E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Impact of First Eye Cataract Surgery on Quality of Life
Get PDFCataracts are the second leading cause of visual impairment and the first cause of blindness, both globally and Indonesia. Cataracts do not only reduce vision but also the quality of life of the patients. Cataract surgery of at least one eye is expected to improve the patient's visual function and quality of life. This study aimed to assess the quality of life of patients with bilateral senile cataracts after the first eye surgery compared to people with normal vision. This was a cross-sectional study on 75 patients who underwent their first eye cataract surgery at the Cataract and Refractive Surgery Unit and 75 people with normal vision who visited the Refraction, Contact Lens, and Low Vision Unit of the National Eye Center of Cicendo Eye Hospital during the period of March-June 2020. The quality of life assessment was conducted through interviews using the National Eye Institute Visual Function Questionnaire-25. The non-inferiority test with a margin of 20% was performed. The mean age of the subjects was 63.49 years with no difference in the proportion of gender. Presenting visual acuity of binoculars after the first cataract surgery was 0.26 LogMAR and normal vision was 0.07 LogMAR. With a margin of 20%, the patient's quality of life after the first cataract surgery was not inferior to the normal vision subjects (d = -2.45% (95% CI -6.3% to 1.4%).) Hence, patients' quality of life after the first cataract surgery is not inferior to those with normal vision
Ajwa Date (Phoenix dactylifera L.) Extract to Prevent Alzheimer’s Disease in Rat Model
Get PDFAlzheimer's disease (AD) is the most common disease of aging characterized by increased extracellular deposits of amyloid-β (Aβ) in the brain. Globally, the number of people affected by AD has increased from 35.6 million in 2010 to 46.8 million in 2015. Ajwa dates contain phenolic compounds that can protect against inflammation and oxidative stress in the brain. This study aimed to analyze the effect of the dose and duration of Ajwa date extract administration on IL-6 levels and SOD activity in rats induced with 400 mg/day homocysteine to trigger Alzheimer's Disease. This was a laboratory experimental study with a pretest-posttest group design conducted at the Laboratory of the Center for Food and Nutrition Studies (PSPG), Universitas Gadjah Mada, Yogyakarta, Indonesia from December 2020 - January 2021. A total of 48 rats were divided into one control group, one untreated group, and 4 treatment groups that received different doses of Ajwa Date Extract (ADE) for 21 and 28 days in rats. The results showed that the administration of ADE (Ajwa date extract) for 21 and 28 days could reduce IL-6 levels but did not have the same effectiveness as donepezil. The administration of 800 mg/kg BW ADE for 28 days can increase SOD activities with the same effectiveness as donepezil. Ajwa date extract can be proven to have beneficial effects to prevent Alzheimer's disease and can be used to prevent decreased antioxidant and increased inflammation. Thus, further studies to explore the potential clinical use of the extract to manage Alzheimer's Disease may be beneficial
Characteristics of Nasal Foreign Body Cases in Dr. Hasan Sadikin General Hospital Bandung
Get PDFBackground: Nasal foreign bodies are caused by the insertion of an extraneous substance into the nasal cavity. These cases frequently occur in children. Nasal foreign bodies are easily diagnosed, yet the treatment may be burdensome with possible complications and costly management. The study aimed to evaluate the characteristics of nasal foreign body cases.Methods: The study was descriptive and cross-sectional, using secondary data taken from all medical records of the Emergency Room in Dr. Hasan Sadikin General Hospital, Bandung, from 2018 to 2021. Data were presented in tables.Results: Of the 57 cases, most of the patients (64.9%) were aged 3-5 years, with boys as the most prevalent cases (59.7%) and the most common complaint was pain (31.7%). Inorganic foreign bodies (61.4%) were more commonly found, and being frequently found in the right nasal cavity (49.1%). The duration of the foreign body in the nasal cavity and the treatment conducted on the patients were mostly not written in the medical records, however, no complications were found.Conclusions: A higher incidence of nasal foreign bodies can be found in boys aged 3-5 years. Inorganic objects and pain are the most common manifestations, although the condition of all patients has been improved. Raising awareness about foreign body cases to the community, especially the parents, is the key to preventing these cases from occurring
Impact of Severe Preeclampsia on the Incidence of Low-Birth-Weight Babies
Get PDFInfant birth weight is an important indicator of survival, growth potential, and developmental capacity. Maternal health plays an important role in determining the well-being of newborns. A complicated pregnancy, inclusive of conditions such as preeclampsia, elevates the risk of giving birth to a low birth weight (LBW) baby. This study aimed to compare the impact of severe preeclampsia on the incidence of LBW babies in Dr. Dradjat Prawiranegara General Hospital Serang, Indonesia. This case-control analysis included 148 parturients recruited randomly from June to October 2022. Logistic regression was used as the analytical tool, with P=0.000 considered as demonstrating a significant association. The incidence rates of LBW and severe preeclampsia in 2018 were 19.84% and 14.15%, respectively. The case group recorded LBW within the weight range of 1,000-2,450 g, with 38% of them were Small for Gestation Age (SGA), while 50% and 12% were Appropriate for Gestational Age (AGA), and Large for Gestational Age (LGA), respectively. In contrast, the control group, with birth weights ranging from 2,600-4,500 g, 13.50% were SGA, while 77% and 9.50% were AGA and LGA, respectively. Parity was a confounding factor influencing the incidence of LBW, while maternal age did not present a significant correlation. Pregnancies with severe preeclampsia were found to have a 29-fold increased likelihood of delivering LBW babies compared to the control group when controlling for parity (P=0.000, CI 95%). Hence, women with severe preeclampsia pregnancies have a higher risk for delivering LBW babies of 29 times higher than the control
Pengaruh Remifentanil Vs Fentanyl Terhadap Hemodinamik dan Kadar Kortisol Pada Pasien Dengan Ventilasi Mekanis Di Ruang Rawat Intensif
Get PDFNyeri pascaventilasi mekanik membutuhkan analgosedasi untuk tata laksana nyeri, namun belum ada rekomendasi pasti penggunaan opioid dan perubahan fisiologis spesifik berdampak langsung pada farmakologi obat yang menyebabkan perbedaan respons antarpasien. Penelitian eksperimental secara double blind randomized control trial (RCT) pada 32 pasien dengan status fisik ASA I–II, usia 18–70 tahun, terventilator dengan durasi 24 jam pascaoperasi tiroid di Intensive Care Unit (ICU) RSUP Dr. Wahidin Sudirohusodo Makassar pada bulan Juni–Agustus 2023. Pasien dibagi dalam kelompok analgosedasia remifentanil dan kelompok analgosedasia Fentanil. Respons hemodinamik, dan kadar kortisol dicatat dan dilakukan uji statistik dengan student t-test dan chi-kuadrat. Dari hasil penelitian didapatkan bahwa kelompok remifentanil menunjukkan perubahan tekanan darah sistole, diastole, rerata tekanan arteri serta denyut jantung yang lebih stabil daripada fentanil. Penggunaan fentanil menunjukkan penurunan kadar kortisol dalam 24 jam yang lebih tinggi daripada penggunaan remifentanil (p<0,05), tetapi kadar kortisol serum dalam 24 jam lebih rendah pada kelompok remifentanil dibanding dengan kelompok fentanil. Simpulan, remifentanil lebih mempertahankan stabilitas hemodinamik dan memberikan kadar kortisol serum yang lebih rendah pada pasien yang terventilasi mekanik. Nyeri pasca ventilasi mekanik membutuhkan analgosedasi untuk tatalaksana nyeri, namun belum ada rekomendasi pasti tentang penggunaan opioid dan perubahan fisiologis spesifik berdampak langsung pada farmakologi obat yang menyebabkan perbedaan respons antar pasien. Penelitian eksperimental secara double blind randomized control trial (RCT) pada 32 pasien dengan status fisik ASA I–II, usia 18–70 tahun, terventilator dengan durasi 24 jam post operasi tyroid di Intensive Care Unit (ICU) RSUP Dr. Wahidin Sudirohusodo Makassar pada bulan Juni sampai Agustus 2023. Pasien dibagi dalam kelompok analgosedasia Remifentanil dan kelompok analgosedasia Fentanyl. Respon hemodinamik, dan kadar kortisol dicatat dan dilakukan uji statistik dengan student t-test dan chi-kuadrat. Dari hasil penelitian didapatkan bahwa kelompok Remifentanil menunjukkan perubahan tekanan darah sistol, diastol, rerata tekanan arteri, denyut jantung, frekuensi pernapasan dan suhu tubuh yang lebih stabil daripada Fentanyl. Penggunaan Fentanyl menunjukkan penurunan kadar kortisol yang lebih tinggi daripada penggunaan Remifentanil (p < 0,05).. Simpulan bahwa Remifentanil lebih mempertahankan stabilitas hemodinamik dan memberikan kadar kortisol serum yang lebih rendah pada pasien yang terventilasi mekanik
Effectiveness of WHO Stress Management for Improving Insomnia Severity Index Score in Telegram’s Self-Isolated Online Group Population
Get PDFInsomnia is one of the various symptoms frequently found in patients with post-covid syndrome (PCS) (19.1%). The WHO Stress Management (WSM) is an eclectic psychotherapy that combines mindfulness and relaxation which, theoretically, can be effective in treating insomnia due to PCS. This study aimed to explore the effectiveness of WSM in improving the Insomnia Severity Index Score for people with PCS. This was a quasi-experimental pre-test-post-test control study on 18 participants in the population of online self-isolation group in the Telegram who experienced insomnia. The intervention applied was WSM. These participants were compared to 18 controls who only received psychoeducation. Clinical insomnia symptoms were examined using the Insomnia Severity Index (ISI) before the intervention, then the control group was given sleep hygiene psychoeducation, and the treatment group was given WSM in 5 Zoom on-cam meetings once a week for 30-60 minutes. A re-assessment using the ISI post-test was then performed, and data were analyzed statistically. There was a change in score for insomnia symptoms in the treatment group (delta score 27.50) compared to the control group (delta score 9.50, p=0.00; OR 0.00, p=0,99, 95% CI). Thus, WSM can improve the insomnia score in the population with PCS
Comparison of Several Indonesian Medicinal Plants Effects on LDL-C and IL-6 Levels in Wistar Rats After High Fat Feeding
Get PDFHigh-fat diet habits lead to an increase in LDL-C levels that eventually influence the atherosclerotic plaque formation and progression, causing coronary heart disease. Atherosclerosis is a chronic inflammatory process that releases various pro-inflammatory cytokines, including IL-6. Indonesians often use medicinal plants to decrease cholesterol levels. This study aimed to compare the LDL-C and IL-6 levels after treatments of ethanol extracts from Java ginger (EEJG), turmeric (EET), garlic (EEG), and pomegranate flowers (EEPF) in a hypercholesterolemia animal model. This study was conducted at the Maranatha Biomedical Research Laboratory from June–December 2020. Male Wistar rats were divided into six groups (n=5 per group) and received high-fat feeding and 0.01% propylthiouracil. The following treatments were given for 28 days: oral carboxymethylcellulose 1% for negative control; 35 mg/200g of oral EEJG, EET, EEG, EEPF for respective treatment groups (n=5 groups); and 0.36 mg/200 g of oral Rosuvastatin for positive control. It was demonstrated that the mean LDL-C levels were 65.75 mg/dL, 55.25 mg/dL, 56.75 mg/dL, and 59.60 mg/dL for EEJG, EET, EEG, EEPF groups, respectively, which were significantly different from that of the negative control (81.73 mg/dL). The IL-6 levels of the EEJG (27.55 pg./mL) and EEG (27.54 pg./mL) group were significantly different from the EEPF group (24.5 pg./mL) but not significantly different from the negative control (25.58 pg./mL), EET (25.60 pg./mL), and rosuvastatin (26.09 pg./mL) groups. The administration of ethanol extracts of Java ginger, turmeric, garlic, and pomegranate flower decreases the C-LDL levels; however, only the ethanol extract of pomegranate flowers administered for 28 days decreases the IL-6 levels of Wistar rat hypercholesterolemia model, albeit insignificantly
PERBANDINGAN EFIKASI MGSO4 DENGAN KETAMIN SEBAGAI ADJUVAN MULTIMODAL ANALGESIA PASKA OPERASI SEKSIO SESARIA
Get PDFNyeri perut pascaseksio sesaria tampaknya menjadi masalah yang signifikan, namun cukup bervariasi, berbagai modalitas analgesia diketahui dapat digunakan sebagai analgesia pascaoperasi. Salah satunya adalah ketamin dan magnesium sulfat yang sering digunakan sebagai tambahan untuk analgesik pascaoperasi. Penelitian ini merupakan studi randomized control trial (RCT) dilakukan selama Agustus–September 2023. Sampel merupakan pasien hamil yang akan menjalani pembedahan seksio sesaria dalam anetesi spinal. Penelitian dibagi menjadi 3 kelompok, MgSO4, ketamin, dan kontrol. Pada periode pascaoperasi, kelompok MgSO4 diberikan infus MgSO4 20 mg/kg/jam, kelompok ketamin menerima infus ketamine 0,2 mg/kg/jam selama 12 jam. Lalu, dilakukan penilaian skala nyeri pascaoperasi Penelitian terdiri dari 30 sampel, yaitu 10 sampel setiap kelompok. Berdasarkan skala nyeri istirahat dan aktivitas didapatkan perbedaan bermakna secara statistik pada pemantauan jam ke-12 dan jam ke-24, p0,05. Didapatkan 2 kejadian sedasi pada perlakuan ketamin dan 8 sampel memerlukan rescue opioid. Terdapat perbedaan efikasi ketamin dibanding dengan magnesium sulfat sebagai adjuvan analgesia pascaoperasi. Ketamin memberikan efek analgesia yang lebih baik dibanding dengan magnesium sulfat. Pendahuluan : Nyeri perut paska seksio sesaria tampaknya menjadi masalah yang signifikan namun cukup bervariasi, berbagai modalitas analgesia diketahui dapat digunakan sebagai analgesia postoperatif. Salah satunya adalah ketamin dan magnesium sulfatyang sering digunakan sebagai tambahan untuk analgesik paska operasi.Metode : Penelitian ini merupakan studi Randomized Control Trial (RCT) dilaksanakan yaitu Rumah Sakit Umum Pusat Haji Adam Malik Medan dan Rumah Sakit Haji Medan pada bulan Agustus-September 2023. Sampel merupakan pasien hamil yang akan menjalani pembedahan seksio sesaria dalam anetesi spinal. Penelitian dibagi menjadi 3 kelompok, MgSO4, ketamin, dan kontrol. Seluruh kelompok menerima perlakuan preoperasi dan intraoperasi yang sama. Pada periode postoperatif, kelompok MGSO4 diberikan infus MgSO4 20 mg/kg/jam, kelompok ketamin menerima infus ketamine 0,2 mg/kg/jam selama 12 jam. Lalu, dilakukan penilaian skala nyeri postoperatif dan efek samping perlakuan pada jam ke-0 (T0), ke-6 (T1), Ke-12 (T2), dan ke-24 (T3).Hasil : Penelitian terdiri dari 30 sampel, yaitu 10 sampel setiap kelompok. Berdasarkan skala nyeri istirahat dan aktivitas didapatkan perbedaan bermakna secara statistik pada pemantauan jam ke-12 dan jam ke-24, p0,05. Didapatkan 2 kejadian sedasi pada perlakuan ketamin, dan 8 sampel memerlukan rescue opioid.Simpulan : Terdapat perbedaan efikasi ketamin dibandingkan dengan magnesium sulfat sebagai ajuvan analgesia paska operasi. Ketamin memberikan efek analgesia yang lebih baik dibandingkan magnesium sulfa
Effect of High Fat and Cholesterol Diet on Total Blood Cholesterol Levels in Pregnant Wistar Rats
Get PDFHypercholesterolemia during pregnancy is a physiological condition resulting from increased insulin resistance, lipoprotein synthesis, and lipolysis in adipose tissue, which mobilizes lipids as an energetic substrate for fetal growth. Consumption of foods high in fat and cholesterol may lead to an increase in total blood cholesterol levels during pregnancy due to saturated fat and cholesterol contents that will increases the synthesis of lipoproteins in the blood. The objectives of this study were to determine the effects of high fat and cholesterol diet on the total blood cholesterol levels in pregnant Wistar rats. This study was a true experimental research using a randomized post-test-only control group design conducted from November 2020 to October 2021on fourteen female Wistar rats that were divided into control and intervention groups. Cow brain was provided as the high fat and cholesterol diet and after the rats gave birth, blood was drawn from the heart. The total blood serum cholesterol levels were assessed using Micro Lab 300 with the CHOD-PAP method and the data were analyzed using an independent t-test. This study showed that the mean total blood cholesterol levels for the control and treatment groups were 80.43±18.512 mg/dL and 142.57±24.786 mg/dL, respectively, which reflected a significant differences in the mean total blood cholesterol level between the control and treatment groups (p-value <0.01). In conclusion, a high fat and cholesterol diet affects the total blood cholesterol level in pregnant Wistar rats
Case Report on Painful Patellar Crepitation Following a Knee Replacement with Preserved Patella
Get PDFPatellar clunk crepitation is a well-known complication following knee replacement surgery and is associated with posterior stabilized knee replacement surgery and surgical technique. Currently, patellar clunk or crepitation management following knee replacement surgery with preserved patella remains unclear. The purpose of this case report is to discuss whether patellar clunk or crepitation management should include debridement with patellar resurfacing or debridement alone. This case describes a patellar crepitation after knee replacement surgery with the preserved patella. The surgery went uneventfully using the standard medial parapatellar approach. However, the patient was still unsatisfied with the chronic left knee pain (>3 months) and crepitation that developed following the surgery, and the patient was diagnosed with patellar clunk and crepitation (PCC). A patellar resurfacing procedure was performed with a satisfactory clinical outcome. Replicating the original joint line level and placing the tibial component posteriorly play a pivotal role in preventing PCC. Debridement and patellar resurfacing procedures are recommended in this type of case to overcome the valgus knee alignment and the placement of the tibial component