Indonesian Journal of Medicine (IJM)
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The Determination of Haemostasis Value in Relation to Potential Blood Leaf Leaves Filtrate (Excoecaria cochinchinensis L) as the External Medicine for Skin Wound of White Rat (Rattus norvegicus)
Get PDFBackground: Plants are currently used as medicine, i.e. medicinal plants. Medicinal plants consist of many chemical compounds, especially bioactive substances. One of them is Sambang Darah (Excoecaria cochinchinensis). Sambang Darah have so many benefits which usually applied in vulnus combutio. This study aimed to determine value of haemostasis after applied Sambang Darah leaves in white rat skins (Rattus norvegicus).Subjects and Method: This was a true experimental study with post test only control group design. This study conducted at Mata-ram University, West Nusa Tenggara, Indo-nesia, from April to October 2017. A total sam-ple of 16 white rats was selected for this study. The dependent variable in this study was the value of haemostasis and the independent vari-able was filtrate of Sambang Darah leaves. The data were analyzed using Man Whitney test.Results: The average level of bleeding time was 3.76 minutes for the control group and 2.58 minutes for test group. The average level of clotting time were 2.20 minutes for control group and 1.36 minutes test group. The number of platelet was 277,000/uL for the control group and 221,000/uL for test group. APTT level was25.06 second for the control group and there was no clot in test group. PT level was 13.95 second for the control group and there was no clot in test group. TT levels was 18.2 second for the control group and there was no clot in test group. And the last, D Dimer level was 0.1 mg/l for the control group and there was no clot in test group. The statistical analysis showed p ≤0.001.Conclusion: Filtrat of sambang darah leaves can be applied as medicine for external wounds but it can not be applied in koagulasi test.Keywords: Haemostasis value, blood leaf filtrate (Excoecaria cochinchinensis L)Correspondence: Siti Zaetun.Program Study of Health Analyst, School of Health Polytechnic, Ministry of Health, Mataram. Jl. Prabu Rangkasari, Dasan Cermen, Sandubaya, Mataram, West Nusa Tenggara. Email: [email protected]. Mo-bile: 081803630063.Indonesian Journal of Medicine (2020), 5(1): 10-16https://doi.org/10.26911/theijmed.2020.05.01.0
Current Concept Management of Carpal Tunnel Syndrome: A Case Report
Get PDFBackground: Carpal Tunnel Syndrome (CTS) is the most common median nerve compression neuropathy. CTS presents in 3.8% of the general population, affecting female more than male. CTS can be clinically or surgically treated, based on the severity of the disease. This study aimed to reported current concept management of carpal tunnel syndrome.Case Presentation: A 48 years old female presents with history of numbness on her left hand since 1 year ago, which were preceded by pain on her wrist. Her symptoms are worse at night, she often awakes because of the pain, and she shakes her hands for relief. The numbness was getting worse when she was working with her left hand. She also felt progressive decrease of sensation on her left hand. No systemic symptoms are noted. On examination, there is obvious thenar muscles atrophy on her left hand. There is no weakness on motoric examination. Wrist and finger range of motion are within normal limit. She felt tingling sensation on her 3 radial digits with Tinel and Phalen maneuvers.Results: Non-operative treatments, like splinting, corticosteroid injection, exercise, and oral medication are still widely used and effective to reduce symptoms of CTS. For operative treatment, OCTR still become a standard treatment of severe CTS.Conclusion: Carpal tunnel syndrome management can be done by operative or non-operative treatments.Keywords: Carpal Tunnel SyndromeCorrespondence: Pamudji Utomo. Department of Orthopaedics and Traumatology Prof. Dr. R.Soeharso Orthopaedics Hospital, Surakarta. Email: utomodr@yahoo.com.Indonesian Journal of Medicine (2020), 05(01): 70-86https://doi.org/10.26911/theijmed.2020.05.01.1
Two-Stage Reconstruction Surgery on Cervical Deformity Caused by Spondylitis TB
Get PDFBackground: Of all form of spinal tuberculosis (TB), cervical involvement is immensely rare and merely found in 3-5% of all cases. Kyphotic deformity in spondylitis TB was caused by vertebral destruction in the anterior segment due to infection that lead to hyperemia, bone marrow edema, and osteoporosis. Treatment of spinal TB was divided into two sections which run simultaneously, medicament and surgery. The use of cage for spinal surgery has shown its effectivity in supporting the anterior segment of vertebrae and providing long term stability. The purpose of this study was to compare functional outcome of two patients with cervical deformity caused by spondylitis TB that underwent two-stage reconstruction surgery with expandable and non-expandable cage. Case Presentation: Two patients were reported with cervical deformity caused by spondylitis TB in Orthopedic Hospital Prof. Dr. R. Soeharso, Surakarta. Both patients had their neurological status, Cobb angle, decompression effects and post-operative fusion rate assessed. The patients were diagnosed with cervical deformity due to spondylitis TB showing the involvement of C4-5 in the first patient and C3-5 in the second one. Both underwent two-stage reconstruction surgery and were evaluated right after. There was no decadence in their post-operative neurological function. In the first patient, pre-operative Cobb angle was 44oand becoming 18o post-operatively. The pre-operative Cobb angle of the second patient was 14o and becoming 3o post-operatively.Results: Assessment of post-operative decompression effects and fusion rate were carried out by CT scan and both patients showed a favorable result even when they both were given a different cage. Although both cages had their own advantages based on surgical consideration, we prefer to used expandable cage due to minimal dissection needed.Conclusion: Two-stage reconstruction surgery using whether expandable or non-expandable cage to treat cervical deformity caused by Spondylitis TB gave equally satisfactory outcome.Keywords: Spondylitis, tuberculosis, cervical deformityCorrespondence: Adhitya Indra Pradhana. Prof. Dr. R. Soeharso Orthopaedic Hospital. Jl. Jenderal Ahmad Yani, Surakarta 57162, Central Java, Indonesia. Email: [email protected] Journal of Medicine (2020), 05(02): 116-124https://doi.org/10.26911/theijmed.2020.05.02.0
Clinical Improvement after Surgical Debridement and Synovectomy on 4 Year Old Girl with Chronic Septic Arthritis of the Hip
Get PDFBackground: Incidence of septic arthritis in children less than 5 years old about 5 from 100,000 cases every year and adult above 64 years old about 8.4 cases every 100,000 people every year. The diagnosis of the chronic septic arthritis, especially in hip joint is still challenging, even for skilled doctor in musculoskeletal. Delayed diagnosis and inadequate treatment can lead to permanent joint damage and impairment.Case presentation: In this case we discuss about clinical improvement of chronic septic arthritis in a 4 year old girl with hip pain that had been felt since 2 months before admission. Physical examination, laboratory examination, and ultrasonography examination was done and the diagnosis had been made.Results: A surgical debridement and synovectomy was done with addition antibiotic therapy. The patient not only felt the pain was relieved but also can return into good function of hip joint.Conclusion: Diagnosis with proper early treatment is expected to reduce permanent joint loss and improve the clinical outcome for the patient.Keywords: septic arthritis, hip, synovectomy, surgical debridementCorrespondence: Pamudji Utomo. Prof DR R Soeharso Orthopaedic Hospital, Pabelan, Kartasura, Surakarta, Central Java. Email: [email protected] Journal of Medicine (2020), 05(03): 253-258https://doi.org/10.26911/theijmed.2020.05.03.1
The Relationship between Ferritin and Calcium Levels in Patients with Thalassemia β Major
Get PDFBackground: Thalassemia is a hereditary disease in which the sufferer is unable to produce sufficient amounts of hemoglobin, causing impaired function of red blood cells and shortened red blood cell age. Thalassemia sufferers are spread all over the world, and thalassemia is one of the health problems in the world. Therapy in patients with thalassemia is with routine blood transfusions. One side effect of repeated transfusions is iron overload which causes deposits of iron in the endocrine glands. This study aimed to determine the relationship between ferritin levels with blood calcium levels in patients with β major thalassemia.Subjects and Method: This was a cross-sectional study conducted at Dr. Moewardi, Surakarta, from June to November 2017. Samples of 49 patients with thalassemia β major aged 5-10 years were selected using consecutive sampling. The dependent variable is blood calcium levels. The independent variable is ferritin level. Data were analyzed with Chi Square test.Results: High ferritin levels reduce calcium level in pediatric thalassemia β major patients, but not statistically significant (OR = 0.27; 95% CI = 0.04 to 1.64; p = 0.134).Conclusion: High ferritin levels decrease with calcium levels in pediatric thalassemia β major patients, but not statistically significant.Keywords: ferritin, calcium, thalassemia β majorCorrespondence: Andhika Trisna Putra. Department of Pediatrics, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta. Telpon/Fax.0271-633348, Email: andhika.pediatric@gmail.comIndonesian Journal of Medicine (2020), 05(02): 137-141https://doi.org/10.26911/theijmed.2020.05.02.0
Effect of Dhikr on Blood Pressure in Pregnant Women with Hypertension
Get PDFBackground: Hypertension is a 5-10% of complications in pregnancy and is one of the most common causes of death besides bleeding and infection, and also contributes to the morbidity and mortality of pregnant women. The purpose of this study was to examine effect of dhikr on blood pressure in pregnant women with hypertension.Subjects and Method: This was an experimental study conducted in Banjarnegara district health center, Central Java, in June 2018. A sample of 30 pregnant women with hypertension was selected for this study randomly. The dependent variable was blood pressure. The independent variable was dhikr. Blood pressure was measured by sphygmomanometer. Mean difference between of systolic and diastolic blood pressure in two groups after intervention was tested by t test.Results: After intervention, diastolic blood pressure in the intervention group (Mean= 136.67; SD= 6.17) was lower than in the control group (Mean= 141.33; SD= 5.16), and it was statistically significant (p= 0.006). After intervention, diastolic blood pressure in the intervention group (Mean= 88.67; SD= 3.52) was lower than in the control group (Mean= 92.00; SD= 4.41), and it was statistically significant (p= 0.025).Conclusion: Dhikr decreases blood pressure in pregnant women with hypertension.Keywords: blood pressure, hypertension, pregnant womenCorrespondence: Dian Nirmala Sari. Applied Midwifery, Graduate Program, School of Health Polytechnics, Ministry of Health Semarang. Jl. Tirto Agung, Pedalangan, Banyumanik, Kota Semarang 50268, Central Java, Indonesia. Email: nirma[email protected] Journal of Medicine (2020), 05(01): 87-94https://doi.org/10.26911/theijmed.2020.05.01.1
Aminoglycocides as An Alternative Antibiotic Therapy Against Urinary Tract Infection in Children due to Extended-Spectrum Β-Lactamase (ESBL) Producing Escherichia Coli in Carbapenem Trends
Get PDFBackground: Extended-spectrum β-lactamase (ESBL) is an enzyme produced by certain Escherichia coli and Klebsiella pneumoniae. ESBL can induce theantibiotic resistance for betalactam antibiotics such as penicillin, cephalosporin, etc. Frequent utilization of carbapenem may induce the risk for carbapenem resistant against ESBLs producing microorganisms. This stud aimed to communicate Aminoglycocides as an alternative antibiotic therapy against urinary tract infection in children.Case Presentation: We present a case of 4 years child who was admitted to the state hospital of Madiun with main complaint of 10 days high fever accompanied by phimosis appearance. Laboratory results based on urine culture show the ESBL positive Escherichia coli. Results: We have used aminoglycoside for treating the patient. Clinical presentation in this patient start showing an improved clinical response and negative bacteriuria in the second urine test after the aminoglycoside therapy.Conclusion: Aminoglycosides such as gentamicin can be considered to be one of the best options for treating an ESBL infection beside carbapenem in order to reduce the carbapenem trend In clinical setting of the urinary tract infection caused by ESBL Eschericia coli.Keywords: Aminoglycosides, Carbapenem, Extended-spectrum β-lactamase, Gentamicin, urinary tract infectionCorrespondence: Muhammad Pradhika Mapindra. General Practitioner in State Hospital of Madiun, Easy Java. Email: [email protected] Journal of Medicine (2020), 05(03): 200-205https://doi.org/10.26911/theijmed.2020.05.03.0
The Difference of Endometrial Vascular Endothelial Growth Factor (VEGF) Expression between Polycystic Ovarian Syndrome (PCOS) and Normal Women
Get PDFBackground: Polycystic Ovarian Syndrome (PCOS) is an endocrine disorder in women characterized by increased levels of androgens, ovulatory dysfunction, and Polycystic Ovarian Morphology (PCOM), as well as a combination of classic clinical features. Women with PCOS experience changes in the endometrium and endometrial receptivity markers such as VEGF (Vascular Endothelial Growth Factor). VEGF increases the permeability and dilation of endometrial blood vessels which play an important role in implantation. This study aimed to analyze the difference of VEGF expression between women with PCOS and normal women.Subjects and Method: This study was a case-control study design conducted at the polyclinic of the Department of Obstetrics and Gynecology, Dr. Moewardi Hospital, Surakarta, Central Java, in July 2020. There were 30 infertile women with PCOS (diagnosis based on Rotterdam criteria, consensus 2003) and 30 women without PCOS as the sample of this study. The dependent variable was VEGF expression. The independent variables were age, BMI, family history with PCOS, menarche, occupation, and education. VEGF expression was obtained from an endometrial biopsy on days 19-24 of periods. The differences in VEGF expression (in %) were analyzed by the Mann-Whitney test. VEGF determinants were analyzed by a multiple linear regression.Results: The mean of VEGF expression in women with PCOS (Mean=64.33; SD=44.43) was higher than in women without PCOS (Mean= 7.90; SD=8.73) and the result was statistically significant (p<0.001). PCOS (b=42.09; 95%CI=64.26 to -19.93; p<0.001) and obese (b=38.63; 95%CI=-63.44 to -13.82; p=0.003) increased VEGF expression.Conclusion: VEGF expression in the endometrium of women with PCOS is higher than normal women.Keywords: VEGF, endometrium, Polycystic Ovarian SyndromeCorrespondence: Ricky Bernadi Saputra. Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta, Indonesia. Telp: 081221161933 Email: rickysaput[email protected] Journal of Medicine (2020), 05(03): 230-239https://doi.org/10.26911/theijmed.2020.05.03.0
Association between Resistin and High Sensitive Troponin I in St Elevation Myocardial Infarction and Systolic Heart Failure
Get PDFBackground: Nearly half of all patients with acute myocardial infarction (AMI) have left ventricular systolic dysfunction and one-third have symptoms of heart failure (HF). In patients with AMI the resistin level correlated inversely with left ventricular ejection fraction (LVEF). Increased levels of high sensitive (hs) troponin I are associated with poorer prognosis. This study aimed to determine the association between levels of resistin and hs troponin I in ST elevation myocardial infarction (STEMI) patients with systolic HF.Subjects and Method: This was a cross-sectional study was conducted at Dr. Moewardi General Hospital, Surakarta, from April 1 to May 31, 2018. A sample of 32 patients who admitted which diagnosed with STEMI was selected for this study. They were divided into two group according to result of LVEF measurement, LVEF < 40% and LVEF ≥ 40%. Blood examination and transthoracic echo-cardiography were performed to all patients. Correlation test using partial and multiple correlation test. To different 2 mean using Mann Whitney test.Results: Mean of patient age was 59.5 years old. Resistin decreased LVEF (r= -0.41; p= 0.009), and it was statistically significant. Hs troponin I decreased LVEF (r= -0.25; p= 0.081), but it was marginally significant. Resis-tin level and hs troponin I increased LVEF (r= 0.47; p= 0.025), and it statistically significant.Conclusion: There was an association between resistin and hs troponin I level together in STEMI patients with systolic HF. There was an association of resistin levels in STEM I patients with systolic HF. There was no association of hs troponin I levels in STEMI patients with systolic HF.Keywords: Resistin, hs troponin I, STEMI, systolic heart failure.Correspondence: Trisulo Wasyanto. Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hos-pital. Jl. Kol. Sutarto 132, Surakarta 57126, Central Java, Indonesia. Email: [email protected] Journal of Medicine (2020), 5(1): 1-9https://doi.org/10.26911/theijmed.2020.05.01.0
The Effectiveness of Albendazole-Levamisole and Mebendazole-Levamisole on the Intensity of Trichuris trichiura Infection in Elementary School Children
Get PDFBackground: Trichuris trichiura worm infection is still a major public health problem in Indonesia, especially in peripheral areas. Until now, the search for antihelmintic combinations that have a high healing ability against T. trichiura infections and in the search for truly effective worming is still being done. Albendazole and Mebendazole single doses still show limited efficacy in the treatment of T. trichuria worms. The combination of Albendazole with Levamisol can increase effectiveness, but this combination still needs further investigation. Based on that fact, it is necessary to study the effectiveness comparison of the degree of infection intensity between the treatment of Albendazol-Levamisol and Mebendazol-Levamisol against T. trichiura.Subjects and Method: A double blind randomized control trial was conducted at the State Elementary School in Medan, North Sumatera, from April to October 2019. A sample of 60 children was selected for this study. The dependent variable was the number of eggs decreased, the cure rate, and side effects. The independent variables were Albendazole 400 mg-Levamisol 50 mg/ 100 mg and Mebendazole 500 mg-Levamisol 50 mg/100 mg. The stools of elementary school children were examined using the Kato-Katz method to find eggs of T. trichiura infection. Data analysis was performed using the Chi square test. Results: Samples in the Albendazol-Levamisol and Mebendazol-Levamisol groups were 30 children, respectively. Children infected with T. trichiura consisted of 58 children of mild intensity (96.7%) and 2 children of moderate intensity (3.3%). On the results of stool examination, a significant difference in the number of eggs decreased in the two groups was obtained (p <0.001) and 96.7% was the cure rate for T. trichiura infection in the two groups of Albendazol-Levamisol and Mebendazol-Levamisol. In this study, there were no significant differences in side effects in the two treatment groups.Conclusion: Treatment of T. trichiura infection with single doses of Albendazol-Levamisol and Mebendazol-Levamisol showed that there were significant differences in the Number of Decreased Eggs. Meanwhile, for the cure rate, there was no difference between the Albendazol-Levamisol and Mebendazol-Levamisol groups.Keywords: T. trichiura, Albendazole-Levamisol, Mebendazole-LevamisolCorrespondence: Endy Juli Anto. Department of Parasitology, Faculty of Medicine, Universitas Methodist Indonesia, Medan, Indonesia. Email: dr.endy[email protected]. Mobile: +62-823 6766-7575Indonesian Journal of Medicine (2020), 5(1): 17-23https://doi.org/10.26911/theijmed.2020.05.01.0