bluuebunny/crossref_metadata_2025 huggingface dataset:
A-39 year old, nulligravida woman with giant leiomyomas: a case report
Authors: Cahyono Endy , Iskandar Teuku Mirza , Ambari Ediwibowo , Putra Very Great Eka , Lubena  , Wardana I Made Prasetya
Published: May 2024

Introduction: The most common neoplasm of the uterus, uterine leiomyomas, or fibroids, are benign growths that affect 20–30% of women between the ages of 30 and 50. The smooth muscle of the uterus gives rise to leiomyomas. In this case report, we sought to highlight the case of a 39-year-old nulligravida lady with a fast expanding abdominal mass and abdominal pain.
Case Presentation: The gynecologist department at Dr. Kariadi General Hospital Semarang received a visit from a 39-year-old nulligravida lady complaining of a fast-expanding lump in her belly and extreme weight loss over the past year. During the abdominal exam, an immovable mass that could have been an 8-month pregnancy was felt in the midline of the abdominal area, extending from the lower abdomen to the epigastric area. Ascites were also discovered. The multislice computerized tomography (MSCT) results showed a solid lobulated inhomogeneous mass with internal calcification which extended from the abdominal cavity to the pelvic cavity and visualized the size of (anteroposterior 21.7 cm x laterolateral 24.1 cm x craniocaudal 36.8 cm), compressing the surrounding bowel structures, liver, spleen, and bladder. Several lymphadenopathies were also discovered. A frozen section, a bilateral salpingo-oophorectomy, and a total abdominal hysterectomy were performed. The results of the histology suggested a benign leiomyoma. Her vital signs were steady after surgery, and she fully recovered. The patient was called for a follow-up one week after being released for surgical suture removal and evaluation. The patient was discharged on the sixth postoperative day in good condition.
Conclusion: In determining if uterine smooth muscle tumors are benign or malignant, clinical characteristics, physical examination, imaging, and pathological findings are still considered very useful. The histopathology examination is still the most reliable diagnostic tool. The decision to perform a hysterectomy on this patient was determined accordingly to the tumor's size, probability of malignancy, and increasing morbidity.
The correlation of neutrophil-lymphocyte ratio and ENLIST ENL severity scale in type 2 leprosy reactions
Authors: Rosyada Rahma , Lubis Ramona Dumasari , Siregar Remenda
Published: May 2024

Link of Video Abstract: https://youtu.be/PlVYFXCyDlY
 
Introduction: Type 2 leprosy reaction or Erythema Nodosum Leprosum (ENL) is an episode of acute inflammation that appears in the clinical course of leprosy. In ENL, antigen-antibody immune complex responses and the complement immune system are suspected. The Neutrophil-Lymphocyte Ratio (NLR) is an easy, inexpensive, and usable parameter related to clinical outcome and disease severity. The ENLIST ENL Severity Scale (EESS) is the world's first validated ENL severity scale. This study aimed to determine correlations between the NLR and the EESS in type 2 leprosy reactions.
Methods: Observational analytic study with a cross-sectional approach was used in this study. The sample of the study was 30 subjects with type 2 leprosy reactions. The recording of basic data and examination of the study subjects included assessing the degree of severity using the ENLIST ENL severity scale and measuring the neutrophil-lymphocyte ratio. Statistical analysis was performed using Pearson's correlation coefficient, with p≤0.05 considered statistically significant.
Results: The research subjects with the highest distribution were in the age group <40 years (73.33%) and male (66.67%). The mean EESS score was 7.97 ± 1.73, with the category of the highest degree of severity in all subjects being mild (60.0%). The mean NLR value for all issues was 7.60 ± 3.58. There was a significantly strong positive correlation between NLR and EESS in type 2 leprosy reactions (p<0.001, r=0.653).
Conclusions: There was a strong correlation between NLR and EESS in type 2 leprosy reactions.
Plasma collection in Indonesia - a challenge to implement fractionation
Authors: Triyono Teguh Triyono , Bidayah Hasna Fadlilatul
Published: May 2024

In recent years, the national usage of Plasma Derived Medicinal Products (PDMPs), particularly albumin and immunoglobulin, has expanded due to a rise in disease prevalence, as well as enhanced patient management practices and broader assurance coverage. Now, Indonesia is a country that imports all of its PDMPs, resulting in high pricing and market reliance; nevertheless, barely a third of recovered plasma gets transfused to patients. The plasma that has not been used should be discarded, at a cost. The government intended to begin meeting the needs of the PDMP by implementing the plasma fractionation program. The decision was taken to use contract fractionation for three years, after which a national fractionation manufacturer was anticipated. The potential utility of recovered plasma and the prospective requirement for plasmapheresis collection have been assessed. The Minister of Health has enacted legislation concerning plasma fractionation, including the potential of establishing plasmapheresis centers to facilitate plasma collections. The Food and Drug Administration of Indonesia has also initiated a certification scheme for blood establishments (BEs), and only certified BEs can provide plasma for fractionation. After the epidemic, the government restarted the fractionation program by modifying existing laws to allow private manufacturers to participate. The difficulty was obtaining plasma from uncompensated donors, recruiting plasma donors, increasing the number of qualified biological examiners, of which only 19 out of 469 have been certified, and increasing technology and personnel capacities. Other significant obstacles were the harmonization or consolidation of existing biological entities (BEs) and the expense of paying for recovered and source plasma. The government and other parties involved had to make substantial efforts and collaborate to overcome these problems.
Comparison of freeze dried human amniotic membrane and its combination with platelet rich fibrin for the epithelial acceleration in an acute wound excision using Rattus Novergicus study model
Authors: Pratama Yanuar Ari , Zarasade Lobredia , Nata’atmadja Beta Subakti , Nurdianto Arif Rahman
Published: May 2024

Link of Video Abstract: https://youtu.be/FvU45HL3HyE
 
Introduction: Human amniotic membrane and platelet rich fibrin (PRF) are biological materials that can accelerate wound healing through their content of growth factors and cytokines. This study aimed to determine the effectiveness of the combination of these two biological agents for wound healing.
Methods: This study used an experimental method with a randomized post-test only control group design, to compare the use of human amniotic membrane alone with a combination of human amniotic membrane and PRF in acute full thickness wounds of the skin of Wistar rats. The research subjects were 32 rats which were divided into four groups. Groups 1 and 2 used human amniotic membrane, while groups 3 and 4 used a combination of human amniotic membrane and PRF, then the epithelialization process was observed on the 3rd and 6th day.
Result: There was no statistically significant difference in the speed of epithelialization of excision wounds on the backs of rats on the third day (Significance 0.498) and Sixth (Significance 0.9) between the Amnion group and the combination of amnion and PRF because it was greater than α = 0.05.
Conclusion: The use of a combination of freeze dried human amniotic membrane and platelet rich fibrin was not significantly more effective than freeze dried human amniotic membrane in accelerating the epithelialization of acute full thickness excision wounds in rats (Rattus novergicus).
Psychometrics of social norm and beliefs on gender-based violence in Indonesia
Authors: Syiddatul Budury  , Nunik Purwanti  , Khamida  , Sari Diah Jerita Eka
Published: May 2024

Introduction: Gender-based violence (GBV) is an important issue, especially violence experienced by women in the household. Social norms and beliefs (SNB) held by a person in society also affect the occurrence of violence. The purpose of this study was to examine the construct validity and reliability of SNB on the GBV scale in Indonesia.
Methods: Cross-sectional research was used in this study. A questionnaire on gender-based SNB was used to gather data. It had two domains—injunctive social norms and personal beliefs—each with three subscales: the husband's right to use violence, preserving family honor, and responding to sexual violence. By using a random sampling technique, data were obtained from 234 people consisting of 197 women and 37 men aged over 18 years. Data were analyzed using SmartPLS.
Results: The item which was strong on social norms with Cronbach's alpha 0.844 was protecting family honor. All items were above 0.5 so it can be stated that the gender-based SNB scale was valid and reliable to be used in measuring gender-based violence in Indonesia.
Conclusions: Psychometrics of SNB about GBV scale in the Indonesian version is valid and reliable.
Mindfulness eating based on spiritual interventions on diet compliance and blood sugar levels in type 2 DM patients
Authors: Riska Rohmawati  , Lono Wijayanti  , Ratna Yunita Sari  , Imamatul Faizah  , Rahayu Anggraini
Published: May 2024

Introduction: Diet is one component of diabetes mellitus (DM) self-management for controlling blood sugar levels. Several obstacles in the implementation of the diet program have the potential for non-compliance, so that blood sugar levels tend to increase. Mindfulness eating based on spiritual intervention is one of the interventions that is expected to form adaptive eating behavior control to achieve dietary compliance and controlled blood sugar levels. The purpose of this study was to analyze the effect of mindfulness eating based on spiritual intervention on dietary compliance and blood sugar levels in patients with type 2 diabetes.
Methods: The study's quasi-experimental, untreated control group design included dependent pre- and post-test samples. The population used was all patients with type 2 diabetes. The sample was taken using a simple random sampling technique with determination according to inclusion and exclusion criteria. The independent variables in this study were mindfulness eating based on spiritual intervention, while the dependent variables were dietary compliance and blood sugar levels. A glucometer and the Personal Diabetes Questionnaire (PDQ) were the tools employed in this investigation. The t-test was used as the statistical test.
Results: There were a total of 50 samples that were divided between the control group and the intervention group. The results of the statistical test showed that mindfulness eating based on spiritual intervention had a statistically significant effect on dietary compliance (p < 0.001) and blood glucose levels (p < 0.001) compared to the control group.
Conclusion: The value of diet adherence is greatly increased by mindfulness eating practices based on spiritual intervention, and mean blood glucose levels are significantly reduced at the conclusion of the study. Exercises in mindfulness eating that are based on spiritual intervention can be popularized as a way to deal with dietary issues and blood sugar regulation.
High levels of interleukin-6 and triglycerides and low levels of soluble leptin receptors as risk factors for leptin resistance in obese adolescents
Authors: Pinatih Komang Januartha Putra , Karyana I Putu Gede , Nesa Ni Nyoman Metriani , Apsari Ni Luh Sri , Wihandani Desak Made
Published: May 2024

Introduction: Obesity is a nutritional disorder that can affect all ages, including teenagers. Obesity can affect gut microbiota and cause increased intestinal permeability. This process leads to interleukin-6 and TNF-α production which can increase leptin levels. The soluble leptin receptor (sLR) is a leptin receptor in the plasma that transports leptin to the hypothalamus. Low sLR numbers are associated with high leptin levels in obesity. Obesity in hyperleptinemia conditions indicates leptin resistance (defects in leptin receptors) which causes hyperphagia and reduces energy expenditure. This study was conducted to prove high TG and IL-6 serum levels and low sLR levels in obese adolescents who have a higher risk of developing leptin resistance than normal adolescents.
Methods: This research is a case-control study. The subjects underwent an assessment including food recall, anthropometric status, and lipid profile. The food recall assessment was obtained by means of a questionnaire given to parents. Blood sampling and laboratory examination are carried out by the Prodia® Clinical Laboratory. Data analysis was performed by computer, using the Independent t-test, Mann-Whitney test. Chi-Square test, and analysis of the ROC curve.
Results: ROC curve analysis obtained the optimal cut points for TG and IL-6 levels, respectively 101.5 mg/dL (sensitivity 82.1%, specificity 89.7%) and 11.95 pg/mL (sensitivity 84.6%, specificity of 80%), with area under the curve (AUC) values of 0.96 and 0.89, respectively. ROC curve analysis obtained the optimal cut point for sLR levels of 19.3 ng/mL (sensitivity 64.1%, specificity 71.8%) with an AUC value of 0.77. Multivariate analysis using logistic regression found a significant relationship between TG and IL-6 levels on the incidence of hyperleptinemia.
Conclusion: This study reinforces the theory of chronic low-grade inflammation and proved that inflammation and high TG levels play a role in hyperleptinemia in obese adolescents.
Effect of dexmedetomidine administration on malondialdehyde levels in lower extremity surgery using tourniquets
Authors: Wijanarko Bayu , Airlangga Prananda Surya , Fitriati Mariza , Sumartono Christrijogo , Kriswidyatomo Prihatma , Lestari Pudji
Published: May 2024

Introduction: The use of a tourniquet in lower extremity surgery can help surgeons optimize the surgical field. However, tourniquet inflation may create ischemic conditions in the extremity, and tourniquet deflation may pose a risk of ischemic reperfusion injury (IRI). Ischemic conditions can increase the production of reactive oxidative stress (ROS), which, if it occurs simultaneously with IRI, will produce malondialdehyde (MDA), a toxic metabolite. The prolonged use of tourniquets can cause damage to the local skin tissue at the tourniquet inflation and poses a risk of IRI to other organs. This study aims to observe the effect of dexmedetomidine administration on malondialdehyde levels in lower extremity surgery using tourniquets.
Methods: This study is an observational study with a prospective cohort design to measure malondialdehyde levels in lower extremity surgery using tourniquets. When the data were normally distributed, a statistical test was performed using an independent sample t-test to compare the demographic data of the two groups. To compare the results of the observation after the induction, 15 and 120 minutes after the release of the tourniquets, a repeated measures ANOVA was performed when the data were normally distributed. Then, to examine the correlation between variables, Spearman's correlation test was applied when the data were not normally distributed.
Results: In this study, almost all the subjects in the isoflurane and dex-iso groups had no significantly different characteristics, and also showed no effect of tourniquet pressure on malondialdehyde levels.
Conclusion: Based on statistical analysis and discussion of the effect of dexmedetomidine administration on malondialdehyde levels in lower extremity surgery using tourniquets, it can be concluded that there was no statistically significant effect of dexmedetomidine administration on malondialdehyde levels in lower extremity surgery using tourniquets.
The relationship between salivary cortisol levels with risk of behavioral-psychosocial-emotional disorders in adolescents aged 12-16 years
Authors: Sanjaya Ayling
Published: May 2024

Introduction: Adolescents suffer from various forms of psychosocial, behavioral, mental and emotional problems. The relationship between salivary cortisol levels and the risk of behavioral-psychosocial-emotional disorders in adolescents is still controversial. To analyze the relationship between salivary cortisol levels and the risk of behavioral-psychosocial-emotional disorders in adolescents aged 12-16 years using PSC-17.
Methods:  An observational analysis with a cross-sectional research design and simple random sampling was conducted from November 2022 - March 2023. Adolescents aged 12-16 years filled out biodata, characteristics and PSC-17 questionnaires. Salivary cortisol levels were measured by the Enzyme-linked immunosorbent assay method. Data analysis with univariate and multivariate tests.
Results: Of 170 adolescents, 53 (31.2%) were at risk of behavioral-psychosocial-emotional disorders with PSC-17 total score ≥15, consisting of risk of internalizing disorders at 73 (42.9%) adolescents, risk of externalizing disorders at 14 ( 8.2%), risk of attention disorder at 23 (13.5%) adolescents. The majority of adolescents who have normal salivary cortisol levels are 117 (68.8%) adolescents, and salivary cortisol levels are abnormal (high) in 53 (31.2%) adolescents. Salivary cortisol levels were associated with adolescents' risk of behavioral-psychosocial-emotional disorders (p<0.001).
Conclusion: Salivary cortisol levels are associated with the risk of behavioral-psychosocial-emotional disorders in adolescents. Likewise, salivary cortisol levels are related to the risk of internalizing disorders, the risk of externalizing disorders, and the risk of attention disorders in adolescents.
A case report of Apert syndrome
Authors: Cahyana Nugraha Wahyu
Published: May 2024

Link of Video Abstract: https://youtu.be/ahjJloTwZQE
 
Introduction: Apert syndrome (AS) is a rare type 1 acrocephalosyndactyly syndrome, characterized by craniosynostosis, severe syndactyly of the hands and feet, and dysmorphic facial features. It exhibits autosomal dominant inheritance assigned to mutations in the fibroblast growth factor receptor gene.
Case Illustration: We presently describe the case of a 14 years old male patient with acrocephaly, prominent forehead, ocular hypertelorism, proptosis, short and broad nose, pseudoprognathism, crowding of teeth and ectopia, maxillary hypoplasia, low hairline, webbed neck, pectus excavatum, and severe bilateral syndactyly of hands and feet. The examination revealed apical cranium, occipital flattening, enlargement and hypoplasia of the premaxillary opening, crowding, ectopic teeth, tapering of the mandibular apex, and pseudognathia.
Conclusion: We reported a 14 years old male patient with AS with craniosynostosis and acrocephalosyndactyly. The characteristics of clinical manifestation of AS should be aware by physicians to be able to diagnose the disease.
BRCA 1 and 2 somatic mutation in high grade serous epithelial ovarian cancer in Indonesian women that was operated on Dr. Soetomo General Hospital, Surabaya in 2019-2021
Authors: Djuanda Jonathan Kevin , Tjokroprawiro Brahmana Askandar , Ariani Grace
Published: May 2024

Link of Video Abstract: https://youtu.be/9kem7M9SNWIBackground: Ovarian cancer remains as major problem worldwide. BRCA1 and BRCA2 play a unique role in deoxyribonucleic acid (DNA) damage repair, especially in homologous recombination repair. There are no data on the prevalence of BRCA1 and BRCA2 somatic mutations in the Indonesian population. This study aimed to determine the incidence of BRCA1 and BRCA2 somatic mutations among a cohort of patients with high-grade serous epithelial ovarian cancer, and assess its correlation with clinical characteristics of the cohort.
Methods: This was an analytical observational study of 26 patients admitted to our hospital from 2019 to 2021. Pathological specimens were obtained from the patients and examined for BRCA1 and BRCA2 somatic mutations. Data on clinical characteristics were collected from medical records. Statistical analysis was performed to determine the relationship between BRCA mutation status and clinical characteristics, including age, stage, menopausal status, parity, family history of malignancy, and patient outcomes.
Results: Twenty-six patients with high-grade serous epithelial ovarian cancer were included in the study. Six patients (27% of 22 patients) had BRCA1 and BRCA2 somatic mutations, four did not pass the quality control test, and the remaining tested negative for these mutations. Most patients were over 50 years of age (73%). Additionally, 84% of patients were diagnosed at stage III, and only one patient had a family history of malignancy. At the end of the study, most patients (65%) had died. Statistical analysis showed no significant differences between the clinical characteristics of the groups.
Conclusion: The incidence of BRCA1 and BRCA2 somatic mutations among patients with high-grade serous epithelial ovarian cancer at our hospital during 2019–2021 was 27%. There were no significant differences in the clinical characteristics of those with and without mutations, hence NGS screening following diagnosis establishment may be beneficial in further management plans.
Obstetrical ballooning and avulsion of levator ani muscle after vaginal delivery: a literature review
Authors: Rahman Muhammad Nurhadi , Sukarsa Mochamad Rizkar Arev , Rinaldi Andi , Achmad Eppy Darmadi , Sasotya Raden Mas Sonny , Armawan Edwin , Yanuaristi Herdifitrianne Saintissa , Putri Azura Nabila
Published: May 2024

Link of Video Abstract: https://youtu.be/TWDe9uP4QX8
 
The levator ani muscle (LAM) is thought to be of central importance concerning pelvic organ support. 10-30% of women experience overstretched or 'ballooning' of the levator hiatus, sometimes followed by detachment or 'avulsion' of the muscle from its insertion. Both ballooning and avulsion of the LAM can occur by itself or co-exist at the same time. This literature review was conducted on multiple databases from previous studies, to help clinicians better understand the ballooning and avulsion phenomenon, thus making early diagnosis possible for earlier prolapse prevention for the patients. LAM avulsion can be diagnosed clinically using digital palpation or using imaging modalities such as ultrasound and magnetic resonance imaging (MRI). During maximal contraction (or at rest) using ultrasound, levator avulsion is indicated through a levator-urethra gap (LUG) diameter > 2.5 cm. MRI is considered highly sensitive, but it requires a higher cost and an experienced radiologist. Hiatal ballooning can be diagnosed by clinical examination based on the sum of Genital hiatus and Perineal body (Gh+Pb) and imaging with 2D, 3D, or 4D ultrasound during the Valsava maneuver. Ballooning is diagnosed clinically if Gh+Pb > 7 cm, by 2D imaging of levator hiatal anteroposterior (LHAP) diameter ≥ 6 cm, and by 3D/4D imaging of the hiatal area ≥ 25 cm2. Physiotherapeutic treatment and pelvic floor muscle (PFM) exercises can be used to treat ballooning and LAM avulsion to avoid urogynecological sequelae. There is some evidence to prevent this condition, including vitamin D consumption, epidural analgesia, kegel exercise, and vaginal dilator. PFM strength, posterior vaginal wall support, and ultrasound evidence of LAM tear can be used as potential indicators to predict pelvic floor injury. Since ballooning and avulsion of the LAM have lifelong morbidity and are not often identified early by clinicians, further research is still needed.
The relationship between parental risk factors with degree of severity in myopia
Authors: Marisa Surya Airlangga  , Deneska Ria Sandy , Rozalina Loebis  , Reni Prastyani
Published: May 2024

Link of Video Abstract: https://youtu.be/5LTsY60dY0s
 
Background: Myopia is one of the numerous visual problems that continue to increase in incidence throughout the world. Various genetic and environmental factors are thought to influence the onset of myopia. Myopia is known to have a significant impact on the economy, vision problems, and a decrease in quality of life so that it needs serious attention. This study aims to explore the relationship between parental risk factors with degree severity of myopia.
Methods: This study is an analytic observational study research design. The population of this study are patients diagnosed with myopia in the Ophthalmology Outpatient Clinic of Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Patients who met the inclusion and exclusion criteria were included as samples. Data are gathered through medical records and by questionnaire, this includes age and spherical equivalent (SE) in right eye or left eye. Degree of severity was classified based on SE. Myopia’s degree of severity and parental history are then analyzed to determine the relationship.
Results: A total 72 patients were included in this study. The majority of participants have a familial history of parental myopia. The degree of severity with the highest frequency is low myopia. The results of statistical tests showed that there was no relationship between history of parental myopia and the severity of myopia in the right eye (RE) (p-value = 0.712) and the severity of myopia in the left eye (LE) (p-value = 0.565).
Conclusion: There was no relationship between the history of parental myopia and the severity of myopia.
A double-blind, randomized controlled trial of hydroxychloroquine for cognitive dysfunction and antibody biomarkers in systemic lupus erythematosus patients
Authors: Suntoko Bantar , Suharyo Hadisaputro  , Handono Kalim  , Suyanto Hadi  , Fenda Aditia
Published: May 2024

Link of Video Abstract: https://youtu.be/51QxGpETzG0
 
Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that leads to persistent inflammation, resulting in organ tissue damage. Cognitive dysfunction is one of the symptoms often found in NPSLE, and hydroxychloroquine is recommended for all levels of SLE from mild to severe. However, studies on the efficacy of hydroxychloroquine for cognitive dysfunction have not been studied. Therefore, this study aimed to evaluate the effect of hydroxychloroquine administration on antibody levels and cognitive function in lupus patients with cognitive dysfunction.
Methods: A Randomized Controlled Trial (RCT) was conducted in patients with SLE who experienced cognitive dysfunction. The treatment group consisted of 20 subjects subjected to standard therapy along with a daily dosage of hydroxychloroquine (200 mg/day) for 8 weeks. Furthermore, the control group comprised 20 subjects who only received standard therapy. The primary outcome of this trial focused on the evaluation of MoCA-INA and sub-MoCA-INA scores, while the secondary outcome included the measurement of anti-NMDA, anti-β2-glycoprotein-1, anticardiolipin IgM and IgG antibodies, as well as lupus anticoagulant levels. Data analysis for unpaired variables used the independent t-test or the Mann-Whitney test.
Results: There was a relationship between giving hydroxychloroquine administration to increasing the sub-MOCA-INA attention score (p<0.05). However, there was no relationship between giving hydroxychloroquine to increasing MoCA-INA scores and decreasing biomarker levels of anti-NMDA, anti-β2-glycoprotein-1, IgM-IgG anticardiolipin, and lupus anticoagulant (p>0.05)
Conclusion: Administration of hydroxychloroquine only affected attentional MoCA-INA sub-scores but did not affect other MoCA-INA sub-scores, overall MoCA-INA scores, and antibody levels.
Effectiveness of Yoga in reducing IL-6 serum level in elderly with knee osteoarthritis
Authors: Wahyuni Nila , Adiputra Nyoman , Adiatmika I Putu Gede , Sundari Luh Putu Ratna , Indrayani Agung Wiwiek
Published: May 2024

Introduction: Osteoarthritis (OA) is a progressive degenerative disease. Yoga exercise is one of the non-pharmacological treatments for knee OA. It can improve joint function through a mind-body connection mechanism. It is also non-invasive and relatively safe to do at all ages, including the elderly. Interleukin-6 is one of the circulating inflammation biomarkers in knee OA. This study showed yoga's effectiveness objectively by measuring inflammatory biomarkers' changes, namely interleukin-6 (IL-6) in knee OA cases.
Methods: This research was a randomized control trial. The study was conducted in 8 weeks when the blood sampling and serum IL-6 level quantifications were taken.
Results: There was a significant difference (p <0.005) and large Effect Size (ES > 0,8) in serum IL-6 levels before and after treatment between yoga and the control group.
Conclusion: Therefore, we conclude that yoga is a lifestyle modification intervention that improves the clinical condition of knee OA by altering the inflammatory control pathways activity. We highly recommend that future studies use a larger sample size and analyze more specific biomarkers describing joint degradation in knee OA cases.
A rare lipodystrophy syndrome with familial partial lipodystrophy 2 (FPLD2)
Authors: Gautama Hendra Ikhwan , Prajitno Jongky Hendro
Published: May 2024

Background: Lipodystrophy (LD) syndromes are a diverse group of ultra-rare diseases characterized by adipose tissue deficiency, resulting in potentially severe metabolic disturbances. Due to their scarcity, diagnosis and management are often challenging for clinicians. This study aimed to report a rare case of LD syndromes, as well their diagnosis and possible management.
Case Presentation: A 27-year-old female presented to Dr. Soetomo General Academic Hospital, Surabaya, Indonesia with a chief complaint of abdominal (epigastric) pain, accompanied by diarrhea, nausea, and vomiting. The patient had a history of uncontrolled type-2 diabetes mellitus (T2DM), dyslipidemia, severe hypertriglyceridemia (HTG), diabetic retinopathy, and glaucoma. Physical examination indicated subcutaneous fat loss, especially from the extremities, and excessive fat accumulation in the face. Hepatosplenomegaly and ascites were detected, further confirmed through abdominal ultrasonography (USG). Laboratory investigations revealed hyperglycemia, dyslipidemia, severe HTG, and renal dysfunction. All of the assessment findings led to the diagnosis of LD syndrome with familial partial lipodystrophy 2 (FPLD2) (Dunnigan syndromes). Therapies included insulin injections and pioglitazone for the treatment of hyperglycemia, simvastatin and fenofibrate to reduce HTG, and some symptomatic drugs to reduce symptoms of the disease. Lifestyle modification (diet and exercise) was recommended to ameliorate metabolic derangements.
Conclusion: There is currently no cure for LD syndrome. Treatment modalities are limited to preventing or reducing severe comorbidities of these syndromes. Increasing knowledge and awareness of the symptoms indicative of LD at an early onset is important.
The association of Hypoxia-Inducible Factor-2α (HIF-2α) overexpression score with Germinal Center B-Cell Like (GCB) and Non-Germinal Center B-Cell Like (Non-GCB) subtypes of Diffuse Large B-cell Lymphoma (DLBCL)
Authors: Adhi Pangarsa Eko , Ewika Ardini Desta Nur , Rizky Daniel , Tandarto Kevin , Istiadi Hermawan , Puspasari Dik , Setiawan Budi , Santosa Damai , Hertanto Wahyu Subagio  , Tri Indah Winarni  , Haryana Sofia Mubarika , Suharti Catharina
Published: May 2024

Link of Video Abstract: https://www.youtube.com/watch?v=KF58IGGdWmc
 
Background: Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin's lymphoma. It is classified into homogeneous subtypes, namely Germinal Center B-Cell Like (GCB) and Non-Germinal Center B-Cell Like (GCB), with the latter associated with worse survival outcomes. Increased expression of Hypoxia-Inducible Factor-2α (HIF-2α) is often observed in DLBCL and has been correlated with enhanced angiogenesis, suggesting its potential as a prognostic factor in managing DLBCL. The study evaluates the association between HIF-2α overexpression and the GCB and non-GCB subtypes of DLBCL.
Methods: This cross-sectional study utilized samples from DLBCL patients at Dr. Kariadi Semarang Hospital between January and December 2021. Immunohistochemistry was performed on the samples to determine the DLBCL subtypes and assess the presence of HIF-2α. HIF-2α was evaluated by immunohistochemistry based on its distribution and intensity. The Kruskal-Wallis test was used to find the association between HIF-2α expression and the GCB and non-GCB subtypes of DLBCL. Furthermore, Spearman's rank correlation test explored the correlation between all numeric variables.
Results: A total of 30 subjects were included in this study, with 7 samples of GCB subtype (23.3%) and 23 samples of non-GCB subtype (76.6%). Kruskal-Wallis test showed no association between HIF-2α expression and the subtypes of DLBCL (p=0.812). Spearman's rho correlation test indicated no correlation between HIF-2α overexpression score with NCCN IPI score in GCB (r=0.219; p=0.637) and non-GCB (r=-0.194; p=0.386).
Conclusion: There was no association between HIF-2α expression and GCB and non-GCB subtypes of DLBCL. Additionally, no correlation was found between HIF-2α overexpression and NCCN IPI score.
The application of enhanced recovery after surgery (ERAS) protocol in radical cystectomy and urinary diversion using bowel segment reduces the length of stay: A multicenter comparative study in Indonesia
Authors: Hamid Agus Rizal Ardy Hariandy , Soeroto Adhitama Alam , Hendri Ahmad Zulfan , Pramod Sawkar Vijay , Prapiska Faurisky Febrian , Aditianingsih Dita , Ratna Nurul , Mochtar Chaidir Arif , Umbas Rainy
Published: May 2024

Link of Video Abstract: https://youtu.be/GvdRCXyJmuk
 
Introduction: Radical cystectomy is one of the most invasive urological procedures, with high difficulty and various complications. The Enhanced Recovery After Surgery (ERAS) protocol was created to improve patient outcomes after such surgery, including radical cystectomy. This study aims to evaluate the application of ERAS on radical cystectomy in Indonesia.
Methods: This was a multicenter study (Jakarta, Yogyakarta, Bandung, and Medan) from July 2016 to April 2021. This study compared the postoperative length of stay, diet intake, bowel movement, and mobilization pattern of the subject receiving ERAS protocol with the non-ERAS subject. Curtailed, fast preoperative carbohydrate loading was administered to patients. There was no mechanical bowel preparation except one day before in selected cases. Postoperative patterns after surgery and the length of stay were analyzed.
Results: We collected 128 subjects in this study, with 74 (60 %) subjects enrolled with ERAS protocol and 54 (40 %) with non-ERAS. There were statistically significant differences in length of stay with a median of 11 days vs. 16 (p: 0.001), intensive care unit admission duration with a median of 2 days vs. 3 (p: 0.004) and time to sit after radical cystectomy with a mean of 2.14 days vs 2.89 (p-: 0.004) in subject with ERAS protocol compared to non-ERAS protocol.
Conclusion: This multicenter study found that ERAS was demonstrated to be efficacious in decreasing the duration of hospital stay, the duration of intensive care unit admission, and the time for the subject to sit after the radical cystectomy.
Surgical outcomes among spinal tuberculosis patients: a study from a provincial reference hospital in Indonesia
Authors: Azharuddin  , Ramadhani Adinda Zahra Ayufi , Sary Nirwana Lazuardi , Rahman Safrizal , Azhary Mulkan
Published: May 2024

Link of Video Abstract: https://youtu.be/_5_xwPSsNFc
 
Introduction: Spinal tuberculosis is one of the most common forms of extrapulmonary tuberculosis, which can cause a significant loss of functional ability and decrease in quality of life. Surgery has become an integral component in the current management of spinal tuberculosis that could improve neurological deficits and functional status, yet it may expose patients to surgical site infection (SSI). The aim of the study was to observe the incidence of SSI and improved neurological deficits and functional status post-surgery among patients with spinal tuberculosis.
Methods: The medical records (n=91) were collected retrospectively from patients admitted between January 2019 and June 2022. Characteristic data collected in this study included age, gender, education, occupation, domicile, history of smoking, history of pulmonary tuberculosis, presence of comorbidity. Patients were contacted for history of SSI, postoperative neurological deficits, and functional status assessments through interview using Frankel Grade and Barthel Index instruments, respectively.
Results: The results revealed that only two percent of the total patients developed SSI. Number of patients with Frankel Grade E increased from 0 to 72 (79.1%), and only three patients (3.3%) had persistent Frankel Grade B after the surgery. Sixty-eight patients (74.7%) who underwent the surgery enjoyed independent state of functional status, whereas prior to the surgery, the number was smaller (n=18, 19.8%). The favorable surgical outcomes were found predominantly in female patients (83.9%), 17–25-year-old patients (93.3%), and those having no history of smoking (82.5%–84.2%) and comorbid disease (81.9%–83.3%). The recovery was mostly observed 1–2 years post-surgery (87.2%).
Conclusion: Spinal surgery for patients with spinal tuberculosis improves neurological deficits and functional status. The risk of contracting SSI after the surgery is considered to be low.
Supplementation of Moringa (Moringa oleifera) leaf capsules on hemoglobin levels in women of reproductive age with iron deficiency anemia in Malaka regency, Nusa Tenggara Timur, Indonesia
Authors: Siagian Carmen , Djogo Maria Fransisca , Nahak Maria Martina , Tedjasulaksana Regina , Manek Alfridus Emanuel , Sormin Elferida , Levina Augusta Geraldine Pieter
Published: May 2024

Link of Video Abstract: https://youtu.be/DjGx56j9LiU
 
Introduction: Women of reproductive age with anemia are recommended to take iron supplements and increase their intake of iron-rich food. Moringa (Moringa oleifera) leaf is a potential plant containing high iron, which is simple to find in Indonesia.
Aims: to determine the effectiveness of Moringa leaves supplementation in women of pro age.
Methods: This type of research is an experiment with experimental research with pre-post test control group design. The sample was 119 subjects collected using purposive sampling according to the inclusion criteria. The study subjects were divided into 3 treatment groups: supplementation of Ferrous sulfate tablets 30 mg per day (Group P0); 3000 mg Moringa leaf capsules three times a day (3 x 1000 mg) (Group P1); and Moringa leaf capsules at a dose of 3000 mg three times a day (3 x 1000 mg) plus 30 mg ferrous sulfate tablets once daily (Group P2) for 60 days, then hemoglobin (Hb) levels were re-evaluated.
Result: The Friedman test showed a mean Hb difference between the three measurement groups, which was statistically significant with p <0.05. The treatment group with P2 had the highest value of 4.74, followed by P1 and P0 of 4.71 and 4.65.
Conclusion: Supplementation of Moringa leaf capsules at a dose of 3000 mg for 60 days may increase Hb levels in women of reproductive age with iron deficiency anemia.
The relationship between traditional postnatal care (TPC) and sociodemographic of postnatal mothers in Kota Kinabalu, Sabah, Malaysia
Authors: Sator Patricia , Nicholas Tze Ping Pang  , Rekaya Anak Vincent Balang  , Rosalia Saimon  , Mohammad Saffree Bin Jeffree  , Norkiah Arsat
Published: May 2024

Link of Video Abstract: https://youtu.be/Ethmg0srBhU
 
Background: Traditional Postnatal Care (TPC) is derived from traditional medicines as health practices. The approaches of knowledge and beliefs incorporating plant and manual techniques are applied singularly or in combination to prevent illnesses and maintain well-being. TPC is used widely among the postnatal mother as a self-care for the healing process, both physically and mentally. As part of the nursing management in a community health setting, understanding the different health and wellness approaches and their benefits is part of the early knowledge and skills when delivering care to postnatal mothers. This study aimed to assess the relationship between TPC and sociodemographic data of postnatal mothers in selected study settings to understand more about the types of common TPC practiced within the study setting.
Methods: Participants were among the postnatal mothers within one week after delivery and selected purposely based on inclusion criteria. A cross-sectional survey from November 2021 to February 2022 with 178 postnatal mothers completed the distributed questionnaires. The researcher used SPSS version 28.0 to analyse the data.
Results: The result showed that the educational background (p=0.001, p<0.05) and household income per month (p=0.001, p<0.05) demonstrated a significant effect concerning postnatal mothers practising and non-practising TPC.
Conclusion: This study identified the significant variables of sociodemographic, namely household income and education level. This study’s result is the starting point for the researcher to begin a broader analysis of this title.
Clinical epidemiology pattern of orthopedic trauma during the COVID-19 pandemic: A multicenter study (Dr. Hasan Sadikin General Hospital and Ulin General Hospital)
Authors: Rahim Agus Hadian , Hidajat Nucki Nursjamsi , Ismiarto Yoyos Dias , Mulyadi Dicky , Arsa Widya , Ramdhan Ahmad , Utoyo Ghuna Arioharjo , Irawan Muhamad Naseh Sajadi Budi , Primadhi Raden Andri , Herman Herry , Alpharian Gibran Tristan , Prasetia Renaldi , Hadar Abdul Kadir , Malik Realita , Noor Zairin , Zulkarnaen Izaak , Siagian Andreas , Putra Husna Dharma , Danayanti Essy Dwi , Kesuma Wongso , Iqbal Muhammad , Cristian Setiadi
Published: May 2024

Link of Video Abstract: https://youtu.be/JRX2wJWFCKs
 
Introduction: COVID-19 has had profound implications on global healthcare systems, and this pandemic management has led to a significant change in orthopedic surgical activity. We aimed to evaluate the types and incidence of fractures treated during the pandemic to provide insight into the situations for which orthopedic trauma surgeons should be prepared in unusual circumstances that may arise in the future.
Methods: Descriptive observational cross-sectional study from Dr. Hasan Sadikin General Hospital and Ulin General Hospital was conducted from electronic medical records between January 2018 and December 2022. Analysis was performed using SPSS version 26 on descriptive analysis using mean, frequency, percentage, and standard deviation.
Results: 2890 patients were enrolled for the current cohort, from 2018 until 2022, with predominantly male (n = 2117). Even though, an increase in overall admission from 2018 (n = 631) to 2019 (n = 784), a decrease after that occurred during the COVID-19 pandemic, which is from 2020, 2021, and 2022 (n = 652, 500, and 323, respectively)
Conclusion: Knowing the number of fractures can be a tool to evaluate the types and incidence of fractures treated during the pandemic to provide insight into the situations for which orthopedic trauma surgeons should be prepared in unusual circumstances that may arise in the future.
Characterization of ultraviolet B light emitting diodes (UVB LED) irradiation device for Wistar rats as an experimental animal model
Authors: Diah  , Prahasanti Chiquita , Rahayu Retno Puji , Wijayanto Vani Rachmad
Published: May 2024

Link of Video Abstract: https://youtu.be/-l5AY96hUI8
 
Background: Light emitting diodes (LED) lamps are used widely in daily because of their many benefits, including their low cost, extended lifespan, low energy consumption, and low environmental impact. The use of LEDs, especially ultraviolet B LED (UVB LEDs) is quite extensive and has been developed for the treatment of skin diseases, irradiating pet reptiles, and conducting research on experimental animals. The use of light for therapy must be done carefully so that unwanted side effects do not occur because light also harms tissue. The purpose of this characterization is to determine the stability of temperature and irradiation of the device we make and to determine the duration of light exposure based on the characterization.
Methods: The irradiation device use UVB LEDs with a wavelength of 305-310 nm. The characterization carried out included temperature stability and irradiation stability, with observations every 30 minutes for 10 hours and no replication. Statistical analysis using the Kolmogorov-Smirnov (Asymptotic Approximation) testing technique. The test criteria state that if the probability value > level of significance (alpha (α) = 5%).
Results: The characterization results from 10 hours of observation with sampling data taken every 30 minutes showed stable LED temperature and room temperature while unstable cage temperature and irradiance.
Conclusion: This device can be considered to use in Wistar rat’ experimental studies using UVB and perhaps developed further. The duration of exposure can be adjusted according to the distance of the object and the dose required.
Successful obesity management in a 115 kg 14-year-old child: a case report
Authors: Budiarto Arief , Widjaja Nur Aisiyah , Irawan Roedi
Published: May 2024

Link of Video Abstract: https://youtu.be/XIJo_o_yeV0Background: Obesity is defined as being 20% ​​or more above ideal body weight (IBW). Obesity is a major problem in children and adolescents, affecting 30% or more. It led to many changes and limited their ability to be physically active. Obese children often suffer from musculoskeletal pain, decreased physical function, and a sense of well-being. This might cause poor motor competency and also developmental alteration.
Case Presentation: A 14-year-old boy was referred to the Pediatric Department following complaints of excruciating pain in his lower leg. Under anthropometry examination, the patient was diagnosed with obesity with 115 kg at presentation. The patient was then treated and managed by changing their inactive lifestyle and increasing daily activities; also referred to a psychologist to help with psychological well-being and behavior change. Family and friends are involved during treatment. After four months of treatment, his body weight dropped from 115 kg to 98 kg to 73 kg in the next 2 years.
Conclusion: Success obesity management needs multidisciplinary involvement, which includes a pediatrician, nutritionist, psychologist, and also the patient's family