bluuebunny/crossref_metadata_2025 huggingface dataset:
THE MOLECULAR BASIS OF RESISTANCE ANTIRETROVIRAL MARKERS AND POLYMORPHISMS OF THE HUMAN IMMUNODEFICIENCY VIRUS-1 SUBTYPE CRF01-AE PROTEASE GENE IN NAÃVE AND TREATMENT FAILURE PATIENTS IN BALI
Authors: Sri Budiyanti N. , Suata I K. , Merati K. T. P. , Mahardika I G.N.K.
Published: December 2022

Application of antiretrovirals (ARVs) in patients with Human Immunodeficiency Virus (HIV) infection has proven to reduce mortality rates and prolong life expectancy. On the other hand, the use of antiretroviral drugs has incited the emergence of HIVDR. The resistance is due to mutation at genes associated with drug resistance. Nowadays, the determination of resistance markers mutations are based on HIV-1 subtype B. However, the majority of HIV in Indonesia, particularly in Bali are of subtype CRF01_AE. Genetic variation between HIV viruses has led to variations in subtypes; therefore, resistance markers of subtype B could be polymorphisms of non-B subtypes. This study aims to determine the number and types of the resistance markers mutations and polymorphisms that occur on the PR gene of HIV-1 subtype CRF01_AE of naÃ¯ve and treatment failure patients in Bali. This is an observational cross-sectional analytical study, conducted at two VCT clinics in Denpasar, during the period of April 2010 until October 2011. Samples consist of 18 HIV patients with treatment failure and 30 naÃ¯ve HIV patients. Mutations were evaluated using PCR, sequenced and aligned were carried out using MEGA4. Interpretations of the mutations were made based on the Stanford HIV database. Hypothesis tests used were Mann-Whitney because of abnormal distribution of data. Hypothesis was accepted if the significant level p<0.05. This study found that of the demographic data, only the predisposing factors of the two groups were significantly different (p<0.05). Two patients with treatment failure and 5 naÃ¯ve patients were found to have L10LV/I mutations. Only one patient with treatment failure had the I54FI mutation. No major mutations were found among the two study groups. The number and types of minor mutations were not significantly different (p>0.05) between the naÃ¯ve group and treatment failure group. M36I and H69K polymorphisms of the PR gene were found in all the study samples. In conclusion of this study, two types of major mutations were found, L10LV/I and I54FI. The number and types of the resistance markers mutations towards the protease inhibitor (PI) group were not significantly different between the two study groups. M36I, H69K mutations of the PR gene are markers of polymorphisms of HIV-1 subtype CRF01_AE.
MUTATIONS IN 1700 BP FRAGMENT OF RPOB GENE OF MULTI-DRUG RESISTANT MYCOBACTERIUM TUBERCULOSIS ISOLATE
Authors: Yowani Chandra , Sukardika I K. , Mantik-Astawa I N. , Junitha I K.
Published: December 2022

This research aimed to amplify a 1700 bp fragment of rpoB gene of multidrug resistance M. tuberculosis (MDR-TB) isolate and determine types of mutation beyond the core region (hot-spot region). DNA sequencing studies indicate that more than 95% of rifampin-resistant M. tuberculosis strains have mutations within the 81-bp hot-spot region (codons 507 to 533) of the RNA polymerase Î² -subunit (rpoB). Since almost 90 % of rifampicin resistant isolate are also resistant to isoniazid, mutation in rpoB gene become important as a surrogate marker for MDR-TB. MDR- TB isolates used for this research, namely isolate 885, was collected by Regional Health Laboratory of Surabaya. PCR was used to amplify the gene, on described steps : a cycle of preheating at 95Â°C for 15 minutes, amplifying in 45 cycles ( 1 minute at 94Â°C, 1 minute at 58Â°C, 1 minute 72Â°C) and post extension for 5 minutes at 72Â°C. The mutations were detected by sequencing and alignment using MEGA4. The result of this research showed that there were new mutations downstream of the core region of rpoB. Sequence analysis showed some mutations such as S594A, S626V, T629A. In conclusion, it is reported for the first time, new mutations at downstream region of the core region of rpoB.
FLOUXETINE IMPROVED INTRAVAGINAL EJACULATORY LATENCY TIME THROUGH DECREASED LEVELS OF INTERFERON-GAMMA AND INCREASED LEVELS OF SEROTONIN IN PATIENT WITH PREMATURE EJACULATION
Authors: I M. Nyandra , W Pangkahila , A. A. Raka-Sudewi , I N. A. Bagiada
Published: December 2022

Pathophysiology of premature ejaculation (PE) is very complex because it is associated with many factors, which can be grouped into biological factors and psychological factors. Various diseases have been found correlate between psychological factors and biological factors through cytokines, one of which is IFN-y (IFN-g). IFN-y affect indolamine dioxygenase enzyme (IDO) and decrease levels of serotonin. Low levels of serotonin leads to PE. The purpose of this study was to prove the relationship of serotonin and IFN-y in pathophysiology of PE.This study was designed as a pretest-posttest double-blind cross-over control group design. Patients with PE were divided into 2 groups: control group and treatment group. Treatment group received flouxetine 20 mg for 30 days. Then the control and treatment groups were crossed after passing a 14-days washout period. Previously as a control group to treatment group and received flouxetine 20 mg per day for 30 days. Before and after treatment in each group was examined the levels of serotonin and IFN-y.Of the 26 subjects, each group there was 13 subjects. Flouxetine 20 mg per day for 30 days increased serotonin levels were significantly (pÂ < 0.05), and decreased levels of IFN-y were significantly (pÂ < 0.05). Increased levels of serotonin and decreased levels of IFN-y was significantly associated with improvements (intravaginal ejaculatory latency time) ejaculation in PE patient.From these results it can be concluded that PE occurs because decreased levels of serotonin. Decreased levels of serotonin are associated with increased levels of IFN-y.Â
NUTRITION STATUS CORRELATED TO THE FIRST PERMANENT MANDIBULAR MOLAR TEETH OF ELEMENTARY SCHOOL CHILDREN IN LINTAU BUO, TANAH DATAR REGENCY, WEST-SUMATRA
Authors: A. Syukra
Published: December 2022

The first permanent mandibular molar teeth is the most important for child, especially to stimulate growth of jaw. The teeth has normally erupted at children age of 6-7 years old. However, it is frequently not happened at this stage. This study aims to determine the nutritional status relate to the first permanent mandibular molars teeth eruption in the elementary school children age of 6-7 years old at Lintau Buo, Tanah Datar Regency, West-Sumatra Indonesia.This is an analytical cross-sectional study, with anthropometric measurements of body mass index/BMI of elementary school children related to eruption of the first permanent mandibular teeth.The results showed that nutritional status of elementary school children age of Â 6-7 years old for the most were within normal category (51.2%). Grade-I (6-7 years old) suffered from emaciation is still quite high (45.4%), 20.3% of 187 students who suffer from emaciation first permanent mandibular molars have erupted, the first permanent mandibular molars in first grade children (6-7 years old) with normal nutritional status, risk of overweight and obese have erupted.Nutritional status affects childrenâ€™s first permanent mandibular molar erupted lower jow. The better the nutritional status of a child then the erupstion of the Â first mandibular molars Â will get better and grow in time.
A NOVEL APPROACH OF VIROTHERAPY BASED HSF-1 shRNA IN CANCER ERADICATION
Authors: Supadmanaba I G. P. , Wibawa-Manuaba I. B. T.
Published: December 2022

Cancer is the second leading cause of death worldwide with continues rise mortality rate. Current cancer treatment modalities are still ineffective and associated with many side effects leading to robust research to find new specific target therapy. Heat shock factor (HSF)-1 is heat shock response mediator protein and act as transcription factor for HSP encoding gene. Many cancers have up-regulated HSP as a result of increase HSF-1 expression. Interestingly, inhibition of HSF-1 has no effect to normal cell, indicating HSF-1 as promises target therapy. RNAi is potential mechanism to block and down regulate HSF-1 which will affect many cellular processes in cancer cell. Combining RNAi base treatment with oncolityc viruses will boost the therapeutic effect of this novel treatment. Despite its potency, this modality still need further research in order to evaluate its efficacy and optimal doses to gain optimal result.
CANTHARANTHUS ROSEUS LEAF EXTRACT ACCELERATES HEALING OF WOUND WISTAR RAT
Authors: Anom-Dada I K. , Berata I K. , Putra-Manuaba I. B. , Damriyasa I M.
Published: December 2022

Cantharantus roseus (C. roseus)Â is a medical plant that has been used to treat various diseases. This study was carried to determineÂ C. roseusÂ leaf extract able to acclerate wound healing in Wistar rat. Full skin-tickness round wounds were created on the back of the rats. Wound healing was evaluated after treated with 15% of a mixture of leaf extract ofÂ C. roseusÂ and vaseline. The rats were divided into two groups, each group consist of 16 rats. Wound healing was assesed in five and fifteen days after treatment by measuring wound area, wound closure, and counting the new capillary vessel number (angiogenesis). The result of the study indicated that extract ofÂ C. roseusÂ leaf accelerates the wound healing in Wistar rat. Coverage rate of wound is faster on treated group than control group (p<0.05). Wound closure and angiogenesis in early wound healing were higher in treated group than control group (p<0.05). These results suggested that the first phase of wound healing was shortened, and the proliferative and maturation phases were advanced by methanol extract ofÂ C. roseusÂ leaf. Therefore, it can be concluded thatÂ C. roseusÂ could be potential to help in topical management of wound healing.
MASSAGE STIMULATION REDUCES TUMOR NECROTIC FACTOR-ALPHA AND INTERLEUKIN-6 IN PRETERM, LOW BIRTH WEIGHT WITH APPROPRIATE GESTATIONAL AGE NEWBORNS
Authors: Trisna Windiani I G. A. , Sotjiningsih S. , Mantik Astawa N. , Kusnandi R.
Published: December 2022

Preterm newborn is susceptible from various stresses such as infections or non infections. During stress, immune response is activated by synthesizing and releasing of cytokines from activated immune cells into the circulation. One of the efforts to overcome the stress is massage stimulation. Several studies have been carried out to find out the benefit of massage stimulation. The objective of this study is to find out the effect of massage stimulation to reduce of TNF-Î± and IL-6 levels on preterm, low birth weight, appropriate to gestational age newborn. This was a randomized controlled trial. Subjects of the study were all preterm newborns with a stable medical condition, birth weight 1,500-2,499 gram, appropriate to gestational age. The study was carried out on October-December 2011, in neonatology ward, Sanglah General Hospital, Vali-Indonesia. The number of cases was 35 subjects and the number of controls was 36 subjects. The examination of TNF-Î±, IL-6 levels and birth weights before and after massage stimulation were performed on both groups. The level of TNF-Î± and IL-6 was examined by applying ELISA method. The level of confidence was Î± Â = 0.05. All statistical analysis was performed by computer programme. There was different level of cytokine pro-inflammation TNF-Î± (p=0.025) and IL-6 (p=0,001) comparing before and after condition massage stimulation. Outcome of body weight were also different at before and after massage stimulation, withÂ p valueÂ 0.042. The conclusion of this study is that massage stimulation can reduce the level of TNF-Î± , Â Â IL-6 and increasing of birth weight on preterm, low birth weight appropriate gestational age newborn. Based on this study, in the future, massage stimulation can be done in newborn with stable medical conditions by parents or trained staffs.
HIGH INTERLEUKIN-6, LOW CD4+ AND CD8+ T-LYMPHOCYTES EXPRESSIONS AS RISK FACTORS OF CERVICAL CARSINOMA INFECTED BY HUMAN PAPILLOMA VIRUS TYPE-52
Authors: Mahendra-Dewi I G. A. S. , Suwiyoga I K. , Joewarini E. , Alit-Artha I G.
Published: December 2022

In Indonesia cervical carcinoma is the most common cancer in women and one of the leading cause of mortality. High risk human papillomavirus (HPV) is the major risk factor of cervical cancer. This study aims to know the role of IL-6, CD4+Â and CD8+Â T-lymphocyte for the risk of cervical carcinoma infected by HPV52. This study was a case control study, specimens of cervical carcinoma patients infected by HPV type-52 as the case group and HPV type-16 or 18 as the control group. HPV genotyping used SPF10 primer and type specific E7 primer by LiPA. Immunohistochemistry method was used to know expression of IL-6, CD4+Â and CD8+Â T lymphocyte. Pearsonâ€™s c2Â test was applied with statistical significance was set at the 2-sided 0.05 level. The odds ratios (OR) were calculated for the risk, with 95% confidence intervals on SPSS 16.0 for windows. PCR examination was performed in 185 paraffin-embedded tissue. The risk of high IL-6 expression in cervical carcinoma infected by HPV type-52 was statistically significant 6-fold higher compare with cervical carcinoma infected by HPV type 16 (OR = 6.00 ; CI 95% = 1.13-31.99; p = 0.03; p < 0.05) and HPV type 18 (OR = 6.00 ; CI 95% = 1.13-31.99; p = 0.03; p < 0.05). The risk of low CD4+Â T lymphocyte expression in cervical carcinoma infected by HPV type 52 was statistically significant 6-fold higher and 7.43-fold higher respectively compare with cervical carcinoma infected by HPV type 16 (OR = 6.00 ; CI 95% = 1.003-35.91; p = 0.04; p < 0.05) and HPV type 18 (OR = 7.43 ; CI 95% = 1.23-45.01; p = 0.02; p < 0.05). The risk of low CD8+Â T lymphocyte expression in cervical carcinoma infected by HPV type 52 was statistically significant 13.5-fold higher and 11-fold higher respectively compare with cervical carcinoma infected by HPV type 16 (OR = 13.50 ; CI 95% = 1.42-128.26; p = 0.01; p < 0.05) and HPV type 18 (OR = 11.00 ; CI 95% = 1.16-103.94; p = 0.02; p < 0.05). No significance different between cases and controls group in mean-age, parity and sexual activity (p > 0.05). In conclusion, this study found that high IL-6 expression, low CD4+Â and CD8+Â T lymphocyte expression were the risk factors of cervical carcinoma infected by HPV type 52.
AMPLICATION OF 0.7KB FRAGMENT KATG GENE FROM CLINICAL MULTI DRUG RESISTANT TUBERCULOSIS ISOLATE IN BALI
Authors: Dwiputri A. W. , Ratnayani K. , Yowani S. C.
Published: December 2022

During last decade has seen a particular increase in the occurrence of drug-resistant of tuberculosis (DR-TB) and multi-DR strains, such as Isoniazid (INH) resistant strains ofÂ M. tuberculosis. Â INH resistance is more frequently associated with mutations in theÂ katGÂ gene. Detection ofÂ katGÂ gene mutations can be performed by PCR technique, followed by sequences. The aim of this study is to amplifyÂ katG gene region (0,7 Kb) from clinical isolate of MDR-TB in Bali. DNA isolation for PCR was done by Boom method andÂ katGÂ gene amplification was performed under the following conditions: predenaturation at 950C for 15 min; fourty cycles of denaturation at 940C for 1 min, annealing at 560C for 1 min, extension at 720C for 2 min; final extension at 720C for 10 min. The amplicons were detected by 1.5% agarose gel electrophoresis and showed a specific band size at 0.7 kb. This suggests that the fragment ofÂ katGÂ gene has been successfully amplified in these areas.
Hubungan komunikasi efektif dokter-pasien terhadap tingkat kepuasan pasien dalam pelayanan medik
Authors: Silaen Dahliana Jessica Aristy , Alferraly Ibnu
Published: December 2022

Introduction: Indonesia is the biggest contributor of medical tourists to Malaysia and Singapore in recent years, mostly from Medan. Literature reviews and experts opinion of community medicine revealed that poor doctorsâ€™ communication skills in Indonesia lead to decreased patients satisfaction and lead to the number of patients seeking treatment abroad.Aim: This study aimed to analyze the relationship between physician-patient communication on the level of patient satisfaction in Central Public Hospital Haji Adam Malik, Medan.Method: This research uses a combination of descriptive-analytic study with cross sectional design. Statistical analysis was performed by chi-square test. The sample selection of research done by consecutive sampling. Measurement doctor-patient communication and patient satisfaction rate is determined by using modified CAT (Communication Assessment Tool) questionnaire.Result: Ten outpatient clinics of Central Public Hospital Haji Adam Malik (10 patients per outpatient clinic) participated in the field test. The average mean score was 4.086 across all modified CAT items (SD = 0.609, range 2.23-5.00). The average proportion of satisfaction rate was 81.7% (S.D. = 12.19, range 44.62-100%). There was a significant relationship between physician-patient communication with patient satisfaction (p <0.05).Conclusion: Assessment doctor-patient communication in Outpatient Clinics of Central Public Hospital Haji Adam Malik categorized as good. Patient satisfaction rate in Outpatient Clinics of Central Public Hospital Haji Adam Malik categorized as satisfied. Effective physician-patient communication associated with patient satisfaction with the physician.
Disregulasi IL-17, CD4 neutrofil, IL-10, PGE-2, iNOS, dan MMP-9 di jaringan kulit terhadap kerusakan saraf dermal pada pasien erythema nodusum leprosum
Authors: Darmaputra I Gusti Nyoman , Sigit Prakoeswa Cita Rosita , Endaryanto Anang , Elis Indira IGAA , Suryawati Nyoman , Ervianti Evy , Astari Linda , Bagus Bagus
Published: December 2022

Introduction: The mechanism of nerve damage in ENL patients is important to be revealed because the problem of nerve damage is not getting enough attention in handling ENL patients. Some pro-inflammatory mediators that have been studied are risk factors for nerve damage in ENL.Aim: This study aim in knowing the mechanism of nerve damage in the relation with its risk factors, which are CD64 neutrophil, IL-17, MMP-9, and iNOS with PGE-2 and IL-10 protective factor and IL-10 in ENL patients.Method: This is an analytic cross-sectional design study with tissue samples from 30 leprosy patients with ENL in Dr. Soetomo General Hospital Surabaya. Samples from biopsy examined using IHC method to evaluate S-100, IL-10, IL-17, PGE-2, iNOS, MMP-9, and CD64 neutrophil expressions. The result calculated within 20 view field with 1000 times magnification.Result: CD64 neutrophil (p=0.022, r=-0.417), IL-17 (p=0.001, r=-0.560), iNOS (p=0.005, r=-0.502) and MMP-9 (p=0.025, r=-0.409) has significant correlation with S-100. There is no significant correlation between IL-10 (p=0.061) and PGE-2 (p=0.407) with S-100.Conclusion: Expressions of IL-17, CD64 neutrophil, MMP-9, and iNOS in tissue correlate with nerve damage in ENL patients.
Karakteristik pasien batu ginjal dengan tatalaksana retrograde intra-renal surgery di Rumah Sakit Umum Pusat Sanglah dan Rumah Sakit Surya Husada: initial report tahun 2017-2019
Authors: Sabudi I Made Nugraha Gunamanta , Duarsa Gede Wirya Kusuma , Santosa Kadek Budi , Yudiana I Wayan , Tirtayasa Pande Made Wisnu , Pramana Ida Bagus Putra , Oka Anak Agung Gde
Published: December 2022

Background: Renal stone is frequent cases that happened in the community. There are a lot of options to treat renal stone; one of them is RIRS. RIRS is an alternative procedure after ESWL and PNL for renal stone.Method: Twenty-seven samples as total sampling of all patients that were done with RIRS in Sanglah Hospital and Surya Husada Hospital from January 2017 until June 2019 retrospectively. Data were collected secondary from Medical Reports of the patients and showed a descriptive study depict how the RIRS patient characteristic in Sanglah Hospital and Surya Husada Hospital. All RIRS patients showed that the RIRS procedure is secondary due to history of ESWL, PNL, URS with insertion of DJ Stent, and or Nephrolithotomy.Results and Conclusion:Characteristic of age in this study was 52,41 years old in mean value, with male and female per cent, respectively 62,96% and 37,04%. Stone size of the study was classified to 4 cluster which are: (1) 37,04% cluster with stone size <1 cm, (2) 33,33% cluster with stone size â‰¥1cm to <2cm, (3) 3,70% cluster with stone size â‰¥2 cm, and (4) 25,93% cluster that with stone size unknown. This study also showed some similarity with two other studies about patient characteristic of RIRS treatment.Â Latar Belakang: Batu ginjal adalah kasus yang sering terjadi di masyarakat. Terdapat banyak pilihan tindakan untuk mengambil batu ginjal salah satunya adalah dengan tindakan RIRS. Tindakan RIRS masih menjadi alternatif tindakan setelah pilihan pertama PNL dan ESWL untuk batu ginjal.Metode: Penelitian ini mengambil 27 sampel pasien dari total sampling seluruh pasien yang dilakukan RIRS di Rumah Sakit Umum Pusat (RSUP) Sanglah dan Rumah Sakit (RS) Surya Husada selama Januari 2017 hingga Juni 2019 secara retrospektif. Data didapatkan dari data sekunder rekam medis pasien. Penelitian disajikan secara deskriptif memberikan gambaran karakteristik pasien yang mendapatkan tindakan RIRS. Seluruh pasien yang dilakukan RIRS di RSUP Sanglah dan RS Surya Husada merupakan pasien dengan mendapat RIRS Sekunder setelah sebelumnya memiliki riwayat pernah ESWL, PNL, URS dengan pemasangan DJ-stent, dan atau nefrolitotomi.Hasil dan Simpulan: Karakteristik usia rata-rata pada penelitian ini adalah 52,41 tahun dengan perbandingan persentase laki-laki perempuan berturut-turut 62,96% dan 37,04%. Ukuran batu pada penelitian dikelompokkan menjadi 4 kelompok dengan masing-masing kelompok: (1) 37,04% kelompok dengan ukuran batu <1 cm, (2) 33,33% kelompok dengan ukuran batu â‰¥1cm s/d <2cm, (3) 3,70% kelompok dengan ukuran batu â‰¥2 cm, (4) 25,93% kelompok yang ukuran batunya tidak tercantum.
Pengaruh puasa berselang terhadap berat badan pada mahasiswa Program Studi Pendidikan Dokter Fakultas Kedokteran Universitas Udayana
Authors: Adi Supraba Putu Ayu , Sutadarma I Wayan Gede , Wiryanthini Ida Ayu Dewi
Published: December 2022

Background: Body weight is used as a measure of body mass in kilogram (kg). The way which is effective for weight loss is a lifestyle changes like diet and exercise. Besides low calorie diet, we can do intermittent fasting to prevent overweight and obesity.Aim: This research aims to know the effect of intermittent fasting on body weight in young adult group.Methods: This research uses pretest-posttest control group design which was conducted during Ramadhan fasting in 2017 in the Department of Physiology, Faculty of Medicine, Udayana University. The subject is divided into two groups, namely fasting group and unfasting group as many as 40 people, respectively. The data include weight before and after fasting.Results: Normality test obtained both fasting groups with p=0.326 and unfasting one with p=0.317, so that both groups are homogenous. Paired-sample t test on the weight for the beginning and end of the fasting group obtained the value of p=0.000, whereas in unfasting group obtained 0.149.Conclusion: Intermittent fasting affects early weight loss and final body weight on fasting group consequently. As for the unfasting group, it was obtained no significant distinction between initial weight compare with latest weight. Latar belakang: Berat badan digunakan sebagai ukuran massa tubuh dalam kilogram (kg). Cara yang paling efektif untuk menurunkan berat badan adalah perubahan gaya hidup meliputi diet dan olahraga. Selain diet rendah kalori, cara untuk mencegah kelebihan berat badan dan obesitas adalah puasa berselang.Tujuan: Penelitian ini bertujuan untuk mengetahui pengaruh puasa berselang terhadap berat badan pada kelompok dewasa muda.Metode: Penelitian ini menggunakan pretest-posttest groups control design yang dilakukan saat puasa Ramadhan 2017 di bagian Fisiologi Fakultas Kedokteran Universitas Udayana. Subjek penelitian dibagi menjadi dua kelompok yaitu kelompok puasa dan kelompok tidak puasa yang masing-masing berjumlah 40 orang. Data yang diambil meliputi berat badan sebelum dan sesudah puasa.Hasil: Hasil uji normalitas didapatkan untuk kelompok puasa dengan p=0.326 dan kelompok tidak puasa p=0.317 yang berarti kedua kelompok homogen. Pada uji t-test berpasangan untuk berat badan awal dan akhir pada kelompok puasa didapatkan nilai p=0.000, sedangkan pada kelompok tidak puasa didapatkan nilai p= 0.149.Simpulan: Puasa berselang berpengaruh terhadap penurunan berat badan awal dan berat badan akhir pada kelompok puasa. Sedangkan bagi kelompok tidak puasa, tidak didapatkan perbedaan yang bermakna antara berat badan awal dengan berat badan akhir.
Awareness of male infertility among the medical students in Udayana University of batch 2015
Authors: Kumar Omprakash Nanda , Yuliana Yuliana , Karmaya I Nyoman Mangku
Published: December 2022

Background: Infertility is defined as the inability to conceive after one year of unprotected sex which was affected eighty million people all over the world. Male infertility is involved in approximately 40% of the more than 2 million infertile married couples in the United States. Health promotion strategies are therefore recommended to begin with educational interventions to increased knowledge of infertility awareness. University years are a time for self-maturation which includes sexual exploration and pregnancy avoidance during this life-course transition to adulthood. There’s still no data about the awareness and knowledge about male infertility among university student especially medical student in Indonesia.Aim: The study aims to know the level awareness on male infertility among the medical students in Udayana University of batch 2015.Methods: This study was a descriptive cross-sectional design conducted on June 2018. The subjects were 102 medical students from regular and international class of Faculty of Medicine, Udayana University. The data derived with questionnaires and a preceding informed consent already had been gained from all the participants.Results: Most of the subjects were belong to the somewhat knowledgeable group (41.2%). English class and female students had the better awareness regarding the male infertility issue (36.8% and 46.7%). The highest percentages of correct answered subtheme questions were diagnosis (55%) subtheme.Conclusion: Infertility awareness, including knowledge of male risk factors, is a critical first step towards fertility preservation through lifestyle modification.
Kesulitan diagnosis pada kasus fraktur kondilus lateral humerus pada anak di bawah umur dua tahun: laporan kasus
Authors: Adisthanaya Surya , Ronny Kesuma Anak Agung Ngurah
Published: December 2022

Background: The lateral humeral condylus fracture in a child can be difficult to diagnose because the bones of a child not ossification yet. This resulted the fracture is difficult to see or even pass in viewing. In management, the lateral humeral condylus fracture in children has controversy, between non-operative and operative (especially in fracture with minimal displace). This case report discusses the case of the humeral lateral condyle fracture in a two-year-old child and discusses its treatment.Case: A two-years-old boy was delivered by his parents to the Emergency Room (ER) in the Wangaya Regional General Hospital Denpasar with complaints of pain in the left elbow since a day ago. Complaints appear after the patient falls on the floor in his home while playing with his brother. On physical examination of the upper extremity, the left elbow is swollen at the elbow with minimal deformity without an open wound. In manage it, open reduction surgery is performed by apply Kirschner-wire and then backslab is placed on the left arm with supination and 30o flexion positions.Conclusions: Difficulties in diagnosing humeral lateral condylus fractures in children are due to the fact that there are still many condyle plates that have not ossification yet, so that it is difficult for radiological examination to see the fracture line. The operative actions that can be taken are open reduction with the installation of Kirschner-wire. Latar Belakang: Fraktur kondilus lateral humerus pada anak dapat sulit terdiagnosis akibat tulang anak yang belum terosifikasi. Hal ini mengakibatkan gambaran fraktur sulit terlihat atau bahkan terlewati. Dalam penatalaksanaanya, fraktur kondilus lateral humerus pada anak memiliki kontroversi, antara non-operatif dan operatif (terutama pada fraktur dengan pergeseran minimal). Laporan kasus ini bertujuan untuk membahas kasus fraktur kondilus lateral humerus pada anak umur dua tahun dan membahas tatalaksananya.Kasus: Seorang anak laki-laki berumur dua tahun diantar oleh orangtuanya ke Unit Gawat Darurat (UGD) Rumah Sakit Umum Daerah Wangaya Denpasar dengan keluhan nyeri pada siku kiri sejak satu hari yang lalu. Keluhan muncul setelah pasien terjatuh di lantai rumah saat sedang bermain dengan saudaranya. Pada pemeriksaan fisik ekstremitas atas, pada siku kiri didapatkan bengkak pada siku dengan deformitas minimal tanpa disertai luka terbuka. Dalam penanganannya, dilakukan tindakan operasi reduksi terbuka dengan pemasangan Kirschner-wire kemudian dipasang backslab pada lengan kiri dengan posisi supinasi dan fleksi 30o.Simpulan: Dalam mendiagnosis fraktur kondilus lateral humerus pada anak diakibatkan masih banyak lempeng kondilus yang masih belum terosifikasi, sehingga pada pemeriksaan radiologis sulit melihat garis frakturnya. Tindakan operatif yang dapat dilakukan berupa reduksi terbuka dengan pemasangan Kirschner-wire.
Keberhasilan Terapi Rituximab pada Seorang Pasien dengan Lupus Nephritis Berat: Laporan Kasus
Authors: Indriyani Ni Putu Dewi , Kurniari Pande Ketut , Kambayana Gede
Published: December 2022

Background: Lupus nephritis is one of complication of systemic lupus erythematosus (SLE) which manifests to the kidneys. Lupus nephritis occur in 50-60% of cases in the first ten years of the onset of SLE. Standard therapy for lupus nephritis are immunosuppressive drugs such as corticosteroids and cytostatics. In a refracter case, biologic agent has giving new hope.Case description: We report a case of seventeen years old female with chief complaints of edema in both feet, skin rash caused by sun exposure, joint pain, mouth ulcer with positive ANA test, proteinuria and high blood sugar level. Patient was then diagnosed with SLE, lupus nephritis and other types of DM. Patient was treated with combination theraphy of cycloposphamide and Rituximab. Patient then discharged in good condition.Conclusion:  we suggest that combination of cycloposphamide and Rituximab is effective in controlling SLE and reducing the dose of steroid theraphy.Keyword: biological agents, systemic lupus erythematosus, lupus nephritis  Latar belakang: Lupus nephritis merupakan salah satu komplikasi penyakit Systemic Lupus Erythematosus (SLE) yang bermanifestasi ke ginjal. Komplikasi lupus nephritis terjadi pada 50-60% kasus dalam sepuluh tahun pertama onset penyakit SLE. Terapi lupus nephritis meliputi obat-obatan imunosupresif seperti kortikosteroid dan sitostatika. Pada kasus-kasus yang refrakter, terapi dengan agen biologis memberikan harapan baru. Harapan hidup jangka panjang dan renal survival pasien SLE dengan lupus nephritis secara progresif telah mengalami peningkatan sejak ditemukannya agen biologis, rujukan yang lebih dini, dan kriteria diagnostik yang lebih baik.Deskripsi kasus:Kami melaporkan kasus seorang perempuan, berusia 17 tahun, suku Timor, datang dengan keluhan utama bengkak pada kedua punggung kaki, kemerahan pada kulit bila terkena sinar matahari, nyeri sendi, ulserasi pada mulut, dengan hasil laboratorium ANA test positif, proteinuria, disertai kadar gula darah yang tinggi. Pasien didiagnosis dengan SLE, lupus nephritis, dan DM Tipe lain. Setelah diberikan terapi cycloposphamide dan Rituximab, kondisi pasien membaik. Kesimpulan: regimen terapi ini efektif untuk mengontrol penyakit SLE dan memungkinkan untuk penurunan dosis terapi steroid.
Prevalensi dry eye pada pasien diabetes melitus tipe 2 di Rumah Sakit Mata Mencirim 77 Kota Medan
Authors: Lukandy Andry , Albar Marina Yusnita
Published: December 2022

Background: Dry eye syndrome is a multifactorial ocular surface disease with characteristic symptoms such as discomfort, irritation and visual disturbance. Dry eye syndrome increases a significant burden on an individual including social function, work and decreases the quality of life. The Women's Health Study Questionnaire (WHSQ) revealed that the prevalence varies around 4.3% in American men to 21.6% in Asian women. Dry eye prevalence in Southeast Asia is around 20.0% to 52.4%.Methods: This study design was a cross sectional study with total sampling. The population in this study were all polyclinic patients at Mencirim 77 Eye Hospital in August 2019. Sample in this study were patients with Diabetes Mellitus Type 2. The data was analyzed by SPSS using chi-square test.Results: There were 124 subjects included in this study. 62 patients with diabetes mellitus and 62 patients without diabetes mellitus. 60 subjects were males and 64 subjects were females. Based on the analyzed result, it’s confirmed that dry eye has significant result with Diabetes Mellitus type 2 patients (p-value=0.027) (p < 0.05). Dry Eye was found 91.1% in the age group ? 50 years, 51.6% female gender, and 42.7% patients suffered severe dry eye.Conclusions: From the result of this study, it can be concluded that dry eye has a significant result with diabetes mellitus type 2 patients at Mencirim 77 Eye Hospital. Latar belakang: Sindrom mata kering merupakan suatu penyakit permukaan okular multifaktoral dengan karakteristik gejala seperti rasa tidak nyaman, iritasi dan gangguan visual. Sindrom mata kering meningkatkan beban yang signifikan terhadap suatu individu termasuk fungsi sosial, pekerjaan dan menurunkan kualitas hidup. The Women’s Health Study Questionnaire (WHSQ) mengungkapkan bahwa prevalensi bervariasi sekitar 4,3% pada pria Amerika hingga 21,6% pada wanita Asia. Prevalensi Dry Eye di Asia Tenggara sekitar 20,0% hingga 52,4%.Metode: Jenis penelitian ini menggunakan studi cross sectional dengan total sampling. Populasi pada penelitian ini adalah seluruh pasien poliklinik di RS Mata Mencirim 77 pada bulan Agustus 2019. Sampel pada panelitian ini adalah pasien dengan Diabetes Melitus Tipe 2. Data di analisa dengan SPSS menggunakan chi-square test.Hasil: Dari 124 pasien Dry Eye, 62 pasien dengan diabetes melitus dan 62 pasien tanpa diabetes melitus. 60 subjek adalah laki-laki dan 64 subjek adalah perempuan. Berdasarkan hasil analisa data didapatkan bahwa dry eye memiliki hasil yang signifikan dengan pasien diabetes tipe 2 (nilai-p=0.027) (p<0.05). Dry Eye ditemukan sebanyak 91.1% pada kelompok usia ? 50 tahun, 51.6% jenis kelamin perempuan, 42.7% pasien menderita Dry Eye berat.Kesimpulan: Dari hasil penelitian ini dapat disimpulkan bahwa Dry Eye menunjukkan hasil yang signifikan terhadap pasien diabetes melitus tipe 2 di Rumah Sakit Mata Mencirim 77.
Karakteristik klinikopatologi osteokondroma di Rumah Sakit Umum Pusat Sanglah Denpasar periode tahun 2013 - 2018
Authors: Atmaja I Gusti Ngurah Pratama Yuda , Sumadi I Wayan Juli , Sriwidyani Ni Putu
Published: December 2022

Background: Osteochondroma is a benign cartilage tumor which is quite a number of events with a clinical picture and quite varied pathology. The cause of osteochondroma is still not known with certainty. Data from osteocondroma cases in Indonesia especially in Bali are still very rarely found, even histopathological data registered at hospitals in Bali are still very rare. Aim: The study aims to determine the clinicopathological characteristics of osteochondroma patients in the Sanglah Hospital Denpasar for 5 years.Method: This research is a cross-sectional descriptive study conducted at the Sanglah Hospital using the histological data archive for the period 2013 - 2018. The sampling technique used total sampling, with a total sample of 32 people.Results: Most of the osteochondroma sufferers in this study were 59.4% male, while female sufferers were around 40.6%, with the most age range being 10 - 20 years (62.5%) and at least those aged > 20 years (15.6%). The most tumor location is the distal femur bone (37.5%). Most tumor size is at the size of 1-5 cm (78.1%). Most cases of osteochondroma based on the thickness of the hyaline cartilage cap are 1-3 mm (59.4%).Conclusion: The clinicopathological characteristics of osteochondroma patients by using histopathological data in the Sanglah Hospital shows that osteochondroma is more common in men. Osteokondroma merupakan salah satu tumor tulang rawan jinak yang angka kejadiannya cukup banyak dengan gambaran klinis dan gambaran patologinya cukup bervariasi. Penyebab osteokondroma masih belum dapat diketahui dengan pasti. Data dari kasus osteokondroma di Indonesia khususnya di Bali masih sangat jarang ditemukan, bahkan data histopatologi yang teregristasi di rumah sakit di Bali masih sangat jarang terjadi. Tujuan: Untuk mengetahui karakteristik klinikopatologi pasien osteokondroma di Rumah Sakit Umum Pusat (RSUP) Sanglah Denpasar selama 5 tahun.Metode: Penelitian ini merupakan penelitian deskriptif cross-sectional yang dilaksanakan di RSUP Sanglah menggunakan arsip data histologi periode tahun 2013 – 2018. Teknik pengambilan sampel menggunakan total sampling, dengan total jumlah sampel sebanyak 32 orang.Hasil: Sebagian besar penderita osteokondroma pada penelitian ini adalah laki – laki selitar 59,4%, sedangkan penderita perempuan sekitar 40,6%, dengan rentang usia terbanyak adalah 10 – 20 tahun (62,5%) dan paling sedikit pada usia > 20 tahun (15,6%). Lokasi tumor paling banyak adalah tulang distal femur (37,5%). Ukuran tumor paling banyak adalah pada ukuran 1 – 5 cm (78,1%). Kasus osteokondroma berdasarkan ketebalan tutup tulang rawan hialin terbanyak adalah pada ukuran 1 – 3 mm (59,4%).Simpulan: Karakteristik klinikopatologi pasien osteokondroma dengan menggunakan data histopatologi di RSUP Sanglah menunjukkan osteokondroma lebih banyak diderita oleh laki – laki.
Cochlear implantation in a child with cystic cochleovestibular malformation: a case report
Authors: Saputra Komang Andi Dwi , Hartayanti Adriyani
Published: December 2022

Background: The inner ear and internal auditory canal (IAC) malformations account for 20% of congenital sensorineural hearing loss in children. The cystic cochleovestibular malformation is one of the congenital malformations in the cochlea, in which the cochlea is empty, unpartitioned, and cystic. The dimension of the cochlea is normal. This presents a significant challenge even to the most experienced clinicians because of difficulty in the surgery with facial nerve anomaly and gusher, choice and placement of electrode, and increased risk of meningitis after the procedure. This study aims to report the procedure of cochlear implantation in one case of cystic cochleovestibular (IP type I) malformation, which still became a challenge in the otology field.Case Presentation: We reported one case of 5 years old boy with bilateral cystic vestibular malformation who underwent cochlear implantation on the left ear. The patient was diagnosed with bilateral profound congenital sensorineural hearing loss. He already used hearing aids on both ears but gained limited improvements. Peri-operative perilymph gusher was happened and was stopped by plugging the cochleostomy hole using fascia. The patient showed good condition after the procedure. Although facial nerve lesion occurred after the operation, it was improved by giving steroids. There is no sign of cerebrospinal fluid leaks such as rhinorrhea, otorrhea, or meningitis.Conclusion: This report showed good outcomes following cochlear implantation in cystic cochleovestibular malformation.
Successful hiatal hernia repair with Nissen fundoplication by laparoscopic approach: a case report
Authors: Celeste Francis , Mahardika I Made Yudi , Jeo Wifanto Saditya
Published: December 2022

Background: Hiatus hernias represent a herniation of viscera, most commonly the stomach, into the mediastinum through the esophageal hiatus of the diaphragm.There are two main classifications, sliding hernias and paraesophageal hernias. This case study aims to evaluate the successful hiatal hernia repair with Nissen fundoplication by a laparoscopic approach.Case Presentation: We present a case of a 60-year-old male who presented with recurrent abdominal discomfort 6 months prior to the consultation. This was accompanied by loose stools, bloating, nausea, and vomiting. An initial diagnosis of Gastroesophageal Reflux Disease (GERD) was made. Conservative treatment was initiated with limited success. Endoscopy was then performed, revealing a hiatal hernia. Surgical intervention was then chosen as a therapeutic option via a laparoscopic approach and additional Nissen fundoplication with favorable outcomes.Conclusion: Symptomatic paraesophageal hernias are indicated for surgical repair.Paraesophageal hernias can be repaired transthoracically and transabdominal. Repairs via the transabdominal route can be performed with an open approach or laparoscopically, with the laparoscopic approach suggesting lower mortality and morbidity. Nissen fundoplication has been proven as an effective measure in GERD's control and in maintaining an intra-abdominal location of the gastroesophageal junction (GEJ).
Association between age, urine pH, and urinary stone incidence in Kardinah Tegal General Hospital, Indonesia
Authors: Ali Zulfikar , Hotasi Stevano Lucianto
Published: December 2022

Introduction: An increase in the incidence of urolithiasis at age> 15 years in Indonesia provides increased morbidity and medical costs. The study aims to determine the association between age, urine pH, and urinary stones incidence in Kardinah Tegal General Hospital, Indonesia.Method: There were 240 subjects from July to August 2019, with urolithiasis in Kardinah Tegal General Hospital who never received any previous treatment for urolithiasis. Subjects were divided into 120 subjects in case group and 120 subjects in control group. Medical records were assessed and reviewed for age, gender, urinalysis (including urine pH), urinary tract infection (UTI), and urinary stones incidence. Kolmogorov-Smirnov was used to assess data distribution of age and urine pH, and Chi-square test was used to evaluate the association between each age category and urinary pH.Results: Subject’s mean age between urolithiasis and non-urolithiasis groups were 47.68 ± 11.74 and 55.49 ± 15.72 years old, respectively There are no significant differences in stone incidence according to urinary pH in both groups. Stone incidence was found to be highest in age group of 50-59 years old in acidic urinary pH. No age group and urinary pH were associated with stone incidence. The odds of urinary stones occurrence would be 0.689 times more likely to happen with the increase of urinary pH,Conclusion: There was significant difference of age between urolithiasis and non-urolithiasis groups. No age group and urinary pH were found associated with stone incidence, however the increase of age and urinary pH, increase the odds of developing urinary stones.
Acute thromboembolic ischemic stroke in rural hospital, the role of early treatment in reducing brain damage
Authors: Akbar Munzirul , Habibie Yopie Afriandi , Mursyida Mursyida
Published: December 2022

Introduction: Stroke has a high mortality and disability rate, and the main cause of physical disability in productive age and elderly. In developed countries stroke is the number one cause of admission of patients to hospital, with a mortality proportion of 20%  within the first 28 days of treatmentCase Report: A 45-year-old man came to the neurology polyclinic of RSUD Aceh Besar on March 21st, 2021 with chief complaints of the general weakness of the left limb, complete numbness and heavy feeling in the left limb since 4 hours of before admission which is felt to be getting weaker from time to time, happened suddenly when the patient was working collecting stones. He complained of dizziness as well, and did not decrease while resting. After the attack, the patient remains conscious with no headache, no nausea and vomiting, no double images were seen. On Siriraj score showed result of -4. The patient was hospitalized with injection of Citicolin 1000 mg and then discharged 5 days later with significant improvement.Conclusion: Ischemic Stroke requires fast, precise and accurate handling to prevent and avoid disability and even death. One of the effective efforts is to organize health promotion and preventive programs starting from the First Level Health Facility (FKTP) on an ongoing basis to the community.
Profil deskriptif pasien dengan apendisitis akut di Rumah Sakit Sekunder periode Juni hingga Desember 2020
Authors: Natario Natario , Pretangga Anak Agung Ngurah
Published: December 2022

Background: Appendicitis is one of the cause of lower abdominal pain and often results in visits to the Emergency Room. Appendicitis caused by luminal obstruction of various etiologies which increases mucus production and bacterial overgrowth. This study aimed to determine the profile of acute appendicitis sufferers.Methods: This descriptive cross-sectional study involved 56 participants obtained with total sampling method from July 2020 until December 2020. Data obtained from medical record of the patients, which diagnosed with acute appendicitis. Descriptive analysis was performed for demographic data, symptoms, types, and each component of Alvarado score.Results: The mean age in this study was 28.79 ± 13.87 years, with dominant were female (51.8%). Most of the patients were without complications (25%). However, most types of case were suppurative (17.9%). From the Alvarado score component, all patients experienced complaints of lower right abdominal pain. Meanwhile, from the laboratory, most patients with leukocytosis (80.4%) and shifted to the left (91.1%) characteristic.Conclusion: Acute appendicitis affects mostly women. Judging from the number of leukocytes, most had leukocytosis. Meanwhile, in terms of type of cases, most did not had any complications. However, the most common type is suppurative. Latar Belakang: Apendisitis merupakan penyebab nyeri perut bawah dan sering menyebabkan kunjungan ke Unit Gawat Darurat. Apendisitis disebabkan oleh obstruksi luminal akibat berbagai etiologi sehingga meningkatkan produksi mukus dan pertumbuhan bakteri berlebih. Penelitian ini bertujuan untuk mengetahui profil penderita apendisitis akut.Metode: Penelitian ini merupakan studi potong lintak deskriptif yang melibatkan 56 sampel. Sampel didapatkan melalui total sampling dari periode Juli 2020 hingga Desember 2020. Data didapatkan dari rekam medis pasien yang didiagnosis dengan apendisitis akut. Dilakukan analisis deskriptif terhadap data demografik, keluhan, tipe kasus, dan masing-masing komponen skor Alvarado. Hasil: Rerata usia pada penelitian ini yaitu 28,79 ± 13,87 tahun. Sebagian besar berjenis kelamin perempuan (51,8%). Sebagian besar pasien tanpa komplikasi (25%). Namun dari tipe-tipe kasus yang ada, sebagian besar yaitu supuratif (17,9%). Dari komponen skor Alvarado, seluruh pasien mengalami keluhan nyeri perut kanan bawah. Sedangkan dari segi laboratorium, sebagian besar mengalami leukositosis (80,4%) dan dengan karakteristik shift to the left (91,1%).Simpulan: Apendisitis akut dialami sebagian besar oleh perempuan. Dilihat dari jumlah leukosit, rata-rata pasien mengalami leukositosis. Sedangkan dari tipe kasus, sebagian besar tidak mengalami komplikasi. Namun, tipe kasus yang paling sering muncul yaitu supuratif.