E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Modified Surgical Treatment for Achilles Tendon Rupture Secondary to Insertional Achilles Tendinopathy Using Midline Dorsal Approach
Get PDFObjective: To assess the pain relief and functional outcomes of patients who undergo surgical management of Achilles tendon rupture secondary to insertional Achilles tendinopathy and associated conditions using a midline dorsal approach.Methods: This prospective observational study included 30 patients diagnosed with Achilles tendon rupture secondary to insertional Achilles tendinopathy. This study recorded risk factors, predisposing factors, and co-morbidities for all cases. Pain relief and functional improvement were assessed by comparing Visual Analogue Scale (VAS) scores and American Orthopedic Foot and Ankle Score (AOFAS) at the time of presentation and at the final follow-up. This study conducted statistical analysis using SPSS 21.0 software, with a significance level of p<0.05.Results: Of the participants, 17 (56.67%) were male and 13 (43.13%) were female, resulting in a male-to-female ratio of 1:0.76. The mean age of male and female patients was comparable (p=0.7515). The majority of patients (60%) were overweight, while 9 (30%) were obese, and 3 (10%) had a normal body mass index. This study observed a significant reduction in pain and functional improvement in the studied cases, as evidenced by a statistically significant reduction in VAS scores and improvements in AOFAS. Eight (26.66%) patients experienced minor complications that could be managed conservatively, but no major complications were observed.Conclusion: Modified surgical treatment of Achilles tendon rupture secondary to insertional Achilles tendinopathy using a midline dorsal approach leads to significant improvements in pain and functional outcomes, with an acceptable complication rate
Interpretation of Platelet Histograms and Its Correlation with Peripheral Smear in Data Showing Thrombocytopenia
Get PDFObjective: To analyze the significance of platelet histograms and peripheral smears in understanding thrombocytopenia and compare them for the incidence of pseudothrombocytopenia.Methods: This prospective study was conducted in the Department of Pathology at a tertiary care medical institute. The study included 200 cases of thrombocytopenia. Platelet parameters (PCT, PDW, MPV) were obtained using an autoanalyzer, and peripheral smears were examined manually. Thrombocytopenia cases were classified into hyper-destructive, hypo-productive, and abnormal pooling categories based on etiology and platelet histogram patterns. The incidence of pseudothrombocytopenia was also compared. A P value of less than 0.05 was considered statistically significant. Results: The gender distribution showed a male preponderance (56% male, 44% female). The mean age of the patients was 26.8 years. The study found hyper-destructive thrombocytopenia to be the most common type, with viral fever, sepsis, and malaria being the common etiologies for this type of thrombocytopenia. Histogram analysis revealed distinct patterns for different types of thrombocytopenia. The study also noted a higher incidence of pseudothrombocytopenia in automated analysis compared to manual methods, with a statistically significant difference.Conclusion: Platelet histograms combined with peripheral smear analysis provide crucial information about the etiology and nature of thrombocytopenia. This integrated approach enhances diagnostic accuracy and aid in effective patient management
Experiences of patients with Breast Cancer in Selecting Conventional and Complementary Therapies in Remote Areas: A Qualitative Study
Get PDFBackground: The selection of therapy is a challenging issue to overcome. The selected therapy must be based on the condition of breast cancer patients and has advantages such as increasing life expectancy, being able to overcome the symptoms and complaints of breast cancer patients and improving the quality of life. This study aimed to explore the experiences of people with breast cancer regarding the reasons for choosing therapy, namely complementary and conventional therapies.Methods: This study was qualitative research with a descriptive phenomenological study approach. Participants obtained using purposive sampling techniques were included until the data was saturated. Research data was collected through in-depth interviews conducted in a semi-structured manner. The thematic analysis used in this study consisted of several stages using the Colaizzi method.Results: This study illustrated that complementary and conventional therapies were beneficial to cancer treatment. The three themes from the analysis results included the benefits of complementary and conventional therapies, access to therapy and treatment costs. The choice of therapy depended on available access and costs for breast cancer treatment.Conclusion: People with breast cancer in remote areas choose complementary therapies, such as herbal medicine, meditation, reflexology, and acupuncture as the first choice and conventional therapies, such as surgery and chemotherapy as alternative therapies. This is because the choice of therapy also depends on the ease of access to treatment and the availability of costs for breast cancer patients
Correlation of Nutritional Status and Early Feeding with Post-Laparotomy Surgical Site Infection in Perforated Peptic Ulcer patients
Get PDFA perforated peptic ulcer is an emergency requiring immediate treatment by laparotomy. Special attention needs to be established on systemic nutritional status. The postoperative early feeding is important to patients with preoperative non optimum nutritional status. This study aimed to examine the correlation between nutritional status, early feeding, and post-laparotomy surgical site infection in perforated peptic ulcer patients. This was a prospective observational study on 32 patients with perforated peptic ulcers underwent emergency laparotomy at Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from October 2021–2022. The nutritional status was assessed using Albumin, SGA. Eleven subjects had severe hypoalbuminemia and six subjects had severe malnutrition (SGA C). Early feeding was not performed on 7 subjects. The highest surgical wound infection rate was found on the 7th day with an incidence rate of 18.8%. Among patients experiencing infection, six (6) had SGA C (p0.05). There is no association among albumin level, SGA, and early feeding in post-laparotomy wound infection in perforated peptic ulcer patients
Association Between Screen Time, Vitamin A Consumption Behavior, and Computer Vision Syndrome in Preclinical Medical Students
Get PDFComputer Visual Syndrome (CVS) refers to visual disturbances induced by electronic media such as computers, laptops, tablets, and smartphones. This research aimed to determine the association between screen time, vitamin A consumption behavior, and CVS symptoms among preclinical medical students. Ninety-five students from a single class at the Faculty of Medicine, Universitas Islam Sultan Agung, Indonesia, participated in this cross-sectional study. Data were collected using an online survey platform in February 2022. The screen time, vitamin A consumption behavior, and CVS were measured using a validated questionnaire. The average daily screen time of the respondents was more than 10 h, with the majority having a moderate vitamin A consumption patterns (66.3%) and experienced CVS (63.2%). The most prevalent CVS symptom identified among these respondents was eye fatigue (62.1%), while double vision and inflamed or watery eyes were the least reported CVS symptoms (9.5% and 8.4%, respectively). The Chi-Square test revealed that there was no correlation between screen time and CVS (p > 0.05), but there was a significant correlation between vitamin A consumption and CVS (p < 0.05). In conclusion, CVS is observed among preclinical medical students due to increased screen time and decreased vitamin A consumption. Therefore, there is a need to develop strategies to manage screen time and vitamin A consumption among students at risk for developing a CVS during their academic careers
Clinical Symptoms and Treatment Outcomes of COVID-19 Patients with Stroke
Get PDFBackground: COVID-19 patients who come to the emergency room often suffer from stroke. This study aimed to examine clinical symptoms and treatment outcomes of COVID-19 patients with stroke.Methods: This study was a retrospective study using secondary data from medical records of COVID-19 patients with stroke, hospitalized at the Universitas Kristen Indonesia Hospital, Jakarta, Indonesia for the period 2020–2022. Patients with PCR test positive for COVID-19 who had clinical symptoms of stroke, confirmed by CT scan showing brain ischemic or hemorrhage were included. Data on gender, age, Glasgow coma scale (GCS), subtype of stroke, severity of COVID-19, and outcome were recorded and analyzed using paired t-test and the Spearman correlation.Results: Of the 49 patients included, 91.8% were over 45 years old and suffered from severe COVID-19. Men were slightly more (51.1%) than women and 93.9% of patients suffered from ischemic stroke. The GCS scores of 46.9% of patients decreased significantly during hospitalization (p=0.02). Most of patients (65.3%) had used non-rebreathing mask (NRM), 10.2% ventilators, and others used nasal cannulas. As many as 46.9% of patients died, 44.9% recovered with neurological deficits, and only 8.2% recovered completely. Interestingly, oxygen delivery devices were significantly correlated with outcome (p=0.00). Patients receiving the antiviral favipiravir had better outcomes compared with those taking remdesivir (p=0.021).Conclusion: The mortality rate for stroke patients with severe COVID-19 is high, and the outcome of patients using NRM or ventilator is worse than patients using nasal cannulas. The antiviral Favipiravir has better outcomes for stroke patients with severe COVID-19
Faktor-faktor yang Mempengaruhi Pemanjangan Lama Rawat Intensif Pasien Atresia Bilier Pediatrik yang Menjalani Operasi Kasai di RSUP Dr Sardjito
Get PDFAtresia bilier merupakan kelainan pada neonatus yang menyebabkan gagal hepar progresif dan kematian bila tidak ditangani. Operasi Kasai merupakan penanganan atresia bilier melalui pembuatan anastomosis untuk drainase empedu. Pemanjangan lama rawat pascaoperasi Kasai meningkatkan morbiditas dan mortalitas. Penelitian ini bertujuan menemukan faktor-faktor yang memengaruhi pemanjangan lama rawat intensif pascaoperasi Kasai. Penelitian ini merupakan studi observasional kohort retrospektif pada pemanjangan lama rawat intensif pasien atresia bilier pediatrik yang menjalani operasi Kasai di RSUP Dr. Sardjito dari 1 Januari 2017 hingga 31 Desember 2021. Terdapat 33 dari 52 sampel (64%) mengalami pemanjangan lama rawat intensif. Uji statistik dilakukan dengan uji regresi logistik univariat dan uji regresi logistik multivariat bagi parameter yang signifikan pada uji sebelumnya (p<0,25). Didapatkan sepsis (OR=39,2) dan malnutrisi (OR=7,55) signifikan memengaruhi pemanjangan lama rawat intensif pascaoperasi Kasai. Simpulan, Sepsis dan malnutrisi signifikan memengaruhi pemanjangan lama rawat intensif pasien atresia bilier pediatrik yang menjalani operasi Kasai masing-masing sebanyak 39 dan 7,5 kali. Atresia bilier merupakan kelainan pada neonatal yang menyebabkan gagal hepar progresif dan kematian bila tidak ditangani. Operasi Kasai merupakan penanganan atresia bilier melalui pembuatan anastomosis untuk drainase empedu. Pemanjangan lama rawat paska operasi Kasai meningkatkan morbiditas dan mortalitas. Penelitian ini merupakan studi observasional kohort retrospektif pada pemanjangan lama rawat intensif pasien atresia bilier pediatrik yang menjalani operasi Kasai di RSUP Dr. Sardjito dari 1 Januari 2017 hingga 31 Desember 2021. Pengujian statistik dilakukan dengan Chi-square dan Fischer exact test, dilanjutkan dengan uji regresi logistik multivariabel. Didapatkan 33 dari 52 sampel (63,46%) mengalami pemanjangan lama rawat intensif. Dari hasil uji multivariabel, didapatkan sepsis (OR = 39,2) dan malnutrisi (OR = 7,55) signifikan mempengaruhi pemanjangan lama rawat intensif paska operasi Kasai. Sepsis dan malnutrisi signifikan mempengaruhi pemanjangan lama rawat intensif pasien atresia bilier pediatrik yang menjalani operasi Kasai masing-masing sebanyak 39 dan 7,5 kali.
Comparison of Different Cycloplegic Refraction Regimens for Children
Get PDFIn the process of a pediatric eye exam, cycloplegic refraction is a crucial step. Since no single cycloplegic drug is ideal, a combination regimen is employed. This study compares the ocular (refractive power and pupil diameter) and systemic (blood pressure and heart rate) effects of administering a combination of 1% cyclopentolate and 2.5% phenylephrine, with or without 1% tropicamide, to children with refractive errors. This study aimed to discover a more feasible regimen for children. This was a single-blind study, a randomized clinical trial conducted from November–December 2020 in children with mild to moderate refractive errors. Group A received 1% cyclopentolate, 2.5% phenylephrine, and 1% tropicamide (SFT), whereas group B received 1% cyclopentolate and 2.5% phenylephrine (SF). The outcomes were measured using an auto refractometer and IOL Master® 700. Before and 60 minutes after medication was administered, blood pressure and heart rate were measured. There were 54 participants (108 eyes) with an average age of 12.85± 2.84 years. Although the SFT group's refractive power and pupil width were greater than those of the SF group, the differences were not statistically significant (p=0.271 and p=0.088). Heart rate (p=0.521) and blood pressure (systolic p=0.201; diastolic p=0.950) did not significantly differ between the two groups. Despite mydriasis manifested more rapidly in the SFT group, there was no discernible difference in the cycloplegic effects between those groups. SF might be a more feasible regimen for cycloplegic refraction in children with refractive errors
Antioxidant and Antiaging Properties of Ethanolic Ripe Sesoot Fruit Extract
Get PDFSkin aging can be characterized by changes in skin, such as the appearance of wrinkles and loss of skin moisture. Some elements that might lead to cell damages and aging are free radicals through the increase of the activities of hyaluronidase and tyrosinase. Bioactive compounds found in sesoot (Garcinia picrorhiza Miq.) are known for their antioxidant properties, which may reduce excessive amounts of free radicals in the body and act as an antiaging agent by inhibiting hyaluronidase and tyrosinase activities. This study aimed to examine the antioxidant, anti-hyaluronidase, and anti-tyrosinase properties found in Ethanolic Extract Ripe Sesoot (EERS). The ethanol extract of ripe sesoot fruit obtained from LIPI, Bogor Botanical Garden was used for the antioxidant and antiaging assays conducted at PT Aretha Medika Utama in December 2016. The activity of antioxidants was measured as the Ferric Reducing Antioxidant Power (FRAP) of the EERS, while the antiaging assays were performed through the inhibition activity of hyaluronidase and tyrosinase. Results indicated that the EERS has a higher FRAP activity (17.58 μM Fe (II)/μg) than xanthone (2.54 μM Fe (II)/μg) at the highest concentration of sample of 5,000 µg/mL. The anti-hyaluronidase of the EERS exhibited lower activity (IC50 of 619.21±12.15 µg/mL) than xanthone (IC50 of 365.55±25.10 µg/mL) and the tyrosinase inhibitory assay demonstrated a lower activity of EERS (IC50 of 1060.68±12.81 µg/mL) compared to xanthone (IC50 of 218.33±9.73 µg/mL). To conclude, EERS shows antioxidant and antiaging properties
Lactic Acid Level as A Predictor of Severity in Patients with Acute Appendicitis
Get PDFPerforated appendicitis is the leading cause of morbidity and mortality of all appendicitis cases in adults and children, with delayed preoperative diagnosis as the main reason. In previous studies, diagnostic modalities such as radiological examination and the current scoring system have been demonstrated as unable to predict the onset of perforated appendicitis. Serological biomarkers of lactic acid are associated with intestinal obstruction and ischemia. The serological value of lactic acid in identifying perforated appendicitis compared to acute one was shown to increase significantly by 0.25 mmol/L (p<0.05) in a previous study. This study aimed to determine the correlation between lactic acid and the severity of appendicitis. This was a cross-sectional prospective analytic observational study in patients treated in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Subjects were adult patients diagnosed with appendicitis during the period of 2021 in the Emergency Room of the hospital. Data were analyzed using the bivariate analysis and correlation test of difference. This study involved 54 subjects, divided into the complicated appendicitis (study) and control groups, with a mean of lactic acid level of 2,5093 mmol/L (0.9 mmol/L–11.8 mmol/L). In the complicated appendicitis group, 20 subjects (37%) demonstrated an increase in lactic acid level (OR 1.07; 95% CI: -0.03–0.22; p=0.14). The correlation analysis resulted in a negative correlation. This study concluded that there is no significant correlation between lactic acid levels and the severity of appendicitis in these patients