bluuebunny/crossref_metadata_2025 huggingface dataset:
Preliminary study of immunomodulatory effects of fermented garlic honey on non-specific immune responses
Authors: Wulansari Devyani Diah , Aguslina Kirtishanti  , Devyana Dyah Wulandari  , Andreas Ragil Putro Santoso  , Emanuela Alicia Christy  , Lidiana Hiskiati  , Dwi Winarni
Published: March 2024

Introduction: Honey and Garlic is recognized to offer several health advantages due to its numerous constituents, one of which being flavonoids. Flavonoids’ pharmacological activity includes antibacterial, antioxidant, antifungal, antiviral, and immunomodulatory properties. Honey's immunomodulatory action plays a vital role in immune system boosting. The purpose of this study is to determine the immunomodulatory effect of fermented garlic honey, which is considered to have a synergistic effect, using two alternative techniques.
Methods: Macrophage phagocytic activity is the first approach, while the delayed type hypersensitivity is the second. Each method used 30 male rats (Rattus norvegicus) divided into 5 groups, where each group consisted of 6 rats. Group I negative (Placebo 0,005 g/kg BW), group II positive (Stimuno 0,005 g/kg BW), group III FGH dose I (1,5 g/kg BW), group IV FGH dose II (3 g/kg BW), group V FGH dose III (4,5 g/kg BW). The dosage form was orally given for 21 days. The Macrophage phagocytic activity method measured %activity of macrophage phagocytosis using a microscope. The rats were injected with an antigen which is Staphylococcus aureus by intraperitoneal route.
Results: The Delayed Type Hypersensitivity was measured volume change of the rat’s feet at the 4, 24, and 48 hours using a plethysmometer.  Based on the results, fermented garlic honey had an immunomodulatory effect. The dose 2 (3 g/kg BW) has the highest effectiveness as an immunomodulator. Fermented Garlic Honey may be concluded to be efficient as an immunomodulator by enhancing the macrophage phagocytic activity indicator and lowering the edema volume of the rat.
Conclusion: Fermented garlic honey can increase the immune system and can be used as an immunostimulant. The most effective dose of fermented garlic honey as immunomodulator is dose 2 was 3 g/kg BW.
Preventive behaviors toward transmission of pulmonary tuberculosis
Authors: Setiyowati Eppy , Khamidah  , Nurul Khamariyah  , Budhi Setianto  , Nety Mawarda Hatmanti  , Difran Nobel Bistara  , Erika Martining Wardani
Published: March 2024

Introduction: Indonesia was ranked as the second largest country in the world as a person with pulmonary Tuberculosis (TB) after India. This shows that there needs to be action to reduce the transmission of pulmonary TB, especially in family members who are in the same house. The purpose of this study was to identify factors related to preventive measures for the transmission of pulmonary tb in the city of Surabaya.
Methods: Quantitative research design with a cross-sectional approach, respondents were pulmonary TB sufferers aged > 15 years old for treatment at the East Perak Health Center and Jagir Health Center was totaling 262 respondents. Research variables include gender, age, education, patient category, drug ingestion supervisor, regularity of drug ingestion, search for treatment, knowledge, attitudes, and behaviors towards TB disease are obtained through the dissemination of questionnaires. Furthermore, data processing and statistical tests through (X2) chi square and linear regression.
Results: The results showed that gender, age, education, patient category, drug ingestion supervisor, regularity of drug ingestion, search for treatment, knowledge, attitudes, and behaviors towards TB disease significantly affect the prevention of pulmonary Tb transmission.
Conclusion: Pulmonary TB patients and family members need to remind each other to behave clean and healthy to prevent the transmission of pulmonary TB. It is very necessary to visit regularly from health services or health workers, to provide education about clean and healthy living behaviors.
Effectiveness of the habit of using mask and not using mask on the carboxyhemoglobin (COHb) levels in public transportation workers in Bangkalan district
Authors: Nidianti Ersalina , Wulandari Devyana Dyah , Andini Ary , Dewi Adinda Priyanti
Published: March 2024

Introduction: Air pollution is increasing due to industrial and transportation activities in the community. This has an impact on health problems, one of which is respiratory problems. Carbon monoxide (CO) is one of the air pollutants resulting from incomplete combustion of transportation and can be harmful to the human body. The purpose of this study was to analyze the levels of carboxyhemoglobin (CoHb) and the effect of the habit of wearing a mask and not using a mask on COHb levels in public transportation workers in the Bangkalan district.
Method: We used analytic observational with cross-sectional design. Respondents used in this study were public transportation workers who had the habit of wearing masks and not wearing masks in the Bangkalan district. COHb levels were checked using the Hinsberg Lang method by reading a UV-Vis spectrophotometer at a wavelength of 414.2 nm with normal values for COHb levels < 3.5%.
Results: There were 13% respondents who had the habit of using masks and smoking, 37% respondents were non-smokers and use masks. While respondents who did not have the habit of using masks and smoking were 27% and non-smokers were 23%. Respondents who smoked and used masks had an average COHb level of 8.56%, whereas those who did not smoke and used masks had an average COHb level of 6.50%. Respondents who smoked and did not use masks had an average COHb level of 9.36%, while those who did not smoke and did not use masks had average COHb levels of 8.08%. Bivariate analysis showed that COHb levels were higher in public transportation workers who did not use masks than those who used masks while working (p < 0.05).
Conclusion: We discovered a correlation between the habit of wearing a mask and the levels of COHb in those who work in public transport in the Bangkalan District. The analysis of respondents' COHb levels based on the type of mask used and consideration of underlying disease should be done in future studies.
Spiritual diabetes self-management health coaching on self-efficacy, self-care, and blood glucose levels in type 2 diabetes mellitus patients
Authors: Sari Ratna Yunita , Hatmanti Nety Mawarda , Faizah Imamatul , Rohmawati Riska , Muhith Abdul , Afiyah Raden Khairiyatul
Published: March 2024

Introduction: Self-management, which rests on self-efficacy and self-care, is the cornerstone of diabetes mellitus treatment in managing blood sugar levels. Healthy behavior affects how a disease develops, therefore it's crucial to develop strategies for sustaining self-management. This study looked at the impact of spiritual diabetes self-management health coaching on patients with type 2 diabetes mellitus' levels of self-efficacy, self-care, and blood sugar.
Methods: This study was designed as a quasi-experiment with a pre-post control group. There were 210 patients with diabetes mellitus overall in the Surabaya A-Yani Islamic Hospital. 120 respondents were included in the research sample, including 60 in the intervention group and 60 in the control group. For one month, Spiritual Diabetes Self-Management Health Coaching was provided to the intervention group once daily for 60 minutes. The control group, meanwhile, received a program in accordance with hospital protocols. a parametric test is used in data analysis.
Results: The intervention group's self-efficacy, self-care, and blood sugar levels differed between the pretest and post-test results. According to the findings, the intervention group's pretest and posttest scores for the variables of self-efficacy, self-care, and blood sugar levels varied.
Conclusion: Spiritual Diabetes Self-Management Health Coaching can improve the self-efficacy and self-care of the type 2 diabetic patients; also reduce their blood sugar levels.
Implementation of coding learning to train art creativity for elementary school teacher education students
Authors: Mariati Pance , Rulyansah Afib , Nafiah  , Hartatik Sri
Published: March 2024

Introduction: The development of technology today is moving very rapidly. Various kinds of activities are associated with technology. In response to this, it is necessary to adopt technology by everyone so that adults and children are not left behind. It is important to introduce technology adaptation to students in order to face the increasingly rapid technological developments in the future. Therefore, one of the efforts to apply technology in the field of art is through the introduction of coding learning. The purpose of this research is to implement learning coding to train the artistic creativity of Elementary School Teacher Education Students at FKIP UNUSA.  
Methods: This research method uses a qualitative research method. The subjects of this study were PGSD 4th semester students as many as 90 people. The research was carried out using the code.org website with dance party material.  
Results: The results showed that the implementation of coding learning can train students' creativity in making simple dance moves that are unique and interesting. In addition, students can also be creative with the background of the stage setting and the floor pattern of the dancers. As many as 80 students are able to make dance choreography by using the code.org website for dance party materials.  
Conclusion: It can be concluded that the artistic creativity of students increases through learning coding.
Service quality analysis as sustainable marketing strategy at Hotel X in Surabaya
Authors: Mardhotillah Rachma Rizqina , Karya Denis Fidita , Sahrin Laila Alfi
Published: March 2024

Introduction: Hotel X in Surabaya is one of the hotels located in the city center. Over time, many competitors have star equivalent to hotel x. The services provided by hotel x are felt to be decreasing as evidenced by the many negative reviews obtained by Hotel X. This study analyzes the quality of service on customer satisfaction at Hotel X Surabaya.
Methods: The method used to identify and prioritize customer satisfaction is the SERVQUAL (Service Quality) method using five dimensions, namely tangible, reliability, responsiveness, assurance, and empathy. The analytical method used is descriptive analysis and Importance Performance Analysis (IPA) which uses a Cartesian diagram to determine the ranking of importance and performance. The number of samples is 100 people using the Slovin formula, sampling by simple random sampling method.
Results: The results showed that most of the hotel customers were satisfied with the service performance provided by Hotel X Surabaya. With the IPA method, there are no attributes that must be improved by Hotel X Surabaya. Then there are 8 attributes whose service quality is following what consumers expect, there are 9 attributes that do not have any influence on consumers, and there are 3 service quality attributes that exist or not.
Conclusion: Consumers are satisfied with the services provided by Hotel X Surabaya.
Utilization of Phyo Referral Score in assessing maternal referral quality in emergency cesarean section of maternal COVID-19 cases in Pekanbaru, Indonesia
Authors: Lubis Ilham Sejahtera , Ganap Eugenius Phyowai
Published: March 2024

Link of Video Abstract: https://youtu.be/H8GILKBIJwo
 
Introduction: During the Coronavirus disease 2019 (COVID-19) pandemic, basic and emergency obstetric healthcare was hampered due to health service protocol changes. The reduced coverage of antenatal service during the COVID-19 pandemic increased the number of undetected high-risk pregnancies and the likelihood of obstetric emergency cases. This study assessed maternal referral quality using the Phyo Referral Score (PRS) on emergency cesarean section (ECS) patients infected by SARS-CoV-2.
Methods: This retrospective cohort study used secondary data originating from patient medical records who went through ECS from 1 January 2021 to 31 December 2021. The subject was chosen purposively by the inclusion criteria. A Total of 609 mothers went through Cesarean Section in 2021, there were 52 mothers who met the criteria. The data were described by frequencies, percentages, and mean ± standard deviation. The data was analyzed by Levene’s test and Chi-square test using IBM SPSS version 26.0.
Results: During the retrospective year, a total of 609 mothers went through Cesarean Section in 2021, there were 52 mothers who met the criteria. The most common indications of ECS were persistent fetal hypoxia (50.0%), placenta previa (13.5%), and maternal respiratory failure (13.5%). Most of the patients had good referral quality. From the parameters of PRS, patients are more likely to have good referral quality if accompanied by medical staff, receiving stabilization procedures, and communicating with the hospital by phone before being referred, and transported by ambulance within the same cities.
Conclusion: Accessibility is a critical component of obstetric emergency cases. Even during the COVID-19 pandemic, ensuring that mothers have a good referral quality to access advanced obstetrical care can help the survival of both mothers and fetuses.
Correlation between the degree of severity and type of intracranial hemorrhage with the incidence of coagulopathy in head injuries at the Ulin Regional General Hospital, Banjarmasin, Indonesia
Authors: Lahdimawan Ardik , Handoko Arif , Noor Meitria Syahadatina , Wibowo Agung Ary , Gusasi Sulandri , Sikumbang Kenanga Marwan , Siagian Andreas
Published: March 2024

Link of Video Abstract: https://youtu.be/iUu03npEjEo
 
Background: Trauma cases, especially head injuries, are cases that are often found in hospital emergency departments. Coagulopathy can occur in head injuries and intracranial bleeding, where a low Glasgow Coma Scale (GCS) is associated with coagulopathy. This study aims to evaluate the correlation between the degree of severity and type of intracranial hemorrhage and the incidence of coagulopathy in head injuries at the Ulin Regional General Hospital, Banjarmasin, Indonesia.
Methods: An observational analytic study with 74 sample populations was conducted among patients with a head injury treated at Ulin Regional General Hospital, Banjarmasin, in the 2019-2022 period taken by total sampling, which met the inclusion and exclusion criteria. The data of each variable was analyzed with the Kruskal-Wallis test. Data were analyzed using SPSS version 25.0 for Windows.
Results: There was a significant relationship between the two variables towards the occurrence of coagulopathy; namely, the degree of severity was 0.000 (p <0.05), and the type of bleeding was 0.003 (p<0.05).
Conclusion: There is a significant relationship between the degree of severity of the incidence of coagulopathy and the bleeding with the incidence of coagulopathy, so knowing the degree of severity by clinical examination of GCS and the type of intracranial bleeding by CT scan of the head, as well as blood tests to determine the incidence of coagulopathy are important so that management can be carried out and assessing outcomes.
Increased 8-OHdG in umbilical cord blood represents the risk of preeclampsia with Intra-Uterine Growth Restriction (IUGR)
Authors: Ola Andi Nurul Faizah Tenri , Lukas Efendi , Riu Deviana Soraya , Previana Rina , Sunarno Isharyah , Mappaware Nasrudin Andi , Chalid Maisuri Tadjuddin
Published: March 2024

Link of Video Abstract: https://youtu.be/VsAy9X8XIAk
 
Background: Preeclampsia is a pregnancy-related disease involving multi-organs, characterized by increased blood pressure in the second trimester of pregnancy. Preeclampsia can have short-term and long-term consequences for the mother and the fetus, including intra-uterine growth restriction (IUGR). One of the markers of DNA damage due to oxidative stress due to endothelial dysfunction in preeclampsia is the increase in 8-OHdG levels in cord blood. This study aims to see an increase in 8-OHdG levels in preeclampsia.
Methods: This study was a cross-sectional study with a total of 41 patients with preeclampsia and 41 patients with healthy pregnant women at Wahidin Sudirohusodo Hospital and its network. Samples were taken using the purposive sampling method according to the inclusion criteria. This 8-OHdG level was examined using the ELISA kit at the HUMRC laboratory of Hasanuddin University Hospital. The data is then processed statistically using SPSS.
Results: This study found 6 patients with PE + IUGR, 31 with PE, and 41 without PE. The examination results of 8-OHdG levels found significant differences between the 3 groups PE + IUGR, PE, and normal pregnancies, which showed a significant relationship between elevated 8-OHdG levels and the incidence of PE accompanied by IUGR (p = 0.006)
Conclusion: Elevated 8-OHdG levels are found in preeclampsia, especially in preeclampsia accompanied by IUGR.
Aquaporin-4 expression related to hydrocephalus severity in hydrocephalus mice model
Authors: Balafif Fachriy , Parenrengi Muhammad Arifin , Suryaningtyas Wihasto , Fauziah Dyah , Sudiana I Ketut , Utomo Budi
Published: March 2024

Link of Video Abstract: https://youtu.be/h1rynQ_AAaY
 
Background: Aquaporin-4 (AQP4), a water channel protein, is important in regulating brain water distribution. We hypothesized that increased expression of AQP4 in the kaolin-induced hydrocephalic mice brain is associated with the severity of hydrocephalus. This study aims to evaluate the AQP4 expression related to hydrocephalus severity in hydrocephalus mice model
Methods: Hydrocephalus was induced in 8-10 weeks Sprague-Dawley mice by kaolin injection into cisterna magna. The mice were randomly divided into normal control and hydrocephalus groups and were sacrificed on days 7, 14, and 21 after kaolin induction. The brains were analyzed for AQP4 expression by histological and immunohistochemistry analysis. Data were analyzed using SPSS version 25.0 for Windows.
Results: Histopathological analysis showed an increase in AQP4 expression in periventricular zone astrocytes with the duration of hydrocephalus (p < 0.001). A significant difference in AQP4 expression in this study was found in the hydrocephalus group between the 7th and 14th days (p = 0.023), 7th and 21st days (p < 0.001), and 14th and 21st days (p = 0.044) after kaolin induction. The highest expression of AQP4 was found in the hydrocephalus induction group on day 21.
Conclusion: The results showed that the expression of AQP4 increased with the severity of hydrocephalus. Expression of AQP4 in the kaolin-induced hydrocephalic mice brain was significantly altered depending on the length of time after kaolin induction. Changes in AQP4 expression in periventricular zone astrocytes may be a compensatory mechanism resulting in drainage of CSF accumulation.
Unsolved mystery, the etiology of acute pancreatitis after liver resection: a case report and literature review
Authors: Fardiansyah Mochamad Syahroni , Septarendra Denny , Normasari Rena
Published: March 2024

Link of Video Abstract: https://youtu.be/WQnJQwwYcHcIntroduction: After liver resection, pancreatitis is a well-known yet uncommon consequence. The actual cause is unclear, and the postoperative condition may mask the clinical symptoms. When a patient unexpectedly worsens after surgery, postoperative pancreatitis should always be taken into consideration due to its high fatality risk. After liver resection, we present our patient with acute pancreatitis. The paper was written using certain hypotheses. First, the surgeon should be aware of the possibility of pancreatitis following liver surgery, which is not included in the literature as a side effect of liver surgery. The second step is to increase our knowledge and develop measures to reduce the risk of acute pancreatitis following liver surgery.
Case Description: We present here a case of acute pancreatitis following liver resection surgery from our institution, and we strongly suspect that the results of our postoperative white bile leak test contributed to this. According to the literature analysis, this test is risk-free and won't have a materially detrimental impact on the patient. Keep in mind the white test rule, which suggested things like focus and spooling following the test.
Conclusion: The white test is effective for identifying bile leakage following liver resection, however, we do not advise frequent use of this test since there is a chance that it can trigger acute pancreatitis, which can have a substantial negative impact on the patient's morbidity or death. The precise process is still a mystery and will require further experimental research.
Transient hyperthyroidism in a woman with hydatidiform mole: a case report on unusual clinical presentation and management
Authors: Labi Mediatris , Novida Hermina
Published: March 2024

Background: Hydatidiform mole (HM) is a genetically abnormal conception involving abnormal growth of placental trophoblast. HM is sometimes accompanied by hyperthyroidism, a rare but potentially life-threatening complication requiring early detection and management. This study aimed to report a case of a woman with HM complicated by transient hyperthyroidism, as well as to analyze some possible pharmacological management before the evacuation of molar tissue.
Case Presentation: A 45-year-old female was referred to Dr. Soetomo Hospital Surabaya with a chief complaint of vaginal bleeding, accompanied by nausea, vomiting, frequent heart palpitations, and hand tremors. The patient had been previously diagnosed with molar pregnancy but refused to undergo curettage. At presentation, physical examination suggested incompatible uterus size with the gestational age, and the vaginal toucher indicated non-palpable ballottement. Vesicles were observed in vaginal discharge. Laboratory findings revealed elevated β-HCG, decreased thyroid stimulating hormone (TSH), and increased free thyroxine (FT4) levels. Abdominal ultrasound exhibited the presence of uterine fibroid and a honeycomb appearance. The patient was then diagnosed with molar pregnancy accompanied by hyperthyroidism; however, Burch-Warsofsky’s (BW) score (25) suggested no thyroid crisis. Before undergoing suction curettage to evacuate the hydatidiform mole, the patient received perioperative treatment for thyrotoxicosis control using methimazole, propranolol, and dexamethasone. After the surgery, hCG levels were regularly followed up until the normal range was reached.
Conclusion: Despite its rarity, hyperthyroidism might become a deadly complication in molar pregnancy. Perioperative treatment to stabilize thyroid levels is prominent to prevent a thyroid storm. Treatment choice depends on the time available for preoperative preparation, the severity of the thyrotoxicosis, and the impact of any current or previous therapies. However, β-blockers should always be used unless absolutely contraindicated. Follow-up of hCG level post-operatively is critical to identify a possible occurrence of gestational trophoblastic neoplasia (GTN).
Complete resolution of hyperopic shift in anterior capsular contraction syndrome after Nd:YAG laser capsulotomy: a case report
Authors: Intifada  , Indri Wahyuni  , Hermawan Dicky
Published: March 2024

Link of Video Abstract: https://youtu.be/UfCbUNzPIRE
 
Background: Anterior capsular contraction syndrome (ACCS) is a disorder in which the anterior capsulectomy opening shrinks excessively. One of the many factors that have been discovered to aggravate the problem is a lack of zonular support for the lens capsule. The prognosis for non-progression of contractions after Nd:YAG anterior capsulotomy is quite excellent. This study aims to present a complete resolution of the hyperopic shift in an anterior capsular contraction syndrome (ACCS), a rare complication of cataract surgery.
Case Illustration: This case report presented a 63-year-old female who developed ACCS in the right eye two years after uncomplicated cataract surgery and intraocular lens implantation. A moderate hyperopic shift of +3.00 D was noted in the affected eye at the initial presentation. Slit-lamp examination revealed an anterior capsule opacification and anterior capsular contraction with fibrosis surrounding the capsulorhexis opening. Ocular and systemic past medical history was unremarkable, and no known risk factors associated with contraction syndrome were found. Nd:YAG laser capsulotomy with six relaxing incisions was performed to release the anterior capsular contraction. Two weeks following capsulotomy, the patient’s visual acuity remarkably improved to LogMAR 0.00 without correction. The hyperopia was completely resolved, and a decrease in anterior chamber depth compared to pre-capsulotomy measurement was noted. ACCS is a possible complication following capsulorrhexis performed in uneventful cataract surgery, which may occur in patients with no known ocular or systemic risk factors. ACCS is commonly asymptomatic, and hyperopic shift is a rare manifestation of ACCS. The backward shift of the intraocular lens (IOL) induces hyperopia due to the anterior capsule contraction. The preferred treatment for ACCS is relaxing incisions using Nd:YAG laser capsulotomy.
Conclusion: Hyperopic shift in ACCS is a rare complication of cataract surgery. However, prompt treatment of contraction release with Nd:YAG laser capsulotomy effectively restored visual function.
Conventional Magnetic Resonance Imaging (MRI) and histopathology agreement for the diagnosis of intracranial meningioma at Dr. Soetomo General Hospital, Surabaya, January 2016–December 2021: a single center study
Authors: Hakim Muhammad Wildan , Wahyuhadi Joni , Utomo Sri Andreani , Fauzi Asra Al , Parenrengi Muhammad Arifin , Utomo Budi
Published: March 2024

Link of Video Abstract: https://youtu.be/OG7qXwNHzHQ
 
Background: Meningioma, a prevalent intracranial neoplasm, ranks among the most frequently encountered tumors within the cranial cavity. The utilization of Magnetic Resonance Imaging (MRI) in the diagnostic process of meningioma has proven to be highly valuable. This study aims to evaluate the Conventional-MRI and histopathology agreement for the diagnosis of intracranial meningioma at Dr. Soetomo General Hospital, Surabaya.
Methods: This study presents a diagnostic test and retrospective case-control analysis to evaluate the precision of head MRI in diagnosing intracranial meningioma, as confirmed by histopathological examination. The research was conducted at Dr. Soetomo Surabaya General Hospital from January 2016 to December 2021. Sample size calculations were performed on a cohort of patients diagnosed with intracranial meningioma who underwent head magnetic resonance imaging (MRI) scans and histopathological examinations at the Radiology and Anatomical Pathology Installation of Dr. Soetomo General Hospital. Only patients who satisfied the predetermined inclusion and exclusion criteria were included in the study. Data were analyzed using SPSS version 25.0 for Windows.
Results: At the time of diagnosis, it was observed that the average diameter of grade II/III meningioma was 6.6 ± 1.5 cm, which was found to be greater than the average diameter of grade I meningioma, measuring 4 ± 1.92 cm. The prevalence of grade I meningioma was higher in the skull base region higher in the skull base region, accounting for approximately 36% of cases. Conversely, grade II/III meningioma was found more frequently in the non-skull base area, constituting approximately 76% of cases. In our investigation, it was observed that there exists a higher occurrence of irregular border shape in grade II/III meningioma, accounting for approximately 75% of cases, as compared to grade I meningioma, which only accounts for 14.2% of cases. The presence of contrast enhancement in meningiomas can provide valuable insights into their histological grade. Grade II/III meningiomas exhibit a higher degree of contrast enhancement, which is observed to be heterogeneously distributed in approximately 75% of cases.
Conclusion: This study highlights the potential of MRI as a valuable tool in assessing the grade of meningioma while emphasizing the importance of considering other diagnostic modalities and clinical factors to ensure accurate diagnosis and treatment decisions.
The relationship between the difference neutrophil to lymphocyte ratio before and after anthracycline-based neoadjuvant chemotherapy with clinical response in locally advanced breast cancer
Authors: Rahman Hadian , Iskandar Ali  , Dwi Hari Susilo
Published: March 2024

Link of Video Abstract: https://youtu.be/Jb1SATaI8oQ
Introduction: The difference in the Neutrophil-to-Lymphocyte Ratio (NLR) before and after chemotherapy, which is commonly called the delta NLR, is thought to be a better predictive factor than pre-chemotherapy NLR or post-chemotherapy NLR in breast cancer patients.
Methods: We analyzed 130 locally advanced breast cancer (LABC) patients who received anthracycline-based neoadjuvant chemotherapy (NACT) at Dr. Soetomo General Hospital Surabaya from January 2017 – December 2021.
Results: Out of 130 patients, 91 (70.0%) responded to chemotherapy. Bivariate analysis showed a significant relationship between delta NLR and chemotherapy response (p = 0.002). Patients with delta NLR < 0 achieved a significantly higher rate of clinical response to NACT compared to those with delta NLR ≥ 0 (OR: 4.67, 95% CI: 1.69 – 12.85, p: 0.003)
Conclusion: LABC patients with delta NLR < 0 have better clinical response to anthracycline-based NACT than those with delta NLR ≥ 0.
Prevalence angle of trunk rotation in adolescents: a study from an idiopathic scoliosis school screening in Surabaya
Authors: Rangkuti Dicky Lukman , Subagio Eko Agus , Utomo Budi , Parenrengi Muhammad Arifin , Suryaningtyas Wihasto , Rahardjo Paulus
Published: March 2024

Link of Video Abstract: https://youtu.be/GtRgpMD7tsM
 
Background: Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis. The condition begins in early puberty, affects 1-3% of adolescents, and randomly affects young women. Scoliosis screening is still a hot topic discussed by various researchers, especially in the school child population, and it is still an important preventive program to reduce the progression of spinal deformity. This study aims to determine the prevalence rate angle of trunk rotation in idiopathic scoliosis school screening in Surabaya.
Methods: This research is a cross-sectional study with a descriptive observational type using surveys and examinations. In this study, the sample used was 405 junior high school students in Surabaya. The sampling method is cluster random sampling, where each member of the population is divided into subclasses with the school as the cluster. Samples were randomly selected from each area of Surabaya. Data were analyzed using SPSS version 25.0 for Windows.
Results: These data found that the age distribution of the scoliosis screening study was an average of 13.87 years and a median of 14 years. The gender distribution of the scoliosis screening study sample was more female, 211 samples (52.1%) compared to men, 194 samples (47.9%). The distribution was obtained from 405 total samples; 2 positive samples were obtained during the Adam's Forward Bend Test, both 14 years old and female. On examination with a scoliometer, both showed 9 and 11 degrees, respectively. The prevalence angle of trunk rotation in idiopathic scoliosis school screening in Surabaya was 0.49%.
Conclusion: This figure is lower than several studies conducted in several other countries. This may be obtained due to differences in the number of research samples undertaken in each country.
Red Blood Cell Distribution Width (RDW) as a predictor of septic shock in children
Authors: Nastiti Prima Hari , Khalida Nadiah Raini , Setyaningtyas Arina , Kusumastuti Neurinda Permata
Published: March 2024

Link of Video Abstract: https://youtu.be/Exh1T2szfoE
 
Background: Septic shock is a prevalent PICU condition requiring prompt intervention. Using the PELOD II score, which has multiple characteristics to examine, it is challenging to predict prognosis in healthcare-limited settings. A link has recently been shown between red blood cell distribution width (RDW) and mortality risk in critically ill patients, albeit the exact mechanism is unknown.
Methods: This retrospective observational study examined RDW values in pediatric septic or non-septic shock patients. This study examined patient clinical features, RDW hematological markers (RDW-CV, RDW-SD, and RDW/albumin ratio), and the area under the curve to determine the cut-off for the hematological marker, sensitivity, and specificity.
Results: Sixty-one pediatric patients met the inclusion criteria (33 with septic shock and 28 with non-septic shock). The red cell distribution width coefficient variation (RDW-CV) (p=0,058), red cell distribution width standard deviation (RDW-SD) (p=0,05), and RDW Albumin Ratio (RAR) (p=0,014) were shown to be significantly different between the septic shock and non-septic shock groups. The cut-off value for RDW-CV was 15.3% (53.6% sensitivity and 97% specificity), 47.4 fl for RDW-SD (64.3% sensitivity and 84.8% specificity), and 5.65 for RDW/albumin ratio (71.4% sensitivity and 84.8% specificity).  RDW-CV odd ratio was 36.9 (95% confidence interval (CI) 4.41-308.96, p 0.001), RDW-SD odd ratio was 10.08 (95% confidence interval (CI) 2.95-34.34, p 0,001), and RDW/albumin ratio was 14.00 (95% confidence interval (CI) 3.98-49.16, p 0,001).
Conclusion: Increased RDW can be one marker in pediatric patients with septic shock. Increased levels of RDW/albumin ratio are significantly associated with the incidence of septic shock. Through the (ROC) area under the curve, the RDW/albumin ratio has better capabilities compared to other predictor markers.
Profile of neck penetrating injury patients at Dr. Soetomo general hospital, Surabaya: A case series
Authors: Utomo Heningtyas Suci , Wibowo Marjono Dwi
Published: March 2024

Link of Video Abstract: https://youtu.be/Tk7yWllByJQ
 
Background: Neck penetrating injuries are a life-threatening emergency. To date, one of the areas of ongoing controversy is whether all penetrating neck wounds in Zone II still require surgical exploration or whether patients can be managed non-operatively. An approach with absolute exploratory management for every penetrating neck wound results in a substantially reduced mortality rate.
Case Description: We presented 5 cases of neck penetrating injury patients. In the first case, a 33-year-old man presented with a neck wound, hoarseness and subcuticular emphysema; the patient underwent colli exploration. In the second case, a 39-year-old man presented with multiple wounds in the neck, hematemesis and subcuticular emphysema; the patient underwent colli exploration. In the third case, a 27-year-old male patient presented with an 8 cm long open wound on the anterior colli, a visible rupture of cricoid and thyroid cartilage; the patient underwent tracheostomy and debridement. In a fourth case, a 37-year-old male patient presented with a 12 cm long sutured wound in the anterior colli, hoarseness, emphysema and air bubbling from the wound; the patient underwent colli exploration. In the fifth case, a 41-year-old male patient presented with a 7 cm long sutured wound at the anterior colli and a defect on thyroid cartilage; the patient underwent colli exploratory surgery.
Conclusion: A hard sign was obtained in all five cases, and immediate colli exploration was performed without diagnostic supportive examination. The decision to perform surgery is now based on the presence or absence of "hard signs" of a penetrating neck wound.
A case of chromoblastomycosis caused by Fonsecaea pedrosoi: challenge in diagnosis
Authors: Indranarum Trisiswati , Axelia Presstisa Gifta , Sandhika Willy , Listiawan Muhammad Yulianto , Ervianti Evy
Published: March 2024

Link of Video Abstract: https://youtu.be/9CxOCuDn4f4
 
Background: Chromoblastomycosis (CBM) is a chronic, granulomatous mycosis of the skin and subcutaneous tissue produced by the traumatic inoculation of various dematiaceous fungi. CBM lesions are clinically polymorphic and often misdiagnosed as multiple infectious and noninfectious diseases. Early diagnosis and prompt treatment of CBM are important to prevent further complications. This case study aims to evaluate the chromoblastomycosis caused by Fonsecaea pedrosoi as a challenge in diagnosis.
Case Presentation: A male, 47 years old, came to the dermatovenereology clinic with a chief complaint of a wound on his right leg 17 years ago. The skin appeared thicker and scaly and felt rough. He also complained of pain and itch on the wound. Dermatological examination revealed multiple verrucous erythematous plaques, sized 10x20 cm, irregular with a well-defined and elevated border and black punctum. Results of potassium hydroxide, culture, and histopathology examination confirmed CBM with F. pedrosoi as the etiological agent. The patient was treated with a favorable outcome with oral itraconazole, local thermotherapy, and CO2 laser.
Conclusion: The diagnosis of Chromoblastomycosis remains a challenge because lesions are clinically polymorphic and often misdiagnosed as various infectious and noninfectious diseases. Physicians should raise awareness of CBM as one of the differential diagnoses for chronic wounds.  This case also showed that the combination treatment of itraconazole with adjuvant thermotherapy and CO2 laser had a favorable outcome.
Dermoscopic features of melasma: a descriptive study in Bali
Authors: Winaya Ketut Kwartantaya , Mahariski Pande Agung , Praharsini I Gusti Ayu Agung , Pramita I Gusti Ayu Sattwika
Published: March 2024

Background: Dermoscopy or dermatoscopy is a noninvasive diagnostic tool in dermatology that identifies the pattern in pigmented lesions such as melasma. Several features commonly found in melasma include brown or gray pigmentation, pigment network, telangiectasis and sparing of follicles and sweat gland openings. This study aimed to describe the dermoscopic features of melasma in Balinese patients.
Methods: A cross-sectional descriptive study conducted by Prof. dr. I G. N. G. Ngoerah General Hospital, Bali, using a secondary source in August 2023. Subjects selected with total sampling from the database in January 2021 to July 2023 at Dermatology and Venereology Outpatient Polyclinic who were diagnosed with Melasma. Characteristics obtained were Fitzpatrick skin type, occupation, contraceptive usage, lesion distributions and dermoscopic features using Dermlite DL4 polarized mode on both check and malar area. Data was analyzed descriptively using Statistical Package for the Social Sciences (SPSS) version 21.
Results: A total of 23 females with melasma were included in this study. The subjects were mainly Fitzpatrick skin type IV (74%), occupation in indoor activity (87%), not using oral contraceptives (96%), and symmetrical distribution (91%). The dermoscopic features obtained mainly were light brown (100%), irregular pigment network (87%), sparing of follicles and sweat glands opening (95.7%), and irregular pattern of telangiectasis (69.6%).
Conclusion: Using dermoscopy as a diagnostic tool for melasma can clarify the characteristics of melasma lesions in more detail. Further research is needed to determine the sensitivity of dermoscopic features and assess the success of treatment in melasma.
Tetanus patient profiles and factors affecting clinical outcomes at Dr. Soedono general hospital, Madiun in 2019-2020
Authors: Setiyandari Bernadeta Hernik , Winantyo Tjahjo , Ali Iskandar
Published: March 2024

Link of Video Abstract: https://youtu.be/VC3Gcd7oS5Y
 
Introduction: Tetanus is a disease that can be diagnosed clinically. However, there is a lack of research data on tetanus patients and their clinical outcomes, especially in adult tetanus patients in Indonesia. This study aims to determine the factors that influence the outcome of tetanus patients.
Method: A cross-sectional study was performed from May to June 2021 at Dr. Soedono Madiun General Hospital. Subjects were recruited by total sampling. The data that will be taken in this study are gender, age, immunization history, incubation period, onset, port of entry, Philips score, and clinical outcomes of patients.
Result: Were 112 patients diagnosed with tetanus at Dr. Soedono General Hospital from January 2019 to December 2020. The male subjects outnumbered female subjects by 81.3%. The youngest subject was 19 years old, and the oldest was 81 years old. The tetanus immunization status showed that 2 patients were known to be fully immunized, 21 were not fully immunized, and 89 (79.5%) had unknown immunization status. This study showed that the port of entry of the wound is most often the entry point for tetanus in the inferior extremity of 72 patients (64.3%). Most onset occurred in 1-7 days, with a mean onset for generalized tetanus was 2.3 ± 1.8 days. The mean incubation period for the appearance of tetanus symptoms in this study was 9.4 ± 5.6 days. The most common comorbid disease in this study was diabetes mellitus (11.6%). This study's clinical outcome of tetanus showed that 74 patients (66.1%) had improved, while 38 patients (33.9%) died during treatment.
Discussion: This study's most common port of entry was on the inferior extremities. This lower limb predominance as the port of entry could be explained by the fact that C. tetani exists in soil; hence, any lower limb injury would be open to contamination and infection by this organism. Based on the Dakar and Phillips score system, tetanus has a worse prognosis when there is a faster incubation period, faster onset, more proximal port of entry location, immunization status, comorbidities and signs of muscle spasm, fever, and tachycardia are obtained.
Conclusion: In this study, tetanus still has a high mortality rate. Male gender, age over 45, a moderate to severe disease degree (considering a relatively short incubation time, short onset period, and unknown immunization status) are a few factors that may affect this high mortality rate.
The 14th Annual Scientific Meeting Indonesian Association of Thoracic, Cardiac and Vascular Surgeons
Authors: Hidayat Niko Azhari
Published: March 2024

Welcome Message
Dear Colleagues,
The Annual Scientific Meeting of the Indonesian Association of Thoracic, Cardiac, and Vascular Surgery (HBTKVI) is crucial in determining the future direction of professional organization and association of Thoracic, cardiac, and Vascular Surgery specialists since the maturity and growth of thoracic, cardiac, and vascular surgery as associations in general and professionals. In the implementation, we held a symposium to improve and maintain the competence of HBTKVI members.
It is an honour for us to be able to invite all of you to participate in the Annual Scientific Meeting of the Indonesian Association of Thoracic, Cardiac and Vascular Surgeons which will be held online and offline on 18 – 21 October 2023 at the Faculty of Medicine, Universitas Udayana, R.S.U.P. Prof. dr. I.G.N.G. Ngoerah and Hotel Hyatt Regency, Sanur, Denpasar City, Bali Province.
We assure this event will differ from our previous Annual Scientific Meeting events. The event will occur in Bali, one of Indonesia's leading medical tourism centres. In addition, this Annual Scientific Meeting is in conjugation with other Asian countries, namely Malaysia, Singapore and Thailand. Other than inviting international speakers in their fields, this Annual Scientific Meeting is proud to invite colleagues involved in the Thoracic, Cardiac and Vascular Surgery scope, such as perfusionists, internists, hypertension & kidney consultants, cardiovascular consultants, and general practitioners.
I am very happy to welcome all of you to join 14th Annual Scientific Meeting Indonesian Association of Thoracic, Cardiac and Vascular Surgeons in Bali either virtually or in person
 
Niko Azhari Hidayat, MDPresident of Organizing Committee of 14th Annual Scientific MeetingIndonesian Association of Thoracic, Cardiac and Vascular Surgeons
Microbial inhibition test and optimization of temperature, aeration fermentation of endophytic Fusarium sp LBKURCC 41 from Dahlia tuber (Dahlia variabilis)
Authors: Shinta Dewi Yudiana , Muhammmad Diki Juliandi  , Widyastuti Widyastuti , Herix Sonata MS  , Saryono Saryono
Published: March 2024

Link of Video Abstract: https://youtu.be/G8AKREK9E9Q
 
Introduction: Synthetic drugs can cause toxicity. Finding new natural sources of medicinal materials with low toxicity is one of the efforts to reduce it. This was done by using biotechnology from endophytic fungi growing on dahlia tubers (Dahlia variabilis). This study aimed to find the optimum temperature and aeration in the fermentation of endophytic fungi Fusarium sp LBKURCC 41 in producing secondary metabolites.
Methods: The method of this research was temperature optimization with temperature variations of 10˚C, 27˚C, 37˚C and 40˚C. For aeration, the variation of oxygen provided was 50 ppb and 100 ppb. Both fermentation environment factors were incubated for 5, 10, 15, 20, and 25 days. The activity test was conducted against pathogenic microbes E. Coli, S. aureus, and C. albicans using the agar diffusion method. Positive controls used ketoconazole for Candida albicans and ciprofloxacin for E. coli and Streptococcus aureus bacteria.
Result: The results showed the optimum temperature of the fermentation of endophytic fungi Fusarium sp LBKURCC 41 based on statistical analysis of T-Test for (p < 0.05) is to have the highest inhibition zone diameter value of 10.5 ± 0.62 mm on day 20 against Candida albicans with a positive control of 6.0 ± 0.23 mm. For aeration, the highest inhibition zone value was 12.3 ± 0.12 mm with a positive control of 19.5 ± 0.12 mm.
Conclusion: The optimum temperature of the fermentation is to have the highest inhibition zone diameter value of 10.5 ± 0.62 mm. The ability of endophytic fungi to produce secondary metabolite compounds is determined by the temperature and aeration used.
Role of cardiac marker troponin I in chronic periodontitis with coronary artery disease
Authors: Sitompul Sanggap Indra , Aryati  , Budi Susetyo Pikir  , Monika Estherlita Sinta
Published: March 2024

Link of Video Abstract: https://youtu.be/Cw5keIvNHoQ
 
Introduction:  This study aims to analyze the effect of chronic periodontitis (CP) on  Troponin I levels in coronary artery disease (CAD) patients.
Patients and methods: This study was a cross-sectional study. A total of 90 CAD patients at Dr. Doris Sylvanus Hospital, Palangka Raya, Central Kalimantan, Indonesia, who underwent coronary angiography and had CP, was involved in the study. CAD was examined based on significant stenosis on coronary angiography. CP was measured based on mean physical diagnostic (PD) and panoramic X-rays. The blood sample was collected to determine Troponin I level by sandwich immunodetection method with fluorescence immunoassay (FIA). Bivariate analysis of factors affecting Troponin I (with threshold ROC results) was conducted using the Chi-square test, followed by multivariate analysis. A logistic regression test was also evaluated to determine the most influential independent variable on Troponin I.
Results: Based on bivariate analysis, CP and dyslipidemia significantly differed in both troponin groups. There was 53.3% mild CP at Troponin I level <0.015 ng/mL, while 80% moderate-severe CP at Troponin I level >0.015 ng/mL with p value=0.018. Based on multivariate analysis showed that CP had a significant effect on Troponin I. Additionally, patients with moderate-severe CP tended to have more Troponin I > 0.015 ng/mL with an odds ratio (OR) of 5.528 (95% CI 1.373-22.247; p value=0.016).
Conclusion: There was an effect of CP on increasing Troponin I levels in CAD patients.
Proceeding Book Bali Clin-Up 2023
Authors: Bali Clinical Nutrition Update 2023
Published: March 2024

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