Indonesian Journal of Medicine (IJM)
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Comparison of Pain in the Kocher and Midline Incisions in Patients with Post Cholecystectomy
Get PDFBackground: Incision techniques that are often used in cholecystectomy laparotomy are the Kocher incision and midline incision. This study was carried out to compare the pain in the Kocher's incision and midline incision in patients with postoperative cholecystectomy laparotomy.Subjects and Method: : This study was an observational randomized controlled trial double sampling study conducted at the Department of Surgery Dr. Moewardi Hospital Surakarta in October 2018 to February 2019. The sample of this study was 30 patients aged 18-65 years old who were diagnosed with symptomatic cholelithiasis based on clinical, laboratory, and radiological tests. The samples were selected by simple random sampling. The dependent variable of this study was the pain. The independent variables were the Kocher and midline incision techniques. The pain was measured on a 24-hour postoperative VAS scale, range 1-10. Data were analyzed by t-test.Results: There was no significant difference in pain level between the Kocher group (Mean= 2.33; SD=0.72) and the midline group (Mean= 2.20; SD=0.97) with p=0.192.Conclusion: There is no difference in pain level due to the Kocher incision technique and the midline incision technique.Keywords: pain, incision, kocher, midline, cholecystectomyCorrespondence: R. Th. Supraptomo. Anesthesia dan Intensive Therapy Department Dr. Moewardi Hospital, Surakarta. Jl. Kolonel Sutarto 132 Jebres, Surakarta, Central Java 57126. Email: [email protected]. Mobile: 081229229567Indonesian Journal of Medicine (2020), 05(03): 240-245https://doi.org/10.26911/theijmed.2020.05.03.09
Fusi In Situ Posterior for Congenital Scoliosis with Wedge Hemivertebrae Using Single Rod and Pedicle Screw Instrumentation in Girl 2 Years Old: A Case Report
Get PDFBackground: Many spinal vertebral anomalies often occur, both scoliosis and kyfosis. In scoliosis, congenital abnormalities caused by hemivertebrae are the most common cause of abnormalities. The choice of treatment used can be either non-operative or operative. However, non-operative treatment does not show satisfactory results to prevent the development of deformity. Operative treatment is an option that is considered to indicate more satisfying results. A variety of procedures such as in-situ posterior or with or without instrumentation anteroposterior fusions, combined anterior and posterior convex hemiepiphysiodesis and hemiarthrodesis, and hemivertebral excision with fusion. Fusi In-situ posterior is a procedure option that is considered more beneficial for both surgeons and patients. This study aimed to evaluate the fusi in situ posterior for congenital scoliosis with wedge hemivertebrae using single rod and pedicle screw instrumentation in girl 2 year old.Case Presentation: Girl 2 year old with wedge hemivertebrae operated with fusion in situ posterior using single rod and pedicle screw instrumentation.Results: The operative treatment was performed on 2 hours operation time with amount of bleeding produced is 80 cc. There were no cranckshaft phenomena and no clinical and radological features suggestive of spinal stenosis. There were no major vascular or neurogical complications related to the pedicle screws. Then patient wore body jacket for limitation movement before fusion.Conclusion: Posterior situ fusion is performed as convex fusion to avoid curve progression. Fusion in situ posterior using single rod and pedicle screw instrumentation. In congenital scoliosis is minimal blood loss, less traumatic, simple, safe and effective procedure. This study showed the early fusi in situ posterior of congenital scoliosis structural changes occur above or below can reduce fusion length, prevent curve progression and effectively achieve a more satisfactory correction without hazardous iatrogenic spinal stenosis, crankshaft phenomena, or neurological complications. Further research is needed to assess the progress of the outcome of surgeryKeywords: congenital scoliosis, wedge hemivertebrae, convex, fusi in situ posteriorCorrespondence: Pamudji Utomo. Department of Orthopaedic & Traumatology, Faculty of Medicine, Universitas Sebelas Maret/ Prof. Dr. R. Soeharso Orthopaedic Hospital, SurakartaIndonesian Journal of Medicine (2020), 05(02): 125-130https://doi.org/10.26911/theijmed.2020.05.02.0
Age-Related Sensory Impairment and Cognitive Decline in Geriatric
Get PDFBackground: Incidence of sensory impairment and cognitive decline were increase with aging, each would give a considerable impact on public health and quality of life especially in geriatric population. Several mechanisms have been proposed to account for the correlation between sensory impairment and cognitive decline and the common mechanisms were sensory deprivation, information degradation, cognitive load, resource allocation and or social isolation. Prolonged reductions in the quality or quantity of sensory input lead to cognitive deterioration due to neuronal atrophy. This study aimed to determine whether age related sensory impairment with cognitive decline.Subjects and Method: This was a cross-sectional study design conducted at geriatric clinic, Dr. Moewardi General Hospital, Surakarta, from May 31 to July 1, 2018. A sample of 54 elderly aged ≥60 years old was selected by consecutive sampling. The dependent variable was cognitive decline. The independent variables were presbyacusis, presbyastasis, olfactory impairment, diabetes, and hypertension. Presbycusis was measured by Pure Tone Audiometry. Presbyastasis was measured by Dynamic Visual Acuity (DVA) test. Olfactory dysfunction was measured by sniffing test. Cognitive decline was assessed by MoCA-Ina questionnaire. The data were analyzed by Chi-square test.Results: The mean age of subjects was 70.5 years old ranging from 61-81 years old and most of the subjects were females (72.2%). Pure tone audiometry test revealed that 44.4% patients had presbycusis. Dynamic Visual Acuity test showed that 25.9% patients had presbyastasis. Sniffing test revealed that 29.6% patients had olfactory dysfunction. Presbyacusis (OR= 11.9; 95% CI= 1.3 to 105.5; p= 0.008) and olfactory dysfunction (OR= 10.8; 95% CI= 1.8 to 61.9; p= 0.002) increased cognitive decline, and they were statistically significant. Presbyastasis decreased cognitive decline (or= 0.9; 95% CI= 0.1 to 5.3; p= 0.948), but it was statistically non-significantConclusion: Sensorineural health may serve as a marker of brain aging therefore sensory measures can be used as screening tools for cognitive decline risk.Keywords: sensory impairment, presbycusis, presbyastasis, olfactory dysfunction, cognitive declineCorrespondence: Dewi Pratiwi. Department of Otorhinolaryngology Head and Neck Surgery, Dr. Moewardi Hospital/ Faculty of Medicine, Universitas Sebelas Maret Surakarta, Central Java. Email: pratiwi[email protected] Journal of Medicine (2020), 05(02): 153-161https://doi.org/10.26911/theijmed.2020.05.02.1
To Pin a SCFE One Screw is Preferred than Two Screws in Children
Get PDFBackground: Slipped capital femoral epiphysis (SCFE) is one of the most frequent hip disorders in children. SCFE is due to the displacement of the epiphysis (femoral head that keeps its location in the acetabulum) relative to the metaphysis (femoral neck) and shaft at the physic level. Treatment seeks to prevent worsening of epiphyseal slippage on the metaphysis, and percutaneous in situ fixation (ISF) using a single cannulated screw has long shown efficacy.Case Presentation: An 11 years old boy presented with diagnosed with slipped capital femoral epiphysiolysis of right hip and treated operatively with one screw pinning guiding fluoroscopy. Post operatively, from X-Ray evaluation confirmed the proper position without joint penetration. Patient is then advised to walk with crutches for gradual weight bearing to full weight bearing after 4 weeks. Then after 6 weeks, patient had already walked normally again.Conclusion: In unstable moderate-to-severe SCFE, the best reduction indications and technique remain controversial. There are many theories supporting one or two screws pinning technique. In this case we used one screw pinning fixation with excellent result.Keywords: slipped capital femoral epiphysis, treatment, one screw in situ fixationCorrespondence: Udi Heru Nefihancoro. Department of Orthopaedic and Traumatology, Dr. Moewardi Hospital/ Faculty of Medicine, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta, Central Java, Indonesia. Email:udyherunefy@ymail.com. Mobile: +62 816-672-767.Indonesian Journal of Medicine (2020), 5(1): 24-30https://doi.org/10.26911/theijmed.2020.05.01.0
The Difference of Endometrial Leptin Expression in Woman with Polycystic Ovarian Syndrome (PCOS) Compared to Normal
Get PDFBackground: Decreased endometrial receptivity is suspected to be one of the factors causing infertility in women with Polycystic Ovary Syndrome (PCOS). Endometrial abnormalities in PCOS due to impaired balance include estrogen, progesterone, growth factors, cytokines and cell attachment modulators including leptin. This study aims to determine the expression of leptin in the endometrium which is suspected to be more common in PCOS patients and related factors.Subjects and Method: A retrospective-case control study was conducted at Dr. Moewardi general hospital, Surakarta. A total of 60 women were involved; 30 infertile women with PCOS based on Rotterdam criteria (if found two of the three symptoms, including hyperandrogenism, ovulation dysfunction and/or polycystic ovaries from ultrasonography) and 30 normal women as control group. Demographic data such as age, family history of PCOS, menarche, BMI, occupation, and education were recorded. Leptin expression was acquired from endometrium biopsy with IHC examination on day 19-24 of the menstrual cycle; under the condition that inclusion and exclusion criteria are fulfilled. The statistical analysis was performed using the Mann-Whitney test.Results: Mean of leptin expression was found significantly higher in PCOS group (Mean= 59.16; SD= 49.34) compared to control group (Mean= 6.00; SD= 22.98, with p= 0.001. PCOS (b= 0.42; 95% CI= 0.10 to 0.73; p= 0.010) and obesity (b= 0.31; 95% CI= 0.41 to 0.58; p= 0.025) increased leptin expression.Conclusion: There is a difference in leptin expression in the endometrium of PCOS compared to normal. Leptin expression is higher in the endometrium of women with PCOS and obesity compared to normal.Keywords: Leptin expressions, endometrium, polycystic ovarian syndrome.Correspondence: Dwi Sakti Berlian Besar. Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi General Hospital, Surakarta, Indonesia. Email: [email protected]. Mobile: +628121845054Indonesian Journal of Medicine (2020), 05(01): 38-46https://doi.org/10.26911/theijmed.2020.05.01.06
Relationship between Anxiety Score and Erythrocyte Sedimentation Rate (ESR) in Hemodialysis Patient
Get PDFBackground: Anxiety in hemodialysis patients often impaired quality of life. Complex interaction between Chronic Kidney Disease (CKD) and anxiety are dynamic and multifactorial, including socio-economic, lifestyle and biological factors. Biological factors are closely related to anxiety in CKD including the immune system, inflammatory pathways of disorders of Hypothalamic-Pituitary-Adrenal Axis (HPA). Erythrocyte sedimentation rate (ESR) is one of the non-specific inflammatory marker that show the degree of inflammatory reaction, Neutrophil-Lymphocyte Ratio (NLR) and Platelet-Lymphocyte Ratio (PLR) also found as an easy and inexpensive measureable marker to show the degree of inflammation. This study aimed to examine relationship between anxiety and hematology inflammation markers in hemodialysis patient.Subjects and Method: This was an observational study with a cross-sectional design. The study was conducted at Dr. Moewardi general hospital, Surakarta, Central Java. A sample of 30 hemodialysis patients was selected for this study. The dependent variables were ESR, NLR, and PLR. The independent variable was anxiety. Anxiety was measured by Taylor Manifest Anxiety Scale (TMAS). Data on ESR, NLR, and PLR, were measured using an assessment from RAND Corporation. The data were analyzed by a multiple linear regression.Results: Anxiety increased NLR and it was marginally significant (b= 0.37; 95% CI= -0.01 to 0.22; p= 0.080). Anxiety decreased ESR and it was statistically significant (b= -0.57; 95% CI= -0.02 to 0.01; p<0.001). Anxiety decreased PLR (b= -0.16; 95% CI= -0.02 to 0.01; p= 0.440) and duration of hemodialysis (b= -0.27; 95% CI= -0.03 to 0.01; p= 0.167), but they were statistically non-significant.Conclusion: Anxiety increases NLR. Anxiety decreases ESR, PLR, and duration of hemodialysis.Keywords: chronic kidney disease, hemodialysis, hematology markers, inflammationCorrespondence: Rohmaningtyas Hidayah Setyaningrum. Department of Psychiatry, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi General Hospital, Surakarta, Central Java. Email: [email protected] Journal of Medicine (2020), 05(02): 109-115https://doi.org/10.¬26911/theijmed.2020.05.02.0
The Effect of Mesenchymal Secretome Stem Cell Therapy toward Caspase-3 Expression in Pregnant Mice with Pristan-Induced Lupus Model
Get PDFBackground: Systemic lupus erythematosus (SLE) is one of the pregnancy complications which cause an increase in fetal and maternal complications which are mainly caused by placental damage due to chronic inflammation and apoptosis. The rate of apoptosis can be assessed by the high expression of caspase-3 which is the majorexecutioner caspases of apoptosis. The use of Mesenchymal Secretome Stem Cell for SLE therapy has an anti-inflammatory and anti-apoptotic role. This study aimed to examine the effect of mesenchymal secretome stem cell therapy toward caspase-3 expression in pregnant mice with pristan-induced lupus model.Subjects and Method: This study was a randomized controlled trial. This study was conducted at the Prodia ProStem Laboratory, Laboratory of the Faculty of Veterinary Medicine of Airlangga University, and Anatomical Pathology Laboratory, Faculty of Medicine, Airlangga University. A total of 14 healthy BALB/C female mice strain aged 6-8 weeks, with a bodyweight of 20-30 grams, were divided into two groups, (1) 7 pregnant mice who received pristan therapy only, and (2) 7 pregnant mice who received pristan therapy and mesenchymal secretome stem cell.The dependent variable was the caspase-3 expression. The independent variable was the administration of mesenchymal secretome stem cell therapy. The caspase-3 expression was measured by an immunoreactive score. The data were analyzed using independent t-test.Results: After giving mesenchymal secretome stem cell therapy, the mean of the caspase-3 expression in the treatment group (Mean=1.86; SD=0.66) was lower than the control group (Mean=3.30; SD = 1.42), with p=0.031.Conclusion: Mesenchymal secretome stem cell therapy is effective for reducing caspase-3 expression in the placenta of pregnant mice with pristan-induced lupus model.Keywords: Caspase-3 expression, lupus, placentaCorrespondence: Febrian Andhika Adiyana. Department of Obstetrics and Gynecology, Faculty of Medicine, Univesitas Sebelas Maret/Moewardi Surakarta, Indonesia. Email: [email protected]. Mobile: 081215897960.Indonesian Journal of Medicine (2020), 05(03): 224-229https://doi.org/10.26911/theijmed.2020.05.03.0
The Effects of Slow Stroke Back Massage and Lavender Aromatherapy on Blood Pressure in Hypertensive Patients
Get PDFBackground: Elderly is an age group which is extremely susceptible to suffer from health problems such as hypertension. Hypertension among the elderly is instigated by structural and functional changes in blood vessels. The changes include atherosclerosis, loss of connective tissue elasticity, and decreased vascular muscle relaxation that it reduces the distension and tensile strength of blood vessels. One of the therapies that may be implemented to elderly with hypertension is slow stroke back massage (SSBM) and lavender aromatherapy. The study aims to discover the effects of slow back massage (SSBM) and lavender aromatherapy toward the reduced blood pressure among hypertensive elderly.Subjects and Method: It was a quasi-experiment study with no control group which had been conducted in Posyandu (Integrated Health Post) Kamboja, Plesungan, Gondangerjo, Karanganyar, Central Java, in July 2019. A sample of 40 elderlies was selected by using total sampling. The dependent variables were systolic and diastolic blood pressure. The independent variables were slow stroke back mass-age (SSBM) and lavender aromatherapy. Blood pressure was measured by sphygmomanometer. The data were analyzed by using Wilcoxon. Results: The average systolic blood pressure post slow stroke back massage therapy and la-vender aroma therapy was (Mean=133.63; SD= 7.34) compared with prior therapy was (Mean= 167.80; SD= 6.12) with the value of p<0.001. The average diastolic blood pressure post slow stroke back massage therapy and lavender aroma therapy was (Mean= 68.28; SD= 4.25) compared with the prior therapy was (Mean= 68.88; SD= 5.72) with the value of p<0.001. Conclusion: Slow stroke back massage (SS-BM) lavender aromatherapy may lower down blood pressure of hypertensive elderly.Keywords: Hypertension, slow stroke back massage, Lavender aromatherapy, elderlyCorrespondence: Fakhrudin Nasrul Sani. School of Health Sciences Kusuma Husada, Surakarta. Email: [email protected] Journal of Medicine (2020), 05(03): 178-184https://doi.org/10.26911/theijmed.2020.05.03.0
Therapy of Cinnamon Decoction using Honey in Reducing Gout
Get PDFBackground: Gout is an antioxidant, the final product that is produced from the metabolism/ breakdown of purines, but if in excessive amounts in the blood, it will experience crystallization and can cause gout. Giving cinnamon extract to male white rats with hyperuricemia has the effect of reducing uric acid levels, because the extract of cinnamon contains Polyphenols namely Sinamldehid which is high enough (68.65%) to be a source of antioxidant compounds which can inhibit Xanthine Oxidase Enzine. This study aimed to analyze the therapy of dekokta cinnamon with honey to reduce uric acid for people with gout.Subjects and Method: This was a quasi experiment with pre and post-test design. The study was conducted in Gambirsari Community Health Center, Kadipiro Subdistrict, Mojosongo, Surakarta, Central Java, in May 2018. A sample of of 50 people with gout sufferers were selected by quota sampling and divided into 2 groups. The treatment group of 25 people received cinnamon decoction with honey with a concentration of 15%. The therapy was carried out for 1 week with a dose of once a day. In the control group, Allopurinol 100 mg was given for 1 week, with a dose of once a day. The data were analyzed by Wilcoxon and Mann-Whitney est.Results: Uric acid in decoction cinnamon with honey group was lower than in control group and it was statistically significant (p= 0.023).Conclusion: Decoction cinnamon with honey can reduce uric acid level among gout patients.Keywords: cinnamon, decoction, honey, goutCorrespondence: Yeti Nurhayati. Nursery Program, School of Health Sciences Kusuma Husada, Surakarta, Central Java. Email: [email protected] Journal of Medicine (2019), 4(1): 35-39https://doi.org/10.26911/theijmed.2019.04.01.0
Yoga Increases the Quality of Sleep in Menopause Women
Get PDFBackground: Menopausal women experience various changes, physical, psychological, and hormonal changes that cause menopausal symptoms. During menopause, women experience sleep disorders and some experience insomnia. Lifestyle changes are one way to reduce menopausal symptoms, such as physical activity. Physical activities such as yoga can stimulate a relaxation response both physically and psychologically that can reduce physical and psychological symptoms in menopausal women. The aim of this study was to examine the effect of yoga interventions on the sleep quality of menopausal women.Subjects and Method: This was a quasi-experiment with a non-equivalent control group design. The study was conducted in the Gedawang-Banyumanik area, Semarang, Central Java. A total of 22 study subjects was collected by purposive sampling. The dependent variable was the quality of sleep. The independent variable was yoga. The quality of sleep was measured using the Pittsburgh Sleep Quality Index (PSQI).Results: Poor quality of sleep score decreased by 10.73 after yoga intervention (95% CI= -4.30 to -0.26; p= 0.029).Conclusion: Yoga interventions improve the quality of sleep in menopausal women.Keywords: quality of sleep, yoga, menopausal womenCorrespondence: Yetty Dwi Fara. Midwifery Program, School of Health Polytechnics Semarang. Jl. Tirto Agung Pedalangan, Banyumanik, Semarang, Central Java, 50239. Email: [email protected]. Mobile: 085279545189.Indonesian Journal of Medicine (2019), 4(3): 278-284https://doi.org/10.26911/theijmed.2019.04.03.1