Majalah Kedokteran Bandung
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Nephroprotective Effects of Sunkist Peel Ethanol Extract on Diabetic Nephropathy
Full text linkThe most common long-term diabetic complication is diabetic nephropathy which, in most cases, falls into the End-Stage Kidney Disease. Numerous studies on the nephroprotective effects of citrus fruit have been conducted recently. This study was performed to investigate the phytochemical properties of Sunkist peel ethanol extract and their possible effects on improving diabetic nephropathy. To get the extract, the Sunkist peels were macerated and the extract was analyzed by GC-MS. An in vivo assay of five different groups of 25 male Wistar rats was then performed using the extracts. The groups included control, standard, 500 mg/kg extract, 750 mg/kg extract, and 1,500 mg/kg BW extract. All rats were sacrificed after 28 days of treatment and VEGF level serum and kidney histology analysis were performed. The VEGF data were first analyzed descriptively, followed by one-way ANOVA or Kruskal-Wallis test based on the data distribution. Meanwhile, the kidney histology was observed and narratively described. Results showed that the Sunkist peel ethanol extract has a potential effect to suppress the VEGF level (p-value < 0.05). The extract at the highest dose revealed the mildest pathology damage in the form of tubular structure degeneration without any glomerular damage. This study indicates that Sunkist peel extract has nephroprotective effects from its various phytochemical compounds that work as antioxidants and anti-inflammation
Antioxidant and Antiaging Properties of Ethanolic Ripe Sesoot Fruit Extract
Full text linkSkin aging can be characterized by changes in skin, such as the appearance of wrinkles and loss of skin moisture. Some elements that might lead to cell damages and aging are free radicals through the increase of the activities of hyaluronidase and tyrosinase. Bioactive compounds found in sesoot (Garcinia picrorhiza Miq.) are known for their antioxidant properties, which may reduce excessive amounts of free radicals in the body and act as an antiaging agent by inhibiting hyaluronidase and tyrosinase activities. This study aimed to examine the antioxidant, anti-hyaluronidase, and anti-tyrosinase properties found in Ethanolic Extract Ripe Sesoot (EERS). The ethanol extract of ripe sesoot fruit obtained from LIPI, Bogor Botanical Garden was used for the antioxidant and antiaging assays conducted at PT Aretha Medika Utama in December 2016. The activity of antioxidants was measured as the Ferric Reducing Antioxidant Power (FRAP) of the EERS, while the antiaging assays were performed through the inhibition activity of hyaluronidase and tyrosinase. Results indicated that the EERS has a higher FRAP activity (17.58 μM Fe (II)/μg) than xanthone (2.54 μM Fe (II)/μg) at the highest concentration of sample of 5,000 µg/mL. The anti-hyaluronidase of the EERS exhibited lower activity (IC50 of 619.21±12.15 µg/mL) than xanthone (IC50 of 365.55±25.10 µg/mL) and the tyrosinase inhibitory assay demonstrated a lower activity of EERS (IC50 of 1060.68±12.81 µg/mL) compared to xanthone (IC50 of 218.33±9.73 µg/mL). To conclude, EERS shows antioxidant and antiaging properties
Risk Factors for Extended Spectrum Beta-Lactamase Producing Klebsiella pneumoniae in Arifin Achmad Hospital Riau, Indonesia
Full text linkMultidrug-Resistant (MDR) bacteria that produce Extended-Spectrum Beta-Lactamase (ESBL) isolates pose a global threat to human health, including in Indonesia. The availability of therapeutic options for ESBL-producing Klebsiella pneumoniae (ESBL-KP) is limited, making early recognition of patients with ESBL crucial to preventing the spread of these bacteria within the hospital. This study aimed to examine the risk factors associated with ESBL-KP in the Arifin Achmad General Hospital Riau, Indonesia. This prospective case-control study was performed from January to March 2018, with the diagnosis of ESBL established using the Vitek 2 compact automated tool. The risk factors examined were gender, age, specimen type, ward of origin, hospitalization exceeding seven days, history of antibiotic usage, presence of diabetes mellitus, chronic kidney disease, immunocompromised status, ICU care, and hospitalization within the past month. Patients hospitalized for more than seven days were 4.75 times more likely to develop ESBL-KP, while immunocompromised patients were 2.92 times more likely to develop ESBL-KP. However, the history of antibiotic use, diabetes mellitus, chronic kidney disease, ICU care, and hospitalization within the past month did not exhibit statistically significant associations with ESBL-KP infection. Therefore, ESBL-KP infection should be anticipated in patients hospitalized for more than seven days and those who are immunocompromised. It is crucial to implement infection prevention and control measures, as well as selecting appropriate antibiotic therapy
Relationship between BMI and Urine pH in Nephrolithiasis Cases in Indonesia
Full text linkIn nephrolithiasis/urolithiasis, urine pH is thought to modulate kidney stone formation at various stages, including crystallization, growth, aggregation, and retention. Moreover, numerous studies have demonstrated that an increase in Body Mass Index (BMI) correlates with a decrease in urine pH. This study aimed to determine the relationship between BMI and urine pH in cases of nephrolithiasis at Dr. Hasan Sadikin General Hospital Bandung. This was analytical observational study with a cross-sectional design, followed by correlation analysis is carried out. A total of 100 patients from January 2021 to December 2022 have met the inclusion criteria. From the results of the analysis, it was discovered that of the 21 patients with acidic urine pH, 42.11% had normal BMI, 26.32% were grade 1 obese, 15.79% were grade 2 obese, 10.53% were overweight, and 5.26% were underweight. The majority of patients who had normal urine pH also had a normal BMI (34.18%), followed by 30.38% with grade 1 obesity, 21.52% with grade 1 obesity, and 13.92% with grade 2 obesity. Of the 2 patients with alkaline urine pH, one person had a normal BMI and another had an overweight BMI. The results of the chi-square test presented a p value of >0.05, thus no significant relationship is observed between urine pH and BMI in nephrolithiasis patients
Association Between Screen Time, Vitamin A Consumption Behavior, and Computer Vision Syndrome in Preclinical Medical Students
Full text linkComputer Visual Syndrome (CVS) refers to visual disturbances induced by electronic media such as computers, laptops, tablets, and smartphones. This research aimed to determine the association between screen time, vitamin A consumption behavior, and CVS symptoms among preclinical medical students. Ninety-five students from a single class at the Faculty of Medicine, Universitas Islam Sultan Agung, Indonesia, participated in this cross-sectional study. Data were collected using an online survey platform in February 2022. The screen time, vitamin A consumption behavior, and CVS were measured using a validated questionnaire. The average daily screen time of the respondents was more than 10 h, with the majority having a moderate vitamin A consumption patterns (66.3%) and experienced CVS (63.2%). The most prevalent CVS symptom identified among these respondents was eye fatigue (62.1%), while double vision and inflamed or watery eyes were the least reported CVS symptoms (9.5% and 8.4%, respectively). The Chi-Square test revealed that there was no correlation between screen time and CVS (p > 0.05), but there was a significant correlation between vitamin A consumption and CVS (p < 0.05). In conclusion, CVS is observed among preclinical medical students due to increased screen time and decreased vitamin A consumption. Therefore, there is a need to develop strategies to manage screen time and vitamin A consumption among students at risk for developing a CVS during their academic careers
Antioxidant and Antimicrobial Potential of Sappan Wood Extract against Porphyromonas gingivalis
Full text linkGingivitis inflammation triggered by microbial biofilms is one of the detrimental causes of periodontal diseases. When a periodontal disease occurs, tooth decay becomes inevitable, and can pose a serious threat to oral health, requiring appropriate treatment. Inflammation in periodontitis is mainly caused by oxidative stress; hence, antimicrobial and antioxidant-based therapies are suggested for periodontitis. Sappan wood is well-known for its brazilin compounds, which have the potential as herbal medicines and antibacterial agents to fight oral pathogens with minimal side effects. This study aimed to examine the antimicrobial and antioxidant activities of sappan wood extract (SE) as a candidate agent for preventing periodontal diseases. This study was conducted at Maranatha Christian University, Sekolah Tinggi Farmasi Indonesia, and Aretha Medika Utama from January-April 2023. The sappan wood was extracted using ethanol 96% and the antimicrobial evaluation was done by calculating the total colony of P. gingivalis while the antioxidant activity was evaluated by ABTS, H2O2, and FRAP Assays. This study revealed that SE was significantly effective in reducing the total colony of P. gingivalis up to 0 CFU/mL. The highest antioxidant activity of SE was found in 100 µg/mL with IC50 19.06 µg/mL for ABTS, 90.99 µg/mL for H2O2, and 564 µM Fe (II) for FRAP. Thus, SE presents its strong antimicrobial and antioxidant activity potentials by in vitro evaluation that could be analyzed further for its utilization as a periodontal-preventing agent. This study also provides basic information for future implication of sappan wood extract as ingredients for dental care products
Correlation Between CA 15-3 And Miller Payne Histopathological Response In Locally Advanced Breast Cancer Undergoing FAC Regiment Neoadjuvant Chemotherapy
Full text linkResponse to chemotherapy for breast cancer can be assessed using the CA 15-3 tumor marker, or through histopathological means such as Miller Payne assessment. This study aimed to explore the correlation between CA 15-3 level and histopathological response in locally advanced breast cancer. This is a cross-sectional study measuring CA 15-3 before and after neoadjuvant chemotherapy using the FAC regiment. This study took place in Dr. Hasan Sadikin Hospital Bandung, Indonesia, from January to August 2022. Data on histopathological responses before chemotherapy and after surgery were also collected. Thirty-nine patients were admitted as subjects. Most patients had invasive carcinoma of no special type (79.5%) and luminal B HER 2 molecular subtype (38.5%). A significant decrease in CA 15-3 level after chemotherapy (from 23.54±18.38 ng/ml to 16.30±6.51 ng/mL) was observed. No significant correlation between CA 15-3 level and Miller Payne histopathological responses were found in the subjects
Unusual Lifespan of Edwards' Syndrome in COVID-19 Era
Full text linkEdwards' syndrome is caused by an extra chromosome on the 18th chromosome. Patients with this diagnosis have median survival of only 3-14.5 days, with the majority of infants with full trisomy 18 type die before or shortly after they are born. There is only supportive treatment available for Edwards’ syndrome. During the COVID-19 pandemic, providing health services was challenging, leading to less than optimum treatments added by patients’ reluctance to visit healthcare facilities due to the fear of COVID-19 transmission. This case study presented an infant with Edwards’ syndrome with major malformation. The patient had several organ problems, was admitted to the NICU, and continued with home care for monitoring for 6 months. Patient then died at 9 months of age. Maintaining the best quality of life for this patient was very challenging for parents and healthcare providers. Since the management for this type of sydnome is more palliative, good education, information, and psychosocial supports for the parents are needed to prepare them with the worst conditions, which was especially more challenging during the COVID-19 pandemic
Management of Stage-4 HIV with Cerebral Toxoplasmosis Coinfection and SIADH Complication
Full text linkHIV/AIDS stage 4 is the stage where the HIV/AIDS patients have low immunity protection against infections, which can led to coinfections and complications. This case report presented an evaluation of the diagnosis and treatment of an HIV/AIDS stage 4 patient with cerebral toxoplasmosis coinfection and SIADH complications. A man (47 years, 35 kg), married with two children, complaining of weakness, nausea, vomiting, weight loss, and low appetite. Sodium level were measured, showing a 117 mg/dL level that continued to decrease throughout the patient's treatment. Five days later, the patient lost his consciousness with a GCS score of 224, indicating severe brain injury, and was diagnosed with cerebral toxoplasmosis based on the result of head CT-SCAN with contrast. On day 6, the patient was tested positive for HIV and diagnosed with stage 4 with an absolute CD4 count of 4 cells/μl. Therapy was provided by giving pyrimethamine-clindamycin therapy for cerebral toxoplasmosis, followed by Tenofovir, Lamivudine, and Evafirenz as antiretroviral therapy. Treatment for hyponatremia was done by administration of 3% NaCl and tolvaptan. The patient started experiencing an improvement in consciousness after the 10th day of medication, and sodium levels fluctuated throughout the treatments. Patient was discharged after 15 days with clinical improvements