Majalah Kedokteran Bandung
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Correlation of Hepatocyte Growth Factor Levels with Myopia Degree and Axial Length in Outpatient Myopic Adolescents
Full text linkMyopia is the most common ophthalmic condition worldwide, with an estimated 22.9% of the population or 1.406 billion people affected. Studies of candidate gene-associated refraction abnormalities have also identified several genes that cause vulnerability myopia, including the hepatocyte growth factor (HGF) and hepatocyte growth factor receptor (MET) genes. The purpose of the study was to analyze the correlation between hepatocyte growth factor (HGF) levels, degrees of myopia, and long axial in adolescents with myopia treated as outpatients in Universitas Sumatera Utara Hospital. This study applied the cross-sectional analytical approach. The inclusion criterion for the participants was patients diagnosed as suffering from myopia by the Ophthalmology Outpatient Clinic of the Universitas Sumatera Utara Hospital. Sampling was performed consecutively with a minimum sample size of 25 patients in control group and 25 patients in the case group. This study revealed that the mean axial length of the right eye in the case group was 23.82 mm, with a significant difference in the axial length between the case and control groups. The mean HGF level in the myopia group was 510.49 ng/mL, which was not significantly different from the mean HGF level in the control or emmetropic group. The HGF levels were highest in the group of subjects with moderate myopia, with an average of 551.87 ng/mL, and differences in HGF levels were identified in different degrees of myopia. Thus, no significant correlation is identified between the HGF levels, axial length, and myopia degree
Neurodegenerative and Neurobehavioral Symptoms in Jember Agricultural Workers Caused by Oxidative Stress and Neurotransmitter Disturbance
Full text linkIncreased use of pesticides can have detrimental health consequences, one of which is chronic neurotoxicity. The symptoms include degenerative and neurobehavioral issues. Chronic neurotoxicity occurs through oxidative stress, inflammation, and neurotransmitter disturbances. This study aimed to determine chronic neurotoxicity and test malondialdehyde and cholinesterase levels as neurotoxicity biomarkers among agricultural workers in Wuluhan, Jember, Indonesia. The 60-person research sample was divided into two groups: agricultural and non-agricultural workers. The interview utilized a mini-mental score examination, Chan's questionnaire, and the Patient Health Questionnaire to analyze the cognitive impairment, Parkinsonism, and depressive symptoms. The examination of serum malondialdehyde levels was performed using the TBARS method and cholinesterase levels by photometric kinetic method at a biochemistry laboratory from October to November 2022. Results showed cognitive impairment and depressive symptoms in agricultural workers, as well as high levels of malondialdehyde and low cholinesterase levels. This study concludes the presence of chronic pesticide neurotoxicity among agricultural workers in Jember, Indonesia, and that malondialdehyde and cholinesterase levels might serve as biomarkers of pesticide-induced neurotoxicity
Bilateral Optic Nerve Atrophy Case Report
Full text linkWolfram syndrome, also known as DIDMOAD or juvenile onset diabetes mellitus, optic nerve atrophy, diabetes insipidus, and deafness, is a genetic neurological condition. This case report provides a description on the first instance of Wolfram syndrome in a Saudi family, which manifested as proliferative diabetic retinopathy and a powder-like cataract, among the other unusual ophthalmological findings. This case involved a 27-year-old Saudi woman with bilateral optic nerve atrophy who was first diagnosed with diabetes mellitus at the age of 8 years. At the age of 18, bilateral optic nerve atrophy was identified. At the age of 27, diabetes insipidus and hearing loss were verified. There were no signs of renal, neurological, or psychiatric issues. Atypical ophthalmological traits were examined and addressed in this study. Any individual with bilateral optic nerve atrophy and insulin-dependent diabetes mellitus within the first 30 years of life should be evaluated for the possibility of Wolfram syndrome. Microvascular diabetes is an incredibly rare complication of Wolfram syndrome. Early diagnosis, treatment, and prevention of severe consequences can result in improved survival rates and quality of life
Patient’s Quality of Life After 3-and 6-Months Cataract Surgery
Full text linkCataract surgery is the most common elective procedure and has been shown to increase patients' visual acuity. However, visual acuity alone cannot adequately represent their quality of life. Quality of life can be measured with a standardized questionnaire, such as the National Eye Institute Refractive Error Quality of Life Instrument. Patients with better quality of life pre-operatively will benefit less from cataract surgery. This study aimed to describe patients' quality of life after long-term cataract surgery in the National Eye Center Cicendo Eye Hospital. This cross-sectional descriptive study used primary data collected using a questionnaire from March to May 2022. The subjects were 33 people with cataracts who underwent uncomplicated cataract surgery at Cicendo National Eye Hospital over the past three and six months of the study. Patients who met the inclusion criteria were given the NEI-RQL 42 questionnaire. In visual clarity, patient expectations, near vision, far vision, daily fluctuations, activity limitations, suboptimal correction, and satisfaction with correction variables, an increase in value at three months was observed, yet slightly decreased at 6 months. There was decreased glare complaints, symptoms, and dependence on correction at preoperative, 3 months, and 6 months. An increase in the level of concern and appearance from preoperative, 3 months, and 6 months post-operative was observed. Thus, an improvement in the patient's quality of life is observed three months after surgery, yet decreases slightly in six months after surgery
Correlation of Nutritional Status and Early Feeding with Post-Laparotomy Surgical Site Infection in Perforated Peptic Ulcer patients
Full text linkA perforated peptic ulcer is an emergency requiring immediate treatment by laparotomy. Special attention needs to be established on systemic nutritional status. The postoperative early feeding is important to patients with preoperative non optimum nutritional status. This study aimed to examine the correlation between nutritional status, early feeding, and post-laparotomy surgical site infection in perforated peptic ulcer patients. This was a prospective observational study on 32 patients with perforated peptic ulcers underwent emergency laparotomy at Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from October 2021–2022. The nutritional status was assessed using Albumin, SGA. Eleven subjects had severe hypoalbuminemia and six subjects had severe malnutrition (SGA C). Early feeding was not performed on 7 subjects. The highest surgical wound infection rate was found on the 7th day with an incidence rate of 18.8%. Among patients experiencing infection, six (6) had SGA C (p0.05). There is no association among albumin level, SGA, and early feeding in post-laparotomy wound infection in perforated peptic ulcer patients
Characteristics and Therapy of Patients with Bartholin's Cysts in An Indonesian Tertiary Hospital
Full text linkA blocked duct of the Bartholin gland causes mucus accumulation and a fluid-filled sac, i.e., a Bartholin cyst, that can develop into an abscess when infected. This study specifically explored the characteristics and treatment Bartholin cysts or abscesses in patients registered at the obstetrics and gynecology clinic of Dr. Cipto Mangunkusumo National General Hospital, a tertiary hospital in Indonesia. This retrospective and descriptive study utilized data from patients registered at the hospital from July 2021 to July 2023. Bartholin cysts were found to be more common in patients aged 40 to 45 (57.1%) with a non-working status (71.4%), and married (90.5%). Cysts were found to be 1 to 3 cm in size (52.4%) and occured unilaterally (95.2%). Four of the fourteen patients complained of recurring Bartholin cysts. On history and clinical examinations, 20 (95.2%) patients reported the presence of lumps. Antibiotics were the most commonly used treatment, with 15 of 21 Bartholin cyst patients (71.4%) receiving them. Obtaining data on the demographic of patient characteristics is essential when providing appropriate health care. Clinical considerations such as cyst size, patient age, symptoms, and history of recurrent Bartholin cysts or abscesses influence the choice of comprehensive medical and surgical management
Smoking Parameters in Coronary Heart Disease Patients Treated at Dr. Hasan Sadikin General Hospital Bandung, Indonesia
Full text linkThe association between smoking and coronary heart disease (CHD) has been studied extensively, though smoking parameters that contribute to the development of CHD may still need to be studied further. This cross-sectional study aimed to describe the characteristics of smoking parameters, including the number of cigarettes smoked, age when started smoking, duration of smoking, and cessation of smoking, in CHD patients treated at Dr. Hasan Sadikin General Hospital, Indonesia. CHD patients aged ≥18 years were included from the cardiology outpatient clinic and hospital wards. Smokers (current smokers/quit smoking <6 months) and ex-smokers (quit smoking ≥6 months) were considered patients who had a history of smoking. The Brinkman index, i.e., duration of smoking x number of cigarettes/day, was used to measure the degree of smoking that were categorized into mild, moderate, and severe smokers. Eighty-seven subjects diagnosed with CHD were recruited in this study. Seventy-seven percent of the subjects were male, and the mean age of subjects studied was 58.5±10.4 years. Among all subjects, a history of smoking was found in 66.7% (37.9% smokers and 28.7% ex-smokers), with all composed of male subjects. The age of subjects who had a history of smoking was 20 (15-35) years. Most were moderate smokers (74.1%) from Brinkman Index measurement. Smoking history has a significant association with male sex, lower total cholesterol, and lower LDL levels (p-value <0.05)
Comparison of Different Cycloplegic Refraction Regimens for Children
Full text linkIn the process of a pediatric eye exam, cycloplegic refraction is a crucial step. Since no single cycloplegic drug is ideal, a combination regimen is employed. This study compares the ocular (refractive power and pupil diameter) and systemic (blood pressure and heart rate) effects of administering a combination of 1% cyclopentolate and 2.5% phenylephrine, with or without 1% tropicamide, to children with refractive errors. This study aimed to discover a more feasible regimen for children. This was a single-blind study, a randomized clinical trial conducted from November–December 2020 in children with mild to moderate refractive errors. Group A received 1% cyclopentolate, 2.5% phenylephrine, and 1% tropicamide (SFT), whereas group B received 1% cyclopentolate and 2.5% phenylephrine (SF). The outcomes were measured using an auto refractometer and IOL Master® 700. Before and 60 minutes after medication was administered, blood pressure and heart rate were measured. There were 54 participants (108 eyes) with an average age of 12.85± 2.84 years. Although the SFT group's refractive power and pupil width were greater than those of the SF group, the differences were not statistically significant (p=0.271 and p=0.088). Heart rate (p=0.521) and blood pressure (systolic p=0.201; diastolic p=0.950) did not significantly differ between the two groups. Despite mydriasis manifested more rapidly in the SFT group, there was no discernible difference in the cycloplegic effects between those groups. SF might be a more feasible regimen for cycloplegic refraction in children with refractive errors
Survival Analysis of Trabeculectomy and Phacotrabeculectomy in Primary Angle Closure Glaucoma
Full text linkGlaucoma is the global leading cause of irreversible blindness. Primary angle closure glaucoma occurs most frequently in Asian populations, including in Indonesian population. Surgical management of Primary Angle Closure Glaucoma (PACG) includes cataract extraction, trabeculectomy, or combined phacotrabeculectomy. Many patients presented in the advanced stages of the disease with significant cataracts, requiring combined surgery. This study aimed to determine whether trabeculectomy alone was better in reducing intraocular pressure compared to phacotrabeculectomy in primary angle closure glaucoma. This was an analytic retrospective observational study reviewing medical records of PACG patients underwent trabeculectomy or phacotrabeculectomy from January to December 2015, within a 5-year follow-up period of a tertiary eye hospital. The success rates of the two groups were assessed with Kaplan-Meier survival analysis. Success criteria were defined as > 20% reduction of IOP or IOP <21 mmHg with or without medication. Results showed 104 and 41 eyes underwent trabeculectomy and phacotrabeculectomy, respectively. The cumulative 5-year survival rate in trabeculectomy group was 58.6%, and 85.4% in phaco trabeculectomy. There was no statistical difference in the success rate between the trabeculectomy and phaco trabeculectomy groups (p=0.102). Postoperative complications observed in the phacotrabeculectomy group were one choroidal detachment, one malignant glaucoma, and one vitreous prolapse. Thus, the cumulative success rate of phacotrabeculectomy was better than trabeculectomy after 5 years of follow up, albeit not statistically significant
Comparison of Phaco-Chop versus Stop-and-Chop Nucletomy Techniques in Patients with Soft to Moderate Nucleus Cataracts
No full textVarious phacoemulsification techniques are commonly used, with phaco-chop and stop-and-chop techniques as the most popular ones. Phacoemulsification inevitably leads to endothelial cell destruction, which, in severe cases, might result in vision impairment. This study aimed to compare endothelial cell characteristics between two phacoemulsification procedures, phaco-chop, and stop-and-chop, in patients with soft to moderate nucleus cataracts. This study was conducted on 142 patients at the National Eye Center of Cicendo Hospital between April and August 2018. Of those, 66 patients underwent the phaco-chop technique, while 76 patients underwent the stop-and-chop technique. Intraoperative parameters such as effective phaco time (EPT), phaco time, average power, and duration were recorded. Endothelial density, hexagonality, coefficient of variation (CV), and central cornea thickness (CCT) were also recorded before surgery, as well as one week and four weeks after surgery. Mean power, EPT, phaco time, and duration in the phaco-chop group were significantly lower than in the stop-and-chop group. Mean (SD) endothelial density at one-week and four-week evaluation in the phaco-chop group were considerably lower than in the stop-and-chop group (p-value=0.024 and p-value=0.000, respectively). Mean (SD) CV at one-week evaluation in the phaco-chop group was significantly higher compared to a stop-and-chop group, 43.3 (8.0) versus 40.0 (6.7) % (p-value=0.009). Mean (SD) hexagonality at four-week evaluation in the phaco-chop group was significantly higher compared to a stop-and-chop group (43.1 (17.6) versus 48.7 (13.2) respectively, p-value=0.045). Phaco-chop technique have significantly lower EPT, average power, phaco time, and surgery duration than stop-and-chop techniques at one-week and four-week evaluation after phacoemulsification