E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Traumatic Brain Injury and Covid-19
Get PDFHead trauma is a head injury caused by external forces in the head or body that results in disruption of the normal functioning of the brain. According to the CDC, deaths from head injuries were about 60,000 in 2016, and rose to more than 61,000 in 2017. The COVID-19 pandemic had caused poor non-COVID patient care, especially in low- and lower-middle-income countries with limited access to health facilities, resulting in increased morbidity and mortality, including among patients with head injuries. The purpose of this study was to understand the characteristics, duration of hospital stay, and difference of time to surgery interval in Traumatic Brain Injury patients in Dr. Hasan Sadikin General Hospital Bandung before and during the COVID-19 pandemic. This study was performed through analytical methods with a cross-sectional study design using analysis of medical records of head trauma patients treated in Dr. Hasan Sadikin General Hospital Bandung, Indonesia in the period before the pandemic (February 2018-February 2020) and during the pandemic (March 2020 - September 2021). Data analysis showed significant differences in length of hospitalization and operating intervals before and during the pandemic (p=0.04 and p=0.03), showing that there are differences in interval operation and duration of stay between patients with head trauma before the pandemic and during the pandemic
Impact of Covid-19 Pandemics on Urology Practices and Residency Training in an Indonesian Tertiary Hospital
Get PDFThe World Health Organization (WHO) declared Covid-19 as a global pandemic on March 11, 2020. Alterations in health service provisions must be applied to maintain prime services and decrease the number of healthcare workers exposure to Covid-19 by reducing the number of patients and workload, as well as cancelling elective surgeries. This study aimed to describe the urological services and residency training program during a Covid-19 year at Dr. Hasan Sadikin General Hospital, Bandung, which is a tertiary health center and teaching hospital in Indonesia. This was a comparative retrospective study conducted from January 2019 to December 2020 that compared the number of patients in inpatient and outpatient settings and emergency department, as well as surgical procedures performed before and during Covid-19 pandemic. Data were obtained from the administration department of the hospital, showing a reduction of 40,94%, 7.39%, 32.3%, and 53.89% of total inpatients, outpatients, emergency cases, and surgical procedures, respectively, in the urology department of the hospital when compared to the previous year. The number of surgeries that could be performed by residents was reduced by 30-60%. This current study showed the decreased number of patients and urological operative procedures during COVID-19 pandemic. This is assumed to give negative impacts to the urological residency training due to the limited exposure to variety of cases and surgical skill procedures
Effect of Curcumin on Nitric Oxide and Endothelin-1 Levels in L-NAME-Induced Preeclamptic Wistar Rat
Get PDFPreeclampsia is a pregnancy disorder marked by the onset of hypertension after the 20th week, posing risks such as cardiovascular disease. Curcumin, a commonly consumed herbal medicine, has been investigated as a potential antihypertensive agent in mouse models of preeclampsia. This study took place in the Bioscience Laboratory of Universitas Brawijaya from March to August 2023, employing a true experimental design with various groups of mice receiving different treatments. Nitric oxide (NO) and endothelin-1 (ET-1) levels were measured using calorimetry and ELISA. The rats were divided into five groups: positive control, negative control and P1, P2, and P3 as the treatment groups. Treatment grups received fifferent curcumin doses of 30mg/kgBW/day, 50mg/kgBW/day, and 100mg/kgBW/day for P1, P2, and P3, respectively. Data analysis using the One-Way ANOVA and Post Hoc LSD revealed that curcumin at 100mg/kgBW/day significantly increased the NO level of 47.75±22.6 and decreased the ET-1 level of 67.03±24.47 when compared to the positive control (p<0.05). However, the 30mg/kgBW/day and 50mg/kgBW/day doses did not significantly affect the NO and ET levels. In conclusion, curcumin supplementation shows positive effects on NO and ET-1 levels in L-NAME-induced preeclamptic Wistar rats, highlighting its potential as an effective intervention for managing this pregnancy-related disorder
Risk Factors and Diagnosis of Head and Neck Squamous Cell Carcinoma
Get PDFHead and Neck Squamous Cell Carcinoma (HNSCC) ranks among the seven most prevalent malignancies globally, associated with significant morbidity and mortality rates. The key risk factors for this malignancy include chronic alcohol consumption, tobacco use, immunosuppression, and infections with oncogenic viruses such as high-risk Human Papillomavirus (HPV) and Epstein-Barr Virus (EBV). This study was a retrospective analysis of HNSCC patients seen at an oncology clinic over a five-year period from January 2015 to December 2020, focusing on the environmental and genetic factors contributing to the disease. A cohort of 1,640 patients was analyzed, assessing their risk factors and diagnostic outcomes. Results indicated that smoking and alcohol consumption were the most significant independent risk factors, displaying a synergistic effect in disease progression. Other variables explored were exposure to air pollution, HPV and EBV infections, age, dietary deficiencies in vegetables, and genetic predispositions. While some factors were statistically significant, others showed weaker associations. This study highlights the importance of preventive strategies focusing on modifiable risk factors, such as lifestyle changes and viral vaccination, to reduce the incidence of HNSCC
Feasibility, Safety, and Efficacy of Segmental Spinal Anesthesia with Predominantly Isobaric Levobupivacaine: A Tertiary Care Hospital Study
Get PDFObjective: To assess feasibility, safety, and efficacy of segmental spinal anesthesia with isobaric levobupivacaine in patients undergoing various abdominal and lower limb surgeries. Methods: This was a prospective cohort study conducted at the Department of Anesthesiology and Critical Care of Kota Heart Institute and group of hospitals in India. The study involved 100 patients undergoing various abdominal and lower limb surgeries under segmental spinal anesthesia (SSA). Isobaric levobupivacaine 0.5% with fentanyl 20-25 μg or dexmedetomidine 5-10 as adjuvant or hypobaric levobupivacaine 0.167% was injected in intervertebral space depending on the surgery. Hemodynamic parameters, postoperative pain level, and adverse effects were analyzed with a p-value less than 0.05 was considered statistically significant.Results: An overall male predominance was observed with a 1:0.515 male-to-female ratio. The most affected age group was 41-50 years (37%), with a mean age of 44.51 ± 11.72 years. ASA classification indicated 34% of patients in ASA I, 40% in ASA II, 24% ASA III and 2% in ASA IV . The primary surgery was laparoscopic cholecystectomy (26%) in normal risk group and orthopedic in high-risk group(20%). Postoperative pain assessment showed mean VAS scores ranging from 1.92 to 3.42 at different time intervals. Common adverse effects were hemodynamic instability (13%), shoulder tip pain (33%), PONV (3%), headache (6%), pruritis (2%) and urinary retention (1%). The hemodynamic instability showed less incidence in ASA III/IV category.Conclusion: Segmental spinal anesthesia can be used successfully for abdominal and lower limb orthopedic surgeries in patients of ASA I to ASA IV
Serum Magnesium Levels in Patients Admitted with Septic Shock and Its Correlation with Outcome
Get PDFObjective: To evaluate the initial serum magnesium levels of critically ill septic shock patients upon admission to the intensive care unit (ICU) and correlate these levels with the patients' requirements and outcomes, including ventilator support, length of stay in the ICU, occurrence of cardiac arrhythmias, and mortality rates.Methods: This was an observational study involving 60 patients who were admitted to the medical Intensive Care Unit (ICU) for septic shock. Serum magnesium levels were measured upon admission to the ICU. A comparison was made between patients with normal and abnormal magnesium levels at the time of admission to evaluate the need for vasopressor support, the average duration of assisted ventilation and dialysis, the incidence of arrhythmia, the average length of ICU stay, and mortality rates.Results: Out of the 60 cases studied, there were 42 males (70.00%) and 18 females (30.00%), resulting in a M:F ratio of 1:0.42. The mean age of both male and female patients was found to be comparable. The need for assisted ventilation and renal replacement therapy was found to be comparable in patients with normal and abnormal serum magnesium levels. The number of days for which assisted ventilation was required, the incidence of arrhythmia, the mean duration of ICU and hospital stay, and mortality were significantly higher in patients with abnormal magnesium levels at the time of ICU admission (P<0.05).Conclusion: Abnormal serum magnesium levels are associated with increased morbidity and mortality in critically ill septic shock patients admitted to the ICU
Significant Relationship between Hypertension and Obesity among Female Patients at A Hospital in Kupang, Indonesia
Get PDFBackground: Hypertension or high blood pressure is one of the most common non-communicable diseases found nowadays, affecting 1.28 billion people worldwide and causing about 7.5 million deaths annually. Many factors contribute to hypertension, one of which is obesity. This study aimed to explore further the relationship between hypertension and obesity, especially in female patients in Kupang, Indonesia.Methods: This study was an analytical observational with a cross-sectional approach, including female patients visited the outpatient’s clinic of internal medicine at a hospital in Kupang, Indonesia from July to August 2022. A purposive sampling technique was used. Data collection used an aneroid sphygmomanometer, stethoscope, and health scale. Data analysis was performed using the Chi-Square test. The strength of the correlation was tested with the coefficient of contingency.Results: Of the 100 female patients, 28% had hypertension and 41% were obese. The majority were housewives, aged 46–66 years. Chi square test results showed a significant relationship between obesity and hypertension (p=0.006). However, the correlation test with the contingency coefficient showed a positive correlation with weak correlation (r = 0.283).Conclusions: There is a relationship between hypertension and obesity in female patients at a hospital in Kupang, Indonesia. This finding highlights the need for effective management and prevention strategies, as well as promoting healthy lifestyles
Predictive Factors of Amputation for Post-Bypass Surgery on Vascular Trauma Patients
Get PDFn Indonesia, most vascular trauma is linked to traffic collisions. According to the Statistics Indonesia (Badan Pusat Statistik, BPS), there were 116,411 accidents in 2019. Limb salvages become important in vascular trauma, which is performed through, among others, vascular bypass surgery. However, secondary amputation still occurs after vascular bypass. This study aimed to determine the predictors of secondary amputation after vascular bypass due to vascular trauma. This study used descriptive analysis of medical records and univariate analysis. Medical records of patients with vascular trauma underwent vascular bypass in Dr Soetomo Regional Hospital, Indonesia, from January 2018 to December 2020 were collected. Independent variables were age, MESS, time interval between the incident of trauma to the first incision of bypass surgery, penetrating and blunt injury, injured arterial segment, multiple injuries, and obesity. The dependent variable was secondary amputation. Fisher Exact Test was used to analyze the correlation between dependent and independent variables. Results showed a significant difference between patients with a MESS score of >7 and those with a MESS score of ≤7 (p=0.044), where more patients with a MESS score of >7 experienced secondary amputation. Other variables showed no significant difference (p>0.05). This study concluded that MESS could be used as a predictor of secondary amputation in vascular trauma after vascular bypass. Further studies using multivariate analysis and a larger sample need to be conducted to get further insights on this phenomenon
Correlation of Hepatocyte Growth Factor Levels with Myopia Degree and Axial Length in Outpatient Myopic Adolescents
Get PDFMyopia is the most common ophthalmic condition worldwide, with an estimated 22.9% of the population or 1.406 billion people affected. Studies of candidate gene-associated refraction abnormalities have also identified several genes that cause vulnerability myopia, including the hepatocyte growth factor (HGF) and hepatocyte growth factor receptor (MET) genes. The purpose of the study was to analyze the correlation between hepatocyte growth factor (HGF) levels, degrees of myopia, and long axial in adolescents with myopia treated as outpatients in Universitas Sumatera Utara Hospital. This study applied the cross-sectional analytical approach. The inclusion criterion for the participants was patients diagnosed as suffering from myopia by the Ophthalmology Outpatient Clinic of the Universitas Sumatera Utara Hospital. Sampling was performed consecutively with a minimum sample size of 25 patients in control group and 25 patients in the case group. This study revealed that the mean axial length of the right eye in the case group was 23.82 mm, with a significant difference in the axial length between the case and control groups. The mean HGF level in the myopia group was 510.49 ng/mL, which was not significantly different from the mean HGF level in the control or emmetropic group. The HGF levels were highest in the group of subjects with moderate myopia, with an average of 551.87 ng/mL, and differences in HGF levels were identified in different degrees of myopia. Thus, no significant correlation is identified between the HGF levels, axial length, and myopia degree
Shallot (Allium cepa L.) Peel Infusion Ameliorates Kidney Histopathological Damages in Diazinon-Induced Wistar Rats
Get PDFDiazinon, an organophosphate pesticide, is used extensively in agricultural sector. Consumption of agricultural products containing diazinon residue may lead to harmful health consequences. Among these is nephrotoxicity, which includes lipid peroxidation, that can damage the kidney. Flavonoids in shallot peel can scavenge free radicals, inhibit necrosis, and activate bone marrow-derived cells for cell regeneration. This study aimed to determine the correlation between shallot peel infusion (SPI) dose and kidney damage amelioration to establish the maximum effective dose of SPI to ameliorate kidney histopathological damage in diazinon-induced rats. This study was performed at the Pharmacology Laboratory, Faculty of Medicine, University of Jember, Indonesia, in April 2021, on 35 rats that were divided into 7 groups—normal, diazinon, and five treatment groups. Diazinon 40 mg/kgBW was administered on day 1-7, while SPI 125, 250, 500, 1,000, 2,000 mg/kgBW were administered on day 8–14 according to the treatment group. Kidney histopathological slides with hematoxylin-eosin (H.E.) staining were assessed using Kocoglu scoring and Kidney damage scores of the treatment groups were analyzed using Pearson test. The maximum effective dose was determined using regression test. The damages found in diazinon-induced rats were tubular degeneration, necrosis, and inflammation with a higher damage score than normal rats (p<0.05). Pearson test showed moderate correlation (coefficient -0.594). Higher SPI doses presented lower kidney damage scores, with 1,359 mg/kgBW being the maximum effective dose. SPI dose and the kidney damage amelioration are moderately correlated with a SPI maximum effective dose to ameliorate kidney damage in diazinon-induced rats of 1,359 mg/kgBW