E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Anti-Inflammatory Effect of Centella asiatica (L.) Extract by Decreasing TNF-α Serum Levels in Rat Model of Traumatic Brain Injury
Get PDFCentella asiatica (L.) has many active ingredients with many important roles, including as antioxidant, anti-inflamation and neuroprotectant. Centella asiatica (L.) can reduce inflammatory reactions by inhibiting the activity of TNF-α. Thus, Centella asiatica (L.) is a potential alternative therapy for traumatic brain injury by reducing inflammation via TNF-α expression modulation. This study aimed to determine the effect of Centella asiatica (L.) on serum TNF-α levels in rat model of traumatic brain injury. This study was conducted during the period of July 3-17, 2020 at the LPPT Unit IV, Gajah Mada University. This was a true experimental with post-test only control group study on 35 male wistar rats as the experimental animals. The rats were divided into 5 groups: P1, P2, and traumatic brain injury groups that received Centella asiatica (L.) treatement at 150, 300, and 600mg/kgBW/d doses, respectively. Blood samples were collected after the experimental animals were terminated to assess serum TNF-α levels. Mean TNF-α levels were 60,980±4,057, 76,931±0,698, P3=75,889±0,948, P4=75,868±1,163, and 74,508±1,126 for P1, P2, P3, P4, and P5, respectively. The Kruskal Wallis test results showed a statistically different between groups (p = 0.005). This study shows that Centella asiatica (L.) can decrease serum TNF-α level in rat model of traumatic brain injury
Five-Year Profiles of Prostate Cancer Patients in A Tertiary Hospital in Indonesia
Get PDFProstate cancer is a malignant disease of the urogenital system, which is the second most common cancer in men and one of the leading causes of death in male population. In Bandung City, Indonesia, no data are available regarding the profile of prostate cancer patients. This study aimed to determine the profile of prostate cancer patients treated at Dr. Hasan Sadikin General Hospital Bandung, Indonesia, which is the tertiary hospital in the most populated province in Indonesia, during the period of 2015-2019. This was a a retrospective descriptive study on secondary data from medical records. Results showed that most prostate carcinoma patients were was 67.95 ± 8.946 years old with most of them (n=92, 81.4%) had a history of hypertension and 62 patients (54.9%) did not have any history of smoking. Most patients had 20-40 cc prostate volume with hard consistency and without nodules; a PSA level of > 20 ng/ml; and a gleason score of 8-10 or poorly differentitated. Age affected increased incidence of prostate carcinoma with the highes prostate volume (20-40cc). The average PSA was 504.66 ± 10.26 and the median gleason score was 8 (6-10). The highest prostate volume is 20-40cc with hard consistency without nodule and the highest PSA value is > 20 ng/ml with a Gleason score of 8-10, showing a poorly differentiated condition
Comparison of Cognitive Function of Ischemic Stroke Patients with and without Pneumonia
Get PDFBackground: Pneumonia is a common complication of ischemic stroke that may worsens brain injury, leading to cognitive impairment as well as patient outcome. The aim of this study was to compare cognitive function in ischemic stroke patients with and without pneumonia.Methods: This study was a comparative numerical analytic retrospective cross-sectional study that was conducted from September 2020 to February 2021. This study used data from ischemic stroke patients treated at Dr. Hasan Sadikin General Hospital in 2019 with the total sampling method. Data were stratified into patients with pneumonia and without pneumonia. The mini mental state examination (MMSE) was used to measure cognitive function in both groups and scores were compared using the Mann-Whitney Test.Result: Of the 164 data, 25 were patients with pneumonia and 139 without pneumonia. Male patients were predominantly prevalent in the pneumonia and non-pneumonia groups. Hemiparesis was the most common neurological deficit. The MMSE score was significantly lower in the pneumonia group (22.6 ± 5.4 vs. 24.7 ± 4.8, respectively; p-value=0.032). Conclusion: Cognitive function is more prevalent in ischemic stroke patient with pneumonia compared to non-pneumonia. However, other factors such as recurrent stroke and possible vascular risk factors should be considered for future studies to better identify the relationship between ischemic stroke and pneumonia
Histopathological Findings in Sudden Cardiac Death: 5-years Autopsy Experience in a Tertiary Hospital in Bandung, Indonesia
Get PDFBackground: Sudden death (SD) is a sudden and unexpected death with an unknown cause. However, it has been assummed that the most common causes of sudden deaths are cardiovascular or non-cardiovascular causes such as gastrointestinal disease, respiratory disease, genitourinary disease, epilepsy, and trauma. This study aimed to portray histopathological findings and causes of sudden cardiac death (SCD) cases based on 5 year autopsy experience in a tertiary hospital in Bandung, Indonesia. Methods: This study was a descriptive cross-sectional study exploring causes of SCD from 2015 to 2019 at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. All medical records with SCD and histopathology findings were retrieved from September to December 2020. Only cases with histopathological examination results were included.Results: SCD was found in 7 of 16 patients with sudden death. Coronary atherosclerosis was the most common (n=4), followed by myocardial infarction (n=2) and ruptured aortic aneurysm (n=1). Myocarditis and calcific aortic valve diseases were not found.Conclusions: In this study, the most common cause of SCD is coronary atherosclerosis, which is identified mainly in older and male patients
Efektivitas oksigenasi dan ventilasi saat induksi anestesi umum menggunakan masker bedah dinilai berdasarkan SpO2 dan EtCO2
Get PDFAnestesiolog memiliki risiko tinggi terpapar aerosol pada saat melakukan tindakan ventilasi maupun intubasi. Anestesiolog harus dapat melakukan ventilasi dengan baik selama induksi anestesi umum. Tujuan penelitian ini adalah mengetahui efektivitas oksigenasi dan ventilasi saat induksi anestesi umum pada pasien yang menggunakan masker bedah dinilai berdasar atas SpO2 dan EtCO2. Penelitian ini merupakan penelitian analisis numerik berpasangan dengan rancangan eksperimental pada pasien yang dilakukan operasi elektif dengan anestesi umum di Instalasi Bedah Sentral RSUP Dr. Hasan Sadikin Bandung pada bulan November–Desember 2020. Selama induksi anestesi, pasien menggunakan masker bedah kemudian dilakukan penilaian SpO2 dan EtCO2 pada saat sebelum induksi dan selama induksi menit ke-1, 2, dan 3. Hasil penelitian mengungkapkan nilai SpO2 dan EtCO2 preinduksi dan pada menit ke-1, 2, dan 3 diperoleh nilai rerata SpO2 dan EtCO2 induksi menit ke-1, ke-2, dan ke-3 tidak lebih inferior dibanding dengan nilai pra induksi (p<0,05) dengan nilai rerata SpO2 dan EtCO2 dalam batas normal.Simpulan penelitian adalah penggunaan masker bedah selama induksi tidak mengurangi efektivitas oksigenasi dan ventilasipada pasien yang dilakukan anestesi umum dinilai berdasar atas SpO2 dan EtCO2. Effectiveness of Oxygenation and Ventilation During General Anesthesia Induction Using Surgical Mask Assessed by SpO2 and EtCO2 Anesthesiologist have high risk for exposure of aerosol during ventilation or intubation. They must do ventilation during induction of general anesthesia effectively. The study was aimed to know how effective the oxygenation and ventilation during induction of general anesthesia while using surgical mask assessed by SpO2 and EtCO2. The research was a numerical analytic with experimental design performed on elective surgery patients done by general anesthesia in central operating theatre Dr. Hasan Sadikin General Hospital Bandung in November–December 2020. During induction of anesthesia, patient were using surgical mask and assessment of SpO2 and EtCO2 was done before induction and during induction in the 1st, 2nd, and 3rd minute induction. The result of the study revealed SpO2 and EtCO2 preinduction and 1st, 2nd, and 3rd minute induction had SpO2 and EtCO2 value in 1st, 2nd, and 3rd minute induction not inferior to pre induction value, with SpO2 and EtCO2 value within normal limit.The study has concluded that using surgical mask during induction does not decrease the effectiveness of oxygenation and ventilation in patient with general anesthesia assessed by SpO2 and EtCO2.Anestesiolog memiliki risiko tinggi terpapar aerosol pada saat melakukan tindakan ventilasi maupun intubasi. Anestesiolog harus dapat melakukan ventilasi dengan baik selama induksi anestesi umum. Tujuan penelitian ini adalah untuk mengetahui efektivitas oksigenasi dan ventilasi saat induksi anestesi umum pada pasien yang menggunakan masker bedah dinilai berdasarkan SpO2 dan EtCO2. Penelitian ini merupakan penelitian analisis numerik berpasangan dengan rancangan eksperimental pada pasien yang dilakukan operasi elektif dengan anestesi umum di Instalasi Bedah Sentral RSUP Dr. Hasan Sadikin Bandung pada bulan November – Desember 2020. Selama induksi anestesi, pasien menggunakan masker bedah kemudian dilakukan penilaian SpO2 dan EtCO2 pada saat sebelum induksi dan selama induksi menit ke-1, 2 dan 3. Hasil penelitian mengungkapkan nilai SpO2 dan EtCO2 preinduksi dan pada menit ke-1, 2 dan 3 diperoleh nilai rata-rata SpO2 dan EtCO2 induksi menit ke-1, ke-2 dan ke-3 tidak lebih inferior dibandingkan dengan nilai pra induksi (p<0,05) dengan nilai rata-rata SpO2 dan EtCO2 dalam batas normal.Simpulan penelitian adalah penggunaan masker bedah selama induksi tidak mengurangi efektivitas oksigenasi dan ventilasipada pasien yang dilakukan anestesi umum dinilai berdasarkan SpO2 dan EtCO2
Correlation of Serum Potassium Status and HEART Score in Acute Coronary Syndrome Patients
Get PDFBackground: Patients with acute coronary syndrome (ACS) often experience hypokalemia which increase the risk of ventricular arrhythmia. The HEART Score can identify the prognosis of ACS. This study aimed to examine the correlation between serum potassium and HEART Score on ACS.Methods: This was a cross-sectional observational, correlative analytic study. The data were taken retrospectively using secondary data. Inclusion criteria were all ACS patients who had been examined for serum potassium parameters at the Emergency Room of Dr. Hasan Sadikin General Hospital Bandung in 2019. The HEART Score was calculated based on history (H), electrocardiogram (E), Age (A), risk factors (R), and troponin (T). Subjects were divided into low risk, intermediate risk, and high risk groups based on the HEART Score value.Results: Fifty-two ACS subjects were mostly male with a mean±SD age of 59±9 years. All subjects had moderate and high HEART scores, with 79% subjects having normokalemia. There was no correlation between HEART Score and serum potassium levels (r = -0.083, p=0.279).Conclusion: There is no relationship between serum potassium and the HEART Score that may need to determine the prognosis in ACS patients. Further study is imperative to explore serum potassium levels which might begin to decline 24 hours after the acute attack.
Validity and Reliability Test of Four-Meter Gait Speed on Six Meter Track for Indonesian Adults
Get PDFWalking is an essential component of daily life and studies have shown the growing number of clinicians performing walking tests in their daily practice. This study is aimed to assess the validity and reliability of the Four-Meter Gait Speed (4MGS) test for healthy Indonesian adults (Mongoloid race). Data collection were conducted at the Rehabilitation Department of Dr. Cipto Mangunkusumo General Hospital during the period of August 2016 to March 2017. Two observers and two trials were involved in measuring the gait speed in the 4MGS test with a 6 meter track. All accumulated data were analyzed for validity using the Bland-Altman test, while test re-test reliability was done using Cronbach's alpha for internal consistency. Sixty-one subjects were involved in this study. There were no significant differences in inter-trial comparison from both observers (P=0.262 and P=0.954). Similarly, intra-observer walking speed comparison in both trials were also not significantly different (P=0.117 and P=0.869). The intraclass correlation coefficient (ICC) value between the first and second tests from observer I was 0.839 (Cronbach Alpha,0.911) while the value for observer II was 0.902 (Cronbach Alpha, 0.948). The ICC value between observer I and II in the first trial was 0.906 (Cronbach Alpha, 0.950); whereas the second trial demonstrated a value of 0.890 (Cronbach Alpha, 0.941). Thus, the 6 meter track 4MGS has a good validity and reliability for healthy Indonesian adults. It is expected that the walking speed from this study can be used for Mongoloid race living in other countries and the 4MGS can become an alternative speed-based walk test, especially during COVID-19 pandemic, due to its practicality in measuring functional capacity in a shorter duration
Agreement on Overt Disseminated Intravascular Coagulation in Sepsis Patients between International Society of Thrombosis and Haemostasis Criteria and Japanese Ministry of Health and Welfare Criteria
Get PDFDisseminated Intravascular Coagulation (DIC) is an acquired syndrome characterized by the activation of intravascular coagulation which is most commonly caused by sepsis. There are two types of DIC disease: overt and non-overt DICs. The International Society of Thrombosis and Haemostasis (ISTH) criteria are more frequently used in the diagnosis of overt DIC compared to Japanese Ministry of Health and Welfare (JMHW). One of the different parameters of the two criteria is the D-Dimer element in the ISTH criteria and Fibrin Degradation Products (FDP) in the JMHW criteria. The availability of fibrin-related markers is different in each health center. This study aimed to see the agreement of the DIC diagnosis based on the ISTH and JMHW criteria and to analyze the correlation between D-Dimer and FDP in sepsis patients to help clinician decide which criteria is better to use. An analytical cross-sectional study was carried out on patients with sepsis based on the clinical diagnosis from the laboratory order forms and the DIC criteria according to the ISTH and JMHW. Patients included in this study were those visiting Dr. Hasan Sadikin General Hospital Bandung from August 2019-April 2020. Data collected were analyzed statistically using Cohen's Kappa test and Spearman test, both were performed in SPSS 17.0 program.There were 35 subjects participating in this study with overt and non-overt DIC with a composition based on the ISTH and JMHW criteria of 31 and 19 vs. 4 and 16, respectively. The Kappa coefficient between ISTH and JMHW was 0.266 (p 0.021) and the correlation between the D-Dimer and the FDP was 0.88 based on the Spearman test. There is a fair agreement on the DIC diagnosis and strong correlation between the FDP and the D-Dimer in sepsis patients when assessed using the ISTH and JMHW criteria. Both criteria are equally able to assist clinicians in determining the type of DIC depending on the type of fibrin-related markers available in the health centers
Hook effect and serum KL-6 in Patients with Systemic Sclerosis-Associated Interstitial Lung Disease (SSc-ILD)
Get PDFObjective To determine whether serum KL-6 can be used as an alternative diagnostic tool for Systemic Sclerosis-associated ILD (SSc-ILD).Method This was a cross-sectional study with compatibility analysis of SSc patients visiting the rheumatology clinic of Dr. Hasan Sadikin General Hospital, Bandung, Indonesia in 2019-2020. Inclusion criteria were aged 18-60 years, diagnosed with SSc, restrictive spirometry results followed by HRCT thorax, having stored biological materials (397.5 unit/mL was declared as ILD. The compatibility analysis was performed using the Cohen’s Kappa test.Results: Thirty-eight subjects, mostly women (94.7%), with mean age of 39 years participated in this study. Most of the subjects suffered from diffuse systemic sclerosis subtypes (57.9%). Subjects had received cyclophosphamide (10.5%), MMF (2.6%), and other medications. Almost all subjects (97.4%) demonstrated ILD features on HRCT thorax. The median serum KL-6 level was 53.22 Units/mL, which was much lower than the findings in other studies, but the hook effect could not be proven. The Kappa coefficient was found to be 0.003 with a p-value of 0.811.Conclusion There is no compatibility between serum KL-6 level and ILD features based on HRCT thorax in SSc-ILD. The presence of hook effect needs more attention
Positive Postoperative Blood Cultures in Major Abdominal Surgery Patients Attending a Tertiary Hospital in Durban, South Africa
Get PDFBackground: Evidence from high-income countries suggests that bloodstream infection is an essential complication following major surgery. However, studies of bloodstream infections following major surgery in lower-income settings, particularly in Africa, are rare. This study aimed to determine the incidence of postoperative bloodstream infection and to explore any association with mortality in high-risk laparotomy patients in South Africa. Methods: This study was a retrospective study, reviewing 435 consecutive adults who underwent laparotomy at a South African tertiary hospital over a five-year period. Incident postoperative bloodstream infection, defined as a positive blood culture following surgery, was determined from laboratory reports in the patient’s medical chart. Source infections and the causative microorganisms were established from laboratory reports. Inpatient mortality was determined from the patient’s hospital discharge summary. Data were summarized using descriptive statistics. Potential associations between bloodstream infection and mortality were tested using the chi-square test.Results: The incidence of postoperative bloodstream infection was 7.4%. Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus were isolated from 21.9%, 18.7%, and 15.6% of blood cultures. Mortality in patients with bloodstream infection was 46.9% vs. 16.1% in patients without bloodstream infection (p<0.001).Conclusions: Postoperative bloodstream infection is an essential complication following major abdominal surgery with K. pneumoniae, E. coli, and S. aureus being the most common causative agents. Bloodstream infection is associated with a higher risk of postoperative mortality. Further studies are recommended to confirm the findings and improve patient management