Althea Medical Journal
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Lipid Level of Street Food at Cibeusi Elementary School in Jatinangor Subdistrict, West Java, Indonesia
Get PDFBackground: School-aged children have quite high energy consumption demand because they are growing and physically active. In Indonesia, school-aged children frequently consume their additional foods/snacks from street food vendors around their schools. This study aimed to reveal the lipid level of street food in Elementary Schools, in Jatinangor Subdistrict, West Java, Indonesia.Methods: This study was an observational descriptive study. Elementary Schools in Jatinangor Subdistrict were selected using a random sampling method. Four frequent street foods were fried meatball (in Indonesian: bakso goreng (basreng)), batagor (bakso tahu goreng), crepes, and egg roll were then taken, and lipid level was measured twice using Soxhlet extraction method.Results: Fried meatball contained 22.10% (±0.23%) or 2.78 gram lipid, batagor 30.091% (±4.14%) or 12.49 gram lipid, crepes 7.14% (± 0.12%) or 0.66 gram lipid, and egg roll 13.66% (±1.63%) or 1.28 gram lipid.Conclusions: Only the batagor fulfilled the lipid demand in one snack time. It is recommended to minimize the intake of batagor as a between-meal snack for a balanced nutrient intake control
Semi-quantitative Digital Analysis for Human Papillomavirus Detection from Environmental Specimens
Get PDFBackground: Recently, human papillomavirus (HPV) deoxyribonucleic acid (DNA) has been detected in urban wastewater, indicating that the virus can reach the sewer and, eventually, other water environments. This study aimed to develop a semi-quantitative assay for HPV DNA detection from environmental specimens using the PCR gel electrophoresis method.Method: This was an experimental descriptive qualitative study conducted from July to November 2019 in a standard molecular laboratory and non-laboratory administration room without air conditioner. Three brands of PCR reagents and different annealing temperatures were compared to identify the best condition for conventional PCR of plasmid DNA containing the HPV L1 gene. The semi-quantitative data were obtained from densitometry digital analysis using an imaging software. The optimized protocol was then applied on DNA serial dilutions to seek for the lower limit of detection (LLOD) value and the linear range of the assay. To evaluate the robustness of the assay, the protocol was further applied to spiked specimens of wastewater. Finally, several wastewater samples were tested for the presence of HPV DNA using this protocol.Results: A broad linear range and HPV L1 gene detection ability were observed with an LLOD of less than 2pg plasmid DNA in field condition. Although the assay successfully detected HPV DNA from several spiked wastewater samples, certain wastewater could interfere with the assay and gave false negative result.Conclusion: A semi-quantitative conventional PCR method to detect HPVDNA from environmental samples has been established and proven to be robust in field condition with non-optimum cold chain
Neutrophil to Lymphocyte Ratio within Clinical Staging of Head and Neck Squamous Cell Carcinoma
Get PDFBackground: Neutrophil to lymphocyte ratio (NLR) is one of the inflammatory markers, associated with malignancies progression and metastasis, including head and neck squamous cell carcinoma (HNSCC). Neutrophil to lymphocyte ratio is presenting the activity index of protumor and antitumor. It is easy to perform in daily clinical practice, obtained from blood examination. The aim of this study was to assess the prognostic value of NLR in HNSCC patients, associated with the clinical staging.Methods: This study was an analytic design to explore the relationship between NLR and clinical staging. The sample was collected from pre-treatment HNSCC patients who came to the Head and Neck Oncology Clinic, Dr.Hasan Sadikin General Hospital. The data consisted of disease history, ENT examination, staging determination, and blood sample examination for NLR count.Results: In total, data on 92 HNSCC patients were collected. There was a statistically significant association between NLR with clinical staging in HNSCC (p<0.001). The higher the NLR, the higher the clinical stage, whereas the lower the NLR, (OR14.1; 95% CI 3.4–59.0).Conclusions: There is a significant association between NLR with clinical staging in HNSCC. Further study is needed to explore NLR as a prognostic marker in HNSCC patient
Clinical Characteristics of Rhabdomyosarcoma in Children: A 4-Year Study in a Tertiary Hospital
Get PDFBackground: Rhabdomyosarcoma (RMS) is the most common soft-tissue sarcomas (STS) in children. Even though the survival rate has increased, the mortality rates remain significantly higher in developing countries due to delay in diagnosis contributed by its diverse and clinical manifestations. This study aimed to describe the clinical characteristics of RMS patients at the Department of Child Health, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.Methods: A descriptive cross-sectional retrospective study was conducted using a total sampling method on medical records of RMS patients aged ≤ 18-year-old during a 4-year period (2015-2018). Data on patient demographics, clinical manifestations, biopsy procedure, histopathological subtype, tumor size, primary site, pre-treatment staging, and treatment were reviewed and presented.Results: Of 30 data retrieved, male (57%), aged 1 to 5-year-old (47%), and diagnosed through open biopsy (63%) comprised the majority of the patients. More than half of the patients came with advanced stage of the disease (80%) and were treated with chemotherapy (83%). Most RMS patients had a tumor located in the head and neck region (40%) with a size of >5 cm (70%) and embryonal subtypes (43%). The remaining patients experienced alveolar subtype (17%), spindle cell subtype (13%), and unknown subtype (27%) of RMS.Conclusion: Children with a tumor in the head and neck region should be suspected as rhabdomyosarcoma, as there are various clinical characteristics of RMS in children found in this study.
Hemoglobin Level Decrease after Open Heart Surgery in a Tertiary Hospital in Indonesia
Get PDFBackground: Open heart surgery is usually performed by connecting the heart to a cardiopulmonary bypass (CPB) machine. The use of the CPB machine may decrease the hemoglobin level and a very low hemoglobin levelcould cause seriouscomplications.This study aimed to explore the decrease in hemoglobin level after open heart surgery.Methods: A cross-sectional retrospective descriptive study was conducted on medical records of patients underwent coronary artery bypass graft (CABG) surgery and heart valve surgery in a tertiary hospital in Indonesia in 2018. The total sampling method was deployed to all medical records of patients underwent CABG surgery (n=25) and patients underwent heart valve surgery (n=3).Results: The decrease in hemoglobin level among young-adult female patients after heart valve surgery was 6.8 g/dl. The average decrease in mid-adult male and female patients after CABG surgery were 6 g/dl and 5.8 g/dl, respectively, and, after the heart valve surgery, the levels were 8.5 g/dl and 5.4 g/dl, respectively. The average decrease in Hb level among late-adult male and female patients after CABG surgery was 6.1 g/dl and 5.4 g/dl, respectively.Conclusion: Hemoglobin level decreases after an open heart surgery. Therefore, observation on the hemoglobin level to prevent complications and to facilitate early treatment is necessary
Clinical and Laboratory Manifestation of Children with Acute Lymphoblastic Leukemia as an Assessment of Severity: A Study in Dr. Hasan Sadikin General Hospital
Get PDFBackground: Acute lymphoblastic leukemia (ALL) is a disease caused by a mutation of lymphoid progenitor cells in bone marrow, that induces uncontrolled lymphoid cell proliferation. ALL is the most common type of leukemia in children. Various clinical and laboratory manifestation makes the diagnostic process more complicated. This study aimed to observe the clinical and laboratory manifestation of children with ALL in Dr. Hasan Sadikin General Hospital for diagnostic and assessment.Methods: The design of this study was a descriptive cross-sectional with a total sampling method. Data of all children under 18 years old with ALL diagnosed in 2015 to 2017 were included. The diagnosis of ALL was confirmed by examination of hematology indices, peripheral blood smear, and bone marrow aspiration classified by FAB. Inaccessible or incomplete medical records were excluded.Results: In total, 192 data of ALL patients were included. Most ALL patients predominantly occurred in boys (59.9%), and the age group of 1–5 years old (40.6%). The clinical manifestations were pallor (89.6%), hepatomegaly (79.7%) and fever (75%). Most patients experienced severe anemia with hemoglobin level 20.000 cells/mm3 (46.9%), severe thrombocytopenia with platelet count 50% (45.3%). Based on FAB classification, the majority of the patients were classified as ALL type L2 (65.6%).Conclusions: Clinical and laboratory manifestation of ALL patients can be used as a parameter for diagnostic and assessment of severity. Earlier diagnosis would result in better prognosis and more precise treatment for ALL patients
Serum Calcium Levels in Chronic Kidney Disease Patient Stratified By Body Mass Index
Get PDFBackground: Most of the chronic kidney disease (CKD) patients have low blood calcium levels, yet hypercalcemia has a worse outcome in CKD patients. Interestingly, CKD patients with higher body mass index (BMI) have better outcomes. This study aimed to elucidate the difference in blood calcium levels stratified by BMI categories in patients with CKD.Methods: The study was conducted using a comparative analytical cross-sectional study design. Patients with CKD (n100), aged over 18 years old were included, Patients with the following were excluded: the history of hemodialysis, history of antioxidants, calcium and vitamin D supplement consumption, history of infection and malignancy. BMI of patients was categorized into underweight (<18.5 kg/m2), normal (8.5-22.9 kg/m2), and overweight or obese (≥23 kg/m2). Data were analyzed to compare blood calcium in different categories of BMI (Kruskal-Wallis test). Results: The age of patients with CKD included in this study had median age of 61 years old, predominantly was men (57%). The blood calcium level of CKD patients was on the lower border of the normal range. Median BMI was 23.48 kg/m2, of which 53% was categorized as overweight or obese. There was a trend that overweight/obese patients had higher blood calcium levels than underweight and normal-weight patients, however, no statistically significant difference between the BMI category (p=0.982).Conclusions: The blood calcium level in chronic kidney disease varies across the BMI category, however, no correlation with the BMI
Annona Muricata L Leaf Infusion Effect on Glucose Absorption in the Intestinal Cells Membrane of Wistar Rats Model
Get PDFBackground: Diabetes mellitus (DM) is a chronic disease that disrupts the homeostasis of glucose. DM is the second of most causes of deaths in urban areas, as well as the sixth in rural areas. Therefore, herbal medicine is constantly developed. Soursop leaves have been long known to have good effects in lowering glucose levels in our blood. This study explored the soursop leaves infusion on glucose absorption in the intestinal cell membrane of the Wistar Rats Model. Methods: This was an exploratory study performed in October 2012 on five male rats Wistar, aged 3-4 months, weighing about 150-300 grams. Using the in situ perfusion method, each rat was given the following; 3 X 10-3 M glucose solution for one hour; 3 X 10-3 M glucose solution with 1 mL of infusion of soursop leaves (Annona muricata L) for one hour; 3 X 10-3 M glucose solution for the last hour. The glucose absorption levels were measured using spectrophotometry method. The glucose level between treatments was analyzed using a paired sample t-test.Results: The concentration of glucose absorption was decreased, the first treatment was 24.42+14.29 mg/dL, the second treatment was 18.63+10.37 mg/dL, and the third treatment was 18.24+8.02mg/dL), however, the decrease of glucose absorption was statistically not significant.Conclusions: There is a slightly decreased of the glucose absorption in the intestinal cell membranes of the Wistar Rats Model after infusion of soursop leaves. Further study is needed to explore the role of soursop leaves infusion in glucose absorption
The Risk Factors and Collateral System in Coronary Artery Disease among Patients in Bandung
Get PDFBackground: The slow blood flow may cause atherosclerotic plaque, leading to an obstruction in the arterial circulation, and thus resulting in among others myocardial ischemia. There are many risk factors associated with the collateral system such as dyslipidemia, obesity, hypertension, diabetes mellitus, and smoking habit. This study aimed to determine the association between risk factors and collateral system in patients in Bandung. Methods: This was an analytical cross-sectional study, using data of 186 medical records taken from Dr. Hasan Sadikin General Hospital in October 2013. The risk factors were assessed and the prevalence ratio reflected the association between the risk factors and the collateral system was analyzed.Results: The study revealed no significant association between each risk factor and the collateral system, including obesity (p=0.690), smoking (p=0.175), dyslipidemia (p=0.747), and diabetes mellitus (p=0.616); however, only hypertension was associated (p=0.020). Furthermore, no significant association was found between the number of risk factor and the collateral system (p=0.233).Conclusions: Of the risk factors published, only hypertension is a significant risk factor among patients in Bandung, while others including obesity, smoking, dyslipidemia and diabetes mellitus are not associated. Further study needs to be performed to explore other risk factors in coronary artery disease, and to prevent the disease among the population.
The Air Quality and Detection of Streptococcus pneumoniae in the Pediatric Ward of Dr. Hasan Sadikin Hospital Bandung
Get PDFBackground: Nosocomial infection can be acquired by inhalation of droplets from contaminated air. In children, nosocomial pneumonia is mainly caused by Streptococcus pneumoniae. This study aimed to explore the air quality level and to detect Streptococcus pneumonia in the air of the Pediatric Ward of Dr. Hasan Sadikin Hospital, Bandung. Methods: This was an observational descriptive study conducted in the Pediatric Ward of Dr. Hasan Sadikin Hospital in November 2012. The different number of modified tryptic soy agar (TSA) plates with 4% blood were exposed and placed in various rooms of the ward for 30 minutes between 12.00 pm to 1.00 pm at heights between 1.0m to 1.5m and according to the respectively room air volume. After exposure, these plates were then incubated for 48 hours at 35°C. The Colony Forming Units (CFU) on each plate was counted per Replicate Organism Detection and Counting (RODACTM). Detection of Streptococcus pneumonia was performed by detecting any round α-hemolytic colonies on the TSA plate, confirmed by Gram staining, optochin susceptibility test, and the bile solubility test. Result: The air quality in 13 rooms of the Pediatric Ward was generally poor ranging from 27.5 to 232.0 CFU/30 min, however, the concentration of microorganisms per cubic meter air was from 0.198 to 4.296 CFU/m3. Moreover, Streptococcus pneumoniae was not present in the air of the ward.Conclusions: Although Streptococcus pneumoniae has not been detected, the air quality in the Pediatric Ward of Dr. Hasan Sadikin Hospital, Bandung is generally poor. General precautions need to be enhanced to increase the air quality in the hospital.