Althea Medical Journal
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Treatment of Rheumatoid Arthritis with Methotrexate Alone or A Combination of Methotrexate and Hydroxychloroquine
Get PDFBackground: Rheumatoid arthritis (RA) is an autoimmune disease that causes significant morbidity in most patients and also premature mortality in some. To prevent this, therapeutic approaches call for the early treatment of RA by using disease-modifying antirheumatic drugs (DMARDSs), either as single therapy or combination therapy. Although in the previous decade DMARDs were rarely used as combination, however now they are used widely to treat RA. The objective of this study was to compare the effectiveness of methotrexate (MTX) alone and the combination of MTX & hydroxychloroquine (HCQ) in RA patients.Methods: An analytic retrospective cohort study was conducted from May 2014 until October 2014, on 46 patients with RA in the rheumatology clinic of Dr. Hasan Sadikin General Hospital Bandung from January 2009−October 2014 who were taking MTX or MTX & HCQ for at least 1 year. The secondary data obtained from these patients’ medical record were then analyzed using the independent t-test and Mann-Whitney test.Results: The study showed that 93.48% of the patients were females. The mean change in disease activity measures were not significant for any of the parameter (p-value for SJC = 0.337; TJC = 0.676; ESR = 0.780). Also the comparisons of the disease activity score (DAS 28) before and after therapy was not significant (p-value = 0.584).Conclusion: There is no difference in the effectiveness of DMARD monotherapy with MTX and combination therapy with MTX & HCQ in RA patients.DOI: 10.15850/amj.v3n3.47
Profile of Blood Transfusion Requests from Hospitals to Bandung Blood Transfusion Unit, Indonesian Red Cross in 2011
Get PDFBackground: Blood transfusion as a part health services should be provided under appropriate indications and in a safe manner. In Indonesia, blood collection is run by the Blood Transfusion Unit of Indonesian Red Cross, where the blood is screened, processed into blood components, and finally distributed to hospitals. The purpose of this study was to describe the profile of blood transfusion requests from hospitals that do not have blood bank facility to the Bandung Blood Transfusion Unit, Indonesian Red Cross.Methods: A descriptive study was carried out using secondary data from Bandung Blood Transfusion Unit Indonesian Red Cross (UTD PMI Bandung). All blood request forms from hospitals during 2011 were collected and analyzed. Variables in this study were the amount of blood units, blood components, blood type, and indications of blood transfusion.Results: The number of blood units requested by hospitals were 35,841 units. The most blood units requested was in August 2011. The blood component requested was the packed red cell (61.1%), whole blood (17.4%), thrombocyte concentrate (10.6%), and fresh frozen plasma (7%). The total percentage of O, A, B and AB blood types were 36.1%, 28.6%, 27.5%, and 7.9% respectively. The most frequent indication for transfusion was anemia (61.7%), followed by surgery and other causes of bleeding. Conclusions: The total blood units requested by hospitals vary each month. The most blood component requested is Packed Red Cell and the type of blood is O blood type. The most frequent indication is anemia. DOI: 10.15850/amj.v2n3.51
Anti-inflammatory Effect of Trigona spp. Propolis in Restricting Edema Volume
Get PDF Background: Inflammation is a normal response that potentially harmful if it is uncontrolled. On the other hand, it is necessary to find an alternative anti-inflammatory as most anti-inflammatory drugs available nowadays still have adverse effects. Trigona spp. propolis is one of the potential anti-inflammatory alternatives because of its flavonoid, especially caffeic acid phenethyl ester, which is known as an active compound in anti-inflammatory process. This study aimed to understand the anti-inflammatory effect of Trigona spp. prolisin reducing edema volume in rat’s paw.Methods: An experimental study was performed on 20 male wistar rats. The rats were divided into control and experimental groups with 10 rats in each group. Control group was treated by propylene glycol 1 ml/day and experimental group was treated by Trigona spp. propolis 200 mg/kg body weight/day. The inflammation was induced by subcutaneous injection of λ-carrageenan 1% at plantar one hour after the treatment. Edema volumes were measured by plethysmometer every hour at 1 to 6 hours and once at 24 hours after induction. The difference in edema volumes was calculated in percentage. This study was conducted during October 2012 at the Pharmacology and Therapy Laboratory, Faculty of Medicine, Universitas Padjadjaran Bandung.Results: The increase of edema volume (in percentage) in control group and Trigona spp. propolis treated group are 100.64±32.22 and 56.46±20.38 respectively (p value=0.000). Multiple comparisons using Dunnet and Duncan post hoc test showed significant differences that were observed at 3, 4, 5, and 6 hours after inflammatory induction.Conclusion: Trigona spp. propolis has an anti-inflammatory effect in reducing edema volume in rat’s paw. The most significant effect was observed at 3, 4, 5, and 6 hours after inflammatory induction. Trigona spp. propolis might have a potential to be developed as a future anti-inflammatory drug.Keywords: Edema volume, inflammation, propylene glycol, Trigona spp, propolisDOI: 10.15850/amj.v2n1.440
Characteristic and Knowledge among Treatment Supporter of Children Patients with Tuberculosis at Lung Clinic Bandung October–November 2012
Get PDFBackground: Children are the most vulnerable to get TB infection and infected by adult patients. One of the components of Directly Observed Treatment Short Course (DOTS) is direct observation by treatment supporter who has important role in the success of TB’s treatment. The aim of this study was to identify the characteristics and knowledge among treatment supporter of children patients with TB at Lung Clinic Bandung.Methods: A descriptive study was conducted in October-November 2012 to 96 treatment supporters of child patients who were diagnosed with TB, either new or old cases. They were selected by consecutive sampling at Lung Clinic Bandung. Validated questionnaire with 14 questions was administered. The percentage of the correct answers was categorized as good, moderate, and poor. The Characteristic variables included age, sex, education, occupation, relation with the patients, living at the same house, presence of other TB patients, and counseling given by providers. Data was analyzed using frequency distribution.Result: Most of the respondents were 21-30 years old (42.7%), female (84.4%), elementary school graduate (33.3%), unemployed (69.8 %), mother of the child, living in the same house, had other TB patients, and had received counseling by providers at Lung Clinic. The knowledge about TB among the respondents was moderate (56.3%). The respondents who had good knowledge had underwent the counseling session.Conclusions: The knowledge of the respondents was moderate. Further study on the relationship between the level of knowledge of treatment supporter and the adherence of TB treatment should be conducted. [AMJ.2015;2(1):167–71
Correlation between Levels of Serum Amylase, Lipase and Triglyceride in Acute Pancreatitis Patients
Get PDFBackground: Acute pancreatitis is an inflammation of pancreas associated with reversible pancreatic parenchymal injury. Studies in several countries indicate that the levels of amylase and lipase are usually elevated among patients with acute pancreatitis. Furthermore, hyperlipidemia, mainly high levels of triglycerides, may present in acute pancreatitis. The aim of this study was to determine the levels of serum amylase and lipase as well as their correlation with serum triglyceride level in acute pancreatitis patients.Methods: A retrospective study was conducted on medical records of 48 acute pancreatitis patients in Dr. Hasan Sadikin General Hospital Bandung, Indonesia from 2007to 2011. Data collected from the medical records were age, sex, levels of serum amylase, lipase and triglyceride. The distribution of data was determined using Shapiro-Wilk test. The correlation between serum pancreatic enzyme and triglyceride was analyzed using Spearman-rank test.Results: Most patients had increased levels of serum amylase and lipase in this study. However, no correlation between serum amylase and triglyceride (p-value = 0.312) was found. Furthermore, there was no correlation between serum lipase and triglyceride (p-value = 0.241).Conclusions: The levels of serum amylase and lipase increase in most patients with acute pancreatitis with no significant correlation between serum pancreatic enzymes (amylase and lipase) and triglyceride.Keywords: Acute pancreatitis, amylase, lipase, triglyceride DOI: 10.15850/amj.v2n1.420
Visual Acuity Before and After Treatment in Patients with Chemical Injuries at the National Eye Center, Cicendo Eye Hospital, Bandung from 2010 to 2011
Get PDFBackground: Chemical trauma is one of the emergency cases in ophthalmology since it can lead to severe, permanent blindness if not immediately treated. This study aimed to reveal pre- and post-therapy visual acuity on patients with chemical trauma at theNational Eye Center, Cicendo Eye Hospital, Bandung.Methods: This study was performed on 40 patients’ medical records from the National Eye Center, Cicendo Eye Hospital Bandung from January 2010 to January 2011 as secondary data, using the descriptive retrospective method. The data were divided into two groups: acid and alkali trauma. The collected data were analyzed and presented in tables.Results: Chemical trauma cases were mostly caused by caustic soda (17/40) whereas the least were caused by vinegar (3/40) and commonly occurred on adult patients in the right eye on alkali trauma. Patients with chemical trauma generally had normal eyesight before therapy.The number of patients with acid and alkali trauma who experienced improved eyesight after therapy alkali were similar (3 patients) while worsening symptoms occurred in one patient with alkali chemical trauma from mild to medium low vision.Conclusions: There are some improvements of visual acuity after treatment in patients with chemical injuries. DOI: 10.15850/amj.v2n3.48
Characteristics of Patient with Brachial Plexus Injury in Neurophysiology Laboratory of Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from 2003 to 2012
Get PDFBackground: Brachial plexus is a network of nerves that controls the upper limb. Unfortunately, it can be injured easily which is called brachial plexus injury (BPI). It can cause disability. Until now, the epidemiology of BPI in Indonesia is still lacking. The aim of this study was to describe the characteristics of patients with BPI in Bandung, in order to increase knowledge and attention of health care provider and community to prevent BPI.Methods: This was a descriptive retrospective study. Data from medical records of patients with BPI who underwent electromyography (EMG) in Neurophysiology Laboratory Dr. Hasan Sadikin General Hospital, Bandung from 2003 to 2012 were collected. The data included age, sex, mode of injury, affected side and distribution of paralysis. Collected data were presented as percentages shown in tables.Results: A total of 91 cases were collected during study period, which consisted of 69 males and 22 females (76% vs. 24%). Most of them were in productive age group (11−20 years and 21−30 years). The main cause of brachial plexus injury was traffic accident (76%), followed by birth injury. Distribution of paralysis was mostly in postganglionic area of cervical (C)5, C6, C7, C8 and thoracal (T)1 (67%). Around two third of the cases involved the right side of upper limb.Conclusions: The study showed that most of patients with BPI are male in their productive ages. Traffic accident is the most common cause, and the most affected side is the right side of upper limb. DOI: 10.15850/amj.v2n3.52
Enteric Pathogen Bacteria in Non-Broiler Chicken Egg Shells from Traditional Market and Supermarket, Jatinangor Subdistrict, West Java
Get PDFBackground: Around 1.5 million of children dying annually due to diarrhea. Contaminated food is one of the sources of the diarrhea incidence (food borne diseases). Eggs are one of the least expensive forms of protein which is affordable by the community and is easily to find in either traditional or modern market/supermarkets.The objective of this study was to identify enteropathogenic bacteria contamination on non-broiler (ayam kampung) egg shell and to compare the findings between eggs sold in traditional and modern markets.Methods: This was a descriptive study performed at the Microbiology Laboratory of the Faculty of Medicine, Universitas Padjadjaran. A total of 40 eggs were used, 20 from two traditional markets and 20 from two modern markets. The eggs were swabbed using saline, dipped in tryptic soy broth and streaked on Mac Conkey agar. The collected data were analyzed and presented in tables.Results: Out of 40 samples, there were 19 positive cultures found from the traditional market and 16 from the modern market. There were 30 pink colonies indicating that they were lactose fermented, 5 transparent colonies indicated non-lactose fermentation, 4 showed no colony growth, and 1 grew an unidentified colony. The most found bacteria were Klebsiella sp. and Enterobacter sp. in both market. Conclusions: Eggs shells from traditional and modern markets are contaminated with Enteropathogenic microbes. DOI: 10.15850/amj.v2n3.48
Profile of Head and Neck Cancer Patients at Department of Otorhinolaringology-Head and Neck Surgery Dr. Hasan Sadikin General Hospital Bandung
Get PDFBackground: Head and neck cancer is a health problem with a high mortality rate. Head and neck cancer are increasing and effect many individuals from diverse backgrounds. Usually patients come with advanced stages, therefore these conditions could lead to decrease their quality of life. Aim of this study was to describe the profile of head and neck cancer patients at the Otorhinolaringology-Head and Neck Surgery Department, Dr. Hasan Sadikin General Hospital Bandung.Methods: A descriptive cross-sectional method was used from medical records of head neck cancer patients at Department of Otorhinolaringology-Head and Neck Surgery, Dr. Hasan Sadikin General Hospital Bandung from 2008 to 2012 that used the total sampling method.Results: There were 665 patients included in this study, which men who participated were 388 and women were 277. Most of them were elementary educated (44.96%), housewives (32.03%), and those aged 46–55 years old (28.33%). There were nasopharyngeal (38.20%), sinonasal (17.29%), larnyx (13.08%), oropharnyx (6.32%), thyroid gland (6.17%), oral cavity (3.91%), hypopharynx (2.41%), and parotid gland (2.26%) cancer. The major histopathological findings were undifferentiated carcinoma (45.41%) and squamous cell carcinoma (22.26%), those were presented with stage I (7.4%), II (13.5%), III (24.4%), and IV (54.7%).Conclusions: Nasopharyngeal carcinoma was the most predominant cases which majority were presented in advanced stage and major histopathology features was undifferentiated carcinoma, while demografic characteristic mostly were in middle aged and older, men with low education background. [AMJ.2015;2(4):474–9] DOI: 10.15850/amj.v2n4.63
Creatine Phosphokinase and Visual Analogue Scale as Indicators for Muscle Injury in Untrained Bodybuilders
Get PDFBackground: Skeletal muscle is a vital tissue in the human body to enable breathing, walking and performing several sports activities. However, this muscle is persistently injured throughout every sports session. Some exercises demand a muscle injury occurrence in order to build a stronger muscle through an adaptation process namely bodybuilding exercise. Importantly, every muscle injury should occur within a physiological range which can be identified by several biomarkers as well as pain scale. The aim of this study was toidentify changes on the level of Creatine phosphokinase (CPK) and Visual analogue scale (VAS) between pre and post training sessions and the correlation between these two indicators.Methods: This was an observational analytical cross sectional comparison study which was conducted in October 2012 and the subjects were adult untrained bodybuilders at the Jatinangor fitness center. The data was obtained by measuring serum CPK and marked VAS. The data were analyzed by t-test, Wilcoxon’s test and Spearman’s correlation.Results: Both CPK and VAS increased significantly by 296 U/L and 19.9 mm respectively. There was a strong positive significant correlation between VAS and CPK (p=0.01, r = 0.711).Conclusion: The healthy untrained bodybuilders chosen in this study experienced a mild (<2000 U/L) muscle injury throughout the training sessions with general increased CPK levels and VAS measurement. [AMJ.2015;2(1):147–52