Sains Medika: Jurnal Kedokteran dan Kesehatan
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Multiple intrathoracic thrombosis detected on ct scan in patient with antiphospholipid antibody syndrome: case report
Full text linkAntiphospholipid antibody syndrome (APS) is the clinical correlation between antiphospholipid antibodies and hypercoagulability syndrome. The prevalence of APS in the general population is undetermined. APS disease carries a notable risk of vascular thrombosis. CT scan is the preferred imaging method for assessing thrombosis, although the timing of image acquisition should be considered. The case report detailed the discovery of many intrathoracic thromboses on a CT scan of a patient diagnosed with the uncommon condition APS. Case study: A 34-year-old woman was hospitalized due to dyspnea, cough, and a 3 kg weight loss over a three-month period. She has a background in Deep Vein Thrombosis (DVT). The test results showed abnormalities in protein C, protein S, and high D-dimer levels. The CT scan revealed numerous intrathoracic thrombi. Antiphospholipid syndrome (APS) is an immunological condition that elevates the likelihood of blood clot formation, resulting in thrombosis inside the arteries and veins. The approximate occurrence rate of APS is five occurrences per 100,000 individuals annually. Antiphospholipid syndrome (APS) leads to the formation of blood clots in the legs, a condition referred to as deep vein thrombosis (DVT). This patient had a history of deep vein thrombosis (DVT) and many blood clots within the chest cavity. A CT scan revealed persistent blood clots in the main pulmonary artery and the right and left pulmonary arteries. Antiphospholipid syndrome (APS) can lead to the formation of blood clots in both arteries and veins. CT scan is the preferred method for evaluating thrombosis, and numerous phases are required to examine all blood arteries
Disaster Prone Areas and Stunting Prevalence in Indonesia: Ecological Study of 34 Provinces
Full text linkIndonesia has a high intensity of disaster events. The prevalence of under-five stunting in Indonesia is also high. One of the targets of the Ministry of Health's Medium-Term Development Plan for 2020-2024 is to reduce stunting in children by 14% in 2024. This study aims to look at the relationship between disaster risk and the prevalence of stunting in 34 provinces in Indonesia. The study design is an ecological study approach sourced from the 2021 Indonesian Disaster Risk Index (IRBI), the 2021 Indonesian Nutritional Status Survey (SSGI), the 2018 Basic Health Research and the 2021 National Socioeconomic Survey (Susenas). This study conducted a spatial analysis, scatter plots, pearson correlation test and multivariable linear regression. From the results, it found that the higher risk of disaster increased the tendency for the prevalence of under-five stunting. It was concluded that disaster risk has a positive relationship with the prevalence of under-five stunting in Indonesia. We suggest that a disaster management program can be considered to reduce stunting in Indonesia
Effect of triamcinolone acetonide injection on pterygium recurrence in postoperative subconjunctival patients
Full text linkPterygium is an eye disorder characterized by fibrovascular tissue from the bulbar conjunctiva encroaching on the cornea. Inflammation has been suggested to play a role in the pathogenesis of pterygium, indicated by elevated levels of anti-inflammatory cells and markers. Triamcinolone acetonide is a steroid commonly used to treat eye diseases. This study evaluated the effects of anti-inflammatory triamcinolone acetonide injection after the pterygium surgery. This study included 71 eyes of 71 patients. The patients were divided into two groups: triamcinolone and control group. Each eye received a subconjunctival triamcinolone injection of 2.5 mg/ 0.1 ml or no after pterygium surgery with bare sclera technique. The infusion was done around the excision area. Before and after the surgery, the ocular pressure was evaluated. Topical steroid antibiotics and oral analgesics were administrated. The outcomes were assessed one day, week, three weeks, and one month after surgery under slit-lamp examination and noncontact tonometry. The evaluated outcomes were the presence of fibrovascular tissue and intraocular pressure. This study was done by a surgeon and assisted by a nurse. There are 71 eyes in this study; 10 eyes are lost during follow-up. The 61 eyes were divided into 28 triamcinolone and 33 control group. The recurrence of pterygium was found in 2 (39. 3%) of the triamcinolone group and in (10.7%) of the control group (p=0.16). Eight eyes showed increased ocular pressure, and one patient developed granuloma. Subconjunctival triamcinolone injection after pterygium surgery did not significantly reduce pterygium recurrence
Traditional herbal medicine for hyperuricemia: A review of randomized clinical trials
Full text linkIn the last decades, traditional herbal medicine for gout has been rapidly advanced. Numerous herbs have been identified for their hypouricidal effect. This review aims to explain the potential and mechanisms of traditional herbal medicine in reducing serum uric acid (sUA). This review included five RCTs and four traditional herbal medicine formulas from a previous systematic review. Articles published in non-English language were excluded for further analysis. Despite limited RCTs design, the formula of Chuanhu; Tufu, and ZinutriK® were beneficial for hyperuricemic individuals. While Yellow-dragon Wonderful-seed mixture showed limited hypouricemic feature. Based on these findings, traditional herbal medicine holds promising potential in treating hyperuricemia and gout. However, further studies are required
Validation of sputum gram stain and culture for diagnosis of pneumonia in critically iii patient: a retrospective observational study
Full text linkValidation of culture results based on direct gram stain plays a vital role in differentiating pathogens' cause of infection or colonization in pneumonia cases. Our study aims to evaluate the validation of diagnostic microbiology based on gram stain and culture compared to chest radiography in critically ill patients with suspected pneumonia. This was a single-center retrospective data analysis in the Intensive Care Unit at Secondary Care Hospital in Central Java. The quality of sputum was determined by using a Modification Criteria of Bartlett and a Semi-Quantitative Score. The results of sputum culture with neutrophils count > 10 and bacterial count > 2 per field in Gram stain were considered the presumptive pathogen. Seventy sputum specimens were collected; however, only 58 were selected for further analysis in this study. In sputum specimens with Bartlett score +2 and Semi-Quantitave score 3 or 4, the chest x-ray results of all patients had positive infiltrates (100%). Diagnostics accuracy of the results of clinical microbiologist examination with chest X-ray had a sensitivity of 90%, specificity of 60.71 %, accuracy of 65.5%, a positive predictive value of 61.36%, a negative predictive value of 78.6%. It was concluded that validation of diagnostic microbiology based on gram stain and culture had susceptible and adequately specific results to differentiate between presumptive pathogens from colonization in pneumonia cases
Detection of human bocavirus (HBoV) in children with acute respiratory infection (ARI) during the covid-19 transition period
Full text linkAcute respiratory infections (ARIs) are the highest cause of death in children in the world. Based on the 2018 Riset Kesehatan Dasar Nasional, ARI cases in Indonesia showed a prevalence of 4.4%, with the highest cases occurring in children. One of the new viruses first identified in 2005 in human nasopharyngeal samples is the human bocavirus (HBoV). HBoV is a single-strand DNA virus belonging to the Parvoviridae family. This study aimed to assess the prevalence of HBoV in children presenting with ARI during the transitional period of the Covid-19 era. HBoV detection was conducted using multiplex PCR and reverse hybridization methods on nasopharyngeal and oropharyngeal swab samples collected from symptomatic children. This study reported a prevalence rate of 4.94% for HBoV in 2022 and 5.04% in 2023. Furthermore, the study identified favorable detection rates for HBoV in children with ARIs as 14.81% in 2022 and 8.45% in 2023. These rates ranked 2nd and 5th highest among other pathogens detected in ARIs. Additionally, there was an increase in positive HBoV samples from 4 samples in 2022 to 6 samples in 2023, which was attributed to the relaxation of nonpharmaceutical Covid-19 interventions by mid-2022. HBoV was identified at a significant rate among children with ARI in Jakarta during the transitional phase of the Covid-19 era (2022-2023). Given its potential to induce severe ARI, HBoV necessitates heightened attention as an etiological agent
Factors influencing infections caused by Extended Spectrum Beta Lactamase (ESBL) producing bacteria in patients with urinary tract infections at RSUD dr. R. Soetijono Blora
Full text linkUrinary tract infection (UTI) is a bacterial infection that is often found in pediatric patients. The prevalence of infections due to ESBL-producing Enterobacterales is increasing worldwide. This study aims to identify and analyze the factors that influence Extended Spectrum Beta Lactamase (ESBL) producing bacteria in UTI patients at RSUD dr. R. Soetijono Blora. A cross-sectional study has been carried out at RSUD dr. R. Soetijono Blora in January-March 2023. The results of this study showed that 58 respondents with urine culture results found Enterobacterales pathogenic bacteria. Based on the sensitivity test for the Extended Spectrum Beta Lactamase (ESBL) enzyme producer, 39 people (67.2%) were categorized as ESBLs and 19 people (32.8%) Non-ESBLs. The study variables included age, gender, history of catheter insertion, history of stones or urinary tract surgery and history of taking antibiotics in the last 6 months. The chi-square test to determine the relationship between variables was used to determine significant risk factors. Bivariate logistic regression showed that history of catheter insertion and history of use of antibiotics in the last 6 months were significant risk factors. Prevalence of UTIs due to ESBL-producing Enterobacterales in RSUD dr. R. Soetijono Blora is high and the wise use of antibiotics, especially the third generation cephalosporins as therapy, is needed for preventive strategies to reduce antibiotic resistanc
The effect of lifestyle modification on metabolic, anthropometric parameters and hirsutism score in polycystic ovary syndrome
Full text linkPolycystic ovary syndrome (PCOS) is a hormonal disorder that affects women of reproductive age. It is characterised by several clinical signs and symptoms, including hyperandrogenism, ovarian dysfunction, and chronic anovulation. Obesity and hormonal imbalances can be reduced in PCOS by modifying lifestyle habits. The effects of lifestyle changes on PCOS were investigated, and it was found that consuming less fat and engaging in physical activity reduced metabolic disturbances. The purpose of this study was to examine the effects of lifestyle modifications on metabolic parameters, anthropometric parameters, and the hirsutism score as they relate to the pathogenesis of PCOS. This study involved a total of 10 patients diagnosed with PCOS at the Sultan Agung Semarang Islamic Hospital. Blood glucose, triglycerides, HDL (high density lipoprotein), blood pressure, waist circumference, hirsutism score, and vital sign data related to PCOS were measured before and after a 4-month treatment. PCOS patients' fasting blood sugar levels, triglycerides (TG), high density lipoprotein (HDL), hirsutism scores, blood pressure (systolic and diastolic), and waist circumference averaged 92, 60; 48.10; 96.90; 10.5; 121.5/77; 86.80, respectively, at baseline (pretreatment). After four months of treatment, the average levels of fasting blood sugar, triglycerides, high-density lipoproteins, blood pressure (systolic and diastolic), hirsutism scores, and waist circumference were 108.7, 50, 99.8, 7, 122.3, 82.7, and 87.50, respectively. Changes in lifestyle led to significant variations in fasting blood sugar levels as a metabolic parameter and hirsutism scores, but not in triglycerides, high-density lipoprotein, waist circumference, or blood pressure
Effect of Phylantus ninuri leaf extract on kidney and liver histopathological features in formaldehyde-exposed rats
Full text linkFormaldehyde (FA) metabolism in the body reduces glutathione levels, resulting in liver and kidney damage. Phylantus ninuri (meniran) has been demontrated to have hepatoprotective properties. However, the effect of meniran administration on the histological features of the liver and kidney in in formaldehyde-exposed rats has not been adequately studied. The study was aimed to determine the effect of meniran on the histopathological feature of liver and kidney cell. This was a posttest randomized control group design. A total of 24 male Wistar rats were divided into 4 groups of 6 rats each. Group 1 was a control group that received only oral formaldehyde. Group 2, Group 3, Group 4 was administered oral formaldehyde together with meniran extract at dose of 100 mg/kg BW, 200 mg/kg BW, and 300 mg /kg BW respectively for 14 days. The histopathological changes of the kidneys and liver were assesed using hematoxylin and eosin (HE) staining. The mean of kidney and liver damage in the meniran group at various doses was lower than that of control group. There was a significant difference in the mean of kidney damage between the control group and the meniran group at various doses (p<0.05). The mean histopathological score of liver damage showed a significant difference between the control group and various treatments (p<0.05). Ethanolic extract of meniran leaves ameliorates liver and kidney damage in formaldehyde-exposed rats
Age
Full text linkMost blood culture contaminants are coagulase-negative staphylococci (CoNS), which are also the leading cause of nosocomial bloodstream infections. To date, no research in Indonesia has analyzed the potential causes of a CoNS infection in the bloodstream. The goal of this research was to better understand who is at risk for developing a CONS-related bloodstream infection while in a hospital setting. Secondary data from the CONS blood culture results at Dr. Kariadi Hospital Semarang were used in this retrospective cross-sectional study conducted between January 1 and December 31, 2016. The Vitek-2 Compact System (Biomerieux, USA) and the Kirby Bauer method (Clinical & Laboratory Standards Institute (CLSI) of the USA) were used for the antibiotic identification and sensitivity testing, respectively. Multivariate with multiple logistic regressions and the Chi-Square test for categorical variables were used in the analysis. Among the study's 272 participants, 158 (58.1%) developed CONS-related bloodstream infections. Risk factors for central nervous system (CNS) bloodstream infection in 18-year-olds include preterm birth, low birth weight (LBW), compromised immunity, malnutrition, immunosuppressive therapy, and peripheral intravenous use. Age >=18, malnutrition, and immunosuppression therapy all ranked high as risk factors in a multivariate analysis. Risk factors for CONS-causing bloodstream infections in people aged 18 include malnutrition and immunosuppressant therapy