E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Role of Ultrasound Imaging in Children with Dengue Fever: A Retrospective Study
Get PDFObjective: To study ultrasound findings of children with dengue and analyze the possible correlation between ultrasound findings and severity of dengue in children.Methods: This retrospective study, which was conducted over one year, analyzed 50 pediatric dengue patients. Ultrasound findings such as gallbladder wall edema, pleural effusion and ascites were assessed. Cases were categorized into dengue without warning signs, dengue with warning signs, and severe dengue according to the World Health Organization's classification of dengue. Correlation between ultrasound abnormalities, severity of dengue, and thrombocytopenia were analyses. A p-value of less than 0.05 was taken as statistically significant.Results: Of 50 pediatric patients diagnosed with dengue participated in this study, 72% were boys, and 28% were girls with a male-to-female ratio of 1:0.38. Fever was the most frequent symptom (100%), followed by nausea/vomiting (84%) and body ache/myalgia (78%). Ultrasound findings revealed that gallbladder wall edema (48%), pleural effusion (44%), and ascites (50%) were significantly associated with severe dengue and dengue with warning signs (p<0.001). Thrombocytopenia was documented in 58% of cases and correlated significantly with ultrasound abnormalities such as gallbladder wall edema, ascites, and pleural effusion (p=0.0017).Conclusion: Ultrasound findings, such as gallbladder wall edema, pleural effusion and ascites, are significantly associated with severe dengue and dengue with warning signs. These features aid in early identification of high-risk patients
Factors affecting Umbilical Cord Vitamin D Concentration and Its Association with Maternal Vitamin D Level
Get PDFObjective: To analyze factors affecting maternal and umbilical cord levels of vitamin D and to understand the correlation between maternal and umbilical cord vitamin D levels.Methods: This was a cross-sectional study conducted at the department of pediatrics of Dr. D. Y. Patil Medical College and Research Centre, Pune, India. Maternal and umbilical cord vitamin D levels were examined in 300 pairs of mother and child over a period of two years. Informed consent was obtained from all participants. The vitamin D level was measured using chemiluminescent immunoassay and classified as either deficient, insufficient or adequate depending on specific cut-offs. Correlations between maternal and neonatal vitamin D levels and demographic factors like religion, socioeconomic status, and sun exposure were also exlored. Statistical tests were performed using the SPSS 21.0 software, with p<0.05 deemed P-valueas significant.Results: There was significantly high prevalence of vitamin D deficiency in neonates, (78.67%). Key factors influencing maternal vitamin D levels were religion (p=0.027), maternal education (p=0.003), gravida status (p=0.035), and sunlight exposure, with sunlight exposure showing a very strong correlation to the deficiency (p<0.001). Moreover, maternal serum calcium levels significantly affected vitamin D status (p<0.001). A significant association was observed between maternal and cord blood vitamin D levels, with the maternal vitamin D level strongly predicted vitamin D status in neonates (p<0.001).Conclusion: The umbilical cord vitamin D level strongly correlates with the maternal vitamin D level, which is significantly affected by maternal education, residence, pregnancy status, gestational age, and sun exposure
Differences in Elastin and Collagen Levels in the Levator Ani Muscle of Primiparous and Multiparous Normal Postpartum Women
Get PDFThe levator ani, comprising the pubococcygeus, puborectalis, and iliococcygeus muscles, is crucial for supporting pelvic organs, maintaining continence, and ensuring pelvic stability. Weaknesses in these muscles or ligaments can lead to pelvic organ prolapse (POP), a condition where the pelvic organs descend and protrude through the vaginal introitus. Collagen and elastin, the key constituents of the extracellular matrix in the levator ani muscle, play a significant role in maintaining its structural integrity and can be influenced by parity. This study aimed to determine the differences in elastin and collagen levels of the levator ani muscle of primiparous and multiparous patients. This was an observational analytical study on 18 postpartum female patients consisting of 9 primiparous and 9 multiparous in January-March 2023. Samples were levator ani muscle biopsies from perineal lacerations of at least grade II from the inpatient Obgyn Department of the Faculty of Medicine, Universitas Brawijaya. Examination was done using the immunohistochemical method. Results showed that the percentage of histological area secreting elastin and collagen was higher in the primiparous group than multiparous, thus the levels were higher (p<0.001; p=0.001; p<0.05). In conclusion, elastin and collagen levels were lower in multiparous women compared to primiparous women. Future studies can evaluate factors affecting the decline in elastin and collagen in multiparous women using a larger sample size
Effectivity of Carrot (Daucus carota) Seed Oil as Hair Growth Promoter on Rats (Rattus novergicus)
Get PDFHair quality and health are important not only for the esthetical reasons but also to maintained the hair’s function in protecting the head. Carrot seed oil (CSO) is rich in vitamin A and beta-carotene, which influence hair quality. CSO also contains carotol, which has anti-fungal properties that treat dandruff. This research aimed to observe the potential of CSO as a hair growth promoter. Twenty male rats were used in the study, with their backs shaved and divided into two areas, each with different frequencies of CSO application. The backs of the rats were given CSO every day for 14 consecutive days with different concentrations, i.e., 25%, 50%, and 75%. Hair growth was assessed based on its length, root, shaft, and tip thickness on days 9,12, and 14 and the results were recorded. On day 15, the rats were euthanized and their skin was collected to observe the number of follicles. Results showed that the application of CSO with different concentrations had no effect on hair length growth but it did affect the thickness of the root, shaft, and tip of the hair, with the best concentration being 75%. The frequency of application did not seem to affect the growth in terms of the length or thickness of the root, shaft, and tip of the hair; however, the application of CSO with 75% concentration and an application frequency of once a day produced the best amount of follicle regeneration
Difference of Neutrophil-to-Lymphocyte Ratio, Monocyte-to-Lymphocyte Ratio, and Platelet-to-Lymphocyte Ratio in Patients with Non-Hodgkin and Hodgkin Lymphoma
Get PDFBackground: Malignancy and inflammation are strongly connected. The inflammatory processes play a significant part in the development of lymphoma. Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) can be used as potential biomarkers of inflammation in lymphoma. This study aimed to discover the differences between NLR, MLR, and PLR in patients diagnosed with non-Hodgkin lymphoma (NHL), and Hodgkin lymphoma (HL). Methods: This study employed a retrospective design using data from the lymphoma registry at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia from 2020 to 2023. Sampling was carried out consecutively. Hematological data of patients with NHL and HL before chemotherapy were collected. The variance between the two groups was examined utilizing the Mann-Whitney U test.Results: In total, 122 data of patients were included, consisting of 75% NHL patients and 25% HL patients with a median age of 54 years (IQR 43–62). The overall NLR, MLR, and PLR tended to be lower in nHL than in HL patients although the differences were not statistically significant; with NLR 2.7 (0.7 – 12.2) vs. 3.2 (1.1 – 10.8) p=0.287, MLR 0.36 (0.04 – 1.86) vs. 0.46 (0.09 – 1.78) p=0.150, and PLR was 160.6 (20.2 – 1533.3) vs. 211.2 (50.6–1156.3) p=0.189, for NHL and HL, respectively.Conclusion: The lower values of NLR, MLR, and PLR in NHL indicate lower systemic inflammatory status in NHL than HL patients. Further studies are needed to evaluate dynamic changes of these biomarkers during treatment
Prevalence and Resistance Patterns of Candida albicans in Diabetic and Non-Diabetic Patients with Urinary Tract Infections
Get PDFBackground: Candida spp. is an opportunistic fungi genus that can turn into pathogens, especially in those with inadequate immune response such as in patients with diabetes mellitus (DM), of which Candida albicans is the most common species. This study aimed to determine the prevalence and antifungal resistance patterns of Candida albicans in DM and non-DM patients with urinary tract infections (UTIs).Methods: A retrospective descriptive observational study was conducted in 2023 using medical record data of DM and non-DM patients with UTIs who were treated at a tertiary hospital in Bandung, Indonesia from July 2019 to December 2021. Data on patient characteristics, proportion of fungal species causing UTI, and antifungal resistance patterns of Candida albicans were analyzed using Microsoft Excel 2019 and presented in tabular form and chart.Results: Of a total 291 patient data, 21 were DM patients and 270 were non-DM patients, mostly were female, 71.4% and 58.2%, respectively. The prevalence of Candida albicans in DM patients was 66.7% and in non-DM patients was 70.7%, mostly resistant to micafungin (7.1% and 8.9%, respectively).Conclusion: Female is more susceptible to UTIs. More than half of DM and non-DM patients with UTIs are infected with Candida albicans, and mostly resistant to micafungin. Antifungal treatment guidelines based on resistance patterns and education on personal hygiene to prevent UTIs are recommended
Clinical Profiles of Obstructive Hydrocephalus in Patient with Von Hippel–Lindau
Get PDFVon-Hippel-Lindau (VHL) is an autosomal dominant disease that affects multiple systems that may result in benign and malignant multisystem tumors. The estimated incidence of VHL is 1 in 36,000 births. Disease incidence ranges from 10 to 40 years, with an average of 26 years, and it impacts diverse ethnic groups. VHL results from mutations in the germ line that have been mapped to chromosome 3P25. Currently, this is the only gene known to cause the syndrome. This study presented a case of obstructive hydrocephalus in a patient with VHL. A 19-year-old female was referred to the Eye Clinic for a diagnosis of papilledema. She began to experience vagal abdominal discomfort for no apparent reason. Per exam, the patient had 20/20 OD and 20/400 OS, with an intraocular pressure of 14 OU. The patient's MRI revealed a posterior fossa cranial cystic brain lesion that was obstructing the fourth ventricle and causing obstructive hydrocephalus. Early detection, management, and focal laser treatment of capillary hemangiomas in the retina's periphery led to favorable visual outcomes. Even after vitreoretinal surgery, the tumors may cause exudative retinal detachment and have an inferior visual prognosis if left untreated
Antioxidant and Antimicrobial Potential of Sappan Wood Extract against Porphyromonas gingivalis
Get PDFGingivitis inflammation triggered by microbial biofilms is one of the detrimental causes of periodontal diseases. When a periodontal disease occurs, tooth decay becomes inevitable, and can pose a serious threat to oral health, requiring appropriate treatment. Inflammation in periodontitis is mainly caused by oxidative stress; hence, antimicrobial and antioxidant-based therapies are suggested for periodontitis. Sappan wood is well-known for its brazilin compounds, which have the potential as herbal medicines and antibacterial agents to fight oral pathogens with minimal side effects. This study aimed to examine the antimicrobial and antioxidant activities of sappan wood extract (SE) as a candidate agent for preventing periodontal diseases. This study was conducted at Maranatha Christian University, Sekolah Tinggi Farmasi Indonesia, and Aretha Medika Utama from January-April 2023. The sappan wood was extracted using ethanol 96% and the antimicrobial evaluation was done by calculating the total colony of P. gingivalis while the antioxidant activity was evaluated by ABTS, H2O2, and FRAP Assays. This study revealed that SE was significantly effective in reducing the total colony of P. gingivalis up to 0 CFU/mL. The highest antioxidant activity of SE was found in 100 µg/mL with IC50 19.06 µg/mL for ABTS, 90.99 µg/mL for H2O2, and 564 µM Fe (II) for FRAP. Thus, SE presents its strong antimicrobial and antioxidant activity potentials by in vitro evaluation that could be analyzed further for its utilization as a periodontal-preventing agent. This study also provides basic information for future implication of sappan wood extract as ingredients for dental care products
Subclinical Left Ventricular Dysfunction Prevention in Breast Cancer Patients after FAC Chemotherapy: A Carvedilol Trial
Get PDFObjective: To assess the cardioprotective effects of Carvedilol in preventing subclinical left ventricular dysfunction (SLVD) in breast cancer patients after completing FAC chemotherapy.Methods: This prospective study employed a quasi-experimental clinical trial conducted from September 2018 to May 2019. Breast cancer patients receiving FAC chemotherapy were divided into two groups: intervention (IG) and control (CG). The IG received Carvedilol 6.25 mg b.i.d., which was increased every three weeks until reaching a tolerated dose. The study evaluated changes in left ventricular global longitudinal strain (GLS) and the incidence of SLVD (GLS reduction ≥15% and GLS >-18%) 24 weeks after initiating the FAC regimen.Result: Of the 81 women enrolled in the study, 31 were in the IG. No significant changes in GLS were observed during or after completing FAC chemotherapy in the IG, whereas the CG showed contradictory results. At the end of the follow-up period, the delta GLS reduction was lower in the IG (0.7; 95% CI -0.60, 3.60) compared to the CG (3.00; 95% CI -2.16, 4.19), with a p-value of 0.035. Similarly, the percentage reduction in GLS was 3.6% in the IG and 14.29% in the CG, resulting in a p-value of 0.05. The incidence rate of SLVD (GLS reduction ≥15% and GLS > -18%) was lower in the IG (41.9% and 25.8%) than in the CG (58% and 48%).Conclusion: Carvedilol may have a cardioprotective effect in preventing the incidence of SLVD, as evaluated by GLS reduction and changes, in women with breast cancer after completing a full cycle of the FAC regimen
Manajemen Perioperatif Pasien Atrial Septal Defect (ASD) dengan Hipertensi Pulmonal yang Menjalani Operasi Tutup Defek
No full textAtrial septal defect (ASD) kompleks yang tidak didiagnosis dan dikoreksi hingga usia dewasa dapat menyebabkan hipertensi pulmonal. Manajemen perioperatif operasi penutupan defek pasien ASD dewasa dengan hipertensi pulmonal memberikan tantangan tersendiri karena dikaitkan dengan tingginya komplikasi perioperatif serta peningkatan morbiditas dan mortalitas. Kami melaporkan seorang wanita berusia 23 tahun dengan ASD dan hipertensi pulmonal yang menjalani operasi tutup defek. Pemeriksaan ekokardiografi praoperasi menunjukkan ASD sekundum right-to-left shunt dengan diameter 25–30 mm dan kateterisasi jantung kanan yang menunjukkan rerata tekanan arteri pulmonal 58 mmHg dan pulmonary vascular resistance 8,1 WU. Induksi anestesi dilakukan dengan balanced opioid, dosis kecil agen induksi, dan pelumpuh otot. Hemodinamik selama operasi stabil, dan periode penyapihan cardiopulmonary bypass berjalan lancar dengan topangan dobutamin dan norepinefrin. Pascaoperasi, pasien dirawat di Intensive Care Unit dengan keadaan umum baik, hemodinamik stabil, nyeri pascaoperasi terkontrol dan tanpa kejadian komplikasi. Penilaian praoperatif yang tepat, manajemen intraoperatif yang berhasil menjaga stabilitas hemodinamik, dan manajemen pascaoperatif yang dapat mencegah dan mengatasi komplikasi pascaoperasi dapat menghasilkan luaran yang baik pada pasien ini.Atrial septal defect (ASD) jenis berat yang tidak didiagnosis dan dikoreksi sampai usia dewasa dapat menyebabkan hipertensi pulmonal. Manajemen perioperatif pada pasien ASD dengan hipertensi pulmonal merupakan tantangan tersendiri karena dikaitkan dengan tingginya komplikasi perioperatif serta peningkatan morbiditas dan mortalitas. Kami melaporkan seorang wanita berusia 23 tahun dengan ASD dan hipertensi pulmonal yang menjalani operasi tutup defek. Pemeriksaan echocardiography praoperasi menunjukkan ASD sekundum right to left shunt diameter 25-30 mm dan kateterisasi jantung kanan yang menunjukkan tekanan rerata arteri pulmonal 58 mmHg dan Pulmonary Vascular Resistance 8,1 WU. Induksi anestesi dilakukan dengan teknik balans opioid, dosis kecil agen induksi, dan pelumpuh otot. Hemodinamik selama operasi stabil dan periode penyapihan Cardiopulmonary Bypass berjalan lancar dengan topangan dobutamin dan norepinefrin. Pascaoperasi, pasien dirawat di Intensive Care Unit dengan keadaan umum baik, hemodinamik stabil, nyeri pascaoperasi terkontrol dan tanpa kejadian komplikasi. Pasien dipindah ke bangsal biasa pada hari ke-3 pascaoperasi. Penilaian praoperatif yang tepat, manajemen intraoperatif yang berhasil menjaga stabilitas hemodinamik, dan manajemen pascaoperatif yang dapat mencegah dan mengatasi komplikasi pascaoperasi dapat menghasilkan luaran pasien yang baik pada pasien ini