Majalah Kedokteran Bandung
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AST to Platelet Ratio Index (APRI), Fib-4 Score, and Pregnancy Outcome of Pregnant Women with Hepatitis B
Full text linkHepatitis B virus infection in pregnancy has become a major concern in many developing countries,. The relationship between hepatitis B virus infection and pregnancy is complex and puzzling. This study aimed to investigate the relationship between hepatitis B virus infection and pregnancy outcomes with the insights into the AST to Platelet Ratio Index (APRI) and Fib-4 score. This was a cross-sectional study on pregnant women with hepatitis B virus infections who underwent labor at dr. Zainal Abidin Hospital General Hospital, Aceh, Indonesia. Data were collected from the obstetric ward patient medical records from 2017 to 2019 and 77 pregnant women was identified to be infected with hepatitis B virus, of which 44 had complete medical record data and were included in the analysis. The median APRI in this study was 0.30 (0.1-1.2) while the median FIB-4 score was 0.74 (0.3-1.9). Delivery with live births was identified in 42 (95.5%) women. Term pregnancy and vaginal delivery were observed in 39 (88.6%) and 10 (22.7%) women, respectively, Complicated pregnancy was seen in 14 (31.8%) of pregnancies that included complications such as oligohydramnios, HELLP, severe preeclampsia, placenta previa, and premature rupture of membranes. APRI was higher in the stillbirth group (0.5 [0.2-0.8] p = 0.682) and preterm birth group (0.4 [0.2-0.6], p = 0.502). FIB-4 scores were higher in the stillbirth group (1.2 [0.5-1.8], p = 0.517) and preterm birth group (0.9 [0.4-1.9], p = 0.529). Hence, pregnancy does not always worsen liver function and is not related to the natural course of hepatitis B infection. Pregnancy with hepatitis B without fibrosis is not associated with poor pregnancy outcomes. Routine liver function examination is needed in pregnant mothers with hepatitis B virus infections
Correlation Between Physical Activity and Fitness Level Among Anesthesiology and Intensive Care Residents
Full text linkAnesthesiologists have a highly varied scope of work. Previous studies demonstrated that the physical activity of anesthesiologists and their residency program in the work environment does not meet the recommended standards. This study aimed to determine the relationship between physical activity and level of physical fitness among anesthesiology residents. This study was an analytical observational study with a cross-sectional design conducted on residents of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Padjadjaran, Indonesia, between January and April 2022. All anesthesiology residents were asked to fill out the International Physical Activity Questionnaire (IPAQ) and had their number of steps measured using a pedometer while the physical fitness level was assessed using the Harvard Step Test. Physical activity was assessed based on the IPAQ and pedometer. The results of IPAQ measurement showed that more subjects had low physical activity (n=44) compared to good physical activity (n=31). When measured using a pedometer, 38 subjects were classified as having low physical activity while 36 had good physical activity. Low fitness level (n=43) was associated with less physical activity on IPAQ (41 and 2)and pedometer (30 and 13). No residents had moderate or better fitness levels. Correlation analysis between physical activity and physical fitness showed a significantpositive correlation with a p-value <0.05 (Spearman Rho: 0.618). Thus,physical activity and fitness level are well-correlated among of Anesthesiology and Intensive Care residents
Impact of First Eye Cataract Surgery on Quality of Life
Full text linkCataracts are the second leading cause of visual impairment and the first cause of blindness, both globally and Indonesia. Cataracts do not only reduce vision but also the quality of life of the patients. Cataract surgery of at least one eye is expected to improve the patient's visual function and quality of life. This study aimed to assess the quality of life of patients with bilateral senile cataracts after the first eye surgery compared to people with normal vision. This was a cross-sectional study on 75 patients who underwent their first eye cataract surgery at the Cataract and Refractive Surgery Unit and 75 people with normal vision who visited the Refraction, Contact Lens, and Low Vision Unit of the National Eye Center of Cicendo Eye Hospital during the period of March-June 2020. The quality of life assessment was conducted through interviews using the National Eye Institute Visual Function Questionnaire-25. The non-inferiority test with a margin of 20% was performed. The mean age of the subjects was 63.49 years with no difference in the proportion of gender. Presenting visual acuity of binoculars after the first cataract surgery was 0.26 LogMAR and normal vision was 0.07 LogMAR. With a margin of 20%, the patient's quality of life after the first cataract surgery was not inferior to the normal vision subjects (d = -2.45% (95% CI -6.3% to 1.4%).) Hence, patients' quality of life after the first cataract surgery is not inferior to those with normal vision
Correlation Between P-Selectin Level and Platelet Aggregation in Cerebral Venous Sinus Thrombosis Patients
Full text linkOne of the causes of cerebral venous sinus thrombosis (CVST) is platelet hyperactivity. Adhesion and secretion are the beginning of platelet activation, which is indicated by a change in the Platelet-selectin (P-selectin) level. The end result of platelet activation is platelet aggregation. However, it is unknown whether the beginning of platelet activation ends with platelet aggregation. This study aimed to discover the correlation between P-selectin level and platelet aggregation in CVST. This study used a cross-sectional escriptive observational correlative approach. Subjects were the CVST outpatients visiting the Neurology Department of Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, from July to September 2021. A total of 49 subjects met the inclusion and exclusion criteria. This study used citrate plasma samples for platelet aggregation and serum for P-selectin assessment. Platelet aggregation were assessed using the light transmission platelet aggregation method while P-selectin was assessed using Enzyme-linked immunosorbent assay (ELISA). Platelet aggregation median was 10.6% (range 0.2–82.4%), which reflected normoaggregation. Platelet hyperaggregation were seen in 9 samples (8.4%). Median of P-selectin was 2.4 ng/mL (range 0.1–10.1 ng/mL) which were normal. High P-selectin level was observed in 16 (32.7%) with 4/16 (25%) experiencing platelet hyperaggregation. Statistical analysis showed a weak negative correlation between P-selectin and platelet aggregation (r=-0.012; p=0.467). In conclusion, no correlation is seen between P-selectin and platelet aggregation, which may be due to the fact that platelets are influenced by many factors that are not examined in this study
Giant Pyonephrosis Due to Calculus of Ureter: A Case Report
Full text linkGiant pyonephrosis (GP) is a rare and severe form of pyonephrosis characterized by a massive enlargement of the affected kidney due to the accumulation of infected fluid. This study presents case of a 51-year-old male patient with giant pyonephrosis who underwent nephrectomy as treatment. The clinical manifestations of giant pyonephrosis are nonspecific, necessitating the use of imaging and laboratory techniques to aid in diagnosis. Nephrectomy is the preferred treatment option for these patients. One week after nephrectomy, the laboratory results showed improvements. Making the right treatment decision is challenging in this particular case
Effect of Community Education on Community Knowledge of Premature Rupture of Membranes
Full text linkPremature rupture of membranes (PROM) is still a health problem with a reasonably high incidence among pregnant women in Indonesia. The PROM is defined as the rupture of membranes before signs of labor are observed. Better knowledge on the causes, signs, symptoms, and complications of PROM is believed to help in reducing maternal and infant mortality caused by PROM. This was a cross-sectional, analytic observational study conducted in Cipacing Village, Sumedang, West Java, Indonesia during the period of June–July 2022. Community education was held to give better knowledge about PROM for women with an obstetric and gynecology specialist and fetomaternal consultant as the resource person. Total sampling was obtained from 62 women. Data were collection using pre-test and post-tests before and after the education session. The mean pre-test score was 6.48, while the mean post-test score was 7.96. A dependent T-test was used to determine the relationship between scores before and after the community education with a p-value of 0.0001. There was a significant increase in knowledge about PROM after the education session compared to before the session. This means community education is effective and impactful to increase the level of knowledge about PROM among women
Association between 25-Hydroxyvitamin D and Mental-Emotional Status in Children during Their First 1000 Days of Life
Full text linkVitamin D receptors are widely expressed in brain tissue, including in the limbic system that plays a role in children's mental and emotional development. This study aimed to analyze the relationship between 25-(OH)-D level and children's mental-emotional development during their first 1000 days of life. A cross-sectional study was conducted on children aged ≤2 years old in Waled and Sukabumi regions using secondary data from previous cohort investigations entitled "The Role of Vitamin D in Efforts to Reduce Maternal and Infant mortality". The measurement of 25-(OH)-D concentration and assessment of the mental-emotional development were performed using the Ages and Stages Questionnaires: Social-Emotional (ASQ-SE) questionnaire. Other child and maternal characteristics, and several laboratory results, were also obtained. Statistical analyses were performed using the Spearman rank, Pearson correlation test, and multivariate linear regression analysis. A total of ninety-two children were included, and the median vitamin D level of the population was 20.17 ng/mL (IQR 4.43–49.97). The correlation analysis showed that no significant relationship between children's mental-emotional scores and the parameters tested, including the concentration of 25-(OH)-D (correlation coefficient 0.08; p=0.446). There was no relationship between the vitamin D concentration and mental-emotional development. Based on these results, it is concluded that there is no correlation between 25-(OH)-D concentration and children’s mental-emotional development during the first 1000 days of life. However, further investigations are recommended to eliminate various confounding factors
Oral Ulcer Healing Activity of Lemon Pepper Ethanol Extract Gel in Streptozotocin-Induced Diabetic Wistar Rats
Full text linkDiabetes mellitus (DM) is a metabolic condition where the body's ability to produce and utilize insulin is impaired; thus, wound healing process is slower than usual in patients with DM. Lemon pepper has both antioxidant and anti-inflammatory properties. This study aimed to investigate the effect of topical application of lemon pepper fruit ethanol extracts on the healing process of oral traumatic ulcers in diabetic rats. This study was performed at the Pharmacology Laboratory, Faculty of Medicine, Universitas Prima Indonesia from September 2021–October 2021. Thirty males diabetic Wistar rats were thermally injured on the lower labial mucosa and divided into five groups: control, standard, and lemon pepper gel 5%, 7.5%, and 10% groups. The ulcer size was measured after injury and on the 7th and 14th day. On the last day, all rats underwent both routine blood count and histology study for oral ulcer tissue. On the 14th day, all treatment groups showed some significant difference wound contraction, with the highest tendency of wound contraction seen in both lemon pepper gel 10% and standard groups (62.50%. p-value =0.001). The improvement of wound contraction was also supported by reduced white blood cell count (p-value<0.05) in routine blood count and regeneration of epidermis and dermis tissues in the histology study. Hence, it can be concluded that the lemon pepper extract gel in all concentrations has good physical stability and the lemon pepper gel with the highest concentration group presents the best ulcer healing activity compared to other concentrations and has similar ulcer healing activity as the standard group that receives Kenalog® in Orabase
Four-Meter Gait Speed Cut-off and Correlation with 6-Minute Walk Test in Adults
Full text linkIn facilities where a track required is not available for gait speed test, a simpler method using a shorter track and test duration is needed. One of such methods is the 4-meter gait speed. This study aimed to determine the cut off values for 4MGS and its correlation with the 6-minute walk test (6MWT), a more common functional performance test with shorter track and time. Data for this study were collected at the Department of Rehabilitation of Dr. Cipto Mangunkusumo General Hospital during the period of August 2016 to March 2017. The consecutive sampling approach was used to recruit healthy Indonesian adults (n=61) aged 18–50 years into this cross sectional study. The anthropometric and respiratory variables were measured as descriptive data and the cut-off values were determined by calculating the mean 4-meter gait speed (4MGS)-2SD for each gender. The 6MWT was performed afterwards to assess the correlation between 4MGS and 6-minute walk distance (6MWD). Results presented a mean 4MGS value of 2.114±0.309 m/s (male) and 1.908±0.227m/s (female) with the cut-off values for normal gait speed of 1.496 m/s and 1.454m/s for male and female, respectively. Factors affecting 4MGS were body height, body weight, forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV1). The 4MGS is only shown to be weakly correlated with 6MWD (r=0.314, p=0.014). The cut-off values for 4MGS can be used as a reference to assess the normality of gait speed as a parameter of functional mobility in healthy Indonesian adults and should be used in adjunct to 6MWT to represent a comprehensive functional capacity status