Journal of the Medical Sciences (Berkala ilmu Kedokteran)
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A rare case of Salmonella sp septic arthritis in a patient with systematic lupus erythematosus (SLE)
No full textSeptic arthritis is considered as a medical emergency which can lead to significant morbidity and cause substantial mortality, especially if the diagnosis is delayed. Prolonged use of immunosuppressive and cytotoxic medications as therapy for systemic lupus erythematosus (SLE) causing patient susceptible to secondary infection. However, septic arthritis due to Salmonella sp. is very rare, makes this is an important extraintestinal manifestation especially in immunosuppressed patients. We presented a case of 25 y.o. female diagnosed with SLE 3 m.o. earlier presented with fever and arthritis on her left genu for 1 wk duration. Genu ultrasonography showed synovitis genu sinistra with fluid volume of 1-2 cc on recessus lateral genu sinistra. The patient was further analysis on her synovial fluid was conducted, the gram stained smear of the fluid showed >25 leucocytes, low power field, and Salmonella sp. was isolated from her synovial fluid analysis. The patient was given intravenous ciprofloxacin and discharged home well. Septic arthritis should always be considered in any patients on long-term immunosuppression state who present with acutely swollen joints. It considered as an important medical emergency with high mortality and morbidity. Hence, prompt recognition, joint aspiration with administration of systemic antibiotics and appropriate surgical intervention plays a pivotal role to minimize morbidity and mortality
The correlation between stress level and eating disorder syndrome in preclinical medical students at Faculty of Medicine and Veterinary Medicine, University of Nusa Cendana, Kupang, East Nusa Tenggara
No full textNowdays with various kinds of needs and demands in life that must be met at any time can cause stress of someone. Medical students are often experience high level of stress due to the demands of high education standards requirements. Continous chronic stress can affect eating behaviour lead to the potential cause of eating disorder syndrome (EDS). This study aimed to evaluate the correlation between stress level and EDS in preclinical medical students of Nusa Cendana University, Kupang, East Nusa Tenggara. It was an analytic observational with a cross sectional design conducting on the preclinical medical students by filling out depression anxiety stress Scale (DASS-42) and eating attitude test (EAT-26) questionnaires. Respondents were selected by the probability sampling method with a stratifies random sampling technique. A total 141 respondents who met the inclusion and exclusion criteria were recruited. Bivariate analysis by using the Wilcoxon Theta correlation test was performed. Among respondents involved in this study, 13 (9.2%) respondents did not experience stress and 128 (90.8%) experienced stress including 43 (30.5%) mild stress, 68 (48.3%) moderate stress, and 17 (12.3%) severe stress. The EDS was observed in 15 (10.6%) respondents. A significant moderate correlation between stress level and EDS was indicated (θ = 0.58). In conclusion, there is correlation between stress level and EDS on preclinical medical students of Nusa Cendana University, Kupang
CEA and Cyfra 21-1 linked to serial miRNA expressions of advanced-stage non-small cell lung cancer in Indonesia
No full textGlobally, lung cancer is one of the cancers leading to dead, dominated by non-small cell lung cancer (NSCLC). In a previous study has shown those serial miRNA expressions (miR-148, miR-34, miR-222, and miR-155) had prognostic value in advanced-stage NSCLC patients. Meanwhile, CEA and Cyfra 21-1, pulmonary tumor markers, are sometimes considered in the Department of Pulmonology, Dharmais Cancer Hospital, Jakarta, although they are not used in routine clinics for prognostication. Both miRNA and CEA-Cyfra 21-1 are valuable biomarkers in NSCLC. This study aimed to evaluate their correlation between CEA and/or Cyfra 21-1 with miRNA expressions in NSCLC patients. It was a cohort retrospective study using data from the previous study. The correlation between variables was analyzed by Spearman-rho. A positive correlation was observed between CEA and Cyfra 21-1 with miR-148, miR-222, and miR-155 [(CEA: p=0.00369, r=0.522; p=0.00242, r=0.542; p 0.00106, r=0.576) (Cyfra: 21-1= p 0.01252, r=0.378; p=0.00035, r=0.519; p=0.01532, r=0.368)]. In conclusion, CEA and Cyfra 21-1 correlate with miR-148, miR-222, and miR-155 expressions in advanced-stage NSCLC
Unique truncated and non-synonymous mutations in functional domains of ORF3a SARS-CoV-2
No full textPrevious studies showed that mutations in the SARS-CoV-2 ORF3a protein can influence viral pathogenesis. Therefore, it is necessary to observe mutations, especially in the functional domain of the protein. We observed the presence of mutations in the ORF3a protein by analyzing 5,131 samples from the GISAID database since it was first discovered in March 2020 until November 2021. The sequence was aligned using Clustal Omega Multiple Sequence Alignment from EMBL-EBI and analyzed using BioEdit version 7.2.5 software using reference sequences NC045512. Samples having the letter N were omitted from the analysis. The effect of point mutations on proteins was analyzed using the Protein Variation Effect Analyzer (PROVEAN) v1.1.3 software. The functional domains of the ORF3a protein were visualized using RasWin software. We identified 312 mutations in the SARS-CoV-2 ORF3a protein. In addition, from 5,131 samples, 915 samples were found to be truncated in the C-terminal region of the protein. These non-synonymous mutations data in functional domains and truncated sequences indicate that amino acid changes in the ORF3a protein require further studies to determine the effect of viral pathogenicity in humans
The effect of appropriate antibiotic use on the length of hospital stay in deep neck abscess (DNA) patients
No full textDeep neck abscess (DNA) is an emergency in the otorhinolaryngology head and neck surgery field due to the formation of abscesses in the potential space between the deep neck fasciae. It is typically caused by the expansion of infection from various sources, including the teeth, mouth, throat, paranasal sinuses, middle ear, and neck. The increase of DNA cases needs for improvement of patient management especially when the patients have comorbidities which lead to an extended length of treatment. The study aimed to evaluate the appropriateness of empirical antibiotics given according to culture results and any comorbid factors that affect the length of hospital stay (LOHS). It was case-control observational study involving 44 cases of DNA patients who treated at Dr. Sardjito General Hospital Yogyakarta in the period of January 2018 to December 2020. The patients were divided into two groups with 22 patients in each group. The first group was the DNA patients with > 7 d LOHS and the second one was those with ≤ 7 d. No significantly relationship was observed between variables evaluated included the appropriate antibiotic use (p=0.546). However, dental caries (DC) was significantly related with the LOHS (p=0.015). In conclusion, there is no relationship between the appropriate antibiotic use and the LOHS. However, the DC is risk factor that influence the LOHS in patients with DNA
Complete recovery of severe coronavirus disease 2019 (COVID-19) infection in an obese patient
No full textThere is strong evidence indicating that excess adiposity in obesity impacts immune function and host defence. However, almost no known mechanism of how the immune and host defence are affected by the low-grade inflammatory response of the obese has been established. The significance of altered immune response in obesity was presumed to be an independent risk factor for increased morbidity and mortality following the influenza pandemic back in 2009. Similarly, obesity is linked with a higher risk of severity and a worse clinical outcome of severe acute respiratory coronavirus 2 (SARS-COV-2) infection.This case reports a complete recovery of a severe coronavirus disease 2019 (COVID-19) infection despite having morbid obesity aggravated by metabolic syndrome
Coinfection of COVID-19 and dengue: a case report
No full textDengue hemorrhagic fever (DHF) and corona virus disease 2019 (COVID-19) are two viral infectious diseases that can occur simultaneously and have the potential to complicate each other. Therefore, sustained attention to this phenomenon is required. A 9 y.o. boy was diagnosed with dengue and COVID-19 at the Panti Rapih Hospital in Yogyakarta, Indonesia, in the early phase of the COVID-19 pandemic. Both viral infectious diseases have distinctive clinical and laboratory features. Acute fever, vomiting, weakness, thrombocytopenia, and hemoconcentration that improve from day 5 after infection are typical symptoms of DHF in children. Complaints of fever, runny nose, cough, and pain when swallowing that usually occurs in COVID-19 also appeared. Medical investigations with serological tests for DHF and COVID-19 at the beginning of the COVID-19 pandemic can be used to diagnose these two infections because standard diagnostic tools using the PCR swab test cannot yet be performed. Symptomatic therapy for moderate degrees of these two viral infections is appropriate
The impact of COVID-19 pandemic on decreasing hospitalization rates and management of acute coronary syndrome: a study from single centre hospital in Yogyakarta, Indonesia
No full textThe Corona virus disease-2019 (COVID-19) pandemic has an impact on the medical field, one of which is service for patients with acute coronary syndrome (ACS). Studies in other countries showed a sudden decrease in admission rates, and percutaneous coronary intervention (PCI), one of ACS treatments, has an impact due to this pandemic. This study aimed to ascertain the effect of COVID-19 on the admissions and management of patients with ACS in Yogyakarta, Indonesia. It was an observational single center study conducted by collecting data for ACS patients at Dr. Sardjito General Hospital, Yogyakarta. Admission data for March 2019 to February 2020 were pre pandemic data, while those gathered from March to December 2020 were pandemic data. Data from 864 (pre pandemic period) and 338 patients (during the pandemic period) were further analyzed. The results showed a decrease in ACS patients’ admission during the pandemic. The most remarkable reduction occurred in those with ST-segment elevation myocardial infarction (STEMI), followed by non-STEMI (NSTEMI) and unstable angina pectoris (UAP) (63.4, 61.4, and 40.9%, respectively). Furthermore, the PCI procedure decreased compared to the period before the pandemic. No significant differences in patients’ characteristics was observed (p>0.05), except for the incidence of pneumonia (p 0.05). This study showed that COVID-19 caused a sensible reduction in the admission rates for ACS patients and the number of PCI procedures have been performed. On the other hand, their mortality rate did not increase significantly. However, it is essential to improve healthcare services for ACS patients considering the uncertainty of ending the COVID-19 outbreak
Protective role of Nigella sativa oil against cisplatin-induced ototoxicity: a literature review
No full textCisplatin is widely used for the chemotherapy of head and neck cancer. However, it has a significant ototoxicity. Nigella sativa has been scientifically proven to have numerous benefits included to prevent adverse effect of a drug. This literature review aimed to evaluate the protective role of N. sativa oil against cisplatin-induced ototoxicity. Relevant publications were searched from PubMed and Google Scholar databases within the last 10 years. Ototoxicity due to cisplatin can occur through the intrinsic and extrinsic pathways. Cisplatin causes endoplasmic reticulum stress, DNA damage, increased reactive oxygen species (ROS) and inflammatory processes, resulting in increased apoptosis of cochlear outer hair cells. The active constituents of N. sativa including flavonoids, phenolics and thymoquinone can prevent the cisplatin-induced ototoxicity. Examination of endogenous antioxidants, antiapoptotic, and proinflammatory could be used as primary approach to evaluate the protective role of N. sativa against cisplatin-induced ototoxicity