Indonesian Journal of Medicine (IJM)
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Effect of Ethanolic Extract in Moringa oleifera, Lam. Leaf on Uric Acid Levels and Body Surface Area of Kidney Glomerulus in Wistar Rats (Rattus novergicus) Induced Metabolic Syndrome Model
Get PDFBackground: There has been an increasing prevalence of metabolic syndrome (MS) caused by life style such as sedentary behavior and western diet. Metabolic syndrome causes degeneration in ren’s structure and processes the elimination of by product in metabolism, which is uric acid. Moringa oleifera Lam. leaves contain antioxidant that can repair damages caused by MS. Studies about improvement of ren’s structure and uric acid level related to Moringa oleifera Lam. leaves’ consumption has not been found yet. Therefore, this study was intended to examine the effects of ethanolic extract in Moringa oleifera Lam. leaves to uric acid and glomerular surface area in male wistar rat (Rattus norvegicus) with induced metabolic syndrome model.Method: This study is an experimental laboratory study. The subjects of this study consisted of 30 rats which were divided into 5 groups with 6 in each group. K1 is control group, K2 is MS group, and K3, K4, and K5 are MS groups given variety of ethanolic extract doses. The induction of MS was done by giving high-fat diet in 28 days and injection of streptozotocin-nicotinamide (STZ-NA) in the 25th day. Rats in group K3, K4, and K5 were given doses of 150, 250, and 350 mg/kgBW in 28 days.Results: The administration of high-fat diet for 28 days and injection of STZ-NA caused MS condition in rats. Repeated ANOVA and One-Way Anova test showed that the administration of ethanolic extract in Moringa oleifera Lam. leaves with doses of 150, 250, and 350 mg/kgBW in 28 days decreased uric acid significantly (p= 0.001; p=0.001; p= 0.001). Another result also found that ethanolic extract from Moringa oleifera Lam. leaves with doses of 250 and 350 mg/kgBW increased area of glomerular surface area in rats significantly.Conclusion: The administration of ethanolic extract from Moringa oleifera Lam. leaves with doses of 150, 250, and 350 mg/kgBW for 28 days decreased uric acid level in rats. Ethanolic extract of Moringa oleifera Lam. leaves 250 and 350 mg/kgBw doses increase glomerular surface area.Keywords: Moringa Oleifera, uric acid, glomerular cross-sectional area, metabolic syndrome, kidneyCorrespondence: Muhammad Dzaki Darmawan. Study Program of Medical Doctor Education, Faculty of Medicine, Universitas Sebelas Maret. Email: [email protected] Journal of Medicine (2021), 06(04): 412-422https://doi.org/10.26911/theijmed.2021.06.04.0
Mixed-Type Melasma Treated with Low Fluence Q-Switched Nd-YAG 1064 nm Laser: A Case Report
Get PDFBackground: Melasma is an acquired, chronic hypermelanosis condition. Melasma is more common in women of all races and occur especially on the face. The pathogenesis of melasma is very complex and the treatment is still a challenge. The purpose of this study was to report mixed-type melasma treated with low fluence Q-switched Nd-YAG 1064 nm laser.Case Presentation: A case of melasma in 54 year old woman was reported. Dermatological examination showed presence of brownish macules and patches in the centro facial area with symmetrical distribution. Examination with wood lamp showed mixed type. Patients have received topical therapy but there were no improvement.Results: The patient was then treated with low fluence Q-switched Nd-YAG 1064 nm laser for three sessions with an interval of 2 weeks. At 6 weeks of treatment the modified MASI (mMASI) value was reduced from 8.4 to 4.6 and the VAS value was increased from 2 to 8.Conclusion: The depth of the pigment determined the response to therapy. In the mixed type melasma the response for therapy is only partial. The low-fluence Q-switched Nd-YAG 1064 nm laser can penetrate deeper into the dermis and damage melanin in a short time.Keywords: mixed typed melasma, low fluence, Q-switched Nd-YAG laserCorrespondence: Aninda Fitri Nugrahani. Department of Dermatology and Venereology, DR. Saiful Anwar Hospital, Malang, East Java/ Faculty of Medicine, Universitas Brawijaya, Malang, East Java. Email: [email protected] Journal of Medicine (2020), 05(02): 95-101https://doi.org/10.26911/theijmed.2020.05.02.0
Management of Laparoscopic Surgery in Intraoperative Subcutaneous Emphysema: A Case Report
No full textBackground: Over the past 50 years, laparoscopy has evolved from a limited gynecological surgical procedure that is only used for diagnosis and tubal ligation to become the main surgical tool used for many gynecological indications. Many studies have shown that laparoscopy is safer, more affordable, and has a shorter recovery time than laparotomy. This study aimed to report the management of laparoscopic surgery in intraoperative subcutaneous emphysema.Case Presentation: The subject of the study was a 37-year-old woman with adenomyosis and chocolate cyst of sinistra with a surgery plan for resection of adenomyosis and per laparoscopic cystectomy with the physical status of the ASA II Plan GAET. The surgery was carried out on October 15, 2018, with surgery for 5 hours. At the intraoperative, subcutaneous emphysema was found from the diaphragm to the thorax. In this condition, the peritoneal insufflation was reduced to 10-12 mmHg. The head down was returned to a position that made it easier for the patient's condition to reduce the occurrence of decreased lung compliance. The patient's postoperative condition was good, the hemodynamic was stable, her breath was spontaneous, and the saturation was 99% with oxygen supplementation via Nasal Kanul 3 lpm. The subcutaneous emphysema gradually disappeared 24 hours postoperatively. Conclusion: Subcutaneous emphysema may occur in the laparoscopic procedures. The close monitoring during surgery and the expertise of the anesthesiologist in diagnosing and intervening is crucial in controlling this condition.Keywords: subcutaneous emphysema; laparoscopy; intraoperative interventionCorrespondence: RTH. Supraptomo. Department of Anesthesiology and Intensive Therapy, Dr. Moewardi Hospital, Surakarta, Central JavaIndonesian Journal of Medicine (2020), 05(03): 206-213https://doi.org/10.26911/theijmed.2020.05.03.05
Comparative Study of Cross and Lateral Fixations on Supracondylar Humerus Fracture among Children
Get PDFBackground: Management of Gartland type III supracondylar humerus fractures is conducted by open and closed repositioning. An adequate reposition and a stable and accurate fixation are desperately needed to prevent fixation failure, deformity, and complication. The study aims to compare the clinical and radiological results between crossed and lateral fixation techniques.Subjects and Method: The study was a retrospective study toward Gartland type III SCHF children in Dr. Soetomo Hospital, Surabaya, Indonesia from 2013–2016. The dependent variable is Supracondylar humerus fracture. Independent variables were the type of fixation option, clinical functional test, degrees of satisfactory, and radiology evaluation. The radiology parameter used was Skaggs criteria. An observation was conducted for the occurrence of complications in the form of infection and peripheral nerve injury. All data were analyzed using Kolmogorov Smirnov and Fischer exact test.Results: The study discovered 28 patients consisted of 20 males and 8 females with an age range from 3 – 13 years old with an average age in crossed fixation group was 7.6 years and in lateral fixation was 4.7 years. The injury sides were 46.4% right elbow and 53.5 % left elbow. Among the crossed fixation group, there were 54.5 % left elbow and 45.5 % right elbow. Among lateral fixation group, there were 50% left side and 50% right side. There was no significant difference in clinical functions, radiology as well as complication in the form of infection and peripheral nerves injury.Conclusion: There is no difference of functional clinical, radiology result as well as post-surgery complication in the form of infection and peripheral nerves injury between crossed fixation technique and lateral fixation technique.Correspondence: Komang Agung Irianto. Department of Orthopedics and Traumatology, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo Hospital, Surabaya. Email: [email protected]. Mobile: +62811336080.Indonesian Journal of Medicine (2020), 05(01): 31-37https://doi.org/10.26911/theijmed.2020.05.01.0
Clinical Profile of Patients with Manus Fracture Caused by Firecracker Blast
Get PDFBackground: Fireworks are traditionally used by various cultures or groups for celebrations. Estimated 10,000 to 12,600 people are injured because of fireworks in America every year. The type of fireworks that cause the highest injury is firecrackers with the incidence rate of 30% to 67% of all cases of injury due to fireworks. Indonesia is a country with the largest Muslim population in the world and firecrackers are often used to welcome Ramadan and Eid al-Fitr. This study aimed to report the Clinical profile of patients with manus fracture caused by firecracker blast.Case Presentation: The case study was taken from patients of Karima Utama Surgical Hospital, Surakarta, Indonesia, during Ramadan and Eid al-Fitr (from May 14 to June 15) 2018. A total of 36 patients were fractured due to firework explosions recorded in medical records during that period. Data such as gender, age and fracture diagnosis were collected in this study.Results: Males have a higher prevalence of 28 (78%) than female 8 (22%), with the highest group age between 11 to 20 years with 11 cases (31%) and more than 60 years being the lowest age group with 2 (6 %) cases of a total of 36 respondents. The right hand as the dominant hand has an injury incidence rate of 31 (86%) compared to the left hand 5 (14%) and more often occurs single fracture 22 (61%) compared to multiple fractures 14 (39%) including the amputated phalanx.Conclusion: Our study showed 36 patients had fractures of the manus due to firecrackers, with the majority of male victims 28 (78%) and single manus fractures 22 (61%) with the right-hand dominance at the age between 11 to 20 years.Keywords: manus fracture, firecrackerCorrespondence: Pamudji Utomo. Department of Orthopedics and Traumatology Prof. Dr. R. Soeharso Orthopedics Hospital, Surakarta. Email: utomodr@yahoo.com.Indonesian Journal of Medicine (2020), 05(01): 57-62https://doi.org/10.26911/theijmed.2020.05.01.0
Risk Factors of Behavioral Problems in Pediatric Epilepsy
Get PDFBackground: Epilepsy is the most common neurological disorders in children and the number of case for epilepsy still increasing. Epilepsy can affect children and their growth physically, psychologically, and socially, yet the treatment of behavioral problems in pediatric epilepsy is still lacking. This study aimed to investigate the association of frequency of seizure, type of seizure, duration of illness, and use of antiepileptic drug with behavioral disorder in children with epilepsy.Subjects and Method: This was an analytical observational study with a cross sectional design. The study was conducted at Pediatric Neurology Unit of Dr. Moewardi hospital, Surakarta, from September to October 2016. A sample of 50 pediatric patients with epilepsy was selected for this study. Parents or caregivers completed behavioral problems screening tool Pediatric Symptom Checklist-17 (PSC-17) and were interviewed about frequency of seizure, type of seizure, duration of illness, and use of antiepileptic drug. The data were analyzed by a multiple logistic regression.Results: Frequent seizure (OR= 3.09; 95% CI= 0.89 to 10.59; p= 0.068) increased behavioral problem. Being treated with ≥1 anti-epileptic drugs (OR= 1.58; 95% CI= 0.44 to 5.71; p= 0.521) increased behavioral problem, but it was statistically non-significant. Type of seizure (OR= 1.01; 95% CI= 0.32 to 3.20; p= 0.991) and duration of illness ≥1 year (OR= 1.03; 95% CI= 0.22 to 4.89; p= 1.000) were not associated with behavioural problem. Conclusion: Frequent seizure increase behavioral problemKeywords: epilepsy, behavioral problems, pediatricsCorrespondence: Fadhilah Tia Nur. Department of Child Health, Faculty of Medicine, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected] Journal of Medicine (2020), 05(02): 162-169https://doi.org/10.26911/theijmed.2020.05.02.1
Plasma Zinc Difference in Children with Thalassemia β Major Received Deferiprone or Deferasirox Zinc
Get PDFBackground: Thalassemia is a blood disease characterized by the most frequently found autosomal recessive hereditary hemolytic anemia. It requires repeated blood transfusions for life. Routine blood transfusion can cause complications in the form of accumulation of ferritin in the tissue. Iron chelation therapy is considered effective for treating body iron deposits. However, iron chelation therapy has the side effect of decreasing levels of other important minerals such as zinc (Zn). This study aimed to examine plasma zinc difference in children with Thalassemia β major received deferiprone or deferasirox zinc.Subjects and Method: This was a cross sectional study conducted at Dr. Moewardi Hospital, Surakarta, from February to April 2017. A sample of 40 children with thalassemia β major aged 3 to 18 years who received deferiprone iron chelation and deferasirox at least 6 months was selected by consecutive sampling. The dependent variable was serum zinc levels. The independent variables were iron deferiprone and deferasirox. Plasma zinc levels were measured by atomic absorption spectroscope. The data were analyzed by t test.Results: Zinc levels in patients with deferiprone therapy (Mean= 54.50; SD= 11.02) were lower than deferasirox therapy (Mean= 60.95; SD= 20.71), but statistically not significant (p= 0.229).Conclusion:Zinc levels in patients with deferiprone therapy are lower than deferasirox therapy, but not statistically significant.Keywords: zinc, deferiprone, deferasirox, children with thalassemia β majorCorrespondence: Wahyu Kusumawardhani. Department of Pediatrics, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta, Central Java. Phone/ Fax: 0271-633348. Email: dhanisuryadiraja@gmail.comIndonesian Journal of Medicine (2020), 05(02): 102-108https://doi.org/10.26911/theijmed.2020.05.02.0
Association between Myeloperoxidase and High Sensitive Troponin I on Myocardial Contractility in Acute Myocardial Infarction Patients
Get PDFBackground: Myeloperoxidase (MPO) levels have been shown to have prognostic values for death events in acute myocardial infarction (AMI) patients. Increased levels of high sensitive troponin I (hs Trop I) are associated with poorer prognosis in AMI patients. This study aimed to determine the association between levels of MPO and hs troponin I at admisson on myocardial contractility in AMI patients.Subjects and Method: This was a prospective observational analytic study, conducted at Dr. Moewardi General Hospital, Surakarta, from November1, 2018 to January 31, 2019. The study subjects were patients who were diagnosed with AMI. A total of 23 patients were included in this study; 15 patients with ST elevation myocardial infarction (STEMI) and 8 with non ST elevation myocardial infarction (NSTEMI). The dependent variable was myocardial contractility. The independent variables were MPO and hs Trop I. Blood tests for MPO and hs Trop I was measured at admission and the left ventricular ejection fraction (LVEF) was measured when predischarge by the Simpson method to examine myocardial contractility. The data were analyzed by Pearson correlation run on SPSS 22. Results: hs Trop I (r= -0.53; p= 0.009) and MPO (r= -0.15; p=0.487) decreased LVEF.Conclusion: Hs Trop I at admission has a correlation with myocardial contractility, and no correlation of MPO at admission with myocardial contractility in AMI patients.Keywords: Myeloperoxidase, High sensitive Troponin I, Acute myocardial infarctionCorrespondence: Trisulo Wasyanto. Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital. Jl. Kol. Sutarto 132, Surakarta 57126, Central Java, Indonesia. Email: [email protected] Journal of Medicine (2020), 05(04): 265-271https://doi.org/10.26911/theijmed.2020.05.04.01.
High Energy Injury Ankle Fracture-Dislocation without Neurovascular Involvement
Get PDFBackground: Open tibiotalar joint dislocation associated with medial malleolus and distal fibular fracture without neurovascular damage are rarely reported.Case presentation: This study present a case of 55-year-old female with open tibiotalar joint dislocation associated with medial malleolus and distal fibular fracture without neurovascular injury treated with emergent debridement, open reduction, and internal fixation.Results: Six months follow-up showed complete bone and soft tissue healing with excellent functional outcome.Conclusion: Emergent debridement, open reduction, and internal fixation is needed to treat tibiotalar joint dislocation associated with medial malleolus and distal fibular fracture.Keywords: high energy injury, ankle joint, fracture dislocationCorrespondence: Asep Santoso. Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: asep[email protected] Journal of Medicine (2020), 05(03): 259-264https://doi.org/10.26911/theijmed.2020.05.03.1
Effect of L- Arginin on Placental Hipoxia Inducible Factor -1-Alpha (HIF-1-A) Expression at Preeclampsia Mice Models
Get PDFBackground: Placental hypoxia is one of the theories that cause preeclampsia. In placental hypoxia of preeclampsia, there is an increase of Hipoxia Inducible Factor 1 Alpha (HIF-1-A) expression as a response to hypoxia. L-Arginine administration through the L-Arginine-Nitric Oxide pathway is expected to improve placental hypoxia. This study aimed to examine the effect of L- Arginin on placental HIF-1-A expression at preeclampsia mice models.Subjects and Method: Experimental study with parallel group post-test only design. The study was carried out at the Veterinary Medicine Faculty of Airlangga University. Thirty six preeclampsia mice models were made with intravenous injection 10ng anti-Qa-2 on day 1-4 of pregnancy. They were divided into 2 groups: (1)18 mice without treatment (control) and (2) 18 mice were given L-Arginin 200 mg/kgBW/day on day 7-15 of pregnancy. They were terminated on day 16 then immunohistochemistry examination of HIF-1-A expression was done on the placental samples. The dependent variable was placental Hipoxia Inducible Factor-1-Alpha (HIF-1-A) expression. The independent variables were L-Arginin administration. HIF-1-A expression was measured by H-Score method. The data were analyzed by t-test. Results: The mean of placental HIF-1-A expressions of treatment group was lower (Mean= 7.98; SD=9.35) than control group (Mean=41.95; SD= 32.20), and it was statistically significant (p <0.001).Conclusion: L-Arginin reduces the Placental Hypoxia Inducible Factor Alpha (HIF-1-A) expression on preeclampsia mice model.Keywords: L-Arginine, HIF-1-A, PreeclampsiaCorrespondence: Nutria Widya Purna Anggraini. Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Sebelas Maret/ Dr. Moewardi General Hospital Surakarta. Jl Kolonel Sutarto 132, Surakarta, Central Java, Indonesia. Email: [email protected]. Mobile: 08122651819.Indonesian Journal of Medicine (2020), 05(03): 191-199https://doi.org/10.26911/theijmed.2020.05.03.03