Majalah Kedokteran Bandung
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Traumatic Brain Injury and Covid-19
Full text linkHead trauma is a head injury caused by external forces in the head or body that results in disruption of the normal functioning of the brain. According to the CDC, deaths from head injuries were about 60,000 in 2016, and rose to more than 61,000 in 2017. The COVID-19 pandemic had caused poor non-COVID patient care, especially in low- and lower-middle-income countries with limited access to health facilities, resulting in increased morbidity and mortality, including among patients with head injuries. The purpose of this study was to understand the characteristics, duration of hospital stay, and difference of time to surgery interval in Traumatic Brain Injury patients in Dr. Hasan Sadikin General Hospital Bandung before and during the COVID-19 pandemic. This study was performed through analytical methods with a cross-sectional study design using analysis of medical records of head trauma patients treated in Dr. Hasan Sadikin General Hospital Bandung, Indonesia in the period before the pandemic (February 2018-February 2020) and during the pandemic (March 2020 - September 2021). Data analysis showed significant differences in length of hospitalization and operating intervals before and during the pandemic (p=0.04 and p=0.03), showing that there are differences in interval operation and duration of stay between patients with head trauma before the pandemic and during the pandemic
Shallot (Allium cepa L.) Peel Infusion Ameliorates Kidney Histopathological Damages in Diazinon-Induced Wistar Rats
Full text linkDiazinon, an organophosphate pesticide, is used extensively in agricultural sector. Consumption of agricultural products containing diazinon residue may lead to harmful health consequences. Among these is nephrotoxicity, which includes lipid peroxidation, that can damage the kidney. Flavonoids in shallot peel can scavenge free radicals, inhibit necrosis, and activate bone marrow-derived cells for cell regeneration. This study aimed to determine the correlation between shallot peel infusion (SPI) dose and kidney damage amelioration to establish the maximum effective dose of SPI to ameliorate kidney histopathological damage in diazinon-induced rats. This study was performed at the Pharmacology Laboratory, Faculty of Medicine, University of Jember, Indonesia, in April 2021, on 35 rats that were divided into 7 groups—normal, diazinon, and five treatment groups. Diazinon 40 mg/kgBW was administered on day 1-7, while SPI 125, 250, 500, 1,000, 2,000 mg/kgBW were administered on day 8–14 according to the treatment group. Kidney histopathological slides with hematoxylin-eosin (H.E.) staining were assessed using Kocoglu scoring and Kidney damage scores of the treatment groups were analyzed using Pearson test. The maximum effective dose was determined using regression test. The damages found in diazinon-induced rats were tubular degeneration, necrosis, and inflammation with a higher damage score than normal rats (p<0.05). Pearson test showed moderate correlation (coefficient -0.594). Higher SPI doses presented lower kidney damage scores, with 1,359 mg/kgBW being the maximum effective dose. SPI dose and the kidney damage amelioration are moderately correlated with a SPI maximum effective dose to ameliorate kidney damage in diazinon-induced rats of 1,359 mg/kgBW
Interleukin-6 Level and Neutrophil-Lymphocytes Ratio and Severity of Coronavirus Disease 19
Full text linkInterleukin-6 (IL-6) is a proinflammatory cytokine that plays an important role in hyperinflammation and cytokine storm in Coronavirus Disease 19 (COVID-19) patients. The neutrophil-lymphocyte ratio (NRL) describes the innate and adaptive immune responses. Elevated IL-6 and NLR levels usually indicate a severe clinical condition in COVID-19 patients. Aim of this study was to determine the correlation of IL-6 and NLR with the severity of illness in COVID-19 hospitalized patients. This was a descriptive correlative observational study with a cross-sectional design using secondary data from COVID-19 patients treated in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, from November 2020 to October 2021. There were 225 subjects who were classified by the severity and analyzed for IL-6 levels and NLR. Median levels of IL-6 at moderate, severe, and critical levels were 4.1 pg/mL, 20.4 pg/mL, and 38.8 pg/mL, respectively. The median NLR at moderate, severe, and critical grades were respectively 4.41, 9.65, and 17.79. The correlation between IL-6, NLR, and severity was 0.441 (p<0.001) and 0.408 (p<0.001). Meanwhile, the correlation between IL-6 levels and NLR in COVID-19 was 0.230 (p<0.001). Thus, IL-6 and NRL levels have a moderate positive correlation with the severity of COVID-19, while IL-6 and NRL have a weak correlation because IL-6 is not the only factor that affects the NRL
Characteristics and Risk Factors of Diabetic Retinopathy Patients in West Java, Indonesia
Full text linkDiabetic retinopathy (DR) is the major microvascular complication of diabetes mellitus (DM) and responsible as the leading cause of vision loss among working-age adults. With the estimated DM cases reaching 578 million in 2030, public health systems are faced with challenges of increasing costs of implementation and maintenance of DR screening program in people with DM. This study aimed to describe characteristics and risk factors of DR among patients of a Primary Health Care Center in West Java, Indonesia. This was a cross-sectional study during the period of March 2021 until June 2022 on 1,080 participants. Among these participants with DM, 28.89% (25.16–33.12% [95% CI]) were classified to have DR. A total of 32.69% (28.14–36.71 [95% CI]) participants with DR had vision threatening DR (VTDR). The prevalence of DR in this study was higher in women (77.23%) with a mean age of 57.26 ± 9.17 and duration of DM of ≥5-years (56.01%), blood glucose level <200 mg/dL (63.79%), high systolic blood pressure (52.03%), high diastolic blood pressure (39.07%), normal BMI (55.5%), high waist circumference (43.7%), and high HbA1C (3.42%). A total of 1,041 (96.39%) participants were using antidiabetic drugs, and 9.63% of them were currently smoking. This study showed that diastolic blood pressure, abnormal abdominal circumference, and high HbA1C levels were more prevalent in DR and VTDR groups. The findings of this study represent the current characteristics of DR patients in West Java and can be used as a baseline or comparison data for other regions in Indonesia
Clinical Profiles of Obstructive Hydrocephalus in Patient with Von Hippel–Lindau
Full text linkVon-Hippel-Lindau (VHL) is an autosomal dominant disease that affects multiple systems that may result in benign and malignant multisystem tumors. The estimated incidence of VHL is 1 in 36,000 births. Disease incidence ranges from 10 to 40 years, with an average of 26 years, and it impacts diverse ethnic groups. VHL results from mutations in the germ line that have been mapped to chromosome 3P25. Currently, this is the only gene known to cause the syndrome. This study presented a case of obstructive hydrocephalus in a patient with VHL. A 19-year-old female was referred to the Eye Clinic for a diagnosis of papilledema. She began to experience vagal abdominal discomfort for no apparent reason. Per exam, the patient had 20/20 OD and 20/400 OS, with an intraocular pressure of 14 OU. The patient's MRI revealed a posterior fossa cranial cystic brain lesion that was obstructing the fourth ventricle and causing obstructive hydrocephalus. Early detection, management, and focal laser treatment of capillary hemangiomas in the retina's periphery led to favorable visual outcomes. Even after vitreoretinal surgery, the tumors may cause exudative retinal detachment and have an inferior visual prognosis if left untreated
Self-Medication using Chlorpheniramine Maleate in Karanganyar Regency, Central Java, Indonesia
Full text linkSelf-medication refers to the use of medications by a person without consulting health professionals and prescription. One of the common drugs used for self-medication is chlorpheniramine maleate (CTM), a drug indicated to relieve symptoms of allergy. However, the lack of knowledge about the indications of CTM leads to its significant misuse. Long-term effects of CTM misuse include heart rate regularity disorder, central nervous system disorders, and even coma. The purpose of this study was to analyze the correlation between sociodemographic factors and the appropriateness of CTM use for self-medication from the perspective of the experience of using CTM for self-medication. This cross-sectional study was performed in Karanganyar Regency, Central Java, Indonesia, from October to November 2022 on 117 respondents sampled randomly using cluster sampling method. A questionnaire that was already proven as valid and reliable was used. Results for the appropriateness of CTM use showed that 95.7% of respondents were in good category, 3.4% were in fair category, and 0.9% were in poor category. The hypothesis tests, which were the Somers’d test and the contingency coefficient, showed no correlation between age (p=0.242), gender (p=0.307), income level (p=0.789), experience (p=0.176), and the appropriate use of CTM for self-medication. However, there is a correlation between education level (p=0.048) and the appropriate use of CTM for self-medication, albeit very weak (r=0.065). Therefore, only the level of education affects the appropriate use of CTM for self-medication
Histopathological Aspects as Predictor of Recurrency of Locally Advanced Breast Cancer
Full text linkThe histopathological aspect of breast cancer has been established as one of the important prognostic factors of recurrence. This study aimed to determine whether histopathological examination can be used as a predictor of the incidence of recurrence in locally advanced breast cancer patients. This was a cohort retrospective observational study with a correlative analytical approach. Subjects of this study were breast cancer patients who have undergone mastectomy and/or received additional therapy at Dr. Hasan Sadikin General Hospital Bandung, Indonesia, between January 2017 and September 2019. Data were collected through medical records and anatomical histopathology data. Subjects were divided based on their recurrency status. A total of 62 breast cancer patients were included in the study with 31 recurrent patients and 31 non-recurrent patients. A total of 29 patients in the recurrent group (93.5%) had lymphovascular invasion. Histopathology grading showed a difference in both groups, in which recurrent group patients were mostly (74.2%) in the high histopathological grade while 51.6% of samples in non-recurrent group were categorized as moderate histopathological grade. Complete histopathological margins were found in both recurrent and non-recurrent groups for 54.8% and 87.1% respectively. There is a correlation between histopathologic grading, lymphovascular invasion, and incision margin with the recurrence of a locally advanced stage breast cancer. It can be concluded that some histopathological aspects can be used as a predictor of recurrence in locally advanced breast cancer
Effect of Saline Nasal Irrigation in Patients with Sinonasal Symptoms
Full text linkNasal irrigation with saline is frequently used as an alternative therapy for sinonasal diseases since it effectively reduces sinonasal symptoms and improves the quality of life when measured by various subjective instruments. The mechanisms of action of saline irrigation remain unclear, but some hypotheses attribute the direct physical cleansing of thick mucus, allergens, and pollutants. This study aimed to determine the effect of nasal saline irrigation on the nasal mucosa using the modified Lund-Kennedy endoscopic score as the objective evaluation. This pre-post-experimental study was conducted at PKU Muhammadiyah Gamping Hospital Yogyakarta, Indonesia, from May to June 2023. The study included 18 individuals presenting with sinonasal symptoms. Participants meeting the inclusion and exclusion criteria who provided informed consent were trained in nasal saline irrigation. Patients were assessed at baseline and one week after nasal saline irrigation using endoscopy, TNSS, and MCC time. Results revealed that the mean of endoscopic scores before and after saline irrigation were 6.89±1.1 and 5.33±1.4, respectively (p-value 0.006), while the mean of TNSS scores before and after saline irrigation was 6.17±2.3 and 4.28±2.6, respectively (p-value 0.006). Thus, nasal saline irrigation significantly improves the endoscopy and TNSS scores, but not the MCC time
Microbial Diversity and Antimicrobial Susceptibility from Wound Dehiscence Isolates in an Indonesian Tertiary Referral Hospital
Full text linkHealthcare-associated infections (HAIs) remain a critical issue for public health in Indonesia, with wound dehiscence associated with surgical site infections (SSIs) being one of them. Globally, SSIs are known as the most common postoperative complications with a heightened prevalence, particularly in low to middle-income countries. With its retrospective and descriptive design, this study aimed to illustrate the microbial patterns identified in Prof. Dr. I.G.N.G. Ngoerah General Hospital from 12 January 2020 to 12 December 2022. The study includes all patients who underwent surgery and were subsequently diagnosed with wound dehiscence and SSIs. Specimens were collected from patients and submitted to the Microbiology Laboratory at the hospital above. Bacterial identification and susceptibility testing to antimicrobials were performed using the Vitek 2 Compact System (bioMerieux, Marcy l'Etoile, France). Patient information was sourced from medical records. Out of 172 samples, 151 (87.8%) yielded positive cultures. Among these, 151 (87.8%) were found to be positive. Gram-negative bacteria were found to be most prevalent, with Escherichia coli (20.2%) and Pseudomonas aeruginosa (19.6%) being the most frequently isolated bacteria. The bacteria isolated were mostly susceptible to amikacin (72.1%), followed closely by meropenem (71.4%). This information could contribute to the development of an empirical antibiotic therapy protocol for wound dehiscence or SSI cases in this local context
Effect of Curcumin on Nitric Oxide and Endothelin-1 Levels in L-NAME-Induced Preeclamptic Wistar Rat
Full text linkPreeclampsia is a pregnancy disorder marked by the onset of hypertension after the 20th week, posing risks such as cardiovascular disease. Curcumin, a commonly consumed herbal medicine, has been investigated as a potential antihypertensive agent in mouse models of preeclampsia. This study took place in the Bioscience Laboratory of Universitas Brawijaya from March to August 2023, employing a true experimental design with various groups of mice receiving different treatments. Nitric oxide (NO) and endothelin-1 (ET-1) levels were measured using calorimetry and ELISA. The rats were divided into five groups: positive control, negative control and P1, P2, and P3 as the treatment groups. Treatment grups received fifferent curcumin doses of 30mg/kgBW/day, 50mg/kgBW/day, and 100mg/kgBW/day for P1, P2, and P3, respectively. Data analysis using the One-Way ANOVA and Post Hoc LSD revealed that curcumin at 100mg/kgBW/day significantly increased the NO level of 47.75±22.6 and decreased the ET-1 level of 67.03±24.47 when compared to the positive control (p<0.05). However, the 30mg/kgBW/day and 50mg/kgBW/day doses did not significantly affect the NO and ET levels. In conclusion, curcumin supplementation shows positive effects on NO and ET-1 levels in L-NAME-induced preeclamptic Wistar rats, highlighting its potential as an effective intervention for managing this pregnancy-related disorder