Journal of the Medical Sciences (Berkala ilmu Kedokteran)
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Role of methylprednisolone on mRNA expression of BAX, BCL-2 genein testicular torsion-detorsion of male albino Wistar rats
No full textStudy Background : Testicular torsion is a genitourinary emergency most common in children and emergencies requiring second surgery in adolescents after acute appendicitis1. Testicular torsion is more common on the left with a 1.2: 1 ratio, which is probably caused by a slightly longer spermatic cord on the left2. Testicular torsion can occur at any age, but the peak incidence is at age 14, with a peak of second occurrence at 1 year of age3. At 1 year of age, testicular torsion is a major cause of acute scrotum (83%). At the age of 3 - 13 years, the most frequent diagnosis is the torsion of the testicular appendix. After the age of 17 years, epididymitis is the most frequent diagnosis (75%)4.
Method: This study is an experimental study, post-test only control group design, the sample was randomly divided into 4 groups, 2 intervention groups and 2 control groups. In this study the independent variables are the duration of the right torsion-detection treatment of the testes and the injection of Methylprednisolone in Wistar male rats. The dependent variables are mRNA expression in apoptosis and anti-apoptosis genes in rats’ ipsilateral and contralateral testes.
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Results and Discussion: In this study, two-way ANOVA is used to analyze data between groups. Significant decrease in BAX gene mRNA expression (
Treatment options for Indonesian triple negative breast cancer patients: a literature review of current state and potentials for future improvement
No full text Triple negative breast cancer (TNBC) is still associated with grave prognosis, especially compared to other breast cancer subtypes. Advances in medical science have improved our understanding on the biological nature and heterogeneity of TNBC, explaining the efficacy variability of existing chemotherapeutic drugs on TNBC patients. Complexity of TNBC has led to wide variation of TNBC treatment across the globe, resulting in unsatisfactory treatment outcome. This issue is further complicated by the absence of TNBC treatment guideline in many countries, including in Indonesia. This review discusses systemic treatment options for TNBC while taking account its molecular heterogeneity. Specific consideration is made for Indonesia, not only for current clinical practice, but also for future improvements. Immunotherapy, especially programmed cell death 1 (PD-1/PD-L1) inhibitor, has recently shown promising result in TNBC patients. It can be concluded that TNBC is heterogenous and treatment option should be tailored based on its molecular profile
Dysphagia as presenting symptom of myasthenia gravis: a case series of successful outcome in multidisciplinary approach
No full textDysphagia can be caused by mechanic or neurologic disorders. Neurologic dysphagia is commonly related to cerebrovascular disease, parkinson disease, amyotropic lateral sclerosis, tardive dyskinesia, and myasthenia gravis (MG). About 15-40% dysphagia occurred in MG generalized type. Only 6% MG with dysphagia were reported as a single symptom. The case reports aimed to demonstrate the role of otolaryngologist in multidisciplinary approach of the MG management. Two cases of MG were reported. First case was a 33 years old woman with moderate MG generalized type with ocular, dysphagia, and disarthria symptoms and second case was a 46 years old man with acute severe MG with crisis. Management therapy was applied according to onset and severity of MG. Acetylcholinesterase (AChE) and corticosteroid were administered for the first case, whereas therapeutic plasma exchange (TPE) for second case. In conclusion, disfagia in MG can be accompanied with other symptom, therefore its management should be based on the severity in order to give a positive result
Potential employment of transcranial magnetic stimulation as a beneficial intervention in children with amblyopia: a brief overview
No full textAmblyopia is an early functional imbalance between each eye and the brain that may result in visual cortex inhibition. Current conservative treatments involve altering the input from the ‘good eye’, for example, using patching or biochemical penalization. Direct brain stimulation to the amblyopic cortex might improve the condition. This paper aimed to systematically review the published scientific literature regarding the use of transcranial magnetic stimulation (TMS) as a potential method for treatment in the amblyopic visual cortex. This study was a systematic review of the published scientific literature related to theTMS for the treatment of amblyopia that was performed using “TMS, amblyopia” as keywords. However, only three research papers were found and included in the literature review. A study showed that repetitive TMS of the visual cortex can temporarily improve contrast sensitivity in the amblyopic visual cortex. Another study used continuous thetaburst stimulation (cTBS) delivered to the visual cortex while patients viewed a high contrast stimulus with their non-amblyopic eye. It was found that daily theta burst TMS stimulation improved amblyopic eye contrast sensitivity in five adult volunteers. The TMS also increased median visual acuity in the patient with amblyopia after stimulation with no significant changes in the placebo group.Protocol employing repetitive administration of TMS might result in beneficial effects in amblyopia treatment. TMS works in brain dynamics and experience-dependent plasticity, all of which could be important in investigating and treating amblyopia
Diagnosis value of prostate specific antigen density (PSAD) and prostate specific antigen (PSA) in bone metastases of prostate cancer among Indonesian population
No full textCancer prostate (PCa) is currently reported as the most diagnosed cancer in males. Bone metastases in PCa indicate poor prognosis and the major cause of pain and death. Early diagnosis of metastases is important in PCa management. Prostate specific antigen (PSA) velocity was used to predict overall survival and metastasis-free survival. However, this test should be conducted 2 times, for at least 4 weeks apart. Therefore, a cross-sectional test with higher positive probability value is needed. This study aimed to compare PSA density (PSAD) and PSA level to evaluate patients at risk of bone metastases in Yogyakarta, Indonesia. Aretrospective study with a total subject of 106 patients with (n = 31) and without (n = 75) bone metastases were analyzed. The initial PSA measurement, as well as bone scan and prostate volume, were evaluated in all patients. Bone survey found to be positive in 31/106 (29.2%) patients. The total of 50(47.2%), 10(9.4%) and 46(43.4%) patients had PSA level 100ng/mL, respectively. Furthermore, receiver operating characteristic (ROC) area under the curve of PSAD (0.75) was higher that that ofPSA (0.65).PSAD more than 0.15 indicated sensitivity of 93% and specificity of 38%, while PSA more than 20 ng/mL shown sensitivity 82% and specificity 21%. In conclusion, PSAD level more than 0.15 shows high sensitivity and specificity in causing potential skeletal metastases. Using this PSAD cut-off value, unnecessary investigation canbe avoided.
Incidental bladder wall alteration as a surgical complication risk factor in Indonesian benign prostate hyperplasia patient
No full textBladder obstruction due to benign prostatic hyperplasia (BPH) causes bladder walls alteration such as trabecular and diverticula. Although it is asymptomatic, however it affects the surgery complication. The aim of this study was to evaluate the correlation between bladder wall alteration and post-surgery complications in BPH patients. It was a descriptive observational study with cross-sectional design involving BPH patients who underwent histopathological examination and surgical intervention in the Bhayangkara Hospital Mataram from January 2010-December 2014. Data of the patients including age, place of birth, intraoperative finding, comorbid condition, and post-surgery complication were obtained from the medical record. The relationship between variables was analyzed using Pearson correlation test and linear regression test.A total 114 subjects were involved in this study with the most common age was in the range 60-69 years (43.0%). Seventy-fivesubjects (74.3%) had trans urethra resection of prostate (TURP). Trabecula (28.7%), diverticula (4.0%), and bladder stone (10.9%) were found when the surgical intervention performed. The most common post-surgical complication was chip or clot retention (56.4%). Significantly relationship betweenintraoperative finding with post-surgical complication was observed (r= 0.265; R2 = 0.07; p<0.05). In conclusion, there is correlation between bladder wall alteration and post-surgicalcomplication in BPH patients. Early bladder wall alteration screening is suggested in BPH patients before surgical intervention performed
Factors affecting tumor response to transarterial chemoembolization (TACE) therapy in patient with hepatocellular carcinoma (HCC)
No full textHepatocellular carcinoma (HCC) is a major problem of global health.Transarterial chemoembolization (TACE) is the treatment of choice for unresectable HCC. The TACE is routinely conducted in major hospitals in Indonesia, however it rarely published.The use of modified response in evaluation criteria in solid tumors (mRECIST) was introduced as an accurate method of measuring tumor response in HCC. This study aimedto investigate the factorsaffecting tumor response to TACE therapy in HCC patients by using mRECIST. It was a retrospective cohort study conducted on 30 patients who successfully underwent the first TACE procedure in the Department of Radiology, Dr. Wahidin Sudirohusodo General Hospital, Makassar, Indonesia from January 2016 to August 2019. The multiphase abdominal computed tomography before and after as well as laboratory examination results before TACE were collected and analyzed. Chi-Square and Spearman-tests were used for the statistical analysis. A significant relationship between tumor location (p=0.016), number of tumor (p=0.001) and Child-Pugh score with tumor response to TACE therapy (p = 0.016) was observed. Solitary tumors tend to have a better therapeutic response, meanwhile, tumors located in the left lobe of patients with Child-Pugh B scores showed a decreased tumor response. Furthermore, no a significant relationship between age (p=0.920), sex (p=0.303), tumor size> 5 cm (p=0.082) and alpha-fetoprotein (AFP) levels (p=0.414) with tumor response was observed. In conclusion, TACE is preferably therapy for multinodular and unresectable HCC. Tumor response after TACE can be well assessed using mRECIST. The factorsaffecting tumor response to TACE therapy arenumber of tumor, location, and Child-Pugh scor
A fatal acute appendicitis with sepsis and pneumonia was caused by melioidosis: a case report
No full textWe report anunderdiagnosed fatal case of melioidosis that involved dygestion system which complicated with pneumonia, and sepsis. The case was initially diagnosed as acute appendicitis, and subsequently the patient underwent an exploratory laparatomy and appendectomy. He was discharged afer 3 days of hospitalization. Thirty days afterward, he was admitted to another private hospital to experience another exploratory laparatomy with indication of pancreatitis, intra-abdominal organs adhesions, and postoperative enterocutaneous fistula (ECF), and hospitalized there for 25 days. He eventually suffered from sepsis, pneumonia, unclosed ECF, anemia, hypoalbuminemia, and electrolyte imbalance. He then referred to a tertiary teaching hospital and hospitalized there for a total 134 days until he passed away. His clinical condition was declining, despite a long course of broad spectrum antibiotics. Treatment delay, prolong hospitalization, and complications were the inevitable, although Burkholderia pseudomallei was finally identified 2 weeks prior to his death. This case highlight that melioidosis canassociate with acute appendicitis, and that the delay on its diagnosis and treatment may trigger complications and death
Utilization of banana (Musa paradisiaca L.) peel as pectin source as antidiarrheal on castor oil-induced diarrheal Wistar rats model
No full textBanana (Musa paradisiaca L.) peel, locally name pisang raja, contains a high concentration of pectin which is used as antidiarrheal to absorb irritants and increase stool consistency. However, it’s use to increase the stool consistency has not been studied, yet. The study aimed to investigate the effect banana peel extract (BPE) administration on stool consistency of diarrheal rat model. It was an experimental study with a post-test only control group design. Thirty male Wistar rats were induced diarrhea with castor oil and then randomized into five groups. Group I as positive control group was given attapulgite at dose of 124 mg/kg BW. Group II as negative control was given 0.5 mL of 1% tween 80. Group III, IV and V as treatment group were give BPE at different doses of 100, 200 and 400 mg/kg BW, respectively.T he stool consistency was measured every hour for 4 h by weighing fresh and dry stool weight and then the water content was calculated. Data analysis was conducted using one-way ANOVA and LSD post hoc test. Significantly different in stool consistency between Group III, IV, and V compared to Group II (p<0.05) and between groups Group III and IV compare to Group I (p<0.05) were observed. However, there was no significantly different between group V compared to Group I (p=0.149).In conclusion, BPE can increase the stool consistency of castor oil-induced diarrhea rats. The BPE at the dose of 400 mg/kg BW has similar effect to attapulgite
Animal model for sporadic dementia of Alzheimer’s type (SDAT) using streptozotocin and lipopolysaccharide combinations in rats
No full textSporadic dementia of Alzheimer’s type (SDAT) pathogenesis has not been revealed completely due to the difficulty in creating an appropriate animal model. The purpose of this study was to investigate the effect of single-dose intraperitoneal (IP) induction of streptozotocin (STZ) and lipopolysaccharide (LPS) on the β-amyloid levels and the brain function of experimental rats. Eighteen rats were divided into three groups i.e. control, TRE1 (STZ 60 mg.kg-1 BW + LPS 3 mg.kg-1 BW), and TRE2 (STZ 30 mg.kg-1 BW + LPS 1.5 mg.kg-1 BW). The substances were administered in a single dose. Behavioral tests were started at day-30 after injection, we performed Morris water maze (MWM) and novel object recognition (NOR) tests. Afterward, we measured whole brain and serum β-amyloid levels, as one of the biomarkers of Alzheimer’s Disease (AD), using the ELISA method. In MWM tests, the escape latency and time spent in the target quadrant of treatment groups were significantly higher than those in control at the day-5 MWM test and probe trial. The rats in treatment groups have negative discrimination indexes in NOR tasks, indicating that the rats could not remember the familiar object. Intraperitoneal STZ and LPS significantly increase soluble brain β-amyloid levels of treatment groups than those in the control group. In conclusion, the treatment of STZ (60 mg.kg-1 BW) and LPS (3 mg.kg-1 BW) indicated spatial and recognition memory impairment, along with an increase of brain soluble β-amyloid level in rats