E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Penile Length of Prepubertal Children in Surabaya
Get PDFBackground: Early recognition of phallic size abnormalities is essential to identify underlying endocrine and genetic disorders. Parents are concerned regarding their son’s penis length, especially obese and short-stature boys. This study aimed to investigate the factors of penile length in prepubertal boys aged 9-11 in Surabaya.Methods: A cross-sectional analytic observational study was conducted between October and November 2021 during the community services program of the Andrology Study Program, Universitas Airlangga. One hundred forty-eight healthy boys aged 9-11 years were enrolled in this study. Penile parameters and anthropometric measures were recorded. Data were analyzed with Spearman Rho’s formula to correlate the variables studied.Results: The average penile lengths and penile circumference of the penis were 6.3±1.4 and 5.2±1.0 cm, respectively. This study found two boys with micropenis (1.35%) with normal and overweight body mass index (BMI). The penile length was positively correlated with height but not with BMI.Conclusion: Androgen and growth hormones significantly influence penile length. Children with abnormal BMI tend to have smaller penile sizes, associated with increasing androgen aromatization
Garcinia Mangostana Pericarp Extract Protection on Reproductive Function of Obese-Diabetic Rats Model
Get PDFBackground: Type 2 diabetes mellitus (T2DM) in obese has been considered a risk factor for male infertility. Garcinia mangostana pericarp extract (GMPE) is known to have anti-hyperglycemic, anti-diabetic, and anti-inflammatory effects. This study aimed to evaluate the effect of GMPE therapy on reproductive function in obese T2DM rats by examining testosterone level, testicular histopathological features, and hs-CRP level.Methods: Thirty-six male Wistar rats, aged 2–3 months, were randomly divided into 6 groups and treated with a standard diet (NC), high-fat diet (HFD) with GMPE 200 mg/kgBW (obese GMPE control/OGC200), HFD with 45 mg/kgBW STZ-NA (obese-diabetic control/ODC), obese-diabetic rats with GMPE 100 (DG100); 200 (DG200); and 400 mg/kgBW (DG400). STZ-NA was administered after 8 weeks of HFD treatment and followed by GMPE for 8 weeks after T2DM was confirmed. The level of hs-CRP and testosterone were measured in the serum using an enzyme-linked immunosorbent assay. Testicular histopathological examination was measured after 8 weeks of treatment by using Modified Jonhson Score (MJS) with HE staining. Results: ODC rats significantly showed increased hs-CRP level compared to NC (8.76±0.27 vs 0.30±0.07 ng/mL, p<0.001) and reduced testosterone level and MJS compared to NC (73.69±2.22 vs 170.14±1.34 ng/dL, 4.57±0.93 vs 9.87±0.16 MJS, respectively, P<0.001). Testosterone and hs-CRP levels showed a negative and significant correlation (r=-0.974 and p<0.001). On the treatment group, GMPE significantly reduced hs-CRP and increased testosterone levels in a dose-dependent manner.Conclusion: GMPE effectively protects reproductive function in obese DM rats by increasing testosterone levels and advanced spermatogenesis, as well as decreasing hs-CRP leve
Use of sEMG for Swallowing Muscles Activity Quantification in Acute Phase of Stroke
Get PDFEarly diagnosis of dysphagia and aspiration risk is very important in minimizing the risk of various medical consequences. This study aimed to establish a scientific database for future sEMG-based dysphagia screening investigations by examining the electrical activity of swallowing muscles in acute stroke cases. A quantitative cross-sectional study was conducted on 61 stroke inpatients admitted to Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, from July to November 2019. The objective of this study was to quantify electrical activities of the suprahyoid (SH) and infrahyoid (IH) muscles during swallowing. Patients participated in both dry swallowing and a 3 mL water swallowing task, with the sEMG used to measure electrical activity parameters (duration, swallowing initiation, time-to-peak, and amplitude) on both paretic and normal sides. The Wilcoxon test was used to compare the electrical activity parameters between the patients paretic and normal sides. Only amplitude showed a significant difference between the paretic and normal side (p=0.023) when performing the 3 mL water swallowing test. Other parameters did not exhibit significant differences in activity between muscle groups during both swallowing tests (p>0.05), although varying water volumes led to distinct activities in both muscles. Despite the absence of a clear pattern in SH and IH contractions during swallowing, the result showed that the sEMG quantification method might become a promising method for screening dysphagia, complementary to FEES and VFSS. The non-invasive and cost-effective sEMG method can serve as an early screening tool for dysphagia in stroke patients. This study underscores the importance of further investigation on sEMG use, incorporating a larger sample size and diverse cohort results with various swallowing exercises (varying in volume and viscosity) to validate the use of sEMG in dysphagia screening
Thyroid Profile and Serum Lipid Level in Women with Normal Pregnancy
Get PDFObjective: To evaluate the changes in thyroid profile and serum lipid level in normal pregnancy.Methods: This observational study was conducted at the Department of Biochemistry of Santosh Medical College, Ghaziabad, UP, India, from June 2021 to February 2022. In this study, 200 average pregnant women were enrolled. The thyroid profile was estimated using the ELISA method, and the lipid profile was measured using the enzymatic kit method. All data were expressed as means and standard deviations, and SPSS version 17 was used for statistical analysis.Results: This observational study observed that the mean T3, T4, and TSH levels increased significantly in the second trimester compared to the first trimester. In contrast, the mean value of T3, T4, and TSH decreased in the third trimester as compared to the second trimester. The mean levels of total cholesterol, triglyceride, and LDL-cholesterol increased significantly, while the mean value of HDL-cholesterol decreased significantly in the second and third trimesters when compared to the first trimester.Conclusion: This study demonstrated abnormal lipid and thyroid metabolism. Changes in thyroid profile may be associated with adverse obstetric outcomes. The altered lipid parameters, mainly High TG and low HDL-C concentrations, may promote vascular dysfunction and oxidative stress
Comparative Evaluation of Effectiveness of Rocuronium Bromide vs. Succinyl Choline on Quality of Intubating Conditions during General Anesthesia
Get PDFObjectives: To compare the quality of intubating conditions and hemodynamic responses to the administration of Rocuronium Bromide and Succinyl Choline during general anesthesia.Methods: This was a comparative study conducted at the anesthesiology department of a tertiary care medical college. Sixty patients undergoing various surgeries under general anesthesia were included in this study based on predefined inclusion and exclusion criteria. Patients were divided into Group S (receiving succinylcholine) and Group R (receiving rocuronium). In all patients, the quality of intubating conditions was assessed. Excellent or good conditions were considered to be acceptable intubating conditions, whereas fair and poor conditions were considered unacceptable.Results: Mean age, weight, gender distribution, and ASA grades were comparable in both groups. The overall quality of intubation was found to be better in group S than in group R, and the difference was statistically significant (P=0.004). The duration of action was significantly longer in group R than in group S (P<0.001). Hemodynamic stability was comparable in both the groups, except for heart rate at 10 min, which was higher in Group R than in Group S. Incidence of fasciculation was significantly more in Group S as compared to Group R, and the difference was found to be highly significant (P=0.0001).Conclusion: Succinylcholine for rapid sequence intubation is associated with better intubation conditions than rocuronium
Comparison of Coagulation Parameters between Severe and Non-severe COVID-19 Patients Treated in a Tertiary Hospital in Indonesia
Get PDFObjective: To determine the differences in coagulation features in patients with severe versus non-severe COVID-19. Method: During the period of the study from July 2020 to June 2021, 371 COVID-19 patients were treated at Dr. Hasan Sadikin Hospital. These patients were divided into two groups based on the WHO critera into severe COVID-19 with clinical signs such as severe acute respiratory syndrome to respiratory failure and non-severe cases with no respiratory symptoms. Data analyzed were Prothrombin Time (PT), Activated Partial Thromboplastin Time (aPTT), International Normalized Ratio (INR), fibrinogen, D-dimer, and platelet count.Results: Median INR was significantly higher in patients with severe cases than in non-severe cases (1.04 vs. 0.94, p0.652 and 246 vs. 242 x103/mm3, p>0.924, respectively).Conclusions: The INR, PT, fibrinogen, and D-dimer can be considered as features that can be used to predict the severity of the disease and to choose the proper treatment for COVID-19 patients
Pengaruh Pemberian Aminophylline pada Pasien dengan Difficult Weaning Ventilator Mekanik Paksa Evanterasi Diafragma
No full textPenggunaan ventilasi mekanik dapat mengakibatkan kelemahan diafragma yang didiagnosis sebagai ventilator induced diaphragmatic injury (VIDD) yang dapat terjadi mulai 72 jam pascapenggunaan ventilator mekanik. Aminofilin, derivat teofilin diketahui dapat meningkatkan rangsangan nervus phrenicus dan kontraktilitas diafragma pada kasus kelemahan diafragma akibat penggunaan ventilator mekanik. Laporan kasus ini membahas pemberian terapi aminofilin pada pasien dengan kesulitan penyapihan ventilator mekanik pascaevanterasio diafragma, dengan komorbiditas ventilator associated pneumonia (VAP) selama rawatan. Aminofilin diberikan dengan dosis 6 mg/kgBB selama lima hari. Evaluasi dilakukan dengan menilai tidal volume, pressure support, dan keberhasilan spontaneous breathing trial. Pada pasien didapatkanpeningkatan tidal volume dengan penurunan kebutuhan pressure support (PS) signifikan pada hari pertama dan kedua pemberian terapi. Penurunan PS dari 12 menjadi 9 mmHg pada hari pertama, dan 6 mmHg pada hari kedua. Pasien dapat dilakukan spontaneous breathing trial (SBT) pada hari ketiga, dan penyapihan ventilator mekanik berhasil dilakukan. Kami menyimpulkan bahwa pemberian aminofilin bermanfaat dalam membantu penyapihan ventilator mekanik pada pasien dengan kesulitan penyapihan. Penggunaan ventilasi mekanik dapat mengakibatkan kelemahan diafragma yang didiagnosa sebagai ventilator induced diaphragmatic injury (VIDD). VIDD dapat terjadi mulai 72 jam paska penggunaan ventilator mekanik. Aminophylline, derivat Theophylline diketahui dapat meningkatkan rangsangan nervus phrenicus dan konrtaktilitas diafragma pada kasus kelemahan diafragma akibat penggunaan ventilator mekanik. Laporan kasus ini membahas pemberian terapi aminophylline pada pasien dengan kesulitan penyapihan ventilasi mekanik paskaevanterasi diafragma, dengan komorbiditas ventilator associated pneumonia selama rawatan. Aminophylline diberikan dengan dosis 6 mg/kgBB selama lima hari. Evaluasi dilakukan dengan menilai tidal volume, pressure support, dan keberhasilan spontaneous breathing trial. Pada pasien didapati peningkatan tidal volume dengan penurunan kebutuhan pressure support signifikan pada hari pertama dan kedua pemberian terapi. Penurunan pressure support dari 12 menjadi 9 mmHg pada hari pertama, dan 6 mmHg pada hari kedua. Pasien dapat dilakukan spontaneous breathing trial (SBT) pada hari ke tiga, dan penyapihan ventilator mekanik berhasil dilakukan. Kami menyimpulkan bahwa pemberian aminophylline bermanfaat dalam membantu penyapihan ventilator mekanik pada pasien dengan kesulitan penyapihan
Awake Tracheal Intubation sebagai Pendekatan Anestesi pada Pasien dengan Predictive Difficult Airway: Laporan Kasus dari Perspektif Frontliner
Get PDFLaporan kasus ini bertujuan meningkatkan kesadaran tentang tantangan risiko dan pengelolaan masalah jalan napas yang sulit di daerah pedesaan dengan kekurangan fasilitas di ruang operasi. Kami melaporkan kasus laki-laki 31 tahun dengan karsinoma sel skuamosa masif di sisi kiri leher yang dikirim untuk eksisi dan drainase tumor. Pasien dinilai dengan status fisik ASA III karena prediksi jalan napas sulit dan suspek septik. Kami mengalami kesulitan untuk meraba sendi temporomandibular dan kekakuan pada leher. Pasien kami intubasi dalam kondisi sadar sepenuhnya dengan beberapa kesulitan karena kekurangan obat dan alat di rumah sakit kami. Pasien diekstubasi dalam kondisi sadar dengan aman setelah proses operasi dan dipindahkan ke ICU.Abstrak: Laporan kasus ini bertujuan untuk meningkatkan kesadaran tentang tantangan risiko dan pengelolaan masalah jalan nafas yang sulit di daerah pedesaan dengan kurangnya fasilitas di ruang operasi. Kami melaporkan kasus laki-laki 31 tahun dengan karsinoma sel skuamosa masif di sisi kiri leher yang dikirim untuk eksisi dan drainase tumor. Pasien dinilai dengan status fisik ASA III karena prediksi jalan napas sulit dan suspek septik. Kami mengalami kesulitan untuk meraba sendi temporomandibular dan kekakuan pada leher. Pasien kami intubasi dalam kondisi sadar sepenuhnya dengan beberapa kesulitan karena kurangnya obat dan alat di rumah sakit kami. Pasien diekstubasi dalam kondisi sadar dengan aman setelah proses operasi dan dipindahkan ke ICU.Kata Kunci: Awake Intubation, sendi temporomandibular tidak teraba, kekakuan leher, manajemen jalan napas sulit.Abstract: This case report aims to raise awareness about risk challenging and management difficult airway problem in the rural area with lack of facilities on operating room. We report a case of 31-years-old man with large squamous cell carcinoma on the left side of neck who sent for tumor excision and drainage. Patient was assessed with ASA III physical status due to predictive difficult airway and septic suspected. We experienced difficulties to palpable temporomandibular joint and neck stiffness. Patient proceeding with fully awake intubation with some difficulties due to lack of drugs and devices in our hospital. The patient was awake extubated safely after surgery process and transported to the ICU.Keywords: Awake Intubation, unpalpable temporomandibular joint, neck stiffness, difficult airway managemen
Association between Maternal Hemoglobin Level and Incomplete Abortion in A West Java Tertiary Hospital, Indonesia
Get PDFObjective: To evaluate the association between maternal hemoglobin concentrations and incomplete abortion.Methods: An analytic, cross-sectional study with consecutive sampling method was conducted using medical records of 45 pregnant women aged 18 – 35 years old visiting the Obstetrics and Gynecology Department of Dr. Hasan Sadikin General Hospital, Bandung, Indonesia from January 1, 2017 to December 31, 2019. Participants were grouped into incomplete abortion and non-abortion groups.Results: Maternal characteristics in the incomplete abortion group showed that the majority of pregnant women in this group were 25.58 years of age, non-anemic (n=37, 82.22%), had no previous spontaneous abortion (n=40, 88.89%), and were nulliparous (n=25, 55.55%) with a mean interpregnancy interval of 4.03 years. The characteristics in both incomplete abortion group and non-abortion group were homogenous in the level of anemia (p-value=0.380), previous spontaneous abortion (p-value=1.00), and interpregnancy intervals (p-value=0.667). The mean hemoglobin concentration for the incomplete abortion group was 11.81 gr/dL (95% CI, 11.30 to 12.26). Heterogenous data was found in age (p-value=<0.001) and parity (p-value=0.002). Parity was a strong confounder, causing the hemoglobin concentration insignificantly associated to incomplete abortion (p-value=0.884).Conclusion: No statistically significant association is found between hemoglobin concentration and incomplete abortion. Most women with incomplete abortion are around 25 years old, nulliparous, non-anemic with a mean hemoglobin concentration of 11.81 gr/dL with no history of previous abortion, and a rather secure interpregnancy intervals
Intubasi Fiber Optic pada Pasien Anak dengan Syngnathia dan Pseudoankylosis Sendi Temporomandibular : Laporan Kasus
Get PDFManajemen jalan napas pada pasien anak dengan malformasi kraniofasial merupakan tantangan karena sulit dilakukan. Laporan kasus ini bertujuan menjelaskan manajemen anestesi pada pasien anak dengan syngnathia anterior dan pseudoankilosis temporomandibular. Seorang anak perempuan berusia 2 tahun dengan diagnosis syngnathia segmen anterior dan pseudoankilosis temporomandibular dijadwalkan untuk operasi elektif. Intubasi fiber optic dilakukan pada pernapasan spontan (spontaneous breathing) melalui insuflasi menggunakan perangkat jalan napas nasofaring yang dimodifikasi. Dilakukan teknik “spray-as-you-go” dengan lidokain yang diencerkan dan intubasi nasal menggunakan fiber optic dari saluran hidung kontralateral menggunakan tabung endotrakeal uncuffed ukuran 4,5. Metode intubasi fiber optic dapat berhasil digunakan pada anak dengan malformasi kraniofasial.Manajemen jalan napas pada pasien anak dengan malformasi kraniofasial merupakan tantangan karena sulit dilakukan. Laporan kasus ini bertujuan untuk menjelaskan manajemen anestesi pada pasien anak dengan syngnathia anterior dan pseudoankylosis temporomandibular. Seorang anak perempuan berusia 2 tahun dengan diagnosis syngnathia segmen anterior dan pseudoankylosis temporomandibular dijadwalkan untuk operasi elektif. Intubasi fiber optik dilakukan pada pernapasan spontan (spontaneous breathing) melalui insuflasi menggunakan perangkat jalan napas nasofaring yang dimodifikasi. Dilakukan teknik “spray-as-you-go” dengan lidokain yang diencerkan dan intubasi nasal menggunakan fiber optik dari saluran hidung kontralateral menggunakan tabung endotrakeal uncuffed ukuran 4,5. Metode intubasi fiber optik dapat berhasil digunakan pada anak dengan malformasi kraniofasial