bluuebunny/crossref_metadata_2025 huggingface dataset:
Aqueous Humour Malondialdehyde Level as Oxidative Stress Marker In Types Of Glaucoma
Authors: Maharani Maharani , Dewi Puspita Kusuma , Prihatningtias Riski , Wildan Arief , Nugroho Trilaksana , Limijadi Edward Kurnia Setiawan , Rahmi Fifin L.
Published: December 2022

Background: Angle-closure glaucoma is the most common type of glaucoma in Asia, leading worse damage due to its oxidative stress. Another type is  open angle glaucoma in second line. The oxidative stress level can be known by malondialdehyde level examination. The study about MDA levels in aqueous humour in primary angle-closure and open angel glaucoma has not been done before.Objective: To determine the difference of malondialdehyde levels in aqueous humour between primary open-angle glaucoma and primary angle-closure glaucoma.Methods: This study was an analytical observational study. Nine subjects were primary open-angle glaucoma patients and ten subjects were primary angle-closure glaucoma patients. The aqueous humour was aspirated from the anterior chamber during trabeculectomy and measured the MDA levels using a spectrophotometer. Data were analyzed by Mann Whitney test.Results: There was no significant difference (p=0.095) of MDA levels in aqueous humour between primary open-angle glaucoma (62.913±17.259 ?mol/L) and primary angle-closure glaucoma (53.485±9.670 ?mol/L).Conclusion: The oxidative stress level in primary open-angle glaucoma and primary angle-closure glaucoma are the same, indicate that inflammation status of both condition have been similar.
Correlation between antenatal magnesium sulfate (MgSO4) total dose and delivery time interval with umbilical cord blood brain-derived neurotrophic factor (BDNF) levels as a neuroprotection strategy in preterm birth
Authors: Bachnas Muhammad Adrianes , Sulistyowati Sri , Akbar Uchti
Published: December 2022

Background: Administration of antenatal magnesium sulfate (MgSO4) to pregnant women is thought to increase the synthesis of Brain-Derived Neurotrophic Factor (BDNF), which functions as a nerve-growth factor for the process of neurogenesis and also strengthen neuronal resilience in the hypoxic condition that occurs during preterm delivery. Protocols for administering antenatal MgSO4 differ between countries and institutions. One of the concerns is whether the dose is given and the time interval to delivery has a big contribution towards a better fetal outcome. These relationships have not been studied before. This study aimed to analyze the correlation of the total dose of MgSO4 and time interval to delivery with BDNF levels in cord blood.
Methods: This study enrolled 72 pregnant women who will deliver the baby prematurely, with gestational age 28-34 weeks. Subjects were divided into three protocols groups: (1) 4 g iv. only, (2) 4 g iv. initial continued with 1 g/hours until maximum 24 hours, and (3) 6 g iv. initial continued with 2 g/hours until a maximum of 24 hours. At the time of delivery, cord blood of preterm babies was collected. The antenatal MgSO4 total dose and time interval to delivery were collected, and BDNF serum levels were then measured with enzyme-linked immunosorbent assay (ELISA). The correlation between antenatal MgSO4 total dose and time interval to delivery with BDNF levels was analyzed using Spearman’s correlation test.
Result: There was a weak significant correlation of antenatal MgSO4 total dose and BDNF cord blood levels (p<0.001; r=0.381). There was no significant correlation between delivery time interval and BDNF cord blood levels (p=0.44; r=0.092).
Conclusion: Regarding the weak correlation of total dose and time interval to delivery with BDNF, we suggest that all protocols provide comparable outcomes if seen only from the BDNF increase perspective.
Antiproliferation and Apoptosis Effect of Cisplatin and Nanocurcumin on Ovarian Cancer SKOV3 Cell
Authors: Purbadi Sigit , Yusuf Muhammad , Arozal Wawaimuli , Naroeni Aroem , Winarto Hariyono , Putra Andi Darma , Sotarduga Gilbert Elia
Published: December 2022

Background: Ovarian cancer is one of the leading cancers in women. Seventy percent were founded in the advanced stage, with a 5-year survival rate of only 46%. The current treatment modality is cytoreduction with platinum-based adjuvant chemotherapy as the first line. The effectiveness of chemotherapy is only 60% in the advanced stage, later developing into recurrent. Therefore, additional types of therapy are required based on agents that work specifically in cancer cells and synergize with current standard treatments. This study aimed to know the anti-proliferation effect and apoptosis effect of combination cisplatin with nanocurcumin on SKOV3 cells.
Methods: This experimental study was conducted in vitro using the biological cell line SKOV3 to determine the anti-proliferation effect (expression Ki67) and the apoptosis effect (caspase 3 and 8) of combination cisplatin with combination with cisplatin nanocurcumin on the cell. The data were analyzed with unpaired T when regular distribution / Mann Whitney test when the distribution is abnormal and using Graph Pad Prism.
Results: Based on this result, 50cc of nanocurcumin is 67 μm, and 50cc of cisplatin is 54 μm, using the MTT Assay method. The viability of the cells in this study decreased according to the dose-dependent, whereas the combined dose of 134 μm nanocurcumin with 108 μm cisplatin found the lowest life cell, 24.3% (p <0.001). Ki67 expression was low in the SKOV3 cells post-exposure to cisplatin, but increased post-exposure to nanocurcumin, suspected nanocurcumin at certain doses of pro-oxidant properties that triggered proliferation. Caspase 3 and 8 cannot be detected in this cell by the ELISA method.
Conclusions: Nanocurcumin has a potential effect on chemosensitive cells. However, our study shows no healing effect in chemoresistance cells, particularly SKOV3.
A patient with Type 2 Diabetes Mellitus (T2DM) with Fournier gangrene: a case report
Authors: Christanti Mike , Prajitno Jongky Hendro , Christanto Rio Yudistira
Published: December 2022

Background: Fournier gangrene is necrotizing fasciitis of the genitalia and perineum that can extend to the abdominal wall, gluteus or lower extremities. Predisposing factors for Fournier gangrene include obesity, diabetes mellitus (DM), alcoholism, smoking, hypertension, chronic kidney disease, perianal trauma and immunosuppressive conditions. This case report aims to evaluate the management of Fournier gangrene on metabolic and surgical treatmentCase Presentation: A-53 years old-female with Type 2 Diabetes Mellitus (T2DM) came to the Emergency Ward of Dr. Sutomo General Hospital, Surabaya, with the chief complaint of sores on the buttocks for 1 week. The patient was diagnosed with Fournier gangrene. On physical examination in the room, erythematous macular lesions were found in the folds of the breast and armpit on chest examination. Obtained scratch marks were found because the patient is often scratched. The wound from the buttock and keep enlarged due to the Fournier gangrene ( necrotizing infection). In this case, the patient was given the antibiotics ceftriaxone and metronidazole. The patient died during the 8th day of treatment due to a suspected septic shock.Conclusion: Surgical management in this patient is debridement. Multi-disciplinary management of obstetrics, urology, digestive surgery, and plastic surgery is required for the management of Fournier gangrene in T2DM patients
C-Reactive Protein (CRP)/Albumin Ratio (CAR) pre-treatment as a predictive factor of radiological response after neoadjuvant chemotherapy in Locally Advanced Rectal Cancer (LARC) patients at Dr. Soetomo General Hospital, Surabaya, Indonesia
Authors: Branko Fariza Hakim Rio , Lesmana Tomy
Published: December 2022

Background: Several serum inflammatory markers have been investigated as prognostic biomarkers for rectal cancer patients, including C-Reactive Protein (CRP)/Albumin Ratio (CAR). We aimed to examine the association between the CAR pre-therapy value and radiological response after neoadjuvant chemotherapyMethods: We recruited locally advanced rectal cancer patients who underwent FOLFOX first-line neoadjuvant chemotherapy (NAC) at Dr. Soetomo General Hospital (Surabaya, Indonesia) from January 2015 to December 2020. Before neoadjuvant chemotherapy treatment, the C-reactive protein (CRP) and albumin were measured. The chemotherapy response was performed by evaluating the CT scan result before and after the NAC was given. We used RESIST criteria to assess the radiological response after NAC treatment. Data were analyzed using SPSS version 23 for Windows.Results: We included a total of 102 patients, with the female being the predominant gender with LARC (52%.0). The well-differentiated adenocarcinoma was the most common adenocarcinoma type found in this study (59.8%). We found 57 patients with positive responses and 45 patients with negative responses. Patients with well-differentiated status who had adenocarcinoma had a higher chance to have a positive response to NAC. Patients with low CAR values had a 2.13 times higher chance of having a positive chemotherapy response than patients with high CAR values (95% CI = 1.30-3.30). Conclusion: There was a significant relationship between high CAR values and poor radiological response after neoadjuvant chemotherapy in locally advanced rectal cancer patients. The CAR value may be a potential biomarker to predict the radiologic response after NAC treatment.
Uncommon presentation of COVID-19 in ophthalmology: a case report
Authors: Kuswidyati Cisca , Chrishalim Klarissa , Andre
Published: December 2022

Introduction: The COVID-19 pandemic is well known for its clinical respiratory symptoms. Currently, the medical literature describing the neuro-ophthalmologic manifestations of COVID-19 is gradually emerging. We hereby report a case with an uncommon presentation of COVID-19 in a patient.
Case Report: A 19-year-old man presented with ptosis and limited left eye movement in his left eye followed by other neurological manifestations, without classical respiratory manifestations. Brain imaging and nasopharyngeal PCR suggest COVID-19 encephalitis.
Conclusion: This experience confirms that COVID-19 infections can be present despite the absence of significant respiratory symptoms mimicry to other symptoms. Therefore, physicians should consider the possibility of COVID-19 infections, and time management may lead to a better outcome.
The prevalence and characteristics of perineal rupture during vaginal delivery at Sanglah General Hospital and Regional Hospitals in Bali from January 2018 until December 2019 period
Authors: Megadhana I Wayan , Indrawan I Gede Suputra , Sanjaya I Nyoman Hariyasa , Aryana Made Bagus Dwi
Published: December 2022

Background: One of the causes contributing to the high maternal mortality rate in Indonesia is postpartum hemorrhage, which can be the consequence of perineal rupture. Perineal rupture can happen spontaneously in normal vaginal delivery or worsen after episiotomy, induction of labor, vacuum and forceps delivery. This study aims to know the prevalence and characteristics of perineal rupture so that it can be used as data to make policy guidelines for preventing and reducing the incidence of perineal rupture.
Methods: This is a retrospective descriptive study analyzing secondary data collected from Sanglah General Hospital and nine other Regional Hospitals from January 2018 until December 2019. The data analysis technique used is a univariable analysis by calculating the frequency distribution and proportion to determine the prevalence and characteristics of the research subjects. Data were analyzed using SPSS version 20 for Windows.
Results: There are 8,178 cases of vaginal delivery, 6,191 cases (75.70%) with perineal rupture and 1,987 cases (24.30%) without perineal rupture. Perineal rupture is most often found in women < 20 years old (82.66%), primigravida (81.76%), preterm gestational age (78.23%), the baby with birth weight > 4,000 grams (94.26%), underweight mother (87.50%), and women with assisted delivery by vacuum or forceps (100.00%). 
Conclusion: The Prevalence of perineal rupture in this study is 75.70%, with the most characteristics being women < 20 years old, primigravida, preterm gestational age, macrosomia baby, normal IMT, assisted vaginal delivery.
Comparison of effects and differences in duration between exposure to conventional cigarette smoke and electronic cigarette vapors on changes in the number of hippocampal pyknotic pyramidal cell
Authors: Wijaya Richard , Sasmita Poppy Kristina , Iskandar Rahardjo Budianto  , Djuartina Tena
Published: December 2022

Background: Cigarettes contained addictive substances that may have adverse effects on health, such as memory impairment. The hippocampus is a part of the brain that plays a role in regulating memory. This study aimed to compare the effects of conventional cigarette smoke and e-cigarette vapor on hippocampal pyramidal cells in animal models.
Method: Experimental study used 30 male Sprague Dawley white rats aged 10-12 weeks. Rats were divided into 5 groups consisting of 1 control group and 4 treatment groups and exposed to conventional cigarette smoke and electronic cigarette vapor for 2 weeks and 4 weeks. The amount of exposure given was 12 times each day. After two weeks and four weeks of exposure, rats were necropsied, the Hippocampus was processed and stained using Hematoxylin and eosin. Pyramidal cell nuclei were viewed with a biological microscope CX-33 microcamera DP2 with 400x magnification in 3 fields of view. The average number of pyknotic nucleus pyramidal cells collected was statistically analyzed using the Mann-Whitney test.
Result: The hippocampal pyknotic pyramidal cells number in each treatment group was higher compared to the control group. A correlation was found between 2 weeks groups and 4 weeks groups of treatment. Conventional cigarette smoke groups showed higher means of pyknotic pyramidal cells than electronic cigarette vapor and were statistically significant in both 2 weeks groups and 4 weeks groups of treatment (p<0.05).
Conclusion: The type of cigarette and the duration of cigarettes exposure affects the number of pyknotic pyramidal cells. Conventional cigarette causes more significant changes than electronic cigarettes, and the exposure duration of conventional cigarettes affects pyramidal cells in the hippocampus.
Self-acceptance of patients that received hemodialysis
Authors: Wijayanti Lono , Wardani Erika Martining , Bistara Difran Nobel , Hasina Siti Nur , Noventi Iis
Published: December 2022

Introduction: Patients undergoing hemodialysis tend to have low self-acceptance; this will impact the willingness to undergo treatment and adherence to hemodialysis therapy to recover. This study aimed to determine the relationship between self-acceptance and compliance in undergoing hemodialysis at A. Yani Islamic Hospital in Surabaya.
Methods: The research design is correlational analytic with a cross sectional approach. The population in this study were all patients who underwent hemodialysis at the A. Yani Islamic Hospital, Surabaya, with 80 patients and a sample size of 36 respondents using a simple random sampling technique. The independent variable in this study was self-acceptance, and the dependent variable was adherence to hemodialysis. The research instrument used a questionnaire. Data analysis used the chi-square test with a significant level of α = 0.05.
Results: The results showed that most respondents who underwent hemodialysis (52.8%) had low self-acceptance, and most (58.3%) had low adherence. The chi-square test results showed p-value = 0.008, which means p < α, then H0 is rejected, indicating a relationship between self-acceptance and compliance with patients undergoing hemodialysis at the A. Yani Islamic Hospital Surabaya. Self-acceptance is directly proportional to the patient's compliance is undergoing hemodialysis. The higher the patient's self-acceptance caused the higher the patient's compliance in undergoing hemodialysis. Families can provide social support to increase the self-acceptance of patients undergoing hemodialysis.
Conclusion: There is a significant relationship between self-acceptance and compliance of patients undergoing hemodialysis at A. Yani Islamic Hospital Surabaya.
Factors that influence on Islamic caring behavior
Authors: Kartini Yanis , Nursalam Nursalam , Ahsan  , Faizah Imamatul , Yunitasari Ratna
Published: December 2022

Introduction: There are not many studies that investigate Islamic caring behavior and the factors that influence it. The purpose of this study was to analyze the factors that influence Islamic caring behavior.
Methods: This study was an observational analytic research design that used nurses' perceptions of Islamic caring behavior and the factors that influence it, including organizational characteristics, job characteristics, and individual characteristics. This survey involved 100 respondents that filled out a questionnaire via a google form. Data analysis using Chi-Square and multiple logistic regression test, with a significance level of <0.05.
Results: This study shows that 51% respondents have good Islamic caring behavior. The factors that influence Islamic caring behavior from organizational characteristics are; 1) vision and mission (p = 0.001), 2) reward system (p = 0.001), 3) selection (p = 0.002), 4) organizational structure and culture (p = 0.003), from job characteristics are 1) performance objective (p = 0.000), 2) work schedule (p = 0.001), 3) job design (p = 0.041), 4) correction (p = 0.002), and 5) feedback (p = 0.002), from the individual characteristics of nurses is attitude (p = 0.028. There are three multivariate test results that have an effect, namely objective performance (p = 0.002; B = 3.19), understanding of vision and mission (p = 0.005; B = 1.401), selection (p = 0.017; B = 1.521), and all three show that there is an interaction.
Conclusion: The most dominant factor influencing Islamic caring behavior is Objective performance.
The effect of workload and length of work on the occurrence of fatigue in workers in the informal industry
Authors: Sunaryo Merry , Ratriwardhani Ratna Ayu
Published: December 2022

Introduction: Work fatigue is a condition that can lead to a decrease in vitality and work efficiency. Workers with heavy workloads are at risk of work fatigue, and working too long in a day will also increase the risk of fatigue. Therefore, it is necessary to know the influence that causes fatigue in workers, especially the workload factor and the length of time working. So that this study can provide a work evaluation to prevent fatigue.
Methods: This research method uses quantitative methods with the type of observational research with a cross-sectional design. The population in this study were informal workers in the furniture industry on Semarang Street, Surabaya City, with a sample taking using a total population of 35 people.
Results: The results of this study indicate that most workers often experience fatigue when working with high classification. Based on the results of the analysis, it is influenced by the workload and length of work, it is known from the results of the significance value <0.05. Fatigue occurs because it is influenced by the length of work in a day that exceeds 7 hours a day (work is done 6 days a week) and the heavy workload factor received by workers.
Conclusion: Can be concluded that giving workers rest time, regulating working hours in a day need to be done, reducing the burden received by workers by dividing the work evenly and so on.
User interface design of Be-Health application for children's learning with a gamification approach
Authors: Wahyudi Muhammad , Destania Herwanda Ayu , Alfandi Rochmat Rizky , Sagirani Tri
Published: December 2022

Introduction: Indonesia has the fourth-largest child population globally, estimated at 80 million children by the Central Statistics Agency (BPS). The application of Clean and Healthy Living Behavior (PHBS) in early childhood can reduce the number of early childhood health complaints in Indonesia. In addition, the role of positive parenting is also needed to keep the child's environment clean and healthy. This study aimed to determine the attractiveness, clarity, efficiency, accuracy, and novelty of the Be-Health application as a target for parents to help implement PHPBS for early childhood.
Methods: The data was taken from the Statistics Agency in 2018. The Be-Health application's implementation stage used the application development method Extreme Programming (XP). XP was chosen because it is a simple, effective, and efficient application development method. There are five stages in developing the Be-Health application, including five stages, including planning, design, coding, testing, software increment.
Results: Be-Health app is an Android-based application that provides a means to help parents apply PHBS to early childhood. Children can play and learn using the Be-Health application that applies the concept of gamification. It allows children to play and learn to complete learning missions about the application of PHBS through the Be-Health application. 
Conclusion: Based on the results of the prototype design of The Be-Health application using the User Experience Questionnaire (UEQ), it can be concluded that the Be-Health application prototype has above average value for the attributes of attractiveness, clarity, efficiency, stimulation and novelty.
Increasing dental and oral health knowledge through health promotion of demonstration
Authors: Sunanto Sunanto , Handayani Erna
Published: December 2022

Introduction: Dental and oral diseases are experienced by many children, especially kindergarten or elementary school children. Health promotion with a demonstration method with props is one of the first steps in conveying dental health knowledge and a mouth that is easy to understand by children, using a humorous approach, the demonstration method is one of the most effective methods. The purpose of the study was to determine the effect of counseling demonstration method on increasing knowledge about dental health and mouth in Children at TPQ Al Jakfar Tiris Probolinggo
Methods: Methods: this study used a pre-experimental design that used a one-group pretest-post-test approach with a design of 20 students.  The type of research is used quasi-experimental with pretest-posttest design with control group design. The research subjects were divided into the treatment group (20 people) and the control group (17 people). The research sample is based on purposive sampling. Questionnaire to measure knowledge and check list to measure skills. Data analysis used paired t-test.
Results: The research shows that there is an effect of demonstration method counseling on increasing knowledge about dental and oral health in children at TPQ Al Jakfar Tiris Probolinggo. From the analysis results showed that the significant data equal to <0.001, p <α = 0,05 the result is H1 is accepted.
Conclusion: Health promotion methods with demonstration models have an effect on increasing knowledge about dental and oral health in children at TPQ Al Jakfar Tiris Probolinggo.
Bacteriuria in pregnancy in Sanglah Hospital: a descriptive study
Authors: Megadhana I Wayan , Pradnyandita Dewa Gede Sidan , Mahayasa Putu Doster , Wijaya Surya I Gusti Ngurah Harry
Published: December 2022

Introduction: Bacteriuria in pregnancy is quite common, with the prevalence of asymptomatic bacteriuria occurring in about 2-5% of pregnancies, acute cystitis occurring in 1.3% of pregnancies and acute pyelonephritis occurring in about 3%. If not treated properly, asymptomatic bacteriuria can increase the risk of pyelonephritis and the incidence of low birth weight (LBW). This study aims to describe the characteristics of patients with bacteriuria in pregnant women at Sanglah Hospital. Acknowledging the characteristics of patients with bacteriuria may help the screening process establish an early diagnosis and management.
Methods: This study is a retrospective descriptive study carried out at Sanglah Hospital Denpasar from January 2018 to January 2020. Pregnant women diagnosed with bacteriuria in pregnancy from January 2018 to January 2020 at Sanglah Hospital Denpasar who had met the inclusion criteria and did not meet the exclusion criteria were included in the study. Data regarding the patient’s age, gestational age when bacteriuria was diagnosed, UTI complaints, bacterial urine levels, and culture results were collected for each subject.
Results: Based on the results of this study, it was found that the prevalence of positive bacteriuria from January 2018 to 2020 was 0.89%. Most of the pregnant women diagnosed with bacteriuria were aged 20-35 years (77.1%), had gestational age of 0 - 28 weeks (64.9%), were multigravida (52.7%), and had high school education level (50.8%). The majority of pregnant women who experience bacteriuria were included in the group of asymptomatic bacteriuria (64.9%). The urinalysis results on pregnant women with bacteriuria showed that most of the pregnant women (45.6%) had +1 bacteria levels, followed by +2 and +3 bacteria levels, namely 28% and 26.4%, respectively.
Conclusion: Bacteriuria in pregnancy is still a problem that is often encountered in daily practice
Characteristic of testicular torsion and predictors of testicular salvage: A retrospective study
Authors: Janardhana Alfryan , Daryanto Besut , Suwarno Budi , Nurdianto Arif Rahman
Published: December 2022

Background: Testicular torsion is one of the urological emergencies that require immediate scrotum exploration. Characteristics of testicular torsion patients, variated time exploration, and the findings of the degree of testicular torsion at the time of exploration can affect the outcome of the testicles. The study aimed to determine the characteristics of testicular torsion diagnosed patients and identify the predictors of testicular salvage.Method: The method used in the study was cohort retrospective with inclusion and exclusion criteria. Receiver operator characteristics analysis is performed to determine the probability of orchidectomy based on time to exploration and degrees of twist. Multivariate logistic regression tests are performed to identify the factors that cause the testicles to be retained. P<0.05 was significant.Results: There are 45 patients mostly diagnosed with testicular torsion aged between 12 to 16 years (64.40%). Left testicular torsion was more frequent than the right torsion (82.20%). The etiology of torsion was mostly idiopathic (77.80%). Orchidopexy procedure was performed on 12 testicular torsion patients (26.70%); on follow-up, one patient was found to have testicular atrophy. The time to explore cut-off value 8.5 hours and the 450 degrees of twisting will cause the testis to not survive with the specificity of 83% and 92% and sensitivity of 81% and 82%, respectively. Multivariate analysis shows time to explore and degree of twisting associated with orchidectomy of the affected testis (p<0.05).Conclusion: Patients are relatively young. Not all patients with testicular torsion will manifest typical symptoms of acute, atypical symptoms such as lower abdominal pain, which can be identified as testicular torsion. Mostly affected left testicle. Orchidectomy is the most commonly performed operation on patients. The outcome of testicular torsion can be predicted by observing the time to exploration factor and the degree of testicular torsion in the patient.
Clinical presentation of maternal death with COVID-19 in rural tertiary care center: A retrospective-descriptive Study
Authors: Kurniawati Devita , Prasetyo Budi , Pandu Hanindito , Nurdianto Arif Rahman
Published: December 2022

Background: Maternal with to COVID-19 is a new maternal emergency issue leading to maternal morbidity and mortality. In Indonesia, the number of cases of maternal mortality with COVID-19 began to increase. This study aims to determine the characteristic of maternal deaths due to COVID-19 in a tertiary care center in Indonesia.Method: This observational-retrospective study descriptively analyzed 15 maternal deaths due to COVID-19 admitted to the Department of Obstetrics and Gynaecology at the tertiary care teaching hospital from March to December 2020. We included suspect, probable, and confirmed COVID-19 in the samples. Therefore, the total sampling was recorded and analyzed descriptively by Microsoft Excel.Results: There are fifteen maternal deaths from 429 maternal cases with COVID-19 in our hospital. The majority ages were in the age group 19-35 years (73.33%); body mass index (BMI) 25-29.9 (33.33%); five days average length of stay; one comorbidity (53.33%); and multiple comorbidities (20.00%). The case fatality rate (CFR) of maternal death due to COVID-19 is 3.49% were profiled out this study. The most cause of death was acute respiratory distress syndrome (ARDS) (53.33%).Conclusions: Most common characteristics of the object of this study were the age between 19-35 years, comorbidity, obesity, upper respiratory tract symptoms, elevated D-dimer, and the complication of ARDS, which are the risk factors of the deaths.
Identification of PST 10 bacterial isolate with ?-hemolysis characteristic isolated from pig's tonsil
Authors: Suharsono Hamong , Suardana I Wayan , Putri Rizki Kusuma
Published: December 2022

Background: Pig's tonsil is one of the entry points and habitat of commensal microbes and pathogenic bacteria, both Gram-positive and Gram-negative bacteria. Recently, a human meningitis outbreak has reported at Sibang Kaja, Badung-Bali. The cause of this outbreak has been suspected due to the consumption of pig-derived foods. The outbreak was known to be caused by Gram-positive ?-hemolytic bacteria. Based on this fact, PST 10 bacterial isolate with similar characteristics to the outbreak caused interesting identification.Method: PST 10 isolate was cultivated in a specific medium 5% defibrinated sheep blood agar plate. Subsequently, Gram staining, catalase, oxidase, salt tolerance (6% NaCl), and hemolysis test. This presumptive isolation was then conventionally identified by KIT API 20 STREP and molecularly using the 16S rRNA gene.Results: PST 10 isolate was identified as Enterococcus faecium using KIT API 20 STREP. Furthermore, the 16S rRNA gene sequencing analysis shows that the isolate has 99.6% similarities with Enterococcus faecalis (MG543832). The isolate shares the same clade in the phylogenetic tree analysis with a 100% bootstrap value.Conclusion: The high sensitivity in molecular identification mainly to distinguish close species using phenotypic approaches, PST 10 isolate was concluded as Enterococcus faecalis.
The effect of metformin on autophagy by LC3 expression in Type 2 Diabetes Mellitus (T2DM) human skeletal muscle cell culture
Authors: Prajitno Jongky Hendro , Pranoto Agung , Adiwinoto Robert Dwitama , Soelistijo Soebagijo Adi
Published: December 2022

Background: Skeletal muscle is an essential tissue in glucose metabolism. Reduced autophagic capacity to remove damaged contractile proteins in skeletal muscle cells will contribute to the loss of muscle mass. Metformin is the first-line agent for treating type 2 diabetes mellitus (T2DM) patients. This study aims to investigate the effects of metformin on autophagy through LC3 expression in human skeletal muscle cell culture (SkMC).
Methods: The T2DM human SkMC was obtained from T2DM treatment naïve patients, purchased from AcceGen Biotech®. Fully differentiated myotubes were randomized into the control and treatment groups. The treatment group was given Metformin in three doses (1 mM, 2 mM, and 3 mM). An immunoblotting assay of AMPKα and LC3 was performed using electrochemiluminescence (ECL). The quantitative expression of AMPKα and LC3 were measured at baseline, after 24-hour, 48-hour, and 72-hour. Data were analyzed using SPSS version 22 for Windows.Results: AMPKα and LC3 expression were higher in the treatment group compared to the control group. The levels of AMPKα and LC3 expression in the treatment group increased dose-dependent. Linear regression analysis demonstrated a significant correlation between metformin administration and LC3 expression levels (p<0.0001).
Conclusion: Metformin administration on T2DM human SkMC resulted in increased autophagic activity, marked by increased LC3 expression.
Change in ratio levels of KIM-1 / urine creatinine and increase serum creatinine levels in human immunodeficiency virus (HIV) patients receiving tenofovir-based antiretroviral (ARV) combination therapy
Authors: Murti I Dewa Gede Teguh Krisna , I Ketus Agus Somia  , Widiana I Gde Raka
Published: December 2022

Background: Human immunodeficiency virus (HIV)-associated nephropathy refers to developing kidney disease associated with HIV infection. Tenofovir is associated with an increased risk of acute kidney injury (AKI). Kidney injury molecule-1 (KIM-1) in urine is very specific for kidney injury. This study aimed to determine the changes in the ratio between the levels of KIM-1/urine creatinine and the increase in serum creatinine levels with the incidence of decreased kidney function in people with HIV.
Method: This was an observational-analytic study. Subjects were taken using consecutive sampling at Sanglah Hospital Denpasar in 2018. KIM-1 levels were measured by the ELISA method.
Results: This study involved 35 patients (21 males and 14 females) with a mean age of 34.89 ± 10.05 years old. The average levels of KIM-1/urine creatinine at 0 hours was 11.039 ± 12.175 ng/ml), KIM-1/urine creatinine at 12  was 12.382 ± 14.671 ng/ml), KIM-1/urine creatinine at 72 was 10.272 ± 11.843 ng/ml). There were no statistically significant differences in the ratio of hours 0 to 12 hours (p = 0.295), and between hours 0-72 (p = 0.413). But there was a significant difference in creatinine levels for 3 months with the initial mean serum (0.848 ± 0.201) and 3 months of evaluation (1.002 ± 0.198) (p = <0.001).
Conclusion: There was no difference in the ratio of changes in serum KIM-1/creatinine levels during the evaluation of 0, 12, and 72 hours. However, there was an increase in serum creatinine levels between the beginning and 3 months of evaluation.
Patient preferences for surgery or non-surgery for the treatment of clavus and callus at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
Authors: Fadila Arisia , Zulkarnain Iskandar , Listiawan Muhammad Yulianto , Utomo Budi , Sari Maylita , Citrashanty Irmadita , Kusumoputro Bagus Haryo
Published: December 2022

Background: Clavus and callus are common hyperkeratotic lesions that can be very painful and affect the quality of life. The clinicians are faced with various factors affecting the resolution of the lesion, and no treatment has been considered ideal. Surgical has been preferable to conservative treatment but is still more likely to increase patients' desirability due to great discomfort. This study aims to evaluate the factors contributing to the resolution of callus and clavus.
Methods: Retrospective analysis was done on 25 medical records of patients who met the inclusion criteria. Factors contributing to the lesion resolution were identified and analyzed using the SPSS version 17 program.
Result: Among 25 (33.7%) patients recruited for the study, 13 were (52%) male and 12 (48%) female. The most common types of lesions were clavus (20 [80%]). In both cases, the distribution of lesion locations was mostly found in the lower extremities (20 [80%]). Excision was performed in 21 cases (84%), and 20 patients (80%) achieved resolution. Treatment modalities were found to be a factor that had a significant relation to the resolution of the lesion after receiving treatment (p = 0.003; Spearman test).
Conclusion: Treatment of callus and clavus has shown satisfactory results in our center. Excision was found to be the most preferred method, with 80% resolution observed during 1 month. The treatment choice was found to be significantly related to the resolution of the lesion after receiving therapy.
The outcome of hypospadias surgery and it’s advanced treatment in Arifin Achmad General Hospital in January 2019 – December 2020
Authors: Wahid Tu Bagus Odih Rhomdani , Utami Tania Nugrah , Harahap Rizka Annisa
Published: December 2022

Introduction: Hypospadias, the most common congenital genital anomaly, is defined as the abnormal ventral opening of the urethral meatus extent from the proximal tip of the glans penis, penis rod, scrotum until perineum. The incidence of Hypospadias continued to increase from time to time. Urethroplasty and orthoplasty is the only possible treatment for Hypospadias until this time. Surgical reconstruction cannot always be done in one step, many cases need more than one reconstruction even though an experienced surgeon did it. This study aims to describe patients’ characteristics in Arifin Achmad General Hospital.
Methods: This is a descriptive retrospective study using a total sampling method and carried out 28 hypospadias patients at Pediatric Surgery of Arifin Achmad General Hospital from January 2019 until December 2020. Data were analyzed descriptively to describe the patient’s characteristics including age, hypospadias type, frequency of surgery based on Hypospadias type, day of hospitalization based on surgical procedure, complication after surgery based on Hypospadias type, and advanced treatment for the complication.
Results: From 28 patients with hypospadias, it could be concluded that the highest number of hypospadias patients found in the 0-5 years age group (50%) with the most common type was penoscrotal as many as 12 cases (43%). One stage procedure was predominant and attributed to 75% more than multistage procedure (25%). Chordectomy procedure got hospitalized for 3 days and multi procedure (cordectomy + urethroplasty + scrotoplasty) got hospitalized for 7 days. Fistula urethrocutaneous majority found in shaft penile type as a complication after surgery (78%) and had cutaneous fistula closure as an advanced treatment for the complication. From the 28 cases, 23 cases were successful without complication (82%) and 5 cases had fistula as a complication after surgery (18%).
Conclusion: Hypospadias treatment in Pediatric Surgery division at Arifin Achmad General Hospital such as Characteristics of hypospadias patient and surgical outcome majority had satisfied outcome and advanced treatment for complication after surgery is fistula urethrocutaneous closure.
TNF-a serum Level between SARS-CoV-2 Infected Pregnant women with normal pregnant women in RSUD Dr. Soetomo Surabaya
Authors: Febryanna Margaretha Claudhya , Wardhana Manggala Pasca , Akbar Muhammad Ilham Aldika , Nurdianto Arif Rahman
Published: December 2022

Introduction: Pregnant women infected with SARS-CoV-2 experienced increased pro-inflammatory cytokines, including TNF-a, resulting in a cytokine storm condition. This study compares TNF-a levels between pregnant women infected and not infected with Covid-19 in the 3rd trimester.Methods: This observational research was conducted with cross sectional design. Our study included pregnant women who came to delivery room/inpatient at RSUD Dr. Soetomo Surabaya before or during the labor period between May and June in 2021. The inclusion criteria were 3rd trimester gestational age or > 28 weeks with SARS-RT-PCR nasopharyngeal swab result. The exclusion criteria were all significant pregnancy complications. The pregnant woman coming to the delivery room will be screened for COVID-19, and blood samples will be examined using the flow cytometry method for the cytokine Th1: TNF-?.Results: There were no significant differences in TNF-a levels in pregnant women who were infected and not infected with COVID-19 (median 3.42 (7.24) pg/ml vs. 2.70 (3.06) pg/ml. p=0.138). There were also no significant differences in TNF-a levels in pregnant women with symptomatic vs. asymptomatic COVID infection (3.21(3.97) vs. 2.41(2.71) pg/ml; p=0.314).Conclusion: This study revealed no significant difference in TNF-a serum level between SARS-CoV-2 infected pregnant women with normal pregnant women.
The severe adverse event in a locally anesthetized circumcision: A case report of a breath-holding spell
Authors: Fadhly Syifa Fauziah , Wahyudi Irfan , Gerhard Reinaldi Situmorang  , Arry Rodjani
Published: December 2022

Introduction: Circumcision in children can be done with local anesthesia. Indifferent from other surgeries, circumcision certainly has its own risks dan complications.
Case description: A 5-month-old baby who underwent circumcision with local anesthesia was reportedly losing consciousness intraoperatively, followed by a generalized seizure. No previous medical abnormalities were known. It was thought that a breath-holding spell (BHS) was a possible etiology of this event. The patient regains consciousness after a few hours. Electroencephalogram showed normal results. BHS is a harmless condition, where it is believed that crying may cause children to be hypoxic due to prolonged breath-holding and may lead to loss of consciousness or even seizure. Patients with BHS usually recover and regain consciousness after several minutes and should not have any long-term effects after the episode.
Conclusion: Although considered a benign condition, BHS is still a frightening situation for parents and even the surgeon; thus, good communication with the patient's parents is necessary.
Relationship between CD4 levels and mucocutaneous manifestations in HIV-AIDS patients at Dr. Soetomo General Academic Teaching Hospital, Surabaya, Indonesia
Authors: Citra Dwi Harningtyas  , Damayanti  , Maylita Sari  , Muhammad Yulianto Listiawan  , Diah Mira Indramaya  , Linda Astari  , Budi Utomo  , Dwi Murtiastutik  , Setyana Widyantari  , Astindari  , Afif Nurul Hidayati
Published: December 2022

Background: CD4 can assess the immune status of a patient with HIV, and this is considered the standard way of assessing and characterizing the severity of HIV-related immunodeficiency. CD4 cell counts are associated with increased mucocutaneous manifestations. This study aims to explain the relationship between CD4 and mucocutaneous manifestations in HIV-AIDS   patients.

Methods: This study is analytical with a retrospective cross-sectional design. The data of the present study was obtained from a number of 614 HIV-AIDS patients with mucocutaneous manifestations, but only 149 patients met the inclusion criteria, including the CD4 level data.

Results: The majority of the patients in this study were male (74.5%), which includes patients under the age group of 25-49 years (70.5%). The most common risk factor was heterosexuality (48.3%). Most CD4 levels were in the CD4 group < 200 (64.4%). Based on the distribution of mucocutaneous manifestations, the various cases were reported as infections (55.8%). Pyoderma and syphilis were significantly associated with CD4 counts ≥ 200 cells/mm3 with a risk of 3.7 and 7.8 times than CD4 cells < 200 cells / mm3. On the other hand, candidiasis was higher in CD4 count < 200 cells/mm3 with a significant difference and a risk of 0.3 times compared to CD4 count ≥ 200 cells/mm3.

Conclusion: Several mucocutaneous manifestations can be considered predictors of advanced immunosuppression (low CD4 level), which were pyoderma, syphilis, and candidiasis in this study.
The relationship sarcopenia, obesity with Lung function in the elderly group in Tabanan City, Bali
Authors: Gotera Wira , Dwipayana I Made Pande , Suastika Ketut , Budhiarta Anak Agung Gede , Saraswati Made Ratna , Semadi I Made Siswadi , Nugraha Ida Bagus Aditya
Published: December 2022

Background: The aging process is characterized by a gradual decline in physical aspect. Changes in body composition are an important sign of the aging process. Lung disease and respiratory disorders are one of the main health problems in the elderly. Various studies have examined the relationship between decreased muscle mass, obesity, and lung function. However, the results of these studies are still unclear. Aims of this study to determine the relationship between sarcopenia, obesity, and lung function in the elderly group in Tabanan City, Bali.
Methods: This study is an analytical study with cross-sectional design conducted at Tabanan City, Bali, in February 2017. The data was taken using the consecutive sampling technique method; 187 samples were collected from the primary data according to inclusion and exclusion criteria—the analysis using univariate, bivariate and multivariate analysis.
Results: Prevalence of Sarcopenia and obesity in the elderly in Tabanan Regency, Bali was 18.2% and 46%, respectively. Meanwhile, those who experienced sarcopenic obesity were 3.2%. Peak expiratory rates were significantly lower in the elderly group with sarcopenia than those without sarcopenia (p=0.026). Peak expiratory rate was significantly higher in the obese elderly group than in the non-obese group p=0.001).
Conclusion: Peak expiratory rates were significantly different in the elderly group with Sarcopenia and obese than those without Sarcopenia or obese.
Analysis of factors that affect the ability in the initial treatment of injured patients with the approach of the airway, breathing, circulation, disability, exposure to the community
Authors: Winoto Priyo Mukti Pribadi
Published: December 2022

Introduction: The global injury death rate is 1.2 million in the world. Airway, breathing, circulation, disability, and exposure can be used for all emergencies with a systematic approach for critical and injured patients. However, not many people understand and are not skilled in doing initial aid handling injured patients. This study aims to analyze the factors that influence the ability in the initial treatment of injured patients with the airway, breathing, circulation, disability, and exposure approach to the community.
Methods: This study used an observational analytic design with a cross-sectional approach. The population is all ordinary people, with a sample size of 110 people taken by simple random sampling. The independent variables are the factors that affect the ability, namely age, education, and experience factors. The dependent variable is ability. Data analysis used linear regression p-value = 0.001.
Results: Research shows that age, gender, and knowledge affect the ability to handle injured patients, so all factors have a significant effect on ability. In general, research was conducted to analyze the factors that affect the skill level in handling injured patients with the airway, breathing, circulation, disability, and exposure approach to the community. The airway, breathing, circulation, disability, and exposure approach proves an ability in the initial treatment of injured patients.
Conclusion: The factors of age, gender, and knowledge affect the ability to handle injured patients. Following that, the BLS guideline 2020 effectively improves the ability for daily emergency management. For health workers, this method is very helpful in reducing morbidity and mortality.