E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
Not a member yet
1208 research outputs found
Sort by
Perbandingan Penggunaan Phenylephrine Secara Bolus Dan Infus Kontinu Sebagai Preventif Terhadap Kejadian Spinal Anesthesia-Induced Hypotension
Full text linkHipotensi merupakan efek samping kardiovaskular yang umum terjadi akibat anestesi spinal, disebabkan oleh blokade simpatis yang memicu vasodilatasi, penurunan tahanan vaskular perifer, dan penurunan tekanan darah. Fenilefrin, agen simpatomimetik yang bekerja langsung sebagai agonis α-1 adrenergik, merupakan pilihan utama dalam pencegahan spinal anesthesia-induced hypotension (SAIH) karena kemampuannya menginduksi vasokonstriksi secara langsung. Penelitian ini bertujuan membandingkan efektivitas fenilefrin dalam bentuk bolus dan infus kontinu untuk mencegah SAIH. Penelitian dilakukan dengan desain uji klinis acak terhadap 38 pasien yang menjalani operasi dengan anestesi spinal di RSUP Haji Adam Malik, Medan. Intervensi meliputi pemberian Fenilefrin secara infus kontinu 20 mcg/menit dan bolus 50 mcg sebelum induksi anestesi spinal. Hasil menunjukkan rerata tekanan darah sistol pada kelompok bolus sebesar 113,78±20,86 mmHg dan pada kelompok infus 112,63±8,17 mmHg (p=0,823), menunjukkan tidak terdapat perbedaan bermakna antara kedua metode. Variabel denyut jantung juga tidak menunjukkan perbedaan signifikan. Simpulan, tidak terdapat perbedaan yang signifikan antara pemberian fenilefrin secara bolus maupun infus kontinu dalam pencegahan SAIH.Pendahuluan Hipotensi merupakan efek samping kardiovaskular dari anestesi spinal. Blok simpatis yang menyebabkan vasodilatasi dari pembuluh darah meyebabkan tahan vascular perifer menurun yang mengakitbatkan turunnya tekanan darah dan terjadinya hipotensi. Phenylephrine adalah obat simpatomimetik yang bekerja langsung sebagai α-1 agonis adrenergik yang bekerja langsung pada pembuluh darah untuk mengaktivasi vasokonstriksi. Sehingga menjadi obat pilihan dalam preventif SAIH. Pemberian phenylephrine dapat diberikan secara bolus dan infus kontinu. Metode Penelitian ini membandingakn efek phenylephrine bolus dan infus dengan jumlah sampel 38 dan dibagi 2 kelompok, dengan desain uji klinis dengan randomisasi, yang dilakukan di RSUP Haji Adam Malik Medan pada pasien yang menjalani operasi dengan anestesi spinal. Penelitian ini dilakukan dengan memberikan phenylephrine infus kontinu 20 mcg/menit dan bolus 50 mcg sebelum dilakukan anestesi spinal. Hasil didapatkan hasil rerata tekanan darah sistol pada kelompok phenylephrine bolus 113,78±20,86 dan pada phenylephrine infus 112,63±8,17 dengan nilai perbandingan 0,823 yang menandakan tidak ada perbedaan yang signifikan. Pada variable heart rate tidak didapatkan perbedaan yang signifikan antara kedua kelompok. Kesimpulan Tidak terdapat perbedaan yang signifikan antara pemberian phenylephrine bolus dan phenylephrine infus dalam preventif terhadap SAI
Association Between Cardiovascular Risk Factors and CAD Severity by CAD-RADS Categories and Comprehensive CTA Score
No full textBackground: Coronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide, including in Indonesia. Risk factors (RFs) play an important role in both pathogenesis and management of cardiovascular (CV) diseases. Coronary computed tomography angiography (CTA) is a reliable non-invasive diagnostic method. Coronary Artery Disease Reporting and Data System (CAD-RADS) categories and comprehensive CTA score describes CAD severity on coronary CTA and provides additional prognostic value.Objective: To explore the link between traditional cardiovascular risk factors and CAD severity based on CAD-RADS and comprehensive CTA scores.Methods: This retrospective, single-center study was conducted at a tertiary hospital using data from the Cardiovascular Imaging Database of the hospital from January 2020 to June 2022. Data meeting the inclusion and exclusion criteria were analyzed using ordinal and binary regressions.Results: A total of 423 patients' data were analyzed. Ordinal regression revealed significant links between age ≥ 65 years, male gender, hypertension, diabetes, and higher CAD severity based on both CAD-RADS and comprehensive CTA scores. Binary regression showed that older age and male gender were independently associated with CAD-RADS ≥ 3 and comprehensive CTA score ≥ 6. Diabetes was linked to CAD-RADS ≥ 3, and hypertension was tied to a comprehensive CTA score ≥ 6. The number of risk factors showed a trend toward CAD severity (p=0.069) and a significant link with comprehensive CTA score (p=0.012).Conclusion: There is a significant association between traditional cardiovascular risk factors and CAD severity as quantified by both CAD-RADS and comprehensive CTA score
Impact of Nutrition Education on Dietary Habits among Bachelor-in-Medicine, Bachelor-in-Surgery (MBBS) Students: A Study in an Indian Medical College
No full textBackground: Unhealthy eating patterns, often triggered by academic pressures and erratic schedules, can negatively impact students’ health and hinder their ability to effectively guide future patients. Nutrition education offers a valuable opportunity to promote healthier eating habits by providing critical knowledge that supports both students’ personal wellbeing and professional competence.Objective: To evaluate the effect of nutrition education on eating habits of first-year Bachelor-in-Medicine, Bachelor-in-Surgery (MBBS) among medical students.Methods: A pre-post interventional study was carried out on 200 Phase-1 MBBS students of Muzaffarnagar Medical College between January and June 2024. Initial dietary habits were assessed using a validated questionnaire. A structured session of nutrition education was provided. The dietary habits were then re-assessed after four weeks, and changes were analyzed using paired statistical tests.Results: Data collected after the intervention showed notable enhancements in dietary practices. The percentage of students consuming three balanced meals a day increased from 32% to 68% (p < 0.001). The intake of fast food decreased from 65% to 35%, and the consumption of sugar-sweetened beverages fell from 58% to 30%. The average servings of fruits and vegetables consumed daily rose from 2.1 to 4.5 (p < 0.01). Nutrition knowledge scores presented a 30% improvement, indicating greater awareness.Conclusion: Medical students' eating habits are much improved by nutrition education, underscoring its significance in medical education. Future healthcare workers may benefit from lifelong good eating habits if such programs are incorporated into the curriculum, which would improve patient care and their own health
Effects of Tamarillo (Solanum betaceum) Extract on Glutathione Peroxidase Expression and Inflammatory Reactions in Lead Acetate-Induced Lung Tissue of Mice
No full textBackground: Lead acetate exposure through oral route has a significant impact on lung tissue as lead can induces the formation of reactive oxygen species (ROS), resulting in decreased glutathione peroxidase (GPx) and triggering inflammatory responses. The induction of exogenous antioxidants may prevent this mechanism. This study aimed to evaluate the protective effect of Tamarillo ethanol extract on GPx expression and inflammatory reactions in the lung tissue of mice induced with lead acetate.Methods: This true experimental laboratory study utilized stored formalin-fixed-paraffin-embedded (FFPE) lung tissue from 30 male mice (Mus musculus). The samples were divided into five intervention groups, each consisting of six mice. Immunohistochemistry and histopathology assessments were performed at 100x and 400x magnification to evaluate the GPx expression using the H-score and to assess inflammatory reactions based on five scoring parameters, which were summed to obtain the total lung injury score.Results: Lead exposure significantly increased inflammatory reactions, particularly in the hemorrhage parameters (p=0.041). A significant increase in GPx expression was observed following lead acetate administration (p=0.027). Administration of Tamarillo ethanol extract at a dose of 400 mg/kgBW increased GPx expression compared with the positive control group (p=0.027).Conclusion: Tamarillo ethanol extract, especially at a dose of 400 mg/kgBW, significantly increases GPx expression in lead acetate-induced lung tissue of mice. This finding highlights the potential role of Tamarillo extract as an antioxidant source to reduce lead-induced lung injury, supporting broader efforts to promote healthy lifestyle practices that protect against environmental toxin exposure
Comparison between Local Infiltration Combination of 1% 200 mg Lidocaine and 10 mg Dexametason with 0.75% 150 mg Ropivacaine on Degree of Pain in Post-Caesarian Operative Wounds
No full textIntroduction: Local anesthetic wound infiltration reduces postoperative pain, promotes early mobilization, and shortens hospital stay after cesarean section. Lidocaine is widely used, and the addition of dexamethasone may prolong its analgesic effect. Ropivacaine provides longer-lasting analgesia but is more expensive and less accessible in many hospitals. This study aimed to compare the analgesic effects of local wound infiltration using 0.75% ropivacaine 150 mg versus 1% lidocaine 200 mg combined with 10 mg dexamethasone on postoperative pain following cesarean section.Methods: This randomized, double-masked, controlled clinical trial involved 38 patients undergoing cesarean section under spinal anesthesia. Participants were randomly allocated using a computer-generated sequence to receive wound infiltration with either 1% lidocaine (200 mg) plus dexamethasone (10 mg) or 0.75% ropivacaine (150 mg). Patients and outcome assessors were blinded to group allocation. Postoperative pain intensity was assessed using the Numeric Rating Scale (NRS) at rest and during passive movement at 2, 6, 12, and 24 hours after surgery.Results: The ropivacaine group had significantly lower NRS scores at rest and during passive movement at 2, 6, and 12 hours postoperatively compared with the lidocaine–dexamethasone group (p 0.05).Conclusion: Local wound infiltration with 0.75% ropivacaine 150 mg provided superior analgesia during the first 12 hours after cesarean section compared with lidocaine combined with dexamethasone. The lidocaine–dexamethasone combination remains a practical alternative where ropivacaine is unavailable
Effectiveness of Low-Impact Aerobic Exercise to Improve Cardiorespiratory Fitness and Quality of Life in Elderly
Full text linkBackground: Aging is associated with declining physical health and decreased quality of life in the elderly population. In response to the rising challenges faced by the aging demographic, this study aimed to investigate the effects of low-impact aerobic exercise on cardiorespiratory fitness and overall quality of life in the elderly. Methods: A quasi-experimental study design was employed involving 42 elderly participants who underwent a three-month low-impact aerobic exercise intervention. This study was conducted in the work area of the Surakarta City Health Service from June to August 2023. Cardiorespiratory fitness was measured using the Harvard Step Test, and quality of life was assessed through the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire. The effect of low-impact aerobic exercise on cardiorespiratory fitness and quality of life was analyzed using the non-parametric test Wilcoxon Test.Results: Most respondents were aged 60–65 years (66.7%) and female (71.5%). The study revealed a significant improvement in both cardiorespiratory fitness (p=0.025) and quality of life (p<0.000) among the elderly participants after low-impact aerobic exercise intervention.Conclusion: Low-impact aerobic exercise has an effect on increasing cardiorespiratory fitness and quality of life in the elderly. This finding is expected to be one of the main therapies that can help maintain the health and well-being of the geriatric population
Comparison of CONUT Score, SGA Score, and GLIM Score as Gold Standard for Colorectal Cancer Patients
Full text linkMalnutrition in colorectal cancer increases toxicity, worsens quality of life, and reduces body functions. Early identification of malnutrition is crucial to determine treatments. This study compared the Global Leadership Initiative on Malnutrition (GLIM) score as the standard nutritional status screening tool to the Controlling Nutritional Status (CONUT) and Subjective Global Assessment (SGA) scores. This study expected to identify a new nutritional status screening tool for colorectal cancer patients. This was a cross-sectional diagnostic study on 60 colorectal cancer patients treated at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia from August 16, 2022 to July 16, 2023. Results revealed that the CONUT score had a sensitivity, specificity, accuracy, and effectiveness values of 80.4%, 0.0%, 85%, and 85%, respectively, in detecting malnutrition. The SGA score had a sensitivity value of 100%, a specificity value of 21.95%, an accuracy value of 85%, and an effectiveness of 85% in detecting malnutrition. When compared with the GLIM score as the gold standard, which is assumed to have a sensitivity and specificity values of 100%, the SGA score was better than the CONUT score for detecting malnutrition in colorectal cancer patients. The SGA score is closest to the GLIM score as the gold standard for assessing malnutrition in colorectal cancer patients
Predictors of In-Hospital Mortality in Patients with Infective Endocarditis: A Single-Center Study
Full text linkBackground: Infective endocarditis remains a life-threatening condition with high in-hospital mortality, necessitating identification of predictive clinical factors.Objective: To identify predictors of in-hospital mortality in infective endocarditis (IE) patients.Methods: This single-center retrospective study included 88 patients with IE aged ≥ 18 years treated at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, between September 2019 and May 2023. During hospitalization, data regarding clinical characteristics, blood cultures, and clinical outcomes were assessed to identify the predictors of in-hospital mortality. Data were analyzed using chi-square and binary logistic regression.Results: Among 88 patients with IE, the majority were male (56.8%) and aged < 60 years old (78%). More than two-thirds of patients had valvular heart disease. During treatment, 22 patients (25%) underwent cardiac surgery, and the total in-hospital mortality rate was 35.2%. Although not statistically significant, in-hospital mortality rate was lower in operated patients (22.7% vs 39.4%). In multivariate analysis, septic shock was the only significant predictor of in-hospital mortality (OR 40, 95% CI: 4.7–339, p 0.001)Conclusion: Septic shock is a strong predictor of in-hospital mortality among patients with infective endocarditis. Invasive management by cardiac surgery does not significantly decrease the mortality risk
Closure Techniques and Postoperative Outcomes of Major Lower Limb Amputation in Acute Limb Ischemia
Full text linkAmputation, derived from the Latin "amputare," refers to the removal of a body part covered by skin, often necessitated by acute limb ischemia (ALI). Effective wound closure is critical for minimizing complications, length of stay, costs, and the risk of re-amputation. This study compared postoperative outcomes of major lower limb amputation in ALI patients with primary versus delayed wound closure. A descriptive analytic study was conducted at Dr. Hasan Sadikin Hospital, Bandung, Indonesia, from January 2020 to December 2023, analyzing medical records of 46 patients aged 19–85 years, with a predominance of female patients. Thrombosis was the leading cause of ALI (76.1%), and hypertension was the most frequent comorbidity. Significant differences were observed in stump complications and revision surgery rates between primary and delayed wound closure groups (p<0.05), while length of stay and mortality did not show statistically significant differencesy. In conclusion, the study highlights a significant relationship between different wound closure methods and complications, suggesting that choice of closure technique may influence the postoperative outcomes in ALI patients
Tension Band Wiring for Chronic Acromioclavicular Joint Dislocations Rockwood Type III/ISAKOS Type IIIB
Full text linkAcromioclavicular joint (ACJ) dislocations account for 10% of shoulder injuries, with Rockwood type III being the most common. Despite its prevalence, there is no consensus regarding a gold standard surgical treatment for chronic ACJ dislocations. tients often delay seeking medical attention during the chronic phase, during which soft tissue healing capacity significantly declines. A 30-year-old male presented with persistent shoulder pain and restricted elevation two months after a motorcycle accident. The patient initially sought alternative treatment, later developed chronic pain and an inability to elevate the shoulder. Physical and radiograph examinations revealed a Rockwood type III ACJ dislocation. After treatment with the tension band wiring (TBW) technique, functional outcomes were assessed using the Disabilities of The Arm, Shoulder and Hand (DASH) and Constant scores. The Constant score improved from 61 to 92 and while the DASH score decreased from 45 to 5 in 3 months and 2 weeks post-operation. International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) subdivided Rockwood Type III injuries into IIIA (stable) and IIIB (unstable), with type IIIB requiring surgical treatment. Several studies suggested that mechanical stabilization with biological augmentation is sufficient in neglected cases. However, this technique is expensive and required specialized skill and expertise in shoulder arthroscopy. To overcome this challenge, TBW has emerged as a cost-effective and straightforward surgical technique that enables faster rehabilitation and provides a stable, pain-free shoulder without postoperative complications. It may serve as a viable treatment option, particularly in resource-limited or rural settings