Althea Medical Journal
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Diagnostic Value of Coproantigen for Detection of Giardia Infection in Stunted Children
Get PDFBackground: Giardiasis is a protozoa infection caused by Giardia intestinalis, which commonly infects children, impairing children’s growth, development, and cognitive function. Standard diagnosis is carried out by microscopic examination of stool. This study aimed to evaluate coproantigen examination in stunted children compared to microscopic examination.Methods: A cross-sectional study was performed on stools collected from a survey among stunted children in Bandung in 2019. Stools were preserved in 10% formaldehyde and kept at -20oC until used. Direct microscopy examination with 2% lugol solution and coproantigen ELISA test using Giardia Cryptosporidium (combo test) coproantigen test kit were performed in Parasitology Laboratory Faculty of Medicine, Universitas Indonesia.Result: A total of 99 stools originated from stunted children aged 2-6 years. with boys predominant (52.5%). Microscopic examination showed that 12.1% (12/99) of the children were harboring intestinal parasites, such as the protozoa Giardia intestinalis, Blastocystis spp, and Entamoeba coli (E. coli). Giardia was the primary infection (9.1%), of which single Giardia infection (n = 8) and mixed infection of Giardia and Blastocystis spp (n = 1). Interestingly, coproantigen examination resulted in 6 positive samples, and 4 samples agreed with the microscopy result. With a sensitivity of 44.4% and a specificity of 97.7%. The positive and negative predictive values were 66.7% and 94.7%, respectively.Conclusion: A moderate prevalence of Giardia in stunted children in Bandung regency has been observed. The combo coproantigen test method has high specificity and is suitable for use as a confirmation test to exclude Giardia infection
Prevalence of Gastroesophageal Reflux Disease among Diabetic Patients at Sharif Medical City Hospital, Lahore, Pakistan
Get PDFBackground: Diabetes mellitus has been linked to various gastrointestinal motility disorders, including gastroesophageal reflux disease (GERD).This study aimed to determine the proportion of GERD in patients with diabetes mellitus.Method: This descriptive cross-sectional study was conducted at the medical outpatient department of Sharif Medical City Hospital, Lahore, from October to December, 2020. Patients previously diagnosed with type II diabetes were included using non-probability consecutive sampling, and the GERDQ questionnaire was used to determine the frequency. IBM SPSS statistics version 23 was used for the analysis of data.Results: Of the 273 participants, 183 (67.0%) were male and the mean age was 51.13±12.8 years. The mean duration of diabetes was 6.97±4.76 years and oral hypoglycemic agents were used by 133 (48.7%) participants. Overall, 133 (48.7%) of the participants had GERD with a mean GERDQ score of 10.8(±1.4).Conclusion: Almost half (48.7%) of the participants have GERD; the most common symptom is regurgitation of stomach contents. Awareness should be raised, and early screening should be done to prevent long-term complications.
Association of Nuclear VDR Immunoexpression with Breslow’s Thickness in Acral Melanoma
No full textBackground: Acral melanoma (AM) is a subtype of malignant melanoma (MM) that has a predilection for glabrous skin and is the most common type of melanoma among Asians. Depth of invasion is one of the prognostic factors in AM. VDR may have an association with depth of invasion in AM. However, reports from Asian patients are still lacking. The aim of this study was to explore the association between VDR immunoexpression and depth of invasion in AM patients in Bandung, Indonesia.Methods: This study was a retrospective cross-sectional study that analyzed the nuclear and cytoplasm VDR expression of melanoma cells and its association with Breslow’s thickness in patients with AM in Dr. Hasan Sadikin General Hospital Bandung. VDR immunostaining was performed on paraffin blocks. The Breslow thickness was measured using dot slide software. Chi square statistical analysis was done to determine the results.Results: Of the 30 patients, 73% had a Breslow thickness of >4 mm. There was a significant inverse association between nuclear VDR immunoexpression and Breslow thickness of AM (p<0.001), but not for cytoplasmic VDR immunoexpression (p=0.914). Conclusion: Low nuclear VDR immunoexpression is associated with the depth of invasion in AM. Nuclear VDR immunoexpression possibly affect progression and should be considered before administration of vitamin D therapy in AM.
Liver Function Profile of Pediatric Patients with Dengue Viral Infection Admitted to a Tertiary Referral Hospital during the COVID-19 Pandemic
No full textBackground: Dengue infection is endemic in more than 100 countries; 70% of cases occur in Asia. One of dengue infection complication is hepatic dysfunction. The COVID-19 pandemic may cause a delay in seeking treatment and affect severe case of dengue infection when admitted to the hospital. This study aimed to analyze the liver function profile in dengue pediatric patients during the COVID-19 pandemic.Methods: All patients under 18 with confirmed dengue serology (NS-1 immunochromatography or IgM anti-Dengue (ELISA) test and IgG anti-Dengue (ELISA) test) in Dr. Hasan Sadikin General Hospital from 2021–2022 were included in this retrospective study. The patients were categorized based on the modified WHO classification of 2009. Data were processed with SPSS® ver. 25 and analyzed using Chi-Square and One Way-ANOVA.Result: In total, 85 patients were tested for the liver function; most severe dengue patients had abnormal SGOT and SGPT levels (100% vs. 64%). The SGOT and SGPT levels during the initial admission were higher in the severe dengue group (634 U/l and 271 U/l) and significantly different among groups (p=0.001 and p=0.032). The elevated SGOT (1,339 U/l vs. 203 U/l vs. 87.3 U/l; p=0.014) and SGPT (438 U/l vs. 100 U/l vs. 42.8 U/l; p=0.005) levels were higher in the severe dengue group.Conclusion: The severity of dengue is in line with the increase in SGOT and SGPT levels. During the COVID-19 pandemic, the liver dysfunction persists and may be interfered with by delays in dengue treatment. Early recognition and prompt treatment are needed to decrease morbidity and mortality
Presence of Multidrug Resistance (MDR) Escherichia coli in the Citarum River located in Greater Bandung Area, Indonesia
No full textBackground: One of the main problems of the Citarum River is the contamination of E. coli due to livestock activities, washing toilets, and industry. In addition, irrational use of antibiotics in the community and livestock can increase E. coli resistant strains to antibiotics. This study aimed to identify the presence of multidrug resistance (MDR) and extended-spectrum β-lactamase (ESBL) E. coli strains in Citarum river clusters, namely industrial, livestock, and residential clusters.Methods: This was a descriptive study. A sample of 100 mL surface water from each Citarum cluster. Culture, antibiotic sensitivity test, and PCR to identify blaCTX-M-15 gene carriers of ESBL E. coli were carried out in the sample.Results: There were 37 isolates of E. coli, with 24% of these isolates showing MDR properties, which can be found in industrial, livestock, and residential clusters at 13%, 8%, and 3% respectively. The most E. coli-resistant antibiotics found in these samples were ampicillin (45%), followed by tetracycline (37%), and azithromycin (29%). The PCR examination did not find the blaCTX-M-15 gene carrying ESBL properties in all three Citarum river clusters.Conclusion: The presence of E. coli isolates in each Citarum river cluster suggests the occurrence of river pollution due to animal, human or industrial waste. Therefore, it is necessary to make better government regulations regarding sanitation and education for the surrounding community regarding the importance of keeping the river clean
Thawing Time Difference between Fresh Frozen Plasma Using Ziplock Plastic and non-Ziplock Plastic in Blood Transfusion Unit Dr. Hasan Sadikin General Hospital Bandung, Indonesia
Get PDFBackground: The quality of fresh frozen plasma (FFP) in a clinical setting depends on thawing time. Thawing using a water bath is often used in blood transfusion units because it is easy to perform, affordable, and easy to look for. Protective plastics (Ziplock and non-Ziplock) are used to reduce the risk of contamination,. This study aimed to determine whether there is a difference in thawing time between FFP using Ziplock plastic and non-Ziplock plastic.Method: This experimental design was conducted in the Blood Bank Unit of Hasan Sadikin Hospital from June-August 2021. Samples were divided into two groups, namely thawing using Ziplock and non-Ziplock. Each group consisted of volume 160-200 ml and 201-240 ml.Results: The total samples were 24 FFP bags. In the group of the bag 160-200 ml, the median thawing time using Ziplock plastic was 8 minutes (8-16 minutes), non-Ziplock was 15 minutes (8-16 minutes) (p value 0,111), whereas in a group of bags with volume 201-240 ml, the median thawing time using Ziplock was 15 minutes (8-28 minutes), non-Ziplock was 20 minutes (14-30 minutes) (p- value 0,332). Although there was a time difference in both groups, the difference was non-significant.Conclusion: The thawing time between the small bag with a volume of 160-200 ml and the larger volume of 201-240 ml shows no difference. Ziplock plastic can be used to reduce the risk of contamination
Poor Glycemic Control Correlates with Iron Deficiency Anemia in Type 2 Diabetes Mellitus
Get PDFBackground: Glycated hemoglobin (HbA1c) has been used extensively to diagnose and monitor diabetes mellitus (DM). Patients with type 2 DM are at risk of experiencing comorbidities and complications such as iron deficiency anemia (IDA). This study aimed to determine the correlation of HbA1c with iron deficiency anemia (IDA) in type 2 DM.Methods: This cross-sectional study was conducted on 115 types 2 DM patients at a hospital in South Jakarta, Indonesia from November to December 2021. Data on HbA1c levels and IDA were obtained from medical records. Data were analysed with the Chi-Square test and significancy at p<0.05.Results: In total, 43 men and 72 women with type 2 DM were included, with predominantly age over 45 years (89.6%), had DM for more than ten years (55.7%), had obesity I (53.9%), and with hypertension as the most common comorbidity (65.2%). Furthermore, the patients did not smoke (64.3%), had poor glycemic control ((76.5%) and had anemia (58.3%). There was a significant relationship between HbA1c levels and IDA (p = 0.003).Conclusions: This study shows a relationship between HbA1c and IDA in type 2 DM, therefore, DM patients with poor glycemic control need to be well monitored for iron deficiency anemia.
Clinicopathological Characteristics of Cervical Carcinoma with Pelvic Lymph Node Metastases in Dr. Hasan Sadikin General Hospital, Bandung 2013-2021
Get PDFBackground: Carcinoma of the cervix is the most common gynecological malignancy, which ranks first among carcinomas in Indonesia. Lymph node metastasis is a risk of recurrence, affecting survival and therapy. The purpose of this study was to determine the clinicopathological characteristics of cervical carcinoma with pelvic lymph node metastasis that had undergone radical hysterectomy and lymphadenectomy at Dr. Hasan Sadikin General Hospital, Bandung.Methods: This study used a cross-sectional retrospective descriptive study. Data on the clinical stage I-II cervical cancer patients with pelvic lymph node metastasis were collected from the archives of the pathological anatomy laboratory during period from 2013 to 2021. Data were presented in percentage.Results: There were 64 data patients, and the most common age of cervical carcinoma ranged from 40 to 50 years old (52%), the most common stage was stage II (66%), and the most frequent histopathological type was squamous cell carcinoma (70%). The highest degree of differentiation was moderate differentiation (50%). There was no difference in tumor size between sizes <4 cm and ≥4 cm.Conclusion: The cases of cervical carcinoma at Dr. Hasan Sadikin General Hospital Bandung are treated with radical hysterectomy and lymphadenectomy. The patients generally aged between 41–50 years old, stage II, and squamous cell carcinoma with a moderate degree of differentiation
Level of Knowledge, Attitude, and Behavior among Specialists of Otorhinolaryngology-Head and Neck Surgery in West Java Towards Cochlear Implants
Get PDFBackground: Hearing loss and deafness are still an issue in Indonesia, especially in West Java, with a prevalence of 2.5% and 0.06%, respectively. Cochlear implants are intended for patients with severe sensorineural hearing loss to stimulate the remaining auditory nerves. Based on their competency standards, Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) Specialists are expected to be able to inform patients and families about the cochlear implantation procedures. This study aimed to explore the level of knowledge, attitudes, and behavior of ORL-HNS Specialists in West Java towards cochlear implants.Methods: This study was a descriptive study with a cross-sectional approach. Primary data were collected through a questionnaire filled out by ORL-HNS Specialists who were actively working in West Java in 2021–2022.Results: Data from 157 specialists showed that 41.4% (n=65) had good knowledge about cochlear implants, and 43.9% (n=69) had adequate knowledge, however, 62.4% (n=98) showed a negative attitude. In addition, 99.3% (n=156) showed good behavior.Conclusions: ORL-HNS Specialists in West Java have a sufficient level of knowledge, negative attitude, and good behavior towards cochlear Implants. The negative attitude of the specialists need to be bettered, updating their knowledge about how cochlear implants work and their effectiveness for patients with hearing impairments might give them a new perspective and hopefully change their attitude towards cochlear implants
Safety and Preliminary Immunogenicity of Recombinant Hepatitis B (Bio Farma) Vaccine in Adults and Children: A Phase 1 Clinical Trial
Get PDFBackground: In order to fulfil the requirements of the national immunization program and sustain the production capacity of the monovalent Hepatitis B vaccine, this study aimed to assess the safety and immunogenicity of the recombinant Hepatitis B Vaccine (Bio Farma) using the new Hepatitis B bulk. Methods: This study was an experimental, randomized, double-blinded, and controlled Phase I clinical trial, with 100 healthy subjects divided into 50 adults and 50 adolescents. Subjects were randomly assigned to receive either the Bio Farma registered Recombinant Hepatitis B Vaccine (group A) or a new source of Hepatitis B bulk (group B). Subjects received one or three doses of vaccine, depending on the baseline anti-Hbs titer. Subjects were given diary cards to record solicited and unsolicited adverse events for 28 days following vaccination. Vaccine immunogenicity was assessed by measuring the level of HBsAg antibody titer elevation.Results: No serious adverse events were reported during clinical trials. The frequencies of adverse events were not significantly different between the two vaccine-randomized groups. The most immediately observed local reaction was local pain, reported by 35.7–42.8% of adults and 24.0–26.3% of adolescents, without any systemic reactions. Seroconversion in adults in group B reached 100% and 78.5% in group A, meanwhile in adolescent subjects in both groups it reached 100%. A substantial increase in geometric mean titer (GMT) was observed in the majority of subjects after immunization.Conclusion: Recombinant Hepatitis B Vaccine with a new source of HBsAg B bulk is safe, well tolerated, and highly immunogenic