Majalah Kedokteran Bandung
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Role of P27kip1 Protein, P45skp2 Coactivator, and P38jab1 Coactivator in Preventing Rhabdomyosarcoma (RMS) in Oral Cavity of Children
Get PDFRhabdomyosarcoma is a rare malignant tumor that attacks the differentiation of skeletal muscle and usually affects children, contributing to about 60% of all soft tissue sarcomas. The purpose of this study was to examine the relationship between p27Kip1 immunoexpression and p45Skp2 and p38Jab1 coactivators, as well as the relationship between p27Kip1 immunoexpression and p45Skp2 and p38Jab1 coactivators on stages and prognosis of oral RMS in children. This was a restrospective study on the immunoexpression of p27Kip1 and p45Skp2 and p38Jab1 coactivators on RMS cells. The RMS stage was determined according to the American Joint Committee of Cancer/AJCC of stages 1–4, and were divided into group I (stages 1 and 2) and group II (3 and 4). Samples were retrieved fromt he paraffin blocks of patients with embryonal RMS. Each paraffin block was cut, and 6 samples with 5 µm thickness from each block were examined using p27Kip1, p45Skp2, and p38Jab1 proteins. The analysis was performed using a linear regression test on the relationship between p27Kip1 and p45Skp2 and p38Jab1, resulting in a p-value of 0.000 (<0.05) and a coefficient value of b -1.36. Meanwhile, the stage was analyzed using the Wald test of 8.0688, resulting in a p-value of 0.0045 with a significant negative correlation. Analysis on the relationship between p45Skp2 and p38Jab1 and the RMS stage was performed using the Gamma test, resulting in a significant positive correlation (p<0.05)
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
Correlation Between Serum Ferritin and Testosterone Level in Adolescent Male with Transfusion Dependent Thalassemia
Get PDFTransfusion-dependent thalassemia (TDT) is a type of beta-thalassemia that needs regular and long-term blood transfusions. Complications can occur due to the deposition of iron in TDT patients, including endocrine complications causing deficiency of testosterone that plays a role in the secondary sexual development in males. The objective of this study was to understand the correlation between ferritin and testosterone level in male adolescences with transfusion-dependent thalassemia. This cross-sectional observational correlative study was conducted from April to August 2019 on 74 males aged 12-18 years old who were presented to the Thalassemia Outpatient clinic, Dr. Hasan Sadikin General Hospital, Bandung. Blood was collected using phlebotomy for ferritin and total testosterone serum examination. Data were then analyzed using SPSS version 17.0. Low testosterone level (<3.0 ng/mL) was found in 63.5% of subjects. Results of the Spearmen correlation test demonstrated a negative correlation with r: -0,699 and p-value <0.001, showing a negative, strong, and significant correlation among those variables. The higher ferritin level in TDT patients indicates a high level of the free iron level in the body that can destroy the endocrine organs and cause deprivation of testosterone secretion, leading to hypogonadism in transfusion dependent thalassemia patients
Anti-Aging Activities of Asparagus Gel Ethanol Extract in Cosmetic Gel Agent for Facial Skin
Get PDFAsparagus is a vegetable that contains phenolic compounds with antioxidant properties that scavenges aging-triggering free radicals. This study aimed to investigate the components and anti-aging potentials of Ethanol Extract form Asparagus (EEA). The study was performed in February 2020 at the Pharmacy Laboratory, University of North Sumatera. The EEA was obtained through maceration using 96% ethanol. An antioxidant assay was performed and the total phenol and flavodoid content were determined using the spectroscopic method. Three gel formulas with different concentrations of EEA was prepared (F1: 1.5%, F2: 2.5%, and F3: 3.5%), and F0 was used as control. The parameters evaluated were moisture, oil content, texture, collagen, wrinkle, pigment, sensitivity, and pore. The result showed that asparagus had a moderate antioxidant activity (IC50: 118,992) with the total phenol and flavonoid contents of 15,9407 mg GAE/g and 3,2286 mg QE/g extract, respectively. The highest aging activities was seen in F3 (3.5%), followed by F2 (2.5%) and F1 (1.5%). The percentage of moisture, oil, texture, collagen, wrinkle, spot, sensitivity, and pore recovery were found to be 40.15%, 49.73%, 71.76%, 17.70%, 70.93%, 49.34%, 42.56% and 25.31%, respectively. Hence, it can be concluded that the EEA Gel at the highest concentration (3.5%) has a high content of phenol and flavonoid which can improve the skin moisture, oil content, texture, collagen, wrinkles, spots, sensitivity, and pores, which promotes anti-aging activities
Methicillin-Resistant Staphylococcus aureus (MRSA) Patterns and Antibiotic Susceptibility in Surgical and Non-Surgical Patients in a Tertiary Hospital in Indonesia
Get PDFMethicillin-Resistant Staphylococcus aureus (MRSA) in the hospital is found mainly in surgical patients, which increases morbidity and mortality. Currently, vancomycin is the drug of choice for the treatment of MRSA infections. The increasing use of vancomycin and its inappropriate administration may increase the resistance of S. aureus to vancomycin. This study aimed to describe the distribution of MRSA and types of antibiotics that are still sensitive to MRSA in surgical and non-surgical patients. This cross-sectional, observational, retrospective descriptive study was conducted at the Microbiology Laboratory, Dr. Hasan Sadikin General Hospital, in 2019 using secondary data on the results of culture examination and antibiotic susceptibility of positive S. aureus culture isolates from all types of isolates from surgical and non-surgical patients. All specimens were cultured in appropriate media. Identification of S. aureus was performed by Gram staining to identify bacterial morphology, and automatic tools. Antibiotic susceptibility test was performed using an automatic machine. Seventy-five isolates (17%) were identified to be MRSA with 46 (53%) of them retrieved from surgical patients. Most of the MRSA isolates came from pus and were mostly due to skin infections. Antibiotic susceptibility results showed two Vancomycin-Resistant Staphylococcus aureus (VRSA) isolates from surgical patients. The positive culture of the MRSA and VRSA was dominated by surgical patients with pus coming from surgical wound infection, burn, and other skin infection as the most common sources. Thus, the proportion of MRSA isolates in the hospital in 2019 is 17% and two VRSA isolates are identified in the same year. The surgical ward was the primary origin of most MRSA isolates. Further studies are necessary to identify the MRSA incidence rate, evaluation and periodic monitoring of antibiotic use, and active surveillance in the surgical patient rooms
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
Knowledge and Severity of Female Urinary Incontinence and Reasons for Not Seeking Treatment
Get PDFUrinary incontinence (UI) is a commonly overlooked problem in women, particularly women of post-menopausal age. Despite the medical, social, and hygiene burdens conferred by UI to its sufferers, past studies have shown that only a few among women afflicted with UI sought treatment. This may be due to various reasons: lack of knowledge and awareness of UI or a wrong belief of UI as a natural part of aging. This study aimed to investigate the association between knowledge and severity of UI and reasons for not seeking treatment among post-menopausal women in Bandung, Indonesia. This was an analytic cross-sectional study conducted at the Geriatric and Gynecology Clinic, Dr. Hasan Sadikin General Hospital, in September 2013. Ninety-one women who met the inclusion criteria were interviewed to assess their knowledge of UI. The severity of UI was assessed using Urinary Distress Inventory 6 (UDI-6). Data were analyzed using the chi-square test. Sixty-five respondents (70.7%) had poor knowledge of UI. Knowledge of UI was not associated with awareness of UI as a medical condition (p=0.633). The difference in UI severity was associated with the perception of UI as a normal part of aging (p=0.008). Post-menopausal women are poorly informed regarding urinary incontinence. However, knowledge alone might not be adequate to encourage women to seek treatment. Further studies are needed to investigate women’s reasons for not seeking treatment for UI
Accuracy of Urine Cytology In Detecting Bladder Cancer
Get PDFOne of the most prevalent and deadly cancers in men is bladder cancer. To achieve the best possible outcome, physicians need to diagnose it promptly. The gold standard for diagnosis is tissue biopsy, but this method is invasive. There is another option for non-invasive diagnostic using urine cytology. The purpose of this study was to measure the accuracy of urine cytology in diagnosed bladder cancer patients. This study extracted data from patients medical records in a tertiary hospital in Indonesia from 2009–2019. The diagnostic accuracy was then compared between urine cytology and biopsy as the gold standard. Data on subjects’ baseline characteristics and diagnostic accuracy (sensitivity, specificity, PPV, and NPV) were collected. Results were then stratified according to the American Joint Committee on Cancer pathology staging for bladder cancer. Of 124 study subjects, male was more dominant (male,88% versus female, 12%) Seventy-five patients had a T1-tumor stage. Overall, the diagnostic accuracy was as follows:sensitivity, 47.8%; specificity, 90.9%; PPV, 98.2%; and NPV, 14.5%. High-grade tumors were shown to have a higher sensitivity. The highest accuracy was found in the MIBC grade T3, which was 90.68%. For diagnostic accuracy, urine cytology offered high specificity, but low sensitivity. The exploration of other markers is needed to establish a non-invasive but accurate method to diagnose bladder cancer
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
Relationship between Knowledge, Attitude, and Behavior on Head and Neck Cancer among Health Workers and Community in Bandung, Indonesia
Get PDFHead and neck cancer is the sixth most common cancer in the world with increasing incidence and mortality in the last three decades. The hidden location of head and neck tumors and their atypical symptoms cause difficulties in diagnosis. Most patients are first diagnosed at an advanced stage. Several factors allegedly related to the incidence of head and neck cancer are knowledge and attitude of the public on early detection of cancer. This study aimed to determine the relationship between knowledge, attitude, and behavior of health workers and community towards head and neck cancer in Bandung, Indonesia. This was a cross-sectional analytical descriptive study using chi-square test as the statistical test. Subjects for this study were sampled using the proportional cluster random sampling on health care workers and community in 30 community health centers in Bandung City during the period of July–August 2019. Data were obtained through a questionnaire distributed to the subjects. This questionnaire included items on knowledge, attitude, and behavior towards head and neck cancer. Of the 650 respondents, most were 40-49 years old (25%), female (62,2%), patients (74%), high school (49%). The levels of knowledge and attitude have a significant relationship with the behavior of early detection of head and neck cancer (p=0.015). The awareness and knowledge of health workers and community on early detection of head and neck cancer are high in Bandung, Indonesia.