Majalah Kedokteran Bandung
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Pili Protein 65.5 kDa of Klebsiella pneumoniae Induced a Decrease in IL-10 in Mice
Get PDFKlebsiella pneumoniae is one of the leading cause of nosocomial infection worldwide with clinical isolates mostly found in Multi-Drug Resistant (MDR) or Extensively Drug-Resistant (XDR). This makes therapeutic options due to this bacteria limited. Several studies have shown that the pili protein of K. pneumoniae with different molecular weights plays a role in the virulence factor, as they are hemagglutinin and adhesin proteins. Pili protein 65.5 kDa of K. pneumoniae can be considered as the antigen candidate for vaccines. This study aimed to determine the immune response based on the IL-10 level as induced by pili protein 65.5 kDa K. pneumoniae. This study was conducted from October 2020 to March 2021 at the Faculty of Mathematics and Natural Sciences and Faculty of Medicine of Jember University. This was true experimental with post-test only controlled group design on 27 male BALB/c mice which divided into 3 groups: K1, K2, and K3. The groups were induced with sterile PBS, pili protein and Freund’s adjuvant, and Freund’s adjuvant only, respectively. Samples were drawn through cardiac puncture, then serum was taken to measure the IL-10 levels using the ELISA method. Hemagglutination test showed a positive result with 1/8 as the highest titer. Results showed that the mean IL-10 levels were 290.92±45.33; 235.05±44.53; 218.54±64,81 for K1, K2, and K3, respectively. One-way ANOVA test results showed a statistical difference between groups (p=0,019). This research shows that pili protein 65.5 kDa K. pneumoniae decreases the IL-10 level. However, when it is provided with the Freund’s Adjuvant, there is no proof of the immunogenicity when compared to the control group
Influence of Pesticide Intoxication Education on Farmer Knowledge and Attitude in Kalidoni District, Palembang City, Indonesia
Get PDFKnowledge and attitude of farmers are among factors that influence pesticide intoxication in farms. They are influenced by several variables, including education. Farmers’ knowledge and attitude on pesticide intoxication may change after they receive interventions, such as education about pesticides. This study aimed to determine the level of knowledge and attitude of farmers on pesticide intoxication before and after an education session on pesticides in Sei Selincah Sub-district, Kalidoni District. This was a quasi-experimental observational analysis with a two-group pretest posttest design with a control group. This study used primary data from farmers in Sei Selincah Sub-district, Kalidoni District. Sampling was performed using the purposive sampling method and seventy-six respondents who met the inclusion and exclusion criteria were recruited. Results of the statistical tests using the Wilcoxon test showed that there was no difference in the level of knowledge and attitude of farmers before and after education, both fort the intervention group and the control group (p>0.05). Thus, education does not influence the level of knowledge and attitude on pesticides and pesticide intoxication among farmers
Effectiveness of Basil, Lime, Honey, Candlenut, and Tiwai Onion Herbs Combination as Analgesics and Stamina Stimulator
Get PDFTraditional medicine is generally considered to be safer than modern medicine because it has lower incidence of side effects and also relatively easy to obtain. The purpose of this study was to examine the analgesic effect of herbs made of basil, lime, honey, candlenut, and Tiwai onions as well as to evaluate the potential of these herbs as a stamina stimulator. This study was conducted at the Laboratory of Animal Management Unit, Faculty of Veterinary Medicine, IPB University, from January–February 2022. Mice were divided into four groups based on the treatment dose with each group consisted of five mice. An analgesic test was conducted using hot water immersion tail-flick test method and the stamina test was performed with swimming endurance test. Data obtained were analyzed using Microsoft Excel 2019 and Minitab 19. Significant differences of the average of each group were shown statistically using the one-way ANOVA and confirmed with Tukey test. Results showed that mice given the combination herbal medicine infusion of with a dose of 4 g/kg body weight had the highest average tail lift time compared to the controls (p<0.05). Mice with a treatment dose of 1 g/kg body weight had the highest analgesic power compared to the other treatment doses. The highest swimming duration was observed in group that received a dose of 1 g/kg body weight. It is concluded that this herbal combination can be used as an analgesic and a stamina stimulator
Protein and Phosphate Intakes are Associated with Hyperphosphatemia in Hemodialysis Patients at Sanglah Hospital, Bali, Indonesia
Get PDFIncreased chronic kidney disease (CKD) mortality rate is significantly associated with increased blood phosphate levels. Hyperphosphatemia control is one of the main focuses in the management of hemodialysis (HD) patients. A high protein diet has been suggested to prevent malnutrition in hemodialysis patients. However, a high protein and phosphorus diet has the risk of increasing the phosphate level in the blood circulation, leading to a higher mortality rate of hemodialysis patients. This study aimed to prove that the level of protein and phosphate intake is associated with hyperphosphatemia in CKD patients with routine HD. This was cross-sectional analytical study conducted from September to October 2020 on 66 CKD patients who underwent hemodialysis. Subject characteristics and phosphorus and protein intake data were obtained from a questionnaire food recall adapted from the Food and Agriculture Organization of the United Nations. Data consumption patterns were processed using the nutritional survey software to obtain the nutritional values. Data were analyzed using the Chi-Square test to identify the relationship and risk between hyperphosphatemia and diet protein, phosphorus, and protein-phosphorus ratio. The confidence level in this study was 95%. There was a significant relationship between protein and phosphorus intake in hyperphosphatemia in CKD patients. The risk factors for hyperphosphatemia were high phosphorus intake (p=0.018; OR=3.886;95% CI: 1.212–12.460) and adequate protein intake (p=0.035; OR=3.674; 95% CI: 1.049-12.865). This study showed no significant relationship between phosphorus-protein ratio, protein-phosphorus ratio, and hyperphosphatemia incidence. In conclusion, high protein intake and excessive phosphorus intake provide a significant relationship to the incidence of hyperphosphatemia in CKD patients undergoing routine hemodialysis
Profile and Frequency of One Hundred Ankle Osteoarthritis Cases in an Indonesian Tertiary Hospital
Get PDFOsteoarthritis is one of the most common cases in orthopedics and traumatology clinic. Ankle osteoarthritis is less common than osteoarthritis of hip and knee. Limited data and literature resulted in suboptimal treatment strategy. The purpose of this study was to describe the profile and frequency of ankle osteoarthritis at Dr. Hasan Sadikin General Hospital Bandung, a tertiary referral hospital in Indonesia. A cross-sectional descriptive observational study was conducted on all patients diagnosed with ankle osteoarthritis enrolled in the medical record database at Dr. Hasan Sadikin General Hospital Bandung, Indonesia in November 2020–November 2021. Results showed that the majority of the patients were female (52%), aged ≥60 years old (44%), graduated from senior high school education (56%), and housewives (30%). The 100 patients were proportionally distributed with most of them were categorized as suffering from secondary osteoarthritis with post-trauma predominance. From the perspective of body mass index, 85% patients were classified as above normal. As many as 76% of patients presented to the hospital in an advanced stage. With the high rate of posttraumatic ankle osteoarthritis, concerns should be given more to the ankle trauma management, as well as to the population with high body mass index. Increased health promotion for general population and health care providers is also needed to reduce the tendency of late presentation at the health care facility
Comparison between the Effectiveness Fecal Immunochemical Test and Colonoscopy As A Tool For Colorectal Cancer Early Detection
Get PDFCancer is a disease that causes a lot of misery and death in humans. According to data from the World Health Organization (WHO) in 2015, there are 8.8 million deaths caused by cancer and colorectal cancer ranked third with 774,000 deaths. One of the prevention effort for colorectal cancer is early detection in the population, especially in high-risk groups and in groups with non-specific symptoms. In general, two types of early detection tests are available: stool-based testing and structural testing. Fecal immunochemical test (FIT) is one type of examination that is categorized as the tool-based test. Meanwhile, the structural test include colonoscopy, CT colonography and flexible sigmoidoscopy. This study aimed to determine difference in the effectiveness of FIT against colonoscopy as an early detection tool for colorectal cancer. This study was a cross-sectional comparative diagnostic analytical observational study to compare FIT to colonoscopy for early detection of colorectal cancer. This study involved patients presented to Dr. Hasan Sadikin General Hospital Bandung, Indonesia. Analysis of diagnostic test data was carried out to obtain the sensitivity, specificity, and the positive and negative predictive values through the use of bivariate analysis in the form of Man Whitney test. Thirty-eight patients were included in this study, consisting of 27 cancer patients and 11 non-cancer patients. Results showed that the sensitivity level of FIT was 81.5%, with 72.7% specificity. There is no significant difference in the effectiveness between FIT and colonoscopy in screening for colorectal cancer
Microbial Culture Characteristics and Antimicrobial Susceptibility Patterns Associated with Vesicovaginal Fistula
Get PDFVesicovaginal fistula (VVF) is commonly linked with recurrent urinary tract infection (UTI). Thus, the patterns of the pathogenic microorganism becomes important consideration in the management of this disease. This study aimed to describe patient profiles, disease etiology, and antimicrobial susceptibility patterns of microorganisms in VVF patients. This retrospective study was conducted on 49 medical records of vesicovaginal fistula patients seen from January 2016 to December 2020. The most prevalent age group of the patients was 40-50 years old. Analysis demonstrated that the leading etiology for VVF among these patients was malignancy (73.47%). The antimicrobial susceptibility was tested using the disc diffusion method and Escherichia coli (44.90%) and Proteus mirabilis (14.29%) were identified as the bacterial pathogens most frequently isolated from urine samples. Of the 39 patients with significant growth of organism cases, 29 (74.35%) had symptomatic UTIs. The isolated gram-negative bacteria had excellent sensitivity to aztreonam, ertapenem, and meropenem, with a more than 90% susceptibility rate, while the gram-positive bacteria had good sensitivity to amikacin, cefepime, tigecycline, aztreonam, ertapenem, and meropenem, with a more than 90% susceptibility. In conclusion, bacterial culture and antibiotic susceptibility test (AST) remains an essential part of managing VVF and their results can be used as a reference for empirical therapy. Amikacin, cefepime, tigecycline, aztreonam, ertapenem, and meropenem should be considered for treatment of UTIs associated with VVF
Spinocerebellar Ataxia 3 (SCA3) Patient with Peripheral Neuropathy
Get PDFSpinocerebellar ataxia (SCA) 3 is a neurodegenerative disease which involves cerebellum and extra cerebellum. Neuropathy in SCA3 manifests in various ways, including axonal and demyelination lesions in sensory and motor nerves. There has not been any study that describes the peripheral neuropathy characteristics of SCA3 patients in Indonesia at the time of this publication. This paper reports a case of a 43-year-old male with known spinocerebellar ataxia 3 presented with hereditary ataxia and mild numbness in both palms since two years before. No abnormalities were found during the sensory examination. The NCS showed severe axonal demyelinating sensorimotor peripheral neuropathy. In magnetic resonance imaging (MRI), an atrophy in the cerebellum with cerebral multiple lacunar infarction was identified. Electrophysiological results revealed profound axonal lesion in peripheral nerves. To conclude, peripheral neuropathy in SCA3 represents the dominance of axonal lesions in motor nerves
Neurotoxicity of Chlorpyrifos, Carbofuran, and Cypermethrin in Adolescent Rats’ Brain
Get PDFChronic exposure to insecticides, even at low levels, has led to chronic neurotoxicity. Adolescent brain is still undergoing important developments, including in the hippocampus. This study investigated neurotoxicity effects of subacute exposure to chlorpyrifos, carbofuran and cypermethrin in the brain of adolescent rats. This study was performed at the Histology, Biochemistry, and Animal House Laboratory of Jember University from November to December 2021. Subjects were divided into five groups: normal, control, chlorpyrifos, carbofuran, and cypermethrin. Short-term memory was evaluated by Y maze test and tissue damage was evaluated by histological examination. Brain MDA levels were determined by thiobarbituric acid reactive substance method to evaluate the oxidative stress effect on the organ. This study showed spontaneous alternation in the Y maze test and the number of pyramidal neurons in hippocampus decreased in the cypermethrin group. There was a significant elevation of brain MDA level in carbofuran and cypermethrin groups. Thus, cypermethrin causes more severe neurotoxicity than carbofuran and chlorpyrifos. Improvements in the insecticide application management are urgently needed to prevent neurotoxicity
Profile of Medico-legal Cases and Body Injuries in a Tertiary Hospital in Padang, Indonesia 2010-2020
Get PDFForensic medicine is a branch of medicine that examines victims for the benefit of justice. Doctors play an important role in documenting injuries or abnormalities on the victim's body in the patient's medical record. This study aimed to determine the characteristics of cases and injuries of patients at M Djamil General Hospital during the period of 2010–2020. This was a descriptive retrospective study on secondary data from the medical records of patients who were examined and consulted to the Forensic Department of Dr. M. Djamil General Hospital, Padang during 2010–2020. During this period, 11.729 patients (victims) were examined by and consulted to the Department. Most of the victims were male (70.6%) aged 10–19 years old (29.2%). Most of the victims were involved in a traffic accident, followed by persecution. Victims of traffic accident dominated the forensic pathology cases after sudden death. Abrasions and open wound injury were the most frequent types of injury, with head and neck as the body parts mostly affected. In terms of the type of wound, most victims experienced injuries caused by blunt force (87%). This study concluded that the forensic cases managed at the Dr. M. Djamil General Hospital vary with blunt forces by a traffic accident as the most frequent cause of injuries while the head and neck become the body parts that are most susceptible to injury, both for survivors and those who died