bluuebunny/crossref_metadata_2025 huggingface dataset:
Visualizing Archaeologists: A Reflexive History of Visualization Practice in Archaeology
Authors: Opgenhaffen Loes
Published: June 2021

Visualization techniques may have changed over the years, but have they fundamentally changed archaeological visual literacy and the ways archaeologists create knowledge? Or do new digital tools merely disguise conventional practices? The answer may reside in a deeper understanding of the long tradition of visualization practice, from the Renaissance to the present, for which the foundation lies in the activities of antiquarians and artists, as well as artistic, technical, and scientific innovations. This paper presents an historical synopsis of two usually separated but complementary research areas, digital archaeology and archaeological visualization, and builds on previous research undertaken on these traditionally separated subjects. By taking a slightly Dutch perspective I will introduce a few visualizing protagonists who have left substantial traces in our collective visual memory, aiming to contribute to a more inclusive historical narrative on archaeological visualization. The overview ends with an integrated discussion on the shared creative visual practice and its epistemic role in archaeological knowledge production. A praxis-oriented and reflexive approach to the history of visualization provides a critical understanding of the current workings of 3D visualization as a creative practice, and how archaeology responds and acts upon innovations and the adoption of new visualization technology.
Pyrolysis and combustion of polystyrene composites based on graphene oxide functionalized with 3-(methacryloyloxy)-propyltrimethoxysilane
Authors: Anghel Ion , Lisa Gabriela , Şofran Ioana-Emilia , Mitroi-Symeonidis Flavia-Corina , Rusu Mihai Marius , Baia Monica , Baia Lucian , Magyari Klára , Danciu Virginia , Cotet Liviu Cosmin , Stroe Malvina , Baibarac Mihaela
Published: June 2021

In this study, polystyrene composites (PS–GOf) with variable concentration (0.5; 1; 2; 3; 4; and 5 wt%) of GOf were obtained through the in-situ polymerisation of the styrene in the presence of benzoyl peroxide and graphene oxide(GO) functionalized with 3-(methacryloyloxy)-propyltrimethoxysilane(γ-MPTS). For determining the morphological and structural particularities of polymeric composites transmission electron microscopy (TEM) measurements were performed. The influence of functionalized GO on thermal and combustion properties of polystyrene (PS)-based composite materials was determined through several methods: Thermogravimetry (TGA); derived thermogravimetry (DTG); microscale combustion calorimetry analysis (MCC); and chemical kinetic studies through TGA and MCC determinations at similar heating rates.
Environmental arsenic exposure and its toxicological effect on thyroid function: a systematic review
Authors: Esform Adeleh , Farkhondeh Tahereh , Samarghandian Saeed , Rezaei Maryam , Naghizadeh Ali
Published: June 2021

Objectives

This study was performed to review epidemiological evidence related to Arsenic (As) effects on the thyroid function by focusing on the serum thyroid hormone concentration.

Content

As, one of the main pollutants, has been recognized as an endocrine-disrupting agent that may affect the function of thyroid as shown by experimental studies.

This systematic study indicates the association between As exposure and thyroid dysfunction. The studies have shown an association between serum and urine concentration of arsenic and thyroid dysfunction. Most of them reported the association between increase in the serum or urine As levels and decrease in the triiodothyronine (T3) and thyroxine (T4), and also elevation in the thyrotropic hormone (TSH) levels.

Outlook

Our findings related to the effects of As on the function of thyroid in humans are still limited and future studies should be done to address this question.
On the smallest singular value in the class of unit lower triangular matrices with entries in [−a, a]
Authors: Altınışık Ercan
Published: June 2021

Given a real number a ≥ 1, let Kn
(a) be the set of all n × n unit lower triangular matrices with each element in the interval [−a, a]. Denoting by λn
(·) the smallest eigenvalue of a given matrix, let cn
(a) = min {λ
n
(YYT
) : Y ∈ Kn
(a)}. Then

c

n

(
a
)

\sqrt {{c_n}\left( a \right)}

is the smallest singular value in Kn
(a). We find all minimizing matrices. Moreover, we study the asymptotic behavior of cn
(a) as n → ∞. Finally, replacing [−a, a] with [a, b], a ≤ 0 < b, we present an open question: Can our results be generalized in this extension?
Quantification of Calcium Oxychloride by Differential Scanning Calorimetry: Validation and Optimization of the Testing Procedure
Authors: Montanari Luca , Tanesi Jussara , Kim Haejin , Ardani Ahmad
Published: June 2021

The American Association of State Highway and Transportation Officials (AASHTO) T 365 standard, Standard Method of Test for Quantifying Calcium Oxychloride Formation Potential of Cementitious Pastes Exposed to Deicing Salts, describes a test methodology that uses low-temperature differential scanning calorimetry (LTDSC) to quantify the formation of calcium oxychloride in cementitious systems exposed to concentrated calcium chloride solutions. AASHTO T 365 is included in AASHTO PP 84, Standard Practice for Developing Performance Engineered Concrete Pavement Mixtures, as a performance indicator for mixtures at risk of calcium oxychloride formation. During the test, the sample temperature is first dropped to −90°C, looped through a brief thermal cycle, then slowly increased to a maximum of 50°C, at a constant heating rate of 0.25°C/minute (min), for a total testing time of approximately 11 hours. The objective of this work is to modify the test to reduce its duration to facilitate wide adoption among practitioners. It is found that by increasing the minimum conditioning temperature from −90°C to −5°C, as well as by increasing the heating rate from 0.25°C/min up to 1°C/min, the test duration can be reduced from approximately 10.7 hours to approximately 1.6 hours without any statistically significant difference in the numerical test results, although an offset of the melting peak and a change in its shape were observed. This change can provide valuable savings in terms of time and energy/gas consumption and make AASHTO T 365 more competitive with other available tests for the estimation of calcium oxychloride formation, such as thermogravimetric analysis (TGA). TGA and LTDSC are compared to each other in terms of mixture classification for susceptibility to calcium oxychloride formation. It is shown that the two tests show good agreement, with 85 % of cases (out of 30 tested) receiving the same classification.
Blood transportation using multi-vehicle systems; optimal blood transport temperature in terms of hemolysis
Authors: Yakushiji Fumiatsu , Yakushiji Koki , Murata Mikio , Hiroi Naoki , Fujita Hiroshi
Published: June 2021

Recently, the use of drones has been proposed for blood transportation. Therefore, in this review, we first detailed the history of blood storage and transportation for red blood cell transfusion, and then presented ideas for creating rules to improve the safety of blood transportation, based on the idea that hemolysis is the problem for blood quality. In particular, it touches on the current logistics of blood transportation in which public transportation is not used, including the recent use of drones to transport blood, and points out the problems with this system. We discuss how instances of improper red blood cell transportation with inadequate temperature control are still observed, and that temperature control, vibration remain the major hindrances to appropriate blood transportation. Therefore, a set of rules that will contribute to appropriate and rapid blood transportation is warranted. Moreover, there are notable differences in blood storage rule between Japan and the US and UK, and there is no legal transportation rule in Japan. Based on our review and experience, we think that basic temperature control at 2–6°C should always be maintained to prevent blood deterioration even if unmanned aerial vehicle (drone) technologies are available.
Congenital myopia complicating pregnancy: A rare case and mini-review of the literature
Authors: Sofoudis Chrisostomos , Eftimios Papamargaritis , Maria Papadaki , Kyriaki Yperifanou
Published: June 2021

A highly myopic 35-year-old female patient (P0, G1) with reduced visual acuity R 3/10 l 3/10 due to bilateral choroidal neovascularization (CNV) admitted at our Department. The patient had atomic history of congenital myopia firstly diagnosed at the age of 2-y-old. The initial diagnosis established a refractive error over 8 diopters (high grade myopia) progressively increased. During third trimester of gestation her vision was acutely diminished. The fundoscopic examination depicted elevated intraocular pressure and deterioration of myopia to -30D bilaterally. (Fruoresceinangiography revealed active CNV). Patient underwent selected caesarean section due to increased risk of macular hemorrhage. She discharged from hospital the 4th pod in good clinical condition. Assiduous ocular and obstetrical monitoring appeared mandatory in order to insure optimal therapeutic mapping. Objective of our study remains proper diagnosis and treatment of such a rare case.
Hydroxyapatite (HAp) From Tenggiri Fish Bones As Abrasive Material In Toothpaste Formula
Authors: Anggresani Lia , Sari Yoli Nopita , Rahmadevi Rahmadevi
Published: June 2021

Cavities are one of the factors of dental and oral health problems that can be prevented by brushing teeth using toothpaste. Toothpaste can be made from a variety of chemicals, one of which is hydroxyapatite (HAp) which has good biocompatible properties. Hydroxyapatite can be obtained by utilizing tenggiri fish bone waste which has the main element of calcium. Fish bones soaked with NaOH and acetone are then calcined at 800 °C for 3 hours to obtain CaO powder and characterized its elemental content using X-Ray Fluorescence (XRF). CaO obtained was then reacted with (NH4)2HPO4 with a mole ratio of Ca/P 1.67 then heated at 90 °C, added NaOH up to pH 12, then the obtained deposits are filtered and calcined at 900 °C.  The solids obtained from the calcination are then characterized using X-Ray Diffraction (XRD) and Scanning Electron Microscope (SEM). Hydroxyapatite (HAp) was formulated into toothpaste with the concentrations of 0% (F0), 45% (F1), 50% (F2), and 55% (F3). Toothpaste was evaluated using organoleptic tests, homogeneity tests, foam height tests, spreadability tests, pH and hedonic tests. XRD analysis shows that the resulting hydroxyapatite (HAp) has a crystal structure in accordance with ICSD standard No. 96-900-3549. SEM analysis showed that granular particles measuring 0.1 μm–0.3 μm in size. All formulated toothpastes (F0, F1, F2, and F3) meet the requirements of a good toothpaste.  Hydroxyapatite (HAp) can be formulated into a good toothpaste with a concentration of 45%.
Urticarial manifestation in COVID-19 infection: A case report
Authors: Djunaidi Anita M , Wirya Andrew Y
Published: June 2021

Background: The COVID-19 pandemic outbreak causes a worldwide health concern. As the epidemic progressed, several cutaneous manifestations are increasingly noticed; therefore, the authors hope this report will provide additional information that may benefit fellow healthcare professionals. Case report: A 45 years old Javanese female patient complained of fatigue, dry cough, dyspepsia, and reddish pruritic swelling on her face for one day. There was no fever, dyspnea, anosmia, diarrhea, or uvula, tongue, vocal cords, and the airway problem. She had no history of food or drug allergy, urticaria, other comorbidities, or any medicine consumption in the last 15 days. Facial dermatological status showed circumscribed, raised, erythematous areas of edema, slightly pruritic. Normal vital signs. Blood laboratory results: leucocyte 5.760/mL, decreased ALC 818/mL, increased NLR 5.0. Chest X-ray showed an increase in bronchovascular pattern and slight opacity on the peripheral, basal part of both hemithorax. COVID-19 rapid test was positive for IgM, and her PCR of upper-airway secretions revealed positive COVID-19 infection. The diagnoses were COVID-19 infection, dyspepsia, and urticaria. The treatments were levofloxacin, isoprinosine, chloroquine sulfate, omeprazole, fluimucyl, vitamin C, and diphenhydramine. Within three days of treatment, the urticaria started to fade off, and her overall condition improved. Conclusion: The COVID-19 poses a global challenge in the health sector, and one of its various manifestations is cutaneous symptoms. Further research is necessary to elucidate how COVID-19 triggers dermatological symptoms.
Breastfeeding Peer Counselor Program in Malaysia: Impact on Breastfeeding Duration and Exclusivity
Authors: Md Monoto Ezura Madiana , Hamzah Zuhra , Mohamad Alwi Nor Kamariah , Abdul Wahab Asrul
Published: June 2021

Background: The Malaysian Breastfeeding Peer Counselor Association (MBfPCA) is a pioneer non-governmental organization (NGO) of trained breastfeeding peer counselors in Malaysia. We explored the effect of peer counseling support on breastfeeding outcomes among postnatal mothers who delivered at a national tertiary teaching hospital and their satisfaction with the peer counseling services.Method: A total of 210 postpartum mothers were recruited in a single-blinded, randomized, controlled trial. Block randomization was used to allocate the participants into the intervention (I) group (n=105), who received telephone-based peer counseling support at 72 hours, 2 weeks, 1, 2, 4 and 6 months postpartum; and the control (C) group (n=105), who received routine breastfeeding advice. The infant feeding practices information was obtained at 2, 4 and 6 months postpartum from both groups. Data on maternal satisfaction with peer counseling services was acquired from the intervention group participants 6 months postpartum.Results: Ninety-four mothers were lost to follow up, leaving 116 (I=60, C=56) for analysis. The number of participants who practiced exclusive breastfeeding was higher in the intervention group at all intervals, with significant difference seen at 6 months postpartum (p = 0.035). Significant differences were also seen in the prevalence of breastfeeding between the groups at 4 and 6 months postpartum (p = 0.017 and p = 0.010). All participants who practiced exclusive breastfeeding found that peer counselors helped them reach their breastfeeding goals (p =0.001) and would recommend peer counseling services to others (p = 0.037).Conclusion: Peer counselor support in Malaysia increased the duration and exclusivity of breastfeeding and was well accepted among postnatal mothers.
The analysis of hand maximum voluntary contraction and its associated factors among hemodialysis-dependent chronic kidney disease patient in Jordan
Authors: A. Almomani Hesham , Almomani Thaker , Almomani Marya , Kanaâ€™an Soha , Al-Khawaldeh Ahmed
Published: June 2021

Introduction: Maximum voluntary contraction (MVC) of handgrip strength is considered a reliable subjective global assessment tool and has been used as predictive tools for human body performance. The usefulness MVC for continuous assessment of muscle strength in chronic kidney disease (CKD) patient's hemodialysis patients need to be investigated.Methods: The research involved 100 CKD patients that underwent routine hemodialysis in Jordan. The subject's demographic and anthropometric data were collected. Subjects also tested for MVC using a dynamometer. The data was analyzed to find the relationship between each of the independent factors, including age, body mass index (BMI), handgrip circumference (HGC), forearm circumference (FAC), to the maximum voluntary contraction (MVC). Linear and nonlinear modeling were generated to estimate the effect of each independent variable.Results: Subjects ages varied from 20-70 years old, for males mean age was 46.48 years old, mean weight 83.74 kg, mean height 167.24 cm, mean BMI 30.28 kg/m2, mean handgrip circumference 21.34 cm, and mean forearm circumference 26.13 cm. For females, the mean age was 47.62 years old, weight 77.28 kg, mean height 162.96 cm, mean BMI 29.24 kg/m2, mean handgrip circumference 20.09 cm, and mean forearm circumference 24.83 cm. For males, the highest MVC Value was 49.3 lbf, while for females, the highest MVC Value was 38.6 lbf, and both from the group aged <30 years old. ANOVA revealed that age was the primary factor that was significantly associated with MVC.Conclusion: The age has major and significant effects on maximum voluntary contraction in CKD patients.
Lipid and cardiac profile assessment following the co-administration of Cisplatin and methanolic extract of Portulaca oleracea in adult Wistar rats: an experimental study
Authors: Okafor Izuchukwu Azuka , Nnamah Uchenna Somtochukwu , Nnaka Jude
Published: June 2021

Introduction. There is a need for continual evaluation of the effective use of plant-based medicine as combination therapies as more therapeutic potentials are being associated with phytomedicine. The changes in the lipid and cardiac profile of adult Wistar rats following the co-administration of Cisplatin and methanolic extract of Portulaca oleracea (MEPO) were investigated.Methods. Twenty-four (24) rats with an average weight of 154 kg were randomly divided into six (6) groups (A-F). Group A was given no treatment and served as the normal control group. Group B received only a cisplatin injection and served as the cisplatin control group. Group C and D were given 400mg/kg and 800 mg/kg MEPO six hours after cisplatin injection. Group E and F were administered 400mg/kg and 800 mg/kg MEPO 6 hours before cisplatin injection. All cisplatin injections were single-dose intraperitoneal injection (2 ml/kg) and MEPO administration lasted for 7 days. Animals were euthanized under diethyl ether anesthesia at the end of the experiment and blood collected for serum lipid profile investigations. Some cardiac and lipid parameters were estimated from standard formulae.Results. There was a significant increase in the serum levels of TG and TC (p=0.01 and p < 0.001) and some estimated parameters â€“ LDL, VLDL, CRR, HDL-LDL and TG-HDL (p<0.001, p=0.049, p<0.001, p<0.001 and p=0.001 respectively) while HTR was significantly decreased (p<0.001) due to cisplatin treatment. HDL and AI levels were unchanged by cisplatin treatment. MEPO significantly reversed (p<0.05) the cisplatin-induced changes in the serum lipid parameters (TG and TC) and estimated parameters (VLDL, CRR and TG-HDL) across all MEPO-treated groups.Conclusion. MEPO shows evidence of attenuating cisplatin-induced hyperlipidemia and cardiac risk.
The correlation between serum fibroblast growth factor-23 with urinary fractional excretion of phosphate in predialysis chronic kidney disease
Authors: Kandarini Yenny , Wirdhani Vika , Lestari Anak Agung Wira Dewi
Published: June 2021

Purpose: To investigate the correlation of serum fibroblast growth factor-23 (FGF-23) with urinary fractional excretion of phosphate (FEPi) in predialysis chronic kidney disease (CKD).Methods: This cross-sectional study involved 75 patients with CKD stage 2-4. Blood and 24-hour urine samples were taken from eligible participants to measure key variables using standard commercial assays. FGF-23 concentration was measured using enzyme-linked immunosorbent assay (ELISA). The correlation between FGF-23 serum level and urinary FEPi was analyzed using the Spearman correlation test.Results: Of 75 eligible subjects, the majority had the characteristics of male gender, CKD stage 3, with mean age and body mass index of 50Â±10.8 and 23.51Â±3.3, respectively. The median FGF-23 level was 108.7 (13.6-1226.2) RU/ml, while the median urinary FEPi was 24.3% (4.04%-65.9%). There was a moderate positive correlation between FGF-23 and FEPi (r = 0.44, p<0.001). Conclusion: The result confirmed the correlation between serum FGF-23 level with urinary FEPi in predialysis CKD.
Dengue hemorrhagic fever with severe ocular complication: case series
Authors: Triningrat Anak Agung Mas Putrawati , Agus Somia I Ketut , Dwi Lingga Utama I Made , Sri Yuliastini NI Putu Ngurah , Wijayati Made Paramita , Handayani Ariesanti Tri
Published: June 2021

Introduction: Ocular complication associated with Dengue Haemorrhagic Fever (DHF) is a rare condition with varied manifestations, ranging from subconjunctival hemorrhage to optic neuropathy. This condition's pathophysiological mechanism is not well understood, with several unpredictable conditions resulting in permanent visual loss. In this case series, three patients with severe ocular complications associated with DHF are presented. Case Report: Case 1: a 16 years old girl presented with proptosis after diagnosed with DHF with no light perception. All findings were consistent with pan-ophthalmitis and retrobulbar hemorrhage. Unfortunately, the right eye turned into phthisis and spontaneous prolapse even with canthotomy with lateral cantholysis and steroid administration. Case 2: 10 years old boy presented with bilateral visual blurring within a month after being diagnosed with DHF with hand movement perception on both eyes and optic disc swelling. The visual acuity recovered to 20/20 in a month of steroid therapy with no optic disc swelling. Case 3: 52 years old man presented with proptosis and dengue shock syndrome with counting finger perception, swelled optic disc, and limited eye movement to all directions. The patient was diagnosed with optic neuritis and retrobulbar hemorrhage. Canthotomy with lateral cantholysis lateral and steroid therapy were planned, but the patient died before treatment was done.Conclusions: Severe ocular complications should be anticipated and monitored in DHF patients. Although visual recovery is possible, permanent ocular complications can be severe and cause permanent visual loss.
Growth parameters in children with atopic dermatitis in Erbil City, Kurdistan Region-Iraq
Authors: Hamid Ahang Mohammed , Qurtas Dindar Sharif
Published: June 2021

Background: Atopic dermatitis is a chronic inflammatory skin condition that significantly impacts patients' quality of life. A disturbed sleep pattern, frequent potent topical and sometimes systemic corticosteroid use, and diet restriction, all of which could affect child's growth.Objective: This study determined height and weight impairment in children with atopic dermatitis.Patients and Methods: A cross-sectional study took children with atopic dermatitis â‰¤18 years, which was conducted in the "Erbil Dermatology Teaching Center." The patients' data included sociodemographic information, family history, drug history, and present complaints. The severity of the disease evaluated using SCORAD score. The weight was recorded using a medical electronic weighing machine, and standing height was recorded using a stadiometer. Â Results: Among 100 children with atopic dermatitis, their mean of age was 6.84Â±1.8 years.Â  Males and Females frequencies were 54 and 46, respectively. The family history of atopic dermatitis was positive in 73%. Generally disturbed sleep pattern was dominant, and almost all severe AD patients had disturbed sleep (87.5%). The severity of AD was classified by SCORAD score to mild (23%), moderate (69%), and severe (8%). Patients having their growth percentile for weight and height for age below 3rd percentile were 10% and 3%, respectively. Patients' weight and height for age below 25th percentile were 15% and 9%, respectively.Conclusions: Atopic dermatitis can affect the height and weight of the children inversely. The study sample's most dominant character was sleep pattern disturbances, which can affect both weight and height.
Development of KET-U-T phenomenon to assess comprehensive care, support, and treatment in people living with HIV
Authors: Suryana Ketut
Published: June 2021

Background: Â Negative psychological responses related to HIV seropositivity status disclosure are prevalent and often remain unattended. We proposed a comprehensive care delivery method with biopsychosocial approach (comprehensive care, support, and treatment [C-CST]) along with an instrument (KET-U-T phenomenon) to assess its efficacy.Methods:Â  A total of 200 individuals HIV positive were consecutively enrolled in this study and equally distributed into pre- and post-C-CST groups. All participants were structurally interviewed to assess HIV-related information level, family support, and KET-U-T phenomenon (K=disappointment, E=emotion/anger, T=denial, U=effort, T=acceptance).Â  Appropriate statistical analyses were done to determine the effect of C-CST on the KET-U-T phenomenon.Results: Post test counselling for 100 individuals pre-C- CST, demonstrated HIV-related information level (68%) and family support (78%) inadequacy, with respective proportion of KET-U-T phenomenon components of; K: 43.0%, E: 12%, T: 30%, U: 100%, T: 15%. Significant improvement post C-CST observed in reduction of HIV-related information level (26%) and family support (38%) inadequacy, with respective proportion of KET-U-T phenomenon components of; K: 18%, E: 2%, T: 5%, U: 100%, T: 75% (p=0.000).Conclusions: Comprehensive care, support, and treatment yielded significant improvement in negative psychological adaptation and seropositive status acceptance in PLWH as observed with the KET-U-T phenomenon.
Assessment of lipid profile among patients with seborrheic dermatitis
Authors: Abdulrahman Barez Burhan , Elethawi Ali Muzan Dhahir , Abdullah Hadi Mohammed
Published: June 2021

Background: Although the complicated interplay of Malassezia, keratinocytes and the immune response against a modified lipid composition in the skin have a vital role in the pathogenesis of Seborrheic Dermatitis (SD), the pathophysiology itself is still inadequately understood.Â  The association of SD with metabolic syndrome like dyslipidemia can be explained by inflammation in both conditions' pathogenesis. The present study was aimed at evaluating the relationship between the lipid profile abnormality and the SD.Â Methods: A prospective cross-sectional study was conducted in the Dermatology teaching center in Sulaimani, Iraq, from 1/9/2019 to 1/3/2020. This study used a structured data collection format comprised of items concentrating on socio-demographic characteristics, duration of the disease, level of SD, the severity of SD, and lipid profile. The data were analyzed by STATA 14 statistical software and summarized in tables and figures. The Chi-square test was done to detect the association between categorical variables. P-value <0.05 was significant.Results: A total of 100 patients with seborrheic dermatitis with the average age of patients was 37.5 Â±13.06 years, and 61 were females. The mean fasting total cholesterol (219.72 mg/dl vs.114.83 mg/dl), LDL-C (123.92 mg/dl vs. 85.08 mg/dl) and triglycerides (170.38 mg/dl vs.102.17 mg/dl) levels were higher for the high-level cases than the normal level cases.Â  The HDL-C level (31.06 mg/dl vs. 38.94 mg/dl) of the high-level patients was lower than normal patients. Age, total cholesterol level, LDL-C, triglycerides, and HDL-C had a statistically significant association with the disease's level and severity. The duration of the disease had a statistically significant association with only the level of disease.Conclusion: Lipid profile has a statistically significant association with the level and severity of SD. Finally, we recommend a large observational study to depict the causal relationship between serum lipid abnormality and SD.
Correlation between perceived stigma and quality of life of Leprosy patients
Authors: Sinambela Duma Wenty Irene , Lubis Syahril Rahmat , Dalimunthe Dina Arwina
Published: June 2021

Background: Stigma is one of many problems that hinders leprosy prevention efforts. Perceived stigma refers to the perceptions and subjective awareness of leprosy patients what the community thinks or do to themselves which can reduce quality of life (QOL). This study aimed to analyze the correlation between perceived stigma and QOL of leprosy patientsMethods: This study involved 30 leprosy patients and the baseline data were collected through interview. We assessed perceived stigma and QOL respectively by using Explanatory Model Interview Catalogue (EMIC) and World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. Pearson correlation test is used to analyze the collected data.Results: There was a significant correlation between perceived stigma and QOL (p=0,011; r= -0,459). The majority of research subjects were aged between 19-40 years old with male sex predominance, senior high school education, income below the city minimum wage and married status. Most of them had negative perceived stigma. Covering illness from others and discussing their illness closest people were the dominant factors affecting perceived stigma. They had ordinary QOL subjectively, not satisfied to health condition, physical domain was the most affected by Leprosy and had a good QOL.Conclusion: There was a significant correlation between perceived stigma and QOL.
The potential role of exosome on cytokine storm and treatment of severe COVID-19 infection
Authors: Kadriyan Hamsu , Prasedya Eka Sunarwidhi , Pieter Nova Audrey L , Gaffar Masyita , Punagi Abdul Qadar , Bukhari Agussalim
Published: June 2021

The symptoms of COVID-19 varies from mild to severe. The risk of severe infection occurs about 10% of cases, while the risk of death occurs about 0-14.6% of cases. One of the suspected pathophysiology in cases of severe infection and death of COVID-19 is due to cytokine storms. Exosome plays a vital role in the pathogenesis of several diseases, including severe disease such as sepsis due to cytokine storm. Exosome has been proven as a nanomaterial carrier that can tackle cytokine storm in the treatment of severe COVID-19 infection. Several studies have been conducted for this purpose, and its clinical application continually increases. This review will explore the role of exosomes in cytokine storms that occur in patients with COVID-19 and seek the opportunity to use exosomes in their management
Clinical presentation and outcome of COVID-19 infection in Type 2 Diabetes Mellitus: a preliminary data from a tertiary hospital in Jakarta during the early days of the pandemic
Authors: Kshanti Ida Ayu , Aji Giri , Epriliawati Marina , Mokoagow Md Ikhsan , Nasarudin Jerry , Magfira Nadya , Sari Anggraini Permata , Manurung Annela , Djojo Aryan Yohanes , Wardoyo Elizabeth Yasmine , Iskandar Martha , Darnindro Nikko , Mardiyah Radhiyatam
Published: June 2021

Introduction. This study aimed to review the clinical characteristics and outcomes of COVID-19 patients presented with in-hospital hyperglycemia or pre-existing type 2 diabetes (T2DM).Methods. This is a retrospective study conducted in Fatmawati General Hospital, Indonesia, from March 18th-Apr 30th, 2020. We reviewed medical records of 27 COVID-19 patients presented with either in-hospital hyperglycemia (11, 12.2%) or pre-existing T2DM (16, 17.8%) from a total of 90 confirmed COVID-19 cases admitted in our hospital.Results. Critical conditions occurred in 50% of T2DM and 54.55% of the in-hospital hyperglycemia group. Mortality was documented in 68.75% of T2DM and 81.82% of in-hospital hyperglycemia group. Hypoglycemia, diabetic ketoacidosis, lactic acidosis and ketosis were found in 12.5%, 25%, 18.75%, and 25% of individuals with T2DM, respectively, resulting in a high mortality rate. Meanwhile, diabetes-related complications were rare among the in-hospital hyperglycemia group. However, respiratory failure (45.45% vs. 6.25%) and septic shock (27.27% vs. 6.25%) were more frequent than in the T2DM group.Conclusion. In this preliminary study, a high mortality rate was documented among COVID-19 patients with preexisting T2DM and in-hospital hyperglycemia. In T2DM subjects, diabetes related-complications contributed to a higher mortality rate, while in-hospital hyperglycemia group, respiratory failure and septic shock were more frequent.
Quickert procedure for involutional lower eyelid entropion: a multi-centre study
Authors: Lubis Rodiah Rahmawaty , Sari Novie Diana , Hutasoit Herna
Published: June 2021

Background: Involutional entropion is the inward turning of the eyelid margin and commonly happens in the inferior eyelids in elderly people. The prevalence is as high as 2.1% in people â‰¥ 60 years old and more common in women than men. This condition may cause ocular surface irritation and discomfort secondary to contact between cilia and the ocular surface. Several etiological factors are suspected to be important causes of involutional entropion. One of them was horizontal eyelid laxity. Quickert Procedure is one of the surgical interventions recommended to correct involutional lower eyelid entropion in the elderly Asian population with 0% of recurrent entropion in a recent study by Miyamoto et al.Methods: This is a descriptive retrospective study of 16 involutional lower eyelid entropion patients (18 eyelids) that needed surgical correction. Â About ten males and six females were undergone Quickert procedure to correct the involutional entropion. Patients were assessed postoperatively for 24 months to evaluate the recurrence entropion, cosmetic, and functional improvement. Data were analyzed by SPSS version 20 for Windows.Results: This study included 16 patients, with mean age was 69.8 years old which range from 62-85 years old. They consisted of 9 (56.0%) patients were male, and the rest was female (44.0%). Eleven (61.0%) patients were with left eye laterality, and 10 (63.0%) patients found without anticoagulant consumption. All patients (100.0%) had positive snapback test and achieved >6 mm in distraction test. After surgical intervention, no patients (0.0%) were found to experience recurrence of involutional entropion nor ocular discomfort due to prior surgery.Conclusion: A detailed assessment of the etiology, accurate preoperative evaluation, and precision in addressing patients underlying eyelid anatomic abnormalities are needed in the selection of appropriate surgical procedures to correct entropion.
High expression of early secretory antigenic target 6 mRNA as a potential predictor of tuberculous lymphadenitis
Authors: Cempaka Rita , Nuryastuti Titik , Laiman Vincent , Yuliani Fara Silvia , Musthafa Ahmad , Pratiwi Hadis , Marcellus Marcellus , Heriyanto Didik Setyo
Published: June 2021

Purpose: Tuberculous lymphadenitis is one of the most common presentations of extrapulmonary tuberculosis. The diagnosis can be challenging due to its varying clinical manifestations and the low sensitivity of conventional bacteriological methods for confirming the causative agent, Mycobacterium tuberculosis. Early secretory antigenic target 6 (ESAT-6), which is released early during M. tuberculosis infection and plays a role in granuloma formation, determines the pathogenâ€™s invasion, its severity, and virulence factors related to the immune response. This study aimed to analyze the potential diagnostic value of ESAT-6 using real-time polymerase chain reaction (RT-PCR) and compare it with histopathologic diagnostics. Materials and methods: This retrospective observational study with the cross-sectional design was conducted using consecutive sampling. A total of 50 formalin-fixed, paraffin-embedded lymph node tissue samples from lymphadenectomy consisted of 25 tuberculous lymphadenitis and 25 granulomatous lymphadenitis were collected. The specimens were diagnosed with tuberculous and granulomatous lymphadenitis based on histopathologic features. Analyses using conventional PCR from commercial kit to detect TB and RT-PCR to determine the expression of ESAT-6 were performed. Statistical analysis of the categorical data was performed using the Mann-Whitney test. Statistical significance was set at p < 0.05.Results: The mean age of the patients was 35.66 years old (range: 6â€“85 years). The age group between 16 and 30 years was the most common (40%). Almost two-thirds (62%) of the patients were female. Sixteen (64%) tuberculous lymphadenitis and 13 (52%) granulomatous lymphadenitis samples were positive by PCR TB. ESAT-6 expression was significantly higher in tuberculous lymphadenitis (p = 0.004).Conclusion: ESAT-6 as a potential predictor of tuberculous lymphadenitis can be used in patients for whom histopathologic diagnostics fail to confirm the presence of M. tuberculosis.
The effectiveness of yoga exercise toward blood pressure and endothelial-derived hyperpolarizing factor (EDHF) level in hypertensive diabetic population
Authors: Wahyuni Nila , Indrayani Agung Wiwiek , Juhanna Indira Vidiari
Published: June 2021

Introduction: Diabetes and its complications are the leading causes of premature death worldwide. Diabetes causes complications such as hypertension and an increased risk of cardiovascular diseases. Endothelial dysfunction is the primary pathophysiology that underlies complications of diabetes mellitus. EDHF (Endothelial-Derived Hyperpolarizing Factor) is a relaxing factor that targets current therapy in vascular dysfunction and insulin resistance in obesity and diabetes mellitus. Yoga training is a physical activity that has been shown to play a role in decrease blood pressure, but to our knowledge, there are no studies that prove the effectiveness of yoga in increasing EDHF levels. Therefore, this study aimed to determine the efficacy of yoga to decrease blood pressure and increase EDHF levels in type II diabetes mellitus patients with hypertension.Methods: This research was a randomized control trial that involved 39 hypertensive diabetic respondents and was conducted in Denpasar, Bali, Indonesia. Yoga exercise was carried out two times a week for eight weeks, with a duration of 60 minutes per session. EDHF levels were examined using the ELISA technique.Results: There was a significant difference in systolic, diastolic and EDHF levels after the intervention between the yoga and control groups and large effect size.Conclusion: In conclusion, yoga training effectively reduced blood pressure and prevented endothelial dysfunction by increasing the blood vessel relaxing factor, namely EDHF.
The quality of life in the treatment of maxillofacial fractures using open reduction: A prospective study
Authors: Ayu Anggayanti Nyoman , Sjamsudin Endang , Maulina Tantry , Iskandarsyah Aulia
Published: June 2021

Purpose: To assess the impact of open reduction on quality of life in patients with maxillofacial fractures.Methods: A prospective study of 15 patients admitted to a general hospital in Bandung for maxillofacial trauma from October 2017 through February 2018 was conducted. Trauma severity was assessed using facial injury severity scale (FISS) score, while the quality of life was assessed using Oral Health Impact Profile (OHIP) -14 questionnaires at one day before surgery (T0) and 14 (T1) and 60 days (T2) after surgery.Results: Male (3.92Â±1.89) and younger patients (3.89Â±1.69) had a greater mean FISS score than their respective counterparts. The most common areas involved in maxillofacial fractures were mandible body (80%) and dentoalveolar (46.67%). The overall quality of life was worse in younger patients as indicated with a higher mean OHIP-14 score. There was a disparity in the domain of interest where younger patients (17-30 years) had more concern over psychological discomfort, whereas older patients (31-50 years) were more concerned about physical disability. Both qualitative and quantitative improvement in quality of life was observed in the follow-up period. Consistent and statistically significant improvement in mean OHIP-14 score before intervention (20.80Â±5.94), 14 days post-intervention (17.93Â±4.68), and 60 days post-intervention (14.67Â±3.42) was observed.Conclusion: Open surgery approach yielded a good outcome in quality of life improvement. Further study on demographic factors, timing, and quality of life domain affected in maxillofacial fractures is recommended.
Ruptured ectopic pregnancy management in the COVID-19 pandemic era: a case report
Authors: Winata I Gde Sastra , Supono Anton
Published: June 2021

Introduction. COVID-19 protocol and the unavailability of proper instruments in the isolation room had complicated the usual protocol to diagnose and manage the medical and surgical conditions. Â This article is about the first ruptured ectopic pregnancy cases encountered during the COVID-19 pandemic in Sanglah General Hospital. Considering the unique circumstances and the difficulty during establishing the diagnosis and conducting the management, we ought to present our experience through this article.Case Description. This case report reviews a 24-years-old female, an asymptomatic COVID-19 case, who was diagnosed with ruptured ectopic pregnancy during appendectomy surgery in Sanglah General Hospital, Denpasar, Bali-Indonesia. The patient complained about mild lower right abdominal pain, with a clinical picture that supports acute appendicitis. However, the history taking revealed a history of post-curettage 15 days prior to admission due to vaginal bleeding suspected for incomplete abortion. Except for a positive pregnancy test, the clinical picture did not support a pregnancy nor a ruptured ectopic pregnancy. We still consider an ectopic pregnancy as no histopathological examination result was available to supports the previous vaginal bleeding was an intrauterine pregnancy. Further to complicate the problem, the patient was reactive for the COVID-19 screening test, thus requiring a COVID-19 protocol. As an ultrasound device was unavailable at the time in the isolation room, we could not assess for extrauterine pregnancy. Only during the surgical procedure for appendectomy, our surgical college notified us of the accompanying presence of sign of ruptured right ampullary pregnancy.Conclusion. The COVID-19 isolation protocol and the unavailability of essential equipment and diagnostic tools in the isolation room could hinder the usual protocol used to diagnose and manage various medical and surgical problems. We hope this article could illustrate how COVID-19 had complicated unusual cases, thus reflect how important clinical judgment and infrastructure in our health care system.
Myasthenic crisis in pregnancy: a case report
Authors: Sanjaya I Nyoman Hariyasa , Supono Anton , Adnyana I Made Oka , Mulyana Ryan Saktika , Pangkahila Evert Solomon , Ariyana I Made
Published: June 2021

Introduction: This case report aims to describe the diagnostic strategy and optimal management of pregnancy with Myasthenia Gravis and Myasthenic Crisis.Case Description: A 27-years-old pregnant female with Myasthenia Gravis complicated by Myasthenic Crisis was hospitalized six times during her pregnancy. Two initial hospitalizations due to acute exacerbation treated with plasmapheresis, and two other hospitalizations complicated with myasthenic crisis treated with massive Therapeutic Plasma Exchange in the Intensive Care Unit. Managing myasthenia gravis in pregnancy, from early pregnancy until delivery, is challenging. Furthermore, the myasthenic crisis in pregnancy is a rare case that requires airway and ventilation support and treatment with plasmapheresis.Conclusion: Myasthenic crisis in pregnancy is a rare condition. Therefore, a guideline about the prenatal, antenatal, delivery plan, exacerbation, and myasthenic crisis management in pregnancy and pregnancy planning women are urgently needed.
Correlation between body mass index with striae in female adolescent
Authors: Putra Imam Budi , Jusuf Nelva K. , Aryunisari Chyntia Giska
Published: June 2021

Background:Â StriaeÂ has been reportedÂ as a skin problem often experienced by a woman and becomes an aesthetic problem. This skin problem can occur at any age, including adolescents, even though it is more common in younger women. Some conditionsÂ increase the risk of striae, such as weight, pregnancy, puberty, and hormonal drugs. Women with higher body mass index (BMI) tend to have more striae. With a limited study on striae, it is quite interesting to evaluate the high incidence of striae in the population.Patients and Methods:Â  This was a cross-sectional study using a total sampling method. The studyÂ was conductedÂ after approval from the Ethics Committee Faculty of Medicine, Universitas Sumatera Utara. Samples are 155Â female studentsÂ aged 18-25 years oldÂ from the Medical Faculty of UniversitasÂ SumateraÂ Utara. All samples were physically examined to diagnose the striae, and the BMI was calculated.Â  All the collected data were analyzed statistically with ETA statistical tests to see the relationship between BMI and striae. P-value <0.05 considered statistically significant.Results:Â The dominant age of the subject is 19 years old (62.5%), followed by 20 years old (30.3%), 21 years old (3.8%), and 18 and 23 years old (0.6%). Out of 155 subjects, there are 117 have striae (75.5%). None of the striae subjects is underweight, normal weight was 113, 3 obese and one overweight. The 38 subjects without striae are in normal BMI. An analysis using ETA proved that BMI is not significantly associated with striae (p>0.05).Conclusion:Â There is no significant relationship between BMI and striae.
Effect of oral L-Arginine supplementation on intima hyperplasia after Fogarty balloon embolectomy catheterization in New Zealand Rabbit (Oryctolagus cuniculus)
Authors: Ibnu Syahroni , Lukiswanto Bambang Sektiari , Legowo Djoko , Kasirin Budiono , Puruhito Ito
Published: June 2021

Background: Acute limb ischemic is a disease that threatens the viability of the leg with the threat of amputation to death. Fast and accurate diagnosis is essential in the management of this disease, one of the most commonly performed surgical therapies in Indonesia is thromboembolectomy using a Fogarty catheter. Thromboembolectomy with this method is very effective but gives a variety of complications, one the complication is the occurrence of intima hyperplasia which affects the lumen restenosis of the blood vessels. The aim of this study is to determine whether the administration of oral L-Arginine as a supplement for 4 weeks after endothelial trauma with a Fogarty embolectomy balloon catheter can prevent the incidence of intimal hyperplasia of the iliac artery of the New Zealand Rabbit (Cuniculus oryctolagus).Methods: Experimental study with 16 experimental animals of Oryctolagus cuniculus rabbits subjected to endothelial trauma with Fogarty catheters and divided into 2 groups. The control group was not given L-Arginine and the experimental group was given post-treatment oral L-Arginine for 4 weeks, then the intima-media ratio was compared with histopathological examination.Results: There was a significant difference in the ratio of intima-media thickness between the control group (without L-Arginine administration) 5.13 Â± 4.12 and the experimental group (with L-Arginine administration) 1.18 Â± 0.59 (p=0.03 ). Significant differences were also found in the intima thickness of the control group 302.22 Â± 217.42 and the experimental group 118.21 Â± 32.59 (p=0.048). Meanwhile, for the thickness of the tunica media and the intima-media complex, there were no significant differences observed.Conclusion: Administration of L-Arginine orally after endothelial trauma with Fogarty catheter in rabbit iliac artery significantly reduces the degree of intima hyperplasia.