E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Perbandingan antara Mobilisasi Cepat dan Mobilisasi Lambat terhadap Komplikasi Neurologis pada Pasien Anestesi Spinal
Get PDFAnestesi spinal merupakan metode yang ekonomis, aman, nyaman, dan efektif yang memberikan anestesi cepat dan dapat diandalkan. Pasien pascaoperasi dengan anestesi spinal yang dilakukan mobilisasi cepat memberikan keuntungan dibanding dengan mobilisasi setelah tirah baring 24 jam. Penelitian ini bertujuan menilai perbandingan antara pasien mobilisasi cepat dan mobilisasi lambat pada pasien pasca-anestesi spinal terhadap komplikasi neurologis yang terjadi. Penelitian dilakukan di Instalasi Bedah Sentral RSUD Dr. Moewardi Surakarta selama Juli–Agustus 2018. Penelitian ini menggunakan uji klinis acak tersamar ganda pada 30 pasien yang menjalani operasi dengan anestesi spinal yang memenuhi kriteria inklusi. Sampel dibagi menjadi 2 kelompok, yaitu kelompok yang mendapat perlakuan mobilisasi setelah efek anestesi spinal hilang dan kelompok yang mendapat perlakuan mobilisasi setelah tirah baring 24 jam. Hasil penelitian didapat tidak ada perbedaan yang signifikan komplikasi neurologis pada pasien pascaanestesi spinal yang dilakukan mobilisasi cepat dibanding dengan mobilisasi lambat dengan nilai p=0,456. Simpulan penelitian ini tidak ada perbedaan kejadian komplikasi neurologis antara pasien pascaanestesi spinal dengan mobilisasi cepat dan mobilisasi setelah tirah baring 24 jam.Comparison of Neurological Complications between Rapid and Slow Mobilization in Spinal Anesthesia PatientsSpinal anesthesia is an economical, safe, convenient, and effective method that provides fast and reliable anesthesia. Postoperative patients under spinal anesthesia who underwent rapid mobilization provided an advantage over mobilization after 24 hours of bed rest. This study aimed to compare patients' fast and slow mobilization after spinal anesthesia with neurological complication incidence at the Central Surgical Installation of Dr. Moewardi Hospital Surakarta. The study was conducted in July–August 2018. This study used a double-blind, randomized clinical trial on 30 patients undergoing surgery under spinal anesthesia who met the inclusion criteria. The sample was divided into two groups: the group that received mobilization treatment after the effects of spinal anesthesia disappeared and the group that received mobilization treatment after 24 hours of bed rest. The results showed no significant difference in neurological complications in post-spinal anesthesia patients who underwent rapid mobilization compared with slow mobilization with a p-value = 0.456. This study concludes that there is no difference in the incidence of neurological complications between post-spinal anesthesia patients with rapid and slow mobilization.Anestesi spinal merupakan metode yang ekonomis, aman, nyaman, dan efektif yang memberikan anestesi cepat dan dapat diandalkan. Pasien pascaoperasi dengan anestesi spinal yang dilakukan mobilisasi cepat memberikan keuntungan dibanding dengan mobilisasi setelah tirah baring 24 jam. Penelitian ini bertujuan menilai perbandingan antara pasien mobilisasi cepat dan mobilisasi lambat pada pasien pasca-anestesi spinal terhadap komplikasi neurologis yang terjadi. Penelitian dilakukan di Instalasi Bedah Sentral RSUD Dr. Moewardi Surakarta selama Juli–Agustus 2018. Penelitian ini menggunakan uji klinis acak tersamar ganda pada 30 pasien yang menjalani operasi dengan anestesi spinal yang memenuhi kriteria inklusi. Sampel dibagi menjadi 2 kelompok, yaitu kelompok yang mendapat perlakuan mobilisasi setelah efek anestesi spinal hilang dan kelompok yang mendapat perlakuan mobilisasi setelah tirah baring 24 jam. Hasil penelitian didapat tidak ada perbedaan yang signifikan komplikasi neurologis pada pasien pascaanestesi spinal yang dilakukan mobilisasi cepat dibanding dengan mobilisasi lambat dengan nilai p=0,456. Simpulan penelitian ini tidak ada perbedaan kejadian komplikasi neurologis antara pasien pascaanestesi spinal dengan mobilisasi cepat dan mobilisasi setelah tirah baring 24 jam.Kata kunci: Anestesi spinal, komplikasi neurologis, mobilisasi cepat, mobilisasi lambat, komplikasi neurologis
Comparison of Single Centrifugation, Double Centrifugation and Turn down-Turn up Techniques for Platelet-Rich Plasma Quality
Get PDFBackground: Platelet-rich plasma (PRP) is a new concept used in medical world, especially for wound healing. The main process that affects the PRP quality is the centrifugation process. This study aimed to assess the PRP separation process and determine the best technique of various centrifugation process.Methods: This experimental study used acid citrate dextrose (ACD) blood taken from 11 healthy respondents and compared three-techniques including the single centrifugation (SC), the double centrifugation (DC), and the double centrifugation turn down - turn up (DC-TDTU) techniques. The quality of PRP was measured based on blood cells count (platelet, leukocyte, erythrocyte count, and Ht value) at each stage of centrifugation. The examination was carried out in 2021 at the Hematology Laboratory, Poltekkes Jakarta 3.Results: The mean values of platelets, leukocytes, and Ht were increased in PRP compared to plasma supernatant both using the DC and DC-TDTU techniques, wherase the SC technique decreased in plasma compared with whole blood. When the procedures using DC and DC-TDTU are carried out properly, platelets would be concentrated in the second centrifugation. However, some erythrocyte and leukocyte contamination occurred by DC-TDTU technique compared to the DC technique.Conclusion: The double centrifugation technique is the best Platelet-rich plasma separation technique compared to the DC-TDTU and SC techniques
Paternity Test Through Kinship Analysis as Forensic Identification Technique
Get PDFPaternity tests is often faced with the unavailability of information from the father, mother, or child as a comparison in forensic DNA examination process. Therefore, comparisons with information from close family lines are needed, for example from the victim's siblings or the perpetrator if there are no comparisons from parents or siblings. This study was conducted by the Human Genetic Study Group of Airlangga University in its campus from January to April 2020. The aim of the study was to analyze the use of kinship analysis in paternity test through STR CODIS examination on siblings. This was an observational laboratory study with a temporary design. DNA sample extraction level and purity results were measured with the mean DNA sample level of 675±5.35ng/µL, while the purity values ranged from 1.05 to 1.86. The paternity test principle is based on comparison process between the parents’ alleles with the child’s alleles. However, if the parents’ alleles are not available, the siblings’ alleles can be used as a comparison for identification purpose, which is known as kinship analysis. Statistically, full siblings have a 2 alleles accuracy probability of [0.25] 25%, which was the same as not having the same allele or 0 allele, while 1 allele accuracy reached 50%. All CODIS STR loci had the highest percentage of 2 allele sharing. Therefore, it is recommended to use sibling or kinship analysis if both parents are absent
Anti-migration Effect of Aaptos suberitoides Fraction in HCT-116 Colorectal Cancer Cell Line
Get PDFBackground: Colorectal cancer is the second leading cause of mortality and the most prevalent cancer worldwide. Most patients, who come with late-stage, have ineffective treatments and some side effects in chemotherapy. Aaptos suberitoides has potential anti-cancer effects due to its bioactive compounds such as aptamine. This study aimed to evaluate the migration inhibition effect of Aaptos suberitoides fraction in HCT-116 cell line.Methods: This study was an experimental study. Aaptos suberitoides specimen was taken in Tinjil Island and fractionated with ethyl acetate. HCT-116 cell line was added with Aaptos suberitoides fraction and cellular migration activity was observed in 48 hours of which the scratch assay was performed. The gap closure area was determined with ImageJ software.Results: The data showed that a low concentration of Aaptos suberitoides fraction inhibited migration activity in HCT-116 cell line as follow; 1 and 5 mg/L Aaptos suberitoides fraction inhibit 3-4 % cancer cell migration in 24 hours, and 10-11% inhibition in 48 hours, respectively. However, 10 mg/L fraction concentration only inhibited 7-14% of the migration effect.Conclusion: Aaptos suberitoides fraction suggests insignificant migration inhibition in colorectal cancer cells and only inhibits less than 15 % HCT-116 cell line
Profile of Osteomyelitis Patients Visiting the Orthopedic Clinic of Dr. Hasan Sadikin General Hospital, Indonesia, in 2017–2018
Get PDFBackground: Osteomyelitis is an inflammatory process caused by microorganism infection that leads to bone destruction. Osteomyelitis may affect all bones, particularly long bones, and infects all ages. This disease is hard to diagnose and the treatment is complex due to the disease’s heterogenicity, pathophysiology, clinical presentation, and management. This study aimed to determine the profile of osteomyelitis inpatients and outpatients presented to the Orthopedic Clinic of Dr. Hasan Sadikin General Hospital Bandung, IndonesiaMethods: This was a descriptive cross-sectional study conducted from July to October 2019 using the total sampling method. Data were collected from the medical records of osteomyelitis inpatients and outpatients presented to the Orthopedic Clinic of Dr. Hasan Sadikin General Hospital Bandung, Indonesia from 2017–2018. Data were then analyzed descriptively and the results were presented in frequencies.Result: In total, 90 data were retrieved. Most of data presented male patients (n= 69, 76.7%) with the age range of 20–29 years old (24.4%). The majority of these patients experienced chronic onset of disease (94.4%) located on the tibia (51.1%), which was caused by a post-operative procedure (61.1%). The most common treatment was operative procedure without antibiotic beads (51.1%). Staphylococcus aureus was the common pathogens identified in these patients (22.2%).Conclusion: The majority of osteomyelitis patients are males in productive age with chronic onset of disease located on the tibia caused by a post-operative procedure. Staphylococcus aureus is the common pathogen involved and the most common treatment is an operative procedure without antibiotic beads
Gestational Monosodium Glutamate Exposure Effects on Anogenital Distance of Male Rat Pups
Get PDFHigh-dose Monosodium Glutamate (MSG) expo sure increases the estrogen level in pregnant rats. However, there are limited data available on whether the MSG-related maternal hormonal effects can affect male litters' genitalia phenotype. This study aimed to analyze the impact of MSG on estrogen level in pregnant rats and anogenital distance in male pups. Experiment for this study was performed at the animal facility of Biomedical Laboratory at the Faculty of Medicine, Universitas Andalas, from April 2019 to February 2020. Pregnant Wistar rats were given MSG orally at 2 and 4 mg/g body weight (BW) for 20 days. On day 21, pregnant rats were sacrificed and blood was drawn intracardially. Estradiol serum level was measured by ELISA. Male pups were counted, and the anogenital distance (AGD) was measured. Maternal serum estradiol levels were statistically analyzed by One-Way ANOVA and the AGD of male litters were analyzed by the Kruskal-Wallis test. Results showed that perinatal MSG exposure increased the estradiol level (26.3±4.5 pg/ml; 37.5±6.7 pg/ml; 62.1±8.2 pg/ml in control, 2 mg/g BW, and 4 mg/g BW group, respectively [mean±SD; p=<0.001]) and decreased the AGD (4 mm; 3 mm; 1.5 mm in control, 2 mg/g BW, and 4 mg/gBW group, respectively [median; p=<0.01]) in a dose-dependent manner. Thus, MSG exposure during pregnancy is a risk factor for male rat feminization.
Open Reduction of Supracondylar Humerus Fractures in Children for Failed Closed Reduction: Outcome of Delayed Treatment
Get PDFSupracondylar fractures of the humerus are common in children and the advocated treatments for these fractures include closed reduction and percutaneous pinning. There are numerous debates on the intervention period selection for delayed treatment in children. This phenomenon is prevalent in regions with limited healthcare support. The objective of this study was to compare the outcome of early and late treatment groups, including preliminary presentations and the management of failed treatment. This was a prospective comparative study on early and late open reduction, featuring Kirschner wire fixation for Gartland type III supracondylar fracture of humerus in children aged less than 18 years. Patients from January 2018 to January 2019 were categorized into early and late groups (n=22 and n=26), consisting of 33 (86.8%) males and 15 (31.25%) females. Flynn’s criteria were used to evaluate them. The average time from injury to surgery was 50.24±23.5 hours in the early group and 373.79±89.23 hours in the late group (p<0.002). While the Bauman’s angle recorded after 12 weeks presented the values of 82.04 ± 5.18 and 77.38±6.43 (p=0.622) for the early and late groups, respectively. Pre-operative nerve injuries were observed only in 4 (8.33%) cases from the early group. The functional outcomes of both categories were not significantly different statistically (p=0.242). The outcome for children with supracondylar humerus fracture Gartland type III was satisfactory in both groups. In conclusion, treatment delay does not result in a difference in the outcome according to Flynn's criteria
Association between Refractive Error Types and Asthenopia in Primary School Students
Get PDFRefractive error is a condition in which the cornea and lens fail to focus the light, resulting in reduced visual efficiency. Twelve million children are experiencing refractive errors worldwide and uncorrected refractive errors in children have been reported to cause asthenopia. This study aimed to determine the association between the types of refractive errors and asthenopia in children. This cross-sectional study was conducted on 111 students aged 10-13 years old in a public elementary school in Indonesia, SDN Penjaringan 10, in 2019. A questionnaire was used to assess asthenopia and the Snellen Chart, trial frames, and trial lenses were used for refractive errors examination. It was demonstrated that 87.4% of respondents experienced asthenopia, and 53.2% of respondents suffered from uncorrected refractive errors, mostly due to myopia. Fisher’s exact test results showed an association between refractive errors and asthenopia (p=0.019) with all myopic students experienced asthenopia. However, there was no significant association between astigmatism and asthenopia (p=0.754). In conclusion, not all types of refractive errors are associated with asthenopia
Cardiovascular-Related Death Risk Factors in Hypertensive Patients: Indonesia Family Life Survey 2000-2014
Get PDFObjective: To determine the characteristics of the risk factors of cardiovascular death in hypertensive patients in Indonesia based on the Indonesian Family Life Survey (IFLS) longitudinal data. Methods: This was a retrospective descriptive study on secondary data from the IFLS population starting from2000 and was followed up in 2007 and 2014. The inclusion criteria for participation were15 years old or older, had hypertension, had cardiovascular events as thecause of death, and had complete data in both IFLS 3 (2000) and IFLS 4 (2007).Results: The IFLS 5 (2014) reported 918 deaths among eligible subjects with complete data, both in IFLS 3 (2000) and IFLS 4 (2007). Of those, a total of 608 subjects experienced hypertension started from 2000 and/or 2007. Of these deaths, 112 were due to cardiovascular events. Cardiovascular death was more common in males (58.9%), age of >65 years old when died (47.3%), had poor socioeconomic status (24.1%), and with normal body mass index (54.9%).Conclusion: Male, late adulthood, low level of education, normal BMI, and poor socioeconomic status represented the greater risks of cardiovascular death among hypertensive patients in Indonesia.
Correlation between MMP-9 Level and Diastolic Dysfunction in Concentric Left Ventricular Hypertrophy Patients
Get PDFObjective: To establish the relationship between plasma matrix metalloproteinase (MMP)-9 levels and diastolic functional abnormalities using the E/e’ measurement in concentric type Hypertensive Heart Disease (HHD) patients.Methods: A cross-sectional study was conducted from November 2014 to January 2015 in population with hypertension and concentric Left Ventricular Hypertrophy (LVH). Diastolic function was assessed with E/e’ measurement using echocardiography. The relationship between the two variables was analyzed using Spearman correlation.Results: Thirty-nine subjects (14 males, 35.9%) with the average relative wall thickness of 0.7(±0.15), average body weight of 63.45 (±12.97) kg, average height of 155.51 (±7.12) cm, average body mass index of 26.23 (±5.08) kg/m2, and mean age of 55 (±10) years were fit to be included in the analysis. The median systolic blood pressure was 140 (110-220) mmHg while the median diastolic blood pressure and median left ventricular mass index were 80 (70-110) mmHg and 119.24 (103.05-205.69) g/m2, respectively. The median MMP-9 was measured at 108 (4-460) ng/mL and the median E/e' was 10.99 (6.2-20.42). There was a significant positive correlation between MMP-9 and E/e' (r = 0.416, p = 0.004).Conclusion: There is a significant moderate positive correlation between the MMP-9 level and diastolic dysfunction in concentric LVH patients.