E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Lipid Profile in Early and Late Stage among Patients with Nephrotic Syndrome-Related Chronic Kidney Disease in Dr. Hasan Sadikin General Hospital Bandung, Indonesia in 2016−2019
Get PDFBackground: Chronic kidney disease (CKD) is a major health problem in children with an increased prevalence globally. CKD is strongly associated with Nephrotic Syndrome (NS) and dyslipidemia, which become a progressive factor of CKD. This study aimed to describe the lipid profile of children with CKD and NS in Dr. Hasan Sadikin General Hospital Bandung, Indonesia.Methods: An observational-retrospective study was conducted with a cross-sectional design involving 150 medical records of children aged 1−18 years who were diagnosed with CKD with NS. Lipid profile data, including total cholesterol, triglycerides, LDL, and HDL, were collected from 2016−2019 using the total sampling method. Subjects with incomplete lipid profile data were excluded from the study.Results: Among the fifty-two children that were eligible and fulfilled the inclusion criteria, 88.5% were diagnosed with stage 1 CKD, and 32.7% were aged between 6−11 years and boys were predominant (67.3%). Lipid profile changes were found in the LDL, HDL, and total cholesterol serum levels between CKD stage I and II–V.Conclusions: Lipid profile of CKD pediatric patients with NS in Dr. Hasan Sadikin General Hospital Bandung in 2016−2019 showed hypertriglyceridemia and hypercholesterolemia. Most subjects were in stage I of CKD and Steroid-Resistant Nephrotic Syndrome, and comparison between stages of CKD and types of nephrotic syndrome is lacking. A prospective analytical study would be more reliable in proofing its significance
In-silico study of the Effectiveness of Allium sativum L. extract as an Angiotensin-Converting Enzyme (ACE) Inhibitor in Hypertension
Get PDFOver the last decade, the global prevalence of hypertension rate has increased by 5.2% and, in Indonesia, the prevalence rate has increased significantly from 25.8% in 2013 to 34.1% in 2018. Hypertension treatments using blood pressure-lowering drugs, such as angiotensin-converting enzyme (ACE) inhibitors, often cause unpleasant side effects. These side effects increase the interest in using potentially effective natural remedies, such as garlic. This study aimed to determine which organosulfur compounds in garlic can act as an ACE inhibitor to reduce blood pressure in hypertension using a cheminformatics approach. Eighteen organosulfur compounds of Allium sativum L. were screened based on Lipinski’s rules and ADMET evaluation. Seven compounds passed the screening and were subjected to QSAR analysis, molecular docking analysis, and molecular dynamics simulations to assess the stability of the protein. The seven compounds then underwent molecular docking and QSAR analysis. Ajoene (4,5,9-trithiadodeca-1,6,11-triene-9-oxide) and S-allylmercaptocysteine (SAMC) were two compounds with better docking values compared to the positive control compound. The QSAR analysis also showed that SAMC had an activity as an ACE inhibitor. The ADMET evaluation showed that Ajoene and SAMC had good absorption and could not penetrate the blood-brain barrier. Molecular dynamics simulation of ACE complexes Ajoene, SAMC, and Captopril ranged from 0.05 to 5.61 Å but exhibited a pattern of synonymous fluctuations for most residues. Based on the simulation data, the organosulfur compounds from garlic, Ajoene, and SAMC are proven to have a mechanism of action as ACE inhibitors to reduce blood pressure in hypertension
Diagnostic Challenge of Adult-onset Type 1 Diabetes Mellitus in a Remote Hospital
Get PDFType 1 Diabetes Mellitus (T1DM) is a chronic endocrinological disease due to an autoimmune process. The prevalence of T1DM is 9.5% worldwide, with the incidence of 15 out of 100,000 people, ranging from childhood to 40 years of age. Autoimmunity-related late-onset Diabetes Mellitus (DM) patients could be diagnosed as classic T1DM or latent autoimmune diabetes in adults (LADA). A 30-year-old male patient with unremarkable previous medical history was admitted to the emergency room with dyspnea for the last three days that was worsened six-hour before admission. Physical examinations showed a body Mass Index (BMI) of 18.75 kg/m2, irregular pulse, and Kussmaul breathing. The patient was diagnosed with diabetic ketoacidosis (DKA) on May 23, 2019. He was discharged with subcutaneous insulin pen injections. Two years later, he was readmitted with DKA due to discontinuing his treatment. He stated that the reason for stopping the insulin was because he was tired of injecting it. The patient was hospitalized and was discharged with oral antidiabetic agents to cope with his injection tiredness issue. One week later, the patient complained of dyspnea and was diagnosed with recurrent DKA. He was hospitalized and prescribed subcutaneous insulin. In this kind of situation, a diagnosis of LADA for patients presenting with DKA without prior history of DM in early adulthood needs to be considered. In contrast to the classic T1DM, the need for insulin occurs late in LADA. Affordable and widely available ancillary examinations are needed, including in remote hospitals. Finally, motivational support for patients is as important as the pharmacological treatment since lifelong insulin injections are needed
Dose and Time-Dependent Lipopolysaccharide Exposure on A549 Cell Model Influences Pro-Inflammatory Cytokine Interleukin 8
Get PDFHyperinflammation in COVID-19 patients is one of the causes of the high mortality rate of COVID-19. An in vitro model mimicking the inflammatory responses in COVID-19 patients is important in the efforts of finding new drug candidates for this disease. Lipopolysaccharide (LPS) can increase the proinflammatory cytokine interleukin 8 in response to the presence of foreign substances. This preliminary study sought to explore the use of the A549 cells as an in vitro inflammatory model. This study was conducted from August to November 2022 at the stem cell research and development laboratory of Bio Farma Indonesia. The exposure of 100, 500, and 1000 g/mL doses of LPS administered for 24, 72, and 120 hours on the A549 cells was analyzed for cell viability, population doubling time (PDT), and the presence of proinflammatory cytokine IL-8. The group differences were examined using one- and two-way analysis of variance in IBM SPSS Statistics Version 29, with a p-value of 0.05 considered significant. Cells exposed to a dose of 1000 g/mL LPS had a lower viability and a higher proliferation rate (p<0.05) based on the viability and PDT. Viability, PDT, and pro-inflammatory cytokines showed concentration- and time-dependent responses. Therefore, increased levels of the proinflammatory cytokine IL-8 in cells exposed to LPS at a dose of 1000 g/mL for 24 hours can be used as a mimic to study hyperinflammation in COVID-19 patients
Age, Gender, and Preoperative LVEF Influence on ICU Length of Stay After CABG
Get PDFCoronary artery bypass graft (CABG) surgery is a surgical therapy for coronary artery disease (CAD) patients who cannot be solely treated using pharmacological therapy. Patients undergoing CABG surgery require careful postoperative monitoring in the intensive care unit (ICU). This leads to the need for careful selection of patients due to the limited number of ICU beds available. A prolonged stay in ICU could delay surgery for other patients. This retrospective study analyzed how preoperative factors such as age, gender, and preoperative left ventricular ejection fraction (LVEF) may influence patient's length of stay (LOS) in the ICU. For this study, subjects were patients undergoing isolated CABG in Dr. Hasan Sadikin General Hospital Bandung, Indonesia, during the period of January 2019- December 2020 who were selected using the simple random sampling method. The subjects were categorized into 96 hours) and non-prolonged ICU LOS (65 years old) is at a higher risk of having prolonged ICU LOS after CABG; thus, a careful scheduling of patients for CABG surgery by age is important to prevent prolonged ICU LOS after CABG
Oxidative Stress in Seminal Plasma Negatively Influences Sperm Quality in Infertile Males
Get PDFObjective: To investigate the association between malondialdehyde concentration in the seminal plasma of infertile men and sperm quality.Methods: This case-control study included 60 male participants ranging from 25-40 years old with half of them were fertile and the other half were infertile. Semen analysis was performed as per the WHO standards, and spectrophotometric measurement of seminal plasma malondialdehyde level was done.Results: Results showed that infertile men had significantly a higher mean level of malondialdehyde in their seminal plasma than fertile men (p<0.001), which was inversely associated with sperm count and motility. Also, malondialdehyde was positively associated with abnormal sperm morphology.Conclusions: Elevated malondialdehyde levels in seminal plasma are associated with poor sperm quality. Malondialdehyde testing can, therefore, be used to diagnose and predict the outcome of male infertility. Antioxidants should also be administered to men with infertility to help counteract the effects of oxidative stress
Intervention of Kusuma Milk-Shake Drink on Cervical Dilatation and Duration of Labor: Experience from Bengkulu, Indonesia
Get PDFBackground: Labor processes require energy consumption regulated by a complex nervous system and hormonal response. Thus, the intensity of maternal nutritional intake since pregnancy should be highly considered for physiological delivery. Nutrients that are high in energy and provide fast-decomposing glucose intake should be chosen by the mothers. Kusuma is a kind of drink made from dates, milk, and honey. This study aimed to analyze the effect of Kusuma milk-shake drink implementations on cervical dilatation and duration of labor.Methods: An experimental study was conducted by post-test only with a controlled group design, including 34 mothers with term pregnancy, which was intervention groups and controls. A completely randomized design in two different places was conducted. Data were analyzed using Shapiro-wilk, independent sample T-test, and Mann-Whitney. Results: There was a significant effect of Kusuma milk-shake implementation on cervical dilatation (p=0.000). The dilatation process was found to be 5.5 times faster, and the duration of labor (p=0.000) was observed to be 9.7 hours faster than the control group.Conclusions: Implementation of the Kusuma milk-shake has a significant effect on the acceleration of cervical dilation and the duration of labor. This research is expected to improve the quality of midwifery services as an effort to realize the concept of a Continuum of Obstetric Care
Thawing Time Difference between Fresh Frozen Plasma Using Ziplock Plastic and non-Ziplock Plastic in Blood Transfusion Unit Dr. Hasan Sadikin General Hospital Bandung, Indonesia
Get PDFBackground: The quality of fresh frozen plasma (FFP) in a clinical setting depends on thawing time. Thawing using a water bath is often used in blood transfusion units because it is easy to perform, affordable, and easy to look for. Protective plastics (Ziplock and non-Ziplock) are used to reduce the risk of contamination,. This study aimed to determine whether there is a difference in thawing time between FFP using Ziplock plastic and non-Ziplock plastic.Method: This experimental design was conducted in the Blood Bank Unit of Hasan Sadikin Hospital from June-August 2021. Samples were divided into two groups, namely thawing using Ziplock and non-Ziplock. Each group consisted of volume 160-200 ml and 201-240 ml.Results: The total samples were 24 FFP bags. In the group of the bag 160-200 ml, the median thawing time using Ziplock plastic was 8 minutes (8-16 minutes), non-Ziplock was 15 minutes (8-16 minutes) (p value 0,111), whereas in a group of bags with volume 201-240 ml, the median thawing time using Ziplock was 15 minutes (8-28 minutes), non-Ziplock was 20 minutes (14-30 minutes) (p- value 0,332). Although there was a time difference in both groups, the difference was non-significant.Conclusion: The thawing time between the small bag with a volume of 160-200 ml and the larger volume of 201-240 ml shows no difference. Ziplock plastic can be used to reduce the risk of contamination