dan sederhana. Penelitian ini bertujuan untuk menilai hubungan PLR dan NLR terhadap terjadinya SKA.
Metode: Penelitian ini merupakan studi retrospektif dengan jumlah 102 pasien SKA selama tahun 2020. Nilai PLR dan NLR dihitung berdasarkan rasio nilai absolut platelet, neutrofil, dan leukosit dari hasil pemeriksaan darah rutin. Sampel penelitian kemudian dibagi menjadi tiga kelompok yaitu UAP, NSTEMI, dan STEMI. Seluruh data dianalisis menggunakan uji One-Way Anova dan Spearman’s Correlation.
Hasil: Berdasarkan total 102 pasien, didapatkan 66.7% laki-laki dan 33.3% perempuan dengan rentang usia terbanyak 50-59 tahun (52%). Uji One-Way Anova menunjukkan adanya perbedaan signifikan antara PLR (p = 0.002) dan NLR (p = 0.017) terhadap SKA. Uji Posthoc menunjukkan hasil bermakna pada sebagian besar kelompok uji (p< 0.05). Uji korelasi Spearman’s menunjukkan adanya korelasi positif PLR (r = 0.508) dan NLR (r = 0.500) terhadap diagnosis SKA (p = 0.000).
Kesimpulan: PLR dan NLR dapat dijadikan sebagai marker hematologi sederhana dalam menentukan derajat keparahan aterosklerosis pada pasien SKA.
Seorang penderita syok anafilaksis dengan allergic myocardial infarction (kounis syndrome)
Authors: Wismayana I Putu Ary , Suardamana I Ketut
Published: December 2022

Background: Kounis syndrome (KS) is defined as the concurrence of acute coronary syndromes associated with mast-cell and platelet activation in the setting of allergic or anaphylactic insults. Prevalence of KS is considered rare, estimated 1.1% of hospitalized allergic reaction patient, with mortality rate 7%.
Case Report: Case of 39 years old male without history of coronary artery disease, having dyspnea, chest discomfort, and pruritus after eating skipjack tuna. 12 lead electrocardiogram showing ST depression segment on lead II, III, and aVF. Patient diagnose as Kounis syndrome variant type I. Treatment of Kounis Syndrome begins with cessation of the causative agent. After therapy using epinephrine and intravenous corticosteroid, clinical improvement was achieved, and ST segment depression on electrocardiogram resolved.
Conclusion: Kounis syndrome is a rare disorder which need careful assessment and swift management. The diagnosis confirmed with sign and symptoms of allergic along with disorder in cardiovascular system.
 
Latar Belakang: Kounis Syndrome (KS) didefinisikan sebagai sindrom koroner akut yang terjadi bersamaan dengan aktivasi sel mast dan trombosit dalam keadaan alergi atau anafilaksis. Prevalensi KS tergolong jarang, diperkirakan 1,1% dari pasien reaksi alergi yang dirawat di rumah sakit, dengan angka kematian 7%.
Laporan Kasus: Laki-laki 39 tahun tanpa riwayat penyakit jantung koroner, sesak nafas, rasa tidak nyaman di dada, dan pruritus setelah makan ikan cakalang. Elektrokardiogram 12 sadapan menunjukkan segmen depresi ST pada sadapan II, III, dan aVF. Diagnosis pasien sebagai sindrom Kounis varian tipe I. Pengobatan Sindrom Kounis dimulai dengan penghentian agen penyebab. Setelah terapi menggunakan epinefrin dan kortikosteroid intravena, perbaikan klinis dicapai serta depresi segmen ST pada elektrokardiogram teratasi.
Simpulan: Kounis syndrome adalah kelainan langka yang membutuhkan penilaian yang cermat dan penanganan yang cepat. Diagnosis ditegakkan dengan adanya tanda dan gejala alergi disertai gangguan pada sistem kardiovaskular.
Comparison of albumin 4%, gelatine, and ringer lactate as volume expander post-resuscitative phase on cardiac output and lactate serum after Coronary Arterial Bypass Grafting (CABG) on-pump: Single-center randomized prospective study
Authors: Adriane Prieta , Dewi Ni Luh Kusuma , Ardiyan Ardiyan
Published: December 2022

Background. The use of protein colloid in fluid management post-cardiac surgery is debatable whether it is more beneficial than non-protein colloid or crystalloid. Patients who still need more volume after the resuscitative phase might benefit from optimal fluid management by choosing the most beneficial fluid. This study compared albumin 4% administration to gelatine and ringer lactate as a volume expanders post-resuscitative phase after coronary artery bypass grafting (CABG) on-pump.Methods. We conducted a single-centered, single-blind, randomized controlled study that assigned 120 patients undergoing elective CABG on-pump. Subjects who met inclusion criteria received 125 ml/hour of either albumin 4%, gelatine colloid, or Ringer's lactate (RL) as the only infusion fluid for 4 hours after the first assessment post-resuscitative phase,  after intensive care unit (ICU) admission. After fluid administration, patients were reassessed. The assessment included cardiac output and lactate serum as the primary outcome, while the duration of mechanical ventilation, ICU, and hospital stay were recorded as secondary outcomes.Results. The mean of cumulative cardiac output improvement differed between the group albumin 4% 1.18 L/min, gelatine 0.88, and RL 0.74 (p=0.002). Lactate serum decreased in the albumin 4% group as much as 3.31 gr/dl compared to gelatine 2.13 and RL group 2.37 (p=0.005). Duration of mechanical ventilation, length of stay in ICU, and hospital post-operative were shorter in the albumin group than in other groups. Conclusions. Albumin 4% used as a volume expander in the post-resuscitative phase still improved cardiac output and tissue micro-perfusion than gelatine and ringer lactate.
Akurasi otoskopi video digital dalam mendiagnosis otitis media akut pada pasien pediatri: sebuah tinjauan sistematik
Authors: Ryantama Anak Agung Wira , Praptika Ni Luh Parameswari , Bhuwana Ni Nyoman Astrid Tri
Published: December 2022

Introduction: Acute otitis media one of the most prevalent ear and throat infection, mostly affecting children. Diagnosis of this condition was complicated by the perceived invasive procedure and the shortage of qualified otologist. Digital video otoscopy is a new and evolving concept in otology which could be further enhanced with telemedicine. It increases access to specialist otologist care by having the examination performed by less qualified healthcare professional. In this review we would like to assess the newest evidence on digital video otoscopy as diagnostic modality for acute otitis media.Methods: We identified literature published from 2000 to 2020 from MEDLINE and Google Scholar. We included studies which reported diagnosis of acute otitis media using digital video otoscopy devices. We include both descriptive and analytical studies. We exclude literatures that reported secondary results or those that does not have acute otitis media as the diagnosis of interest. Articles that fulfill the criteria was then analyzed qualitatively to identify the themes that emerges.Results: Literature search resulted in 10 included studies which includes descriptive studies, diagnostic studies, and RCTs. Digital video devices used varied from add-ons to smartphones to dedicated digital video otoscopy results. The reported examiners also varied from otologist, general practitioners, to telemedicine facilitators. Most studies concur that digital video otoscopy provided adequate inter-examiner and intra-examiner reliability. At the same time, digital video otoscopy provides adequately accurate diagnosis of acute otitis media. Where comparison was available, the accuracy of digital video otoscopy was not significantly different compared to other modes of otoscopy.Conclusions: Digital video otoscopy provide adequately reliable and accurate diagnostic examination for acute otitis media. Some digital video otoscopy system was simple enough to be operated by nurses or telemedicine facilitators, supporting the utilization of this system for telemedicine.
Contamination of Escherichia coli, Salmonella sp. and Vibrio sp. on ice cubes at food stalls in Karangasem Regency, Bali Province in 2021
Authors: Wiguna I Gede Wikania Wira , Darwinata Agus Eka , Pinatih Komang Januartha Putra , Fatmawati Ni Nengah Dwi
Published: December 2022

Background: Waterborne diseases spread through drinking water and food products made from drinking water, including cooking utensils that are washed using contaminated water. Ice cube is widely used by the people in Indonesia. There was no study regarding bacteria contamination on an ice cube in Karangasem Regency. This study aimed to determine the contamination of Escherichia coli, Salmonella sp., and Vibrio sp. on ice cubes at food stalls in Karangasem Regency in 2021.
Methods: This study used a cross-sectional research design and simple purposive sampling as the sampling technique. Ice cubes were taken from 42 food stalls from eight sub-districts. Samples were cultured on Lactose Broth (LB) media for the Most Probable Number (MPN) test procedures and Eosin Methylene Blue Agar (EMBA) to identify the presence of E. coli, Salmonella Shigella Agar (SSA) for Salmonella sp., and Thiosulfate Citrate Bile Sucrose (TCBS) for Vibrio sp. and followed by gram staining. Data processing was carried out descriptively to determine the percentage of samples with positive contamination. Data were analyzed using Microsoft Excel version 2010 for Windows.
Results: Based on the study results, it was found that all samples contained coliform bacteria through the MPN test (100.0%). In addition, 5 samples (11.9%) were found positive for E. coli. While the identification of Salmonella sp. and Vibrio sp was found no positive results.
Conclusions: There was coliform bacteria contamination in the tested ice cube samples. In addition, E. coli was found in the sample; however, there were no Salmonella sp. and Vibrio sp. on ice cube samples.
Nilai diagnostik thoraks foto pada pasien coronavirus disease-2019 (covid-19) terhadap hasil real time polymerase chain reaction (RT-PCR) di Rumah Sakit Umum Daerah Wangaya Denpasar periode Juni-November 2021
Authors: Khrisna Anak Agung Parama Swari , Kirana Ni Luh Jaya
Published: December 2022

Introduction: COVID-19 is an infectious disease caused by a new virus causes that attacks the upper respiratory tract and the lungs. The numbers of cases and deaths have increased on a daily basis on the scale of a global pandemic. Chest X-ray images have proven useful for monitoring various lung diseases and have recently been used to monitor the COVID-19 disease. Imaging modalities such as chest x-rays have the benefit of providing initial imaging before confirming with RT-PCR examination. The purpose of this study was to determine the value of the diagnostic examination of the chest x-ray compared to the RT-PCR examination which is the gold standard in diagnosing COVID-19.Methods: This study used a diagnostic study design with a retrospective approach at Wangaya Hospital, Denpasar during the period June-November 2021. Analysis of the diagnostic test used cross tabulation and then calculated sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), negative likelihood ratio (LR-), and accuracy were performed.Results: Thorax imaging diagnostic test value compared with the gold standard RT-PCR examination in form of sensitivity, specificity, PPV, NPV, LR+, LR-, and accuracy was 78%, 23%, 84%, 16.6%, 1.01, 0.95, and 69% respectively.Conclusion: Thorax imaging provide a high sensitivity and accuracy of diagnostic in person with clinical presentation of COVID-19. Pendahuluan: COVID-19 merupakan suatu penyakit menular yang disebabkan oleh virus baru dan menyerang saluran pernapasan bagian atas dan paru-paru. Jumlah kasus dan kematian telah meningkat setiap hari dalam skala pandemik global. Modalitas pencitraan seperti thoraks foto memiliki manfaat untuk memberikan pencitraan awal sebelum mengkonfirmasi dengan pemeriksaan RT-PCR. Tujuan penelitian ini adalah untuk mengetahui nilai pemeriksaan diagnostik yang dimiliki thoraks foto dibandingkan dengan pemeriksaan RT-PCR yang merupakan baku emas dalam mendiagnosis COVID-19.Metode: Penelitian ini menggunakan desain studi diagnostik dengan pendekatan retrospektif di Rumah Sakit Umun Daerah Wangaya Denpasar selama periode Juni-November 2021. Analisis uji diagnostik menggunakan tabulasi silang kemudian perhitungan sensitivitas, spesitifitas, positive predictive value (PPV), negative predictive value (NPV) positive likelihood ratio (LR+), negative likelihood ratio (LR-) dan akurasi dilakukan.Hasil: Nilai uji diagnostik thoraks foto dibandingkan dengan pemeriksaan baku emas RT-PCR berupa sensitivas, spesitifitas, PPV, NPV, LR+, LR-, dan akurasi adalah masing-masing 78%, 23%, 84%, 16.6%, 1.01, 0.95, dan 69%.Simpulan: Thoraks foto memberikan sensitivitas dan akurasi diagnostik yang tinggi secara langsung pada presentasi klinis COVID-19.
Breathing exercise and chest physiotherapy in post-acute COVID-19 patient: a case report
Authors: Adidharma Nyoman Chandra , Dharma Bagus Diva Indra , Negara Kade Ngurah Dwi Putra , Sudewa I Gede Adi
Published: December 2022

Background: Severe acute respiratory syndrome (SARS CoV2) and coronavirus disease 2019 causes vary from mild to severe clinical manifestation. Complications from COVID-19 can show several manifestations such as pulmonary, cardiovascular, neuromuscular, and renal systems, which could lead to multi-organ failure. Lung fibrosis and recurrent pneumonia are some of some sequelae of survivors, and some need readmission to hospital, although the PCR swab test remains negative. Post-acute COVID-19 is a syndrome characterized by persistent clinical symptoms beyond four weeks from the onset of acute symptoms.
Case: In this writing, a 57-year-old male presented with chief complaints of shortness of breath and cough 2 days after being discharged from the hospital because of a COVID-19 infection. His PCR swab test result remains negative when readmission. The patient was on non-invasive ventilation, medical therapy and physical therapies such as breathing exercises and chest physiotherapy. The physical therapy was done twice daily. On the seventh day of exercise, the shortness of breath was improved, and NIV was tapered down. The patient was discharged after 27 days of hospitalization.
Conclusion: This case shows the benefit of breathing exercises and chest physiotherapy for the Post-acute COVID-19 patient. This helps improve respiratory muscle strength and chest expansion in order to improve oxygen perfusion.
Potensi terapi kombinasi Liver Growth Factor (LGF) dan Adrenomedullin (ADM) sebagai harapan baru penatalaksanaan Azoospermia Non-Obstruktif (ANO): tinjauan pustaka
Authors: Hartaningsih Ni Made Dian , Prabawa I Putu Yuda , Putu Benediktus Bosman Ariesta Gusti , Sindhughosa Dwijo Anargha , Manuaba Ida Bagus Amertha Putra , Pramesemara I Gusti Ngurah
Published: December 2022

Non-Obstructive Azoospermia (NOA) is caused by the failure of spermatogenesis process. This case becomes the highest prevalence, 95% of the total azoospermia. Therapeutic modalities in use today such as invasive techniques, hormonal therapy, and gene therapy are less effective in the treatment of azoospermia. In addition, the overall therapeutic modalities also have serious side effects such as infection, testicular atrophy, nerve damage and other side effects. Referring to the problems above, non-obstructive azoospermia is an urgent health issue and requires effective and efficient management with minimal side effects, as the combination of Liver Growth Factor (LGF) and Adrenomedullin (ADM). LGF is able to regenerate spermatogenesis after spermatogonia testicular stem cell damage. LGF also works specifically by stimulating germinal cells without changes in somatic cells. The motility of reactivation could be improved by combining the ADM into therapy, which bind to specific receptors, and the result of increasing the cAMP / PKA and NO that are important in the regulation of cilia’s movement. Combination LGF and ADM are potential to create new therapeutic candidates in the management of non-obstructive azoospermia, which can be immediately implemented as effective and efficient therapy. Azoospermia Non-Obstruktif (ANO) adalah azoospermia yang disebabkan kegagalan proses spermatogenesis dan merupakan kasus dengan prevalensi tertinggi (95% dari total azoospermia). Modalitas terapi yang digunakan sampai saat ini seperti teknik invasif, terapi hormonal, dan terapi gen terbukti belum efektif dalam tatalaksana azoospermia. Selain itu, keseluruhan modalitas terapi ini juga memiliki efek samping serius yang perlu diwaspadai seperti infeksi, testis atropi, kerusakan saraf, serta efek samping lainnya. Merujuk pada permasalahan diatas, azoospermia non-obstruktif merupakan masalah kesehatan yang mendesak dan membutuhkan tatalaksana yang efektif dan efisien dengan efek samping yang minimal seperti dengan kombinasi terapi LGF dan ADM. LGF mampu meregenerasi testis dan mereaktivasi spermatogenesis setelah kerusakan sel punca spermatogonia. LGF juga bekerja secara spesifik dengan menstimulasi sel-sel germinal tanpa menyebabkan perubahan pada sel-sel somatis. Motilitas sperma hasil reaktivasi spermatogenesis kemudian ditingkatkan dengan mengkombinasikan ADM kedalam terapi dimana berikatan pada reseptor-reseptor spesifik sehingga berefek pada peningkatan cAMP/PKA dan NO yang penting dalam pengaturan kibasan flagella. Perpaduan antara terapi LGF dan ADM ini sangat berpotensi menciptakan kandidat terapi baru dalam penatalaksanaan NOA yang efektif dan efisien.
The role of Bone Morphogenetic Protein-2 in craniofacial osteogenesis: A literature review
Authors: Sanjaya I Gusti Putu Hendra , Sri Maliawan
Published: December 2022

Bone Morphogenetic Protein (BMP) is a type of growth factor that belongs to the Transforming Growth Factor Beta (TGF-B) group. Bone Morphogenetic Protein-2 (BMP-2) is recognized as one of the first commercially available osteoblast inductors. When new bone is needed, mesenchymal stem cells can develop into osteoblasts, which then implant as osteocytes in the bone, providing additional structure and support. The principal agent that differentiates stem cells into osteoblasts is BMP-2. BMP-2 will be released into the bone matrix or serum in performing their job. BMP-2 activates the SMAD1/5/8 signal via mediating the physiological action of type I and II serine/threoninekine receptors. The active SMAD protein will form a complex with the SMAD4 protein, translocate DNA to the nucleus, and bind to particular genes like Dlx-2/5, Osx, and transcription. According to a recent study, BMP-2 boosts osteogenic growth. BMPs are effective in the treatment of craniofacial defects in current research. The subjects of this paper are the molecular mechanism of BMPs and their involvement in the clinical application of craniofacial deformity patients.
Colonization of Citrobacter koseri and Streptococcus agalactiae in a case of cellulitis cruris dextra et sinistra
Authors: Sari Luh Gede Melia Puspita , Fatmawati Ni Nengah Dwi , Praharsini I Gusti Ayu Agung , Giantoro Marvin
Published: December 2022

Background: Cellulitis is a skin infection involving the deep dermis and subcutaneous tissue, characterized by localized pain, swelling, tenderness, erythema, and warmth. The most common causes of cellulitis are group A streptococci and Staphylococcus aureus. Streptococcus agalactiae or the so-called group B Streptococcus can also cause cellulitis. This case report aims to evaluate the colonization of Citrobacter koseri and Streptococcus agalactiae in a case of cellulitis cruris dextra et sinistra.
Case Presentation: A 53-year-old married woman presented to the outpatient clinic complaining of swelling and redness in her left and right legs since five days ago. At first, there was only a little redness around the calf, but it became wider and pain in that area. On examination, there were multiple erythematous macules, patches, and multiple erosional lesions, warm palpable and tender to palpation, and the diascopy test disappeared with pressure. Based on the wound culture results, isolated Citrobacter koseri and Streptococcus agalactiae bacteria were considered colonization. Both of these bacteria were less virulent. The patient was treated with systemic and topical antibiotics, analgesics, wound care management and elevated lower limbs.
Conclusion: The diagnosis of cellulitis is based on history and physical examination. On examination of the wound culture of this case, Citrobacter koseri and Streptococcus agalactiae were found, considered as colonization. The patient showed clinical improvement at each observation after administration of antibiotics and wound care management. The patient's prognosis is dubious ad bonam.
The role of tumor necrosis factor-alpha (TNF-α) inhibitor in steven johnson syndrome/toxic epidermal necrolysis (SJS/TEN) management: a systematic review
Authors: Kurnia Icasia Yuseli
Published: December 2022

Background. Steven Johnson Syndrome and Toxic Epidermal Necrolysis are dermatologic emergencies with high mortality rates characterized by extensive skin involvement. TNF-α has a role in inducing the production of granulysin that enhances keratinocyte cell death. Thus, the use of TNF-α inhibitors such as etanercept and infliximab is promising to halt the disease progression. This systematic review aims to evaluate the efficacy of TNF-α inhibitor in SJS/TEN management.
Method. A systematic review using an online database was conducted based on PRISMA guidelines. Inclusion criteria were studied about the role of TNF-α inhibitor in SJS/TEN management. The exclusion criteria were a letter to the editor, commentary report, review, meta-analysis, study not used humans as a study subject, not available in full text and not in English or Bahasa Indonesia.
Result. Fourteen studies are included in this systematic review consisting of ten case reports, three cohort retrospective studies, and one randomized controlled trial. TNF-α inhibitors such as etanercept and infliximab are beneficial for SJS/TEN management because they accelerate skin healing time and re-epithelization, reduce in-hospital duration and mortality rate, and minimal complications and side effects. TNF-α inhibitors should be given quickly after the disease onset, and combination with other immunosuppressive agents should be avoided to prevent the excessive immunosuppressive effect.
Conclusion. TNF-α inhibitors such as etanercept and infliximab promise therapy to halt SJS/TEN progression.
Nonsteroid anti-inflammatory drug choices in patients with juvenile idiopathic arthritis: A systematic review
Authors: Biantara Yogi Priyatna , Widhiarma Surya Fajari , Kusuma Widia Trilaksana
Published: December 2022

Background: Disease-modifying anti-rheumatic drugs (DMARDs) are still a priority in treating juvenile idiopathic arthritis (JIA). The choice of drug therapy for the NSAIDs as an alternative to the therapy used in managing JIA cases due to the side effects of DMARDs. However, the former discussion of the choices therapy of NSAID therapy in JIA patients is still limited. This systematic review was conducted to present any choices of NSAIDs used for the treatment JIA and presented their effectiveness and adverse reaction compared with other NSAIDs used for treating JIA.
Methods: Comprehensive electronic searches were performed in PubMed/Medline, EMBASE, and Cochrane Library, choosing Randomized Controlled Trials of NSAIDs for treating children with JIA up to January 2009. The risk of bias was assessed using the Cochrane Risk of Bias Tools for randomized controlled trials.
Results: Eight eligible randomized controlled trials (RCT) out of 1309 studies were included, with a total of 1112 participants with JIA identified, addressing 19 kinds of interventions with nine types of medications. First RCT concluded that Celecoxib 3 mg/kg and Celecoxib 6 mg/kg were at least as effective as naproxen 7.5 mg/kg in terms of reducing clinical symptoms of arthritis and joint swelling. Second RCT concluded that Low Dose (0,3 mg/kg) and High Dose (0.6mg/kg) Rofecoxib showed a greater improvement than the Naproxen group to relieve the pain. The third RCT stated that good efficacy or satisfaction is most frequent in the participant with Meloxicam 0.125 mg/kg rather than Meloxicam 0.25 mg/kg or Naproxen 10 mg/kg. Fourth RCT concluded that Ibuprofen 30-40 mg/kg/d is an effective agent for symptomatic treatment of JIA and is well-tolerated in many children. Fifth RCT informed that Piroxicam show more effective in controlling the symptoms and improving function than Naproxen 10 mg/kg/day. Sixth RCT concluded that Acetylsalicylic acid 75 mg/kg/day has better efficacy than Naproxen 10 mg/kg/d in relieving the symptoms. The seventh study stated that both diclofenac sodium 2-3 mg/kg/day and acetylsalicylic acid 50-100 mg/kg/d at least as good as placebo. The last RCTs study stated that tolmetin 15 mg/kg/day decreased the duration of morning stiffness and reduced joint pain. Also, aspirin 50mg/kg/day resulted in ROM improvement in JIA patients.
Conclusions: We present Celecoxib, Rofecoxib, Meloxicam, Ibuprofen, Piroxicam, Acetylsalicylic Acid (ASA), Diclofenac Sodium, Tolmetin Sodium, and Naproxen as the NSAIDs choice drugs on pediatric patient diagnosed with JIA. which has each adverse event on each therapy.
Comparison of knee society scores in osteoarthritis patient before and after total knee arthroplasty: a case report
Authors: Putra I Dewa Gede Indra Pratama , Pratama Dewa Gede Kurnia , Sucitra Putu Budi
Published: December 2022

Introduction: Osteoarthritis is a degenerative disease characterized by joint pain in the cartilage. It requires further management, especially in severe conditions that have not responded to pharmacological therapy, such as Total Knee Arthroplasty (TKA). Therefore, the authors aim to compare the knee quality of patients with Knee Society Scores (KSS) before and after TKA surgery.
Case description: Female patient, 55 years old, came with the chief complaint of stiffness and pain in both knees for the last two years. The patient had previously undergone regular treatment and is now getting worse. The radiological found the impression of right and left knee osteoarthritis was grade IV, and the KSS assessment results were 40. The patient was then treated with TKA surgery. After the total knee arthroplasty procedure was observed for one month, the patient had no complaints of joint stiffness and did not feel severe pain in both knees. The KSS assessment results were 71 with good interpretation results.
Conclusion: There was an improvement in the knee quality of patients with KSS before and after TKA surgery.
Determinant of service utilization for triple elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B among women living with HIV during COVID-19 pandemic in Indonesia
Authors: Ngakan Putu Anom Harjana  , Sally Nita  , Meirinda Sebayang  , Oldri Sherli Mukuan  , Asti Setiawati Widihastuti
Published: December 2022

Background: HIV-AIDS and sexually transmitted infections are still a public health burden in Indonesia. Women living with HIV have a higher risk of transmitting HIV, Syphilis, and Hepatitis B to their babies. While the effort to increase the services coverage for the prevention of mother-to-child transmission (PMTCT) was detained due to the COVID-19 pandemic and the lack of published studies that explore this, this study aimed to assess the determinant of service utilization for triple elimination of mother-to-child transmission of HIV, Syphilis, and Hepatitis B among women living with HIV during COVID-19 pandemic in Indonesia.
Methods: This cross-sectional study targeted women living with HIV in Indonesia who are planning to get pregnant. A simplified-snowball sampling technique was used in this study. A dependent variable in this study was the service utilization of PMTCT for HIV, Syphilis, and Hepatitis B. In contrast, the independent variables in this study consisted of demographic characteristics, perception according to Health Belief Model constructs, and stigma and discrimination experiences. Multiple logistic regression was used to find the determinants of service utilization.
Results: Among 336 women living with HIV that were interviewed, only 28.27% (95% CI = 23.69 – 33.34) accessed the PMTCT services during the COVID-19 pandemic. Moreover, the likelihood of PMTCT service utilization was decreased among the women living with HIV who perceived higher barriers (aOR = 0.56; 95% CI = 0.31 – 0.99) and experienced stigma and discrimination from partner (aOR = 0.50; 95% CI = 0.25 – 0.99). On the other hand, the PMTCT service utilization was increased among those who perceived less severity (aOR = 2.07; 95% CI = 1.21 – 3.54). No other factors were associated with the PMTCT service utilization among women living with HIV during the COVID-19 pandemic.
Conclusion: The PMTCT service utilization was relatively low, increased by the higher perceived severity, and reduced among those who perceived higher barriers and experienced stigma and discrimination from the partner. Therefore, improving the knowledge about HIV, Syphilis, and Hepatitis B related to PMTCT services is essential, as well as providing social support to reduce the stigmas and discrimination among women living with HIV.
The outcome of early rehabilitation therapy for the patient after percutaneous coronary intervention: a systematic review and meta-analysis
Authors: Budiarta Pande Made Dwi , Prawira S Adhyasta Nata , Sofyan Citra Wulandari , Bagaskara Putu Topan
Published: December 2022

Background: Acute myocardial infarction (AMI) is one of the leading causes of mortality, morbidity and physical disability worldwide. The chief treatment for AMI is primary percutaneous coronary intervention (PCI). However, the effectiveness of early rehabilitation therapy after PCI patients still lacks documentation. Therefore, a meta-analysis has assessed the patient's outcome of early rehabilitation therapy after PCI.
Methods: The searching protocol was carried out using several databases, such as PubMed, ScienceDirect, and Google Scholar, to identify relevant topics in June 2022. This study used the Preferred Reporting Items for Systematic Review and Meta-Analysis 2020 (PRISMA) guidelines.
Result: There were nine studies included in this systematic review and meta-analysis. All of the reviewed studies were written in English. Most of the included studies were carried out in China. Most of the included studies were carried out in China. The mean age of the patient were all above 18 years. The total participants were 858 patients with PCI. There was a significant difference in 6-minute walk distance (MD = 85.64; 95% CI = 78.68–92.60; p < 0.01); left ventricle ejection fraction (LVEF) (MD = 5.97; 95% CI = 5.30–6.63; p < 0.01) and body mass index (BMI) score score (MD = 1.43; 95% CI = 0.86–2.00; p < 0.01) between groups in overall analysis.
Conclusion: Early rehabilitation in patients with PCI has better outcomes (6-minutes walk distances, LVEF, and BMI score) than in the control group.
Penatalaksanaan dan edukasi pasien sirosis hati dengan varises esofagus di rsup sanglah denpasar tahun 2014
Authors: Fajarini Budhiarta Dita Mutia
Published: December 2022

Introduction: Cirrhosis is a chronic liver disease characterized by fibrosis is reversible, disorganization lobules and vascular structures, as well as regenerative nodules of hepatocytes. The overall incidence of cirrhosis in the United States an estimated 360 per 100,000 populations. The cause is largely due to alcoholic liver disease and chronic viral infections. Sarjito hospital in Yogyakarta, the number of patients with liver cirrhosis range in 4.1% of patients admitted to the internal medicine during the period of 1 year in 2004. Etiology of cirrhosis affects the handling of the disease. Therapy was carried out aimed at reducing disease progression, avoid ingredients that can add to liver damage, prevention and treatment of complications. Educating patients and families about the disease and the complications that may occur will greatly help improve treatment outcomes, and is expected to help improve the quality of life of patients. Case: Patient male, aged 43 years, Muslims, Madurese, came to the clinic and hospital with complaints of weakness since a week before coming, said to the entire body limp. This makes patients reluctant to perform daily activities. Patients also complain of pain in the gut. This pain is often felt after eating and drinking accompanied by nausea and vomiting, so patients are less appetite. Patients stated that the feeling of pain is also accompanied by a feeling of fullness in the abdomen. Frequency of urination is increased since the last few months, is said to be more than 4 times a day to urinate, but once the urinary volume of about Â¼ cup aqua (240 cc) with a brownish color like tea. The desire to defecate patient is said to be normal.
Intervensi koroner perkutan pada infark miokard akut disertai elevasi segmen ST awitan lebih dari 12 jam dengan penyulit syok kardiogenik
Authors: Dwipawana I Gusti Bagus Aginda , Pratama Vireza , Callista Mia Amira
Published: December 2022

Background: Percutaneous coronary intervention (PCI) is the primary therapy in patients with acute myocardial infarction with-ST Segment Elevation (AMI-STE) in the first 12 hours of onset of symptoms. However PCI still needs to be done in patients with onset more than 12 hours who still showed prolonged ischemia process. Case: A man, 49 years old came to the emergency room Central Army Hospital Gatot Subroto (RSPAD) with chest painÂ  typically infarction angina since 6 days ago. Patient was referred from Islamic Hospital with anterior AMI-STE-onset 2 hours TIMI 7/14 Killip Class IV without revascularization and acute renal failure. Patient determined to be referred after treated in ICVCU Islamic Hospital, but patient had a progressive chest pain and hemodynamic disturbances. After revascularization in the RSPAD Hospital, clinical and hemodynamic conditions of this patient slowly improved. Discussion: Reperfusion therapy should be given if there is clinical evidence or evidence which showed prolonged ischemic ECG, even if the patient according to the symptoms have lasted more than 12 hours. It is because the onset of actual attack is certainly known. AMI-STE guidelines by ESC and AHA also recommend PCI procedure in patients with signs of prolonged ischemia process. Conclusion: Revascularization in patients with AMI-STE onset more than 12 hours should be performed in patients who still show a prolonged ischemia process and hemodynamic disturbances.
Extra virgin olive oil menurunkan kadar mda (Malondialdehyde) pada tikus (Rattus norvegicus) jantan galur wistar yang dipapar asap rokok
Authors: Tan Meilina
Published: December 2022

Aging is a physiological process that will be experienced by all living organism. In aging the accumulation of damage by free radicals in the cell all the time can cause cell damaging, disruption to cell death. Free radicals will attack cell membrane which is contain lipid bilayer (lipid peroxidation). In the state of oxidative stress, it required adequate and optimal antioxidant to the body. Smoking raises ROS which can cause oxidative stress through the mechanism of cell membrane lipid destruction. In this study use extra virgin olive oil (EVOO) contains phenolic, tocopherols, squalene, pigments and Î²- carotene which works to prevent oxidative stress from cigarette smoke. The aim of this study is to prove the effect of EVOO to decrease MDA level in male Wistar rats exposed by cigarette smokeThis experimental study has been conducted as pre-posttest control group design. 16 Wistar male rats used as a sample that was divided into 2 groups. Both group was exposed with cigarette smoke for 45 minute twice a day. Group 1 was the control group which were exposed to cigarette smoke and administered aquabides. Group 2 was the treatment group which were exposed to cigarette smoke and extra virgin olive oil oral dose 1cc (1gram/KgBW).Study result showed that MDA level pretest in control group was 9,3487 Â± 0,69287 nmol/ml and treatment group was 8,8838 Â± 0,63541 nmol/ml. Both group control and treatment of MDA level showed normal distribution and homogeneous. Comparability test for both group showed no significant differences MDA level between both group (p > 0,05). Result Posttest was, control group MDA level increased 10,2625 Â± 0,53361 nmol/ml. This showed cigarette smoke in long term increased MDA level. Treatment group that was given extra virgin olive oil and cigarette smoke decreased MDA level into 3,4925 Â± 0,85058 nmol/ml. This means statistically evaluated that the decrease of MDA in the treatment group was significantly different (p < 0,05). Paired T-test in control group pretest and posttest showed significant increased (p<0,05) and in treatment group pretest and posttest that was given extra virgin olive oil showed decreased of MDA level significantly (p<0,05). Independent T-test pretest between both group exposed by cigarette smoke showed no differences significantly (p>0,05) and for both group after given treatment EVOO showed significant differences (p<0,05).This study concluded that oral administration of extra virgin olive oil oral dose 1cc (1gram/KgBW) decreased MDA level in male Wistar rats exposed by cigarette smoke.
Gambaran Tingkat Pengetahuan pada Wanita Usia Subur dalam Pemakaian Kontrasepsi Pasca Persalinan di Desa Gelgel, Klungkung
Authors: Gunasekaran Sanjivan , Aryani Putu
Published: December 2022

Tujuan dari keluarga berencana adalah untuk mencegah ledakan penduduk, menurunkan angka kematian ibu melahirkan dan kematian bayi, meningkatkan status gizi ibu dan anak serta meningkatkan perkembangan otak anak manakala kontrasepsi pasca persalinan merupakan pemasangan kontrasepsi dalam jangka waktu 42 hari setelah melahirkan untuk mencegah kehamilan dengan jarak dekat yang terlalu dekat, sehingga bayi yang baru lahir mendapatkan cukup nutrisi,perhatian dan kasih saying dalam perkembangannya. Tujuan dari penelitian ini adalah untuk mengetahui gambaran tingkat pengetahuan pada wanita usia subur dalam pemakaian kontrasepsi pasca persalinan di Desa Gelgel wilayah kerja Puskesmas Klungkung I. Penelitian ini menggunakan rancangan penelitian deskriptif, dengan metode cross-sectional. Pengambilan sampel dilakukan dengan metode total sampling.Â  Data yang diperoleh dianalisa secara deskriptif kuantitatif kemudian disajikan dalam bentuk tabel frekuensi dan naratif. Hasil penelitian ini menunjukkan masih kurangnya tingkat pengetahuan wanita usia subur (WUS) di desa Gelgel,Klungkung terhadap penggunaan kontrasepsi pasca persalinan (54,3%). Oleh karena itu, diperlukan optimalisasi penyuluhan untuk meningkatkan tingkat pengetahuan terhadap penggunaan kontrasepsi pasca persalinan untuk mendapat perilaku yang baik.Â
Faktor resiko terjadi infestasi kutu pada anak-anak di panti asuhan
Authors: Ganesan Haritharan , Damayanti Putu Ayu Asri
Published: December 2022

Infestation with lice is most common among preschool- and elementary school-age children and their household members and caretakers hence becoming an increasing problem in orphanage because of the poor hygiene and knowledge of children on lice. This study explores about the risk factor of knowledge, social risk and personal risk among the students who are living in the orphanage. Study design chosen for this research is descriptive study with 98 student from two orphanages home as respondents. Questionnaires were given to answer to all the 98 respondents. The questionnaire were subdivided into three section to determine the respondentâ€™s knowledge, social and personal risk. Later on the risk factors were evaluated according to the score and categorized into categories to determine the risk level. Among all the 98 respondents it is known most of the students have adequate knowledge about lice and infestation of lice shows that the students knows about lice, and average risk in social history which shows there is a chance of infestation from this risk factor because of the close living conditions, it was also show that the students have good personal history which shows that the responders have good personal behavior and hygiene, the risk factors was also researched using the difference between the orphanages and the age of the responder for a better understand of the risk factor. Thus, it is concluded that lice infestation risk in the orphanage is low considered as the students have adequate knowledge, social and personal risk. The results of this research could be applied as an analytical studies for further research in lice infestation.
Hubungan status gizi terhadap angka kejadian community-acquired pneumonia (CAP) pada balita di RSUP Sanglah Denpasar
Authors: Nandika Wintari Putu , Siadi Purniti Putu
Published: December 2022

Latar Belakang: Pneumonia hingga saat ini masih tercatat sebagai penyebab utama kematian pada anak-anak. Di rumah sakit, penyakit pneumonia termasuk dalam daftar 10 penyakit penyebab kematian pada penderita rawat inap yakni sebesar 2,92% dari seluruh kematian Pneumonia memiliki beberapa faktor resiko yang dapat memperberat penyakit tersebut antara lain adalah status gizi yang dimiliki penderita. Penelitian ini bertujuan untuk melihat hubungan antara status gizi dengan angka kejadian pneumonia.Metode: Disain penelitian adalah cross-sectional study dengan sampel 168 orang. Sebagai variabel bebas adalah status gizi sedangkan pneumonia sebagai variabel tergantung. Data yang digunakan diambil dari buku catatan pasien SMF Ilmu Kesehatan Anak RSUP Sanglah.Hasil: Dari sampel yang berjumlah 168 orang, ternyata 119 orang dengan gizi baik, dan 49 orang dengan gizi buruk. Pasien yang mengalami pneumonia adalah 84 orang dan yang bukan mengalami pneumonia adalah 84 orang. Hasil uji bivariat menunjukkan adanya hubungan yang bermakna antara status gizi dengan angka kejadian pneumonia p = 0,011 (p < 0,05), dengan nilai OR sebesar 2,425 (95% CI 0,216 - 4,839).Simpulan: Dari hasil penelitian ini dapat disimpulkan bahwa ada hubungan yang bermakna antara status gizi dan angka kejadian pneumonia pada pasien anak yang dirawat di SMF Ilmu Kesehatan Anak RSUP Sanglah.
The ethanolic extract of red cabbage (Brassica oleracea l. var,capitata f. rubra) in cream preparation to the dermal-thickness of male Wistar mice (Rattus norvegicus) after Ultraviolet-B exposure
Authors: Krishnan Gayathiri Mohana , Arijana IG Kamasan , Sugiritama I Wayan
Published: December 2022

Background: Photoaging effect in dermal layer of skin was commonly caused by Ultraviolet B (UV-B) rays exposure This study aims to assess the histological features of the dermis layer in the male Wistar mice after applied with the ethanolic extract of red cabbage following UV-B exposure.Methods: About 25 male Wistar rats were enrolled in this study by using post-test only control group design during 2 weeks. They were divided into 5 groups as follows: control group (P1), basic cream (P2), 5% ethanolic extract of red cabbage cream (P3), 10% ethanolic extract of red cabbage cream (P4), and 20% ethanolic extract of red cabbage cream (P5). The UV-B dosage used are 325 mJ/cm2 among groups prior to study. The dermis-elastic fiber thickness was assessed by Image Raster software. Statistical analysis was carried out using SPSS version 20 in measuring normality test, mean, and ANOVAResults: There was no statistically significant difference in the thickness of dermal layer among groups (P = 0.3). The mean of dermis thickness was 666.60Â±143.15Âµm in P5 group, followed by 651.19Â±189.18Âµm in P4 group, and 547.43Â±188.41Âµm, 544.76Â±100.67Âµm, and 504.10Â±129.40 Âµm in P3, P2, and P1 group respectively.Conclusion: There was no a significant difference among different dosage of the ethanolic extract cream of red cabbage to the thickness of dermal layer after UV-B exposure.
Management of central diastema with high-frenulum labialis
Authors: Kainama Karpov RB. , Anggani Haru S.
Published: December 2022

Objective: To explain the management of the central diastema case in a patient with high- frenulum labialis.
Methods: Using a conventional Orthodontic appliance MBT system. This method is selected to orthodontically corrected central diastema while eliminating deep bites and other existing malposition in this case.
Results: Central diastema and deep bite corrected, as well as other malposition. However, the frenulum labialis which was planned to undergone frenectomy was postponed to avoid an open gingival embrasure (black triangle).
Conclusion: Correction of central diastema done by using a conventional orthodontic appliance MBT system. However, the disposal of frenulum labialis should not always be done, because it should consider the possibility of the emergence of gingival embrasure (black triangle) after the Labialis frenulum was discarded.
Oral potentially malignant disorder awareness level among elder community in the Belawa Distric, Wajo, South Sulawesi, Indonesia
Authors: Marlina Erni , Sumintarti  , Ilmar Harlina , Yusran Ali , Usman Nur A. , Israyani  , Mauliana Andi A.
Published: December 2022

Objective: to assess awareness of senior community in the Belawa distric, Wajo, South Sulawesi, Indonesia regarding their oral soft tissue abnormality specifically regard to Oral potentially malignant disorders, and to assess community ability to descript any pain or uncomfortably origin from their oral cavity.

Methods: A self-made questionnaire written in Indonesia language was given to the old aged-adult based on WHO criteria with age range between 45 to 75 years old, who was willing to participate in this study. The questioner   consists some picture representing oral mucosal cavity with clinical feature of some ulcers, clinical feature of candida infection, and some clinical appearances of oral potentially malignant disorders.

Results: In term of oral mucosal diseases questions, 22 (55%) participants had history of ulceration, however only 5 (45%) participants could specifically point out its previous ulcer location. However, history of pain only stated by 11 (28%) participants, 24 (60%) did not experienced any pain, and 5 (12%) did not answer the questions.

Conclusion: knowledge and awareness regarding oral health lesion, especially the associated-potentially malignant lesion was far from ideal in the Belawa Community.