E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Correlation of Abdominal CT scan Score and Alpha-fetoprotein Levels in Hepatocellular Carcinoma
Get PDFObjective: To assess the correlation between the Alpha-fetoprotein (AFP) level and characteristics of liver lesions listed in the abdominal computed tomography (CT) scan scores in hepatocellular carcinoma.Methods: This was a retrospective analytic observational study with a cross-sectional design conducted at Sanglah Hospital in January 2017–January 2021. Subjects were patients diagnosed with hepatocellular carcinoma based on clinical and laboratory features. Samples were taken by consecutive sampling. The results of the abdominal CT scan were read by two radiologists with a predetermined abdominal CT scan scoring system. The AFP level data were taken at a maximum of 5 days before an abdominal CT scan was performed.Results: A total of 64 subjects were included in this study. The mean serum AFP level was 1,000 IU/mL (range 0.54–61830 IU/mL). The mean abdominal CT scan score by examiner one was 10.093±5.59, while the examiner two provided a score of 10.281±5.45. The difference in mean CT scan scores between the two examiners was very low and insignificant (mean difference score -0.188; 95% CI -1.894–1.519). The rho Spearman value was 0.918 (p<0.001) between serum AFP levels and abdominal CT scan scores. In the partial correlation, the value of r=0.678 (p<0.001) was obtained after controlling for body mass index (BMI), age, and sex variables.Conclusions: There is a strong positive correlation between serum AFP levels and abdominal CT scan scores in hepatocellular carcinoma patients. Further research is needed with a prospective design to reduce research bias
Thoracic Radiography Findings of Multi Drug Resistant Tuberculosis at Dr. Hasan Sadikin General Hospital Bandung
Get PDFBackground: The prevalence of multidrug-resistant pulmonary tuberculosis (MDR-TB) continues to increase, especially in Indonesia. Thoracic radiography examination plays a role in the TB diagnosis by providing findings of typical lesions in patients. The aim of the study was to determine the thoracic radiography findings in MDR-TB patients.Methods: This was a cross-sectional retrospective descriptive study. This study had explored secondary data from medical records of patients who previously had a clinical diagnosis of MDR-TB and underwent thoracic radiography examinations at the Department of Radiology, Dr. Hasan Sadikin General Hospital, Bandung on July - August 2020 Result: Of 110 data collected, the average age was 37±12.6 years with male patients were predominantly prevalent and 65.5% had large lesions. The most frequent findings of lesions were calcification (94.5%) and fibrosis (90.9%). Other major findings were infiltration (88.2%), consolidation (55.5%), cavity (65.5%), ground-glass opacity (60.9%) while other were found in less than half of the cases such as bronchiectasis (23%), nodule (34.5%), atelectasis (36.4%), lymphadenopathy (34.5%), and others. Interestingly, the miliary pattern was not found.Conclusion: Large lesions, calcification, fibrosis, infiltration, consolidation, cavities, and ground-glass opacities are the main features of the radiographic findings in the majority of MDR-TB patients
Snakebites and the Effect of Serum Anti Bisa Ular (SABU) Antivenom at Dr. Hasan Sadikin General Hospital Bandung, Indonesia: an Overview Period 2015–2019
Get PDFBackground: Snakebite is considered a global health issue, especially in the Southeast Asian region. However, data regarding snakebite cases in Indonesia are still very limited. This study aimed to explore the venomous snakebite cases and the serum anti bisa ular (SABU) antivenom effect in treating venomous snakebite caused by other than the snake species indicated in currently available SABU antivenom formulas.Methods: The analytical descriptive method with a cross-sectional study design was conducted in 2021 using a total sampling from the medical records of 63 patients diagnosed with snakebite at Dr. Hasan Sadikin General Hospital Bandung from 2015 to 2019. Characteristics of patients, clinical manifestation, and correlation between snakes species and outcomes after treatment with or without administration of SABU antivenom were collected.Results: Out of 63 patients, males (79%) were predominant with an average age of 39 years. Fifty-six patients arrived at the Emergency Room less than 24 hours after the occurrence (89%). Most cases were categorized as grade 2 (41.%) where the upper extremities were commonly bitten the body area (64%). Edema (83%) was the most common manifestation. There was no correlation between snake antivenom administered to a specific snake species and the stated outcome (p=0.053), meaning that SABU antivenom might be an effective alternative to treat more types of snakebites.Conclusions: Snakebites are most common in males, attack the upper extremities, categorized as grade 2 with edema. Administration of SABU antivenom provides the similar outcome compared to the group caused by the Javan spitting cobra, Banded krait, and Malayan pit viper
Delirium Pasca Operasi sebagai Prediktor Mortalitas pada Geriatri yang Menjalani Operasi Non-Kardiak: Tinjauan Sistematis
No full textDelirium postoperatif merupakan suatu bentuk delirium yang sering tidak disadari serta dapat meningkatkan morbiditas dan mortalitas. Studi yang telah dilakukan sebelumnya menunjukkan masih terdapat konflik terkait hubungan delirium pascaoperasi sebagai prediktor mortalitas, terutama pada pasien geriatri. Oleh karena itu, tinjauan sistematis ini bertujuan mengetahui hubungan delirium pascaoperasi sebagai prediktor mortalitas pada pasien geriatri yang menjalani anestesi pada pembedahan non-kardiak. Penelusuran dilakukan melalui database online seperti Medline®, ClinicalKey®, Science Direct®, EBSCO®, ProQuest®, dan Cochrane®. Telaah kritis terhadap artikel ilmiah yang memenuhi kriteria inklusi dan tidak termasuk eksklusi dilakukan berdasarkan Center of Evidence-Based Medicine, University of Oxford for prognosis study.Berdasarkan hasil penelusuran diperoleh tiga studi yang memenuhi kriteria inklusi dan tidak termasuk eksklusi. Hasil telaah kitis terhadap ketiga studi tersebut menunjukkan tidak terdapat cukup bukti kuat yang mendukung delirium pascaoperasi merupakan prediktor independen terhadap mortalitas pada pasien geriatri. Delirium pascaoperasi bukan merupakan prediktor independen, namun meningkatkan risiko mortalitas bersama faktor lain seperti frailty, usia, jenis operasi, urgensi operasi, dan komorbid, hingga terdapat studi yang cukup kuat untuk mendukung delirium pascaoperasi bukan sebagai prediktor mortalitas. Klinisi tetap harus berupaya mencegah kondisi delirium pascaoperasi agar tidak menjadi mediator yang meningkatkan risiko mortalitas. Postoperative Delirium as Mortality Predictor in Geriatrics Undergoing Non-Cardiac Surgery: A Systematic ReviewPostoperative delirium is a form of delirium that often goes unrecognized and can increase morbidity and mortality. However, there are still conflicts in previous studies regarding the relationship between postoperative delirium as a predictor of mortality, especially in geriatric patients. Therefore, this systematic review aimed to determine the relationship to postoperative delirium as a predictor of mortality in geriatric patients undergoing anesthesia for non-cardiac surgery. Searches were conducted through online databases such as Medline®, Clinical Key®, Science Direct®, EBSCO®, ProQuest®, and Cochrane®. A critical review of scientific articles that met the inclusion and exclusion criteria was carried out by the Center for Evidence-Based Medicine, University of Oxford, for prognostic studies. The search resulted in three studies that met the inclusion criteria. A clinical review of these three studies has shown insufficient evidence to support that postoperative delirium is an independent predictor of death in geriatric patients. Postoperative delirium is not an independent predictor but increases the risk of death and other factors such as frailty, age, type of surgery, urgency of surgery, and co-morbidities. Until there are sufficiently robust studies to support postoperative delirium rather than as a predictor of mortality, clinicians should continue to strive to prevent postoperative delirium from becoming a mediator that increases the risk of death. Latar belakang: Delirium postoperatif merupakan suatu bentuk delirium yang sering tidak disadari serta dapat meningkatkan morbiditas dan mortalitas. Studi yang telah dilakukan sebelumnya menunjukkan masih terdapat konflik terkait hubungan delirium postoperatif sebagai prediktor mortalitas, terutama pada pasien geriatri. Oleh karena itu, tinjauan sistematis ini bertujuan untuk mengetahui hubungan delirium postoperatif sebagai prediktor mortalitas pada pasien geriatri yang menjalani anestesi pada pembedahan non-kardiak.Metode: Penelusuran dilakukan melalui database online seperti Medline®, ClinicalKey®, Science Direct®, EBSCO®, ProQuest®, dan Cochrane®. Telaah kritis terhadap artikel ilmiah yang memenuhi kriteria inklusi dan eksklusi dilakukan berdasarkan Center of Evidence-Based Medicine, University of Oxford for prognosis study.Hasil: Berdasarkan hasil penelusuran diperoleh tiga studi yang memenuhi kriteria inklusi dan eksklusi. Hasil telaah kitis terhadap ketiga studi tersebut menunjukkan tidak terdapat cukup bukti yang kuat yang mendukung delirium postoperatif merupakan prediktor independen terhadap mortalitas pada pasien geriatri.Kesimpulan: Delirium postoperatif bukan merupakan prediktor independen, namun meningkatkan risiko mortalitas bersama faktor lain seperti frailty, usia, jenis operasi, urgensi operasi, dan komorbid. Hingga terdapat studi yang cukup kuat untuk mendukung delirium postoperatif bukan sebagai prediktor mortalitas, klinisi tetap harus berupaya mencegah kondisi delirium postoperatif agar tidak menjadi mediator yang meningkatkan risiko mortalitas
DMBA-induced Modulate Estrogen Receptors α and β Breast Cancer’s Animal Model
No full textThe high incidence of breast cancer cases in the world requires the use of applicative methods. The 7,12-dimethylbenz(a)anthracene (DMBA) induced breast cancer animal model is a widely used chemical-induced animal models for research on breast cancer. However, the molecular mechanism related to DMBA induction remains unclear. Good understanding on DMBA-induced animal models is crucial for studies related to future breast cancer treatments as animal models will provide a deeper understanding of anticancer medication, specifically those aimed for treating breast cancer. The aim of this study was to develop an DMBA-induced animal model for breast cancer. This study used female Wistar rats injected subcutaneously with DMBA as a carcinogen-induced agent (20 mg/kg) to induce tumor. Rat tumors were then evaluated and breast appearance was observed weekly, starting from day 28th after DMBA injection. Breast cancer tissue was then sampled and stored at -80°C until it was used for western blot and histological study. This study indicated that DMBA induced cancer in female Wistar rat’s breasts, and cytoplastic cells and lung metastatic was identified macroscopically and histopathologically. The metabolic sign was observed in the lung and breast sections. Interestingly, the DMBA induction in this study does not only induce organ cancers but also induces estrogen receptors and stimulates signaling of estrogen receptors α (ERα), ERβ, and Akt
Nutmeg Extract Alters Mitochondrial Genes Regulation of Skeletal Muscle Fibers in Aging Rats
Get PDFNutmeg as one of Indonesia native plants has already been used widely in herbal treatment. It has been demonstrated that nutmeg presents activities related to mitochondria functions. Nutmeg potentially has the effect of peroxisome proliferator activated receptors Υ (PPAR Υ) which contributes to myogenesis, and may alters mitochondrial homeostasis in respiration and biogenesis. In this study, how nutmeg extract alters oxidative process in skeletal muscle of aging rats was explored. Twenty aging Wistar male rats aged 80 weeks old were divided into two groups (control and nutmeg treatment). Nutmeg extract was administered for 12 weeks using a gavage. After that, the soleus muscles were collected, weighted, frozen, and stored at -800C until used. Nutmeg was observed to increase the COX1 (1.9 folds, p<0.01), COX2 (1.6 folds, p<0.05), and COXIV (2.8 folds, p<0.01) gene expressions, in parallel with increased protein carbonyl levels (1.5 folds, p<0,01). Nutmeg treatment also significantly increased the expressions of antioxidant endogen COQ7 (2 folds, p<0,01) and PDSS2 (2 folds, p<0,01) in the soleus muscle. Taken together, nutmeg extract may improve mitochondrial respiratory oxidative activities in type I aging skeletal muscle
Correlation between Albumin, Colon Leakage Score (CLS), and Anastomotic Leakage after Colorectal Cancer Resection
Get PDFAnastomotic leakage is still the most undesirable complication of colorectal surgery. The reported incidence of anastomotic leakage after colorectal surgery varies from 1.8% to 15.9%. The impact of anastomotic leakage is increased morbidity, mortality (12–30%), length of stay, and cost of hospitalization; hence, this complication should be prevented as much as possible.Several studies have shown a correlation between low albumin levels and increased anastomotic leakage.The Colon Leakage Score (CLS) is a standard score for predicting anastomotic leakage, but this score does not include the albumin level as a parameter of anastomotic leakage despite the importance of the albumin level’s contribution on the anastomotic leakage. Therefore, this study sought to analyze the correlation between the albumin level, CLS, and the incidence of anastomotic leakage after anastomotic resection surgery in colorectal cancer (CRC) patients at Dr. Hasan Sadikin General Hospital Bandung, Indonesia. This study was a cross-sectional retrospective analytical study on medical records of CRC patients over the age of 18 who underwent intestinal anastomotic resection surgery between 2016–2020. There were thirty-two patients with colorectal cancer underwent anastomotic resection during the study period, with two patients experienced anastomotic leakage. Correlation analysis showed that the correlation coefficient for the albumin level and anastomotic leakage was 0.209, while the correlation coefficient between CLS and anastomotic leakage was 0.110. There is no correlation between albumin level, CLS, and the incidence of anastomotic leakage after anastomotic resection surgery in CRC patients treated at Dr. Hasan Sadikin General Hospital Bandung, Indonesi
Use of Herb Combination (Jamu Atoke) Before Mating to Improve Rat Pup Health
Get PDFMortality and health disturbances in children often correlate with maternal health and fertility. Avocado, mung bean sprouts, and holy basil have been traditionally used to improve maternal health, before and during pregnancy. This study was aimed to assess the efficacy of herbal combination of avocado, mung bean sprouts, and holy basil (Jamu ATOKE) in optimizing reproductive health. Eighteen female Sprague Dawley rats (9–10 weeks old, BW: 180–250 g) were randomly divided into 3 treatment groups (n=6 rats for each group) of control, group I and II. ATOKE were added into rats drinking water and consumed for 30 days before pregnancy. After the rats were pregnant and gave birth, pup per parent ratio, pup mortality, and pup health performance (body weight gain, feed and drink consumption, motor activity, pup speed in finding light and feed, red blood cell (RBC) count, white blood cell (WBC) count and differential, SGPT, SGOT, blood urea nitrogen (BUN), creatinine, and proinflammatory mediators (TNF-α and IL-6) were analyzed. Pups born to in group I had a generally better health performance compared to the control group. There was a 100% mortality in the litter of group II due to the excessive aggressive behavior of the dams as a sign of toxicity. Administration of 2.5% Jamu ATOKE showed the best effects on the health and intelligence of the rat pup
Diabetes Retinopathy Prevalence and Risk Factors among Diabetic Patients Seen at Highland Eye Clinic Mutare Zimbabwe: A Retrospective Study
Get PDFObjective: To determine the prevalence of diabetic retinopathy and its association with hypertension, age, gender, and fasting blood glucose level.Methods: This retrospective study assessed the prevalence of diabetic retinopathy with its associated risk factors on 135 diabetic patients, aged 18 years and above, visiting the Highland Eye Clinic Mutare, Zimbabwe. Data were collected on the age, sex, and type of retinopathy. Based on the identified retinopathy, subjects were divided into no retinopathy, non-proliferative diabetic renopathy, and proliferative diabetic retinopathy groups. Analysis were then performed using multivariate and univariate regression analyses to test the association between the presence of retinopathy and several risk factors, and results were presented in percentages, with P< 0.05 considered to show statistical significance.Results: The average age of the subjects this study was 60.8 ± 14 with female subjects constituted more than half of the total number of subjects (58.5%). Forty four percent were overweight (BMI 25-30), 34.8 % were obese, and the overall prevalence of diabetic retinopathy was 31.1% (non-proliferative diabetic renopathy, 20%; proliferative renopathy, 11.1%). The proportion of subjects with retinopathy increased with duration of DM, being 23.3% in those with a DM duration of less than 10 years and 46.6% in those with a DM duration of more than 10 years. Age and hypertension were significantly associated with the presence of diabetic retinopathy (P< 0.05) in univariate analysis, but no association was identified between retinopathy and fasting blood glucose (chi-square test, P =0.0965)Conclusion: The prevalence of diabetic retinopathy (DR) is high (31.1%), Non-proliferative DR is more common than the proliferative (DR). There is a strong association between diabetic retinopathy, hypertension, and age