Journal of the Medical Sciences (Berkala ilmu Kedokteran)
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Association between hearing loss and hypertension in non ear infection patients in Universitas Gadjah Mada Academic Hospital
No full textHearing loss is a common occurrence that can decrease productivity and quality of life. The incidence of hearing loss is often experienced by adults due to several factors, and one influencing factor is cardiovascular disease. Hypertension is known to have an effect on decreasing inner ear vascularization that will result in hearing loss. The objective of this study was to evaluate the association of hearing loss and hypertension in non-ear infection patients. This case-control study recruited subjects who underwent audiometric examination at the Universitas Gadjah Mada Academic Hospital, Yogyakarta, from June 2018 - July 2019. Hypertension was determined based on the results of blood pressure examination based on JNC 8 criteria. Hearing threshold value was taken from pure tone audiometry. The association of hypertension with hearing loss was analysed in each group and between study groups. Sixty patients who underwent audiometric examination divided into two groups with 30 patients in each group were involved in this study. There was a significant relationship between hypertension and hearing loss (OR=13.1; 95%CI: 3.8-45.0; p= 0.001). Hypertension acts as a variable that significantly affects the incidence of hearing loss. Patients with hypertension have a greater risk of hearing loss compared to patients without hypertension
Ethanolic extract of Dutch eggplants (Solanum betaceum) protects spermatozoa motility exposed to lead acetate
No full textLead is a toxic material that can have negative effects on reproductive organs. Lead exposure reduces the activity of endogenous antioxidant enzymes and increases the number of oxidants in the body. High free radicals will affect spermatogenesis and result in decreased motile spermatozoa. Antioxidants are known to protect the motility of spermatozoa, and adequate antioxidants can be found in Dutch eggplants (Solanumbetaceum). This study aimed to evaluate the effect of S. betaceum on spermatozoa motility after exposure to lead acetate. This study is a true experimental design with a randomized post-test-only control group design. Forty male Balb/C mice 12 weeks old were randomly divided into 5 groups: two control groups (C0, C1) and three treatment groups (T1, T2, T3).The C0 received distilled water, and the C1 received 75 mg/kg BW lead acetate. The T1, T2 and T3 received 100, 200 and 400 mg/kg BW of S. betaceum, respectively, an hour before exposed lead acetate. The data were analyzed using one-way ANOVA with a significant level of p <0.05. A significantly increasein the mean total motility of spermatozoa in T1, T2, and T3 was reported.This study indicates that S. betaceum have a protective effect on spermatozoa motility when exposed to lead acetate
The association between malaria incidences and air temperature at Kulon Progo District, Yogyakarta Special Province
No full textMalaria is still a public health problem in Indonesia including in Kulon Progo District, Yogyakarta Special Province. Kulon Progo District remains become malaria endemic area, with significant number of malaria cases for more than the last ten years. Previous studies proved that malaria transmission is associated with climatic conditions. However, these conditions have never been investigated in Kulon Progo District. The aim of this ecological study was to investigate the association between the distribution of malaria cases and climatic condition in the Kulon Progo District using spatial-temporal approach. A total of 1439 malaria cases were collected during the period of 2005-2015. Time-trend, bivariate analysis, and spatial analysis were performed. The results showed that air temperature lag 0 (p = 0.0000; r = 0.5225), air temperature lag 1 (p = 0.0009; r = 0.2850), air temperature lag 2 (p = 0.0329; r = 0.1858) related to the incidence of malaria. Spatial analysis and time-trend analysis also showed direct relationship pattern between malaria and air temperature. In conclusion, there is a relationship between malaria cases and air temperature in Kulon Progo District. Spatial analysis approach is important for early alert system, to decrease morbidity and mortality due to malaria
The risk factor of metastatic status of retinoblastoma patient in Yogyakarta Tertiary Hospital
No full textThe metastases of the tumor become a serious problem malignancy including retinoblastoma. This study aimed to observe the correlation between several risk factors with the metastatic status of retinoblastoma patients in Yogyakarta Tertiary Hospital. Records of patients with retinoblastoma treated between 2011 and 2017 were obtained for observational analytic study. The gender, laterality, age, Body Mass Index (BMI) classification, BMI for age, type of retinoblastoma, and metastatic status were analyzed. The association was statistically analyzed by the correlation ratio of Eta test. Thirty-seven cases of retinoblastoma were enrolled in this study, with mean age 29.44 (±14.1) months; 14 females and 23 males. Ten patients (27.0%) have no metastases, while 27 patients (72.9%) exhibit metastases. The multivariate logistic regression analysis demonstrated that male gender (OR 8.3; 95% CI 1.07–64.5; p = 0.04) and age below 24 months (OR 17.6; 95% CI 1.26-248.31; p = 0.03) were a predictive of the metastatic status for retinoblastoma. On the other hand, the laterality, BMI classification, BMI for age, and types of retinoblastoma were not associated with the metastatic status of retinoblastoma. The gender and age were significantly associated with the metastatic status of retinoblastoma. Male patients and age below 24 months were more likely to have metastatic disease of retinoblastoma
Reducing post-radical cystectomy complications with enhanced recovery after surgery (ERAS) protocol: is it time to change?
No full textRadical cystectomy (RC) remains associated with a greater number of postsurgical complications than any urological procedure. Enhanced recovery after surgery (ERAS) protocol is a multimodal perioperative care pathway designed to achieve early postsurgical recovery. We evaluated the perioperative outcome of post-RC patients, comparing the effectiveness of ERAS to conventional recovery protocols. We identified 37 patients who underwent RC for bladder cancer from 2016 to 2018. The characteristics, complication rate and clinical outcomes were evaluated in these groups of patients. In this study, the mortality was 8.1%, and the complications were 37.8%. The most frequent complications were anastomotic leakage (16.2%), wound dehiscence (13.5%), infections/sepsis (8.1%), and paralytic ileus (8.1%). The ERAS protocol significantly reduced operative time (p=0.001; OR=216; CI95%: 12.0-3855.2) and reduced overall complications (p=0.04; OR= 0.14 CI95%: 0.016-1.132). Extensive complications and mortality develop following the RC procedure. Meanwhile, refinement in perioperative care has been reducing the rate of serious complications. The ERAS protocol distinctly reduces the post-RC complication rate
Review of immune responses correlated with COVID-19 outcomes: the fight, debacle and aftermath in the Indonesian context.
No full textIn the current pandemic, the highly contagious nature of the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) leads to an enormous burden for the global health care system and creates challenging socioeconomic problems. Respiratory mucosa, the main entrance of SARS-CoV-2 infection, are equipped with an innate immune defense system as the initial response against infection. Activation of the adaptive immune system facilitates viral clearance as well as providing immunological memory for prevention from subsequent exposure. However, despite repeated efforts at implementing appropriate interventions, severe and fatal cases are continuing to occur and reports of recurrent cases need clarification. Host factors may contribute to the severity of the diseases while viral immune evasion is a common phenomenon leading to severe outcomes and recurrent infection. Discussions of immunological-based tests for screening, herd immunity, along with the possible advantages or potentially futile efforts of development of vaccine and alternative immunotherapy have become a part of daily household conversations. In this review, evidence of innate and adaptive immune responses or lack of them, and immunological problems relevant for SARS-CoV-2 will be summarized. Finally, perspectives for future studies especially in the Indonesian population will be sketched
Neurological findings in patients with COVID-19: a systematic review
No full textSince the emerging of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in Wuhan, China at the end of 2019, the coronavirus disease 2019 (COVID-19) has become pandemic for months. Due to fast increased number of the positive patients with COVID-19, SARS-CoV-2 is considered highly pathogenic virus with various clinical presentations. Apart from the typical respiratory symptoms, neurological complains in COVID-19 involving central and peripheral nervous systems have been reported. This paper aimed to review the neurological findings reported in patients with COVID-19. We qualitatively reviewed studies reporting COVID-19 patient(s) with neurological manifestations according to the recommendations of PRISMA statement.There were twelve studies included in this brief review. We found that patients with neurological findings were reported ranging from symptomatic complain of headache and dizziness to specific neurological diseases/syndromes, such as meningitis/encephalitis, acute cerebrovascular diseases, Guillain-Barré syndrome, and Miller Fisher syndrome. This review suggests the possible neurological involvement in COVID-19. We hope to raise the awareness of the health workers in taking care of the patients with COVID-19 and neurological diseases.
Chloroquine and hydroxychloroquine for COVID-19 treatment
No full textCoronavirus disease 2019 (COVID-19) is an emerging disease caused bysevere acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that has been causing many people around the world affected. There is no approved treatment for COVID-19. Meanwhile, vaccine development still needs a long time before it becomes available to protect people from contracting COVID-19. Repurposing the available drugs is one of the fastest ways to get COVID-19 treatment. Studies have been conducted to discover for COVID-19 treatment that results in the finding of potential medication for COVID-19. Chloroquine and hydroxychloroquine are some of the available medication that shows potential for COVID-19 treatment. Preclinical study showed that the both drugs are active against SARS-CoV-2 in vitro. A pilot clinical study also showed their efficacy in COVID-19 treatment. Many clinical trials are now being conducted to prove their safety and efficacy for the prevention and treatment of COVID-19. However, until now there are not enough data to support the use of these drugs in COVID-19 management. Under the pressure to treat COVID-19 patients with chloroquine or hydroxychloroquine, clinicians shouldnot use these drugs for COVID-19 without considering the available information regarding theiruse for COVID-19. This review summarized the evidence regarding the potential of chloroquine and hydroxychloroquine in COVID-19 management
Literature review of conjunctivitis, conjunctival swab and chloroquine effect in the eyes: a current updates on COVID-19 and ophthalmology
No full textThis overview briefly describes current literature findings in ophthalmology related to coronavirus disease 2019 (COVID-19) that become a worldwide pandemic. It included the current updates related to conjunctivitis that believed as the early sign of COVID-19, the effectiveness of conjunctival swab in detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compared to naso- or oropharyngeal swab and the long-term side effect of chloroquine use to the eyes. The analysis from four current published literatures revealed, overall sensitivity of conjunctivitis was 2.42% (CI 95%: 0.79-5.55) and conjunctival swab was 2.90% (CI 95%: 1.07-6.20). There were no current COVID-19-related literatures discussing the side effect of chloroquine to the eyes, however, previous literatures revealed there were potential long-term harmful effects of chloroquine treatment to the eyes.
Comparison of high-intensity and low-level laser therapy effecton combined sensory index, sensory conduction velocity and distal motoric latency: a study in moderate carpal tunnel syndrome patients
No full textCarpal tunnel syndrome (CTS) is the most common neuropathy compression syndrome. The effectiveness of low-level laser therapy (LLLT) as one of the conservative therapy for CTS is still debatable. High-intensity laser therapy (HILT) is developed with higher energy and deeper tissue penetration than LLLT. This study aimed to compare the effect of HILT and LLLT on sensory and motoric electrophysiologic parameters in moderate CTS patients. This was an experimental randomized pre and post-test group study. Sixteen patients (fifteen females and one male) with moderate CTS were randomly assigned into two groups. The HILT group was given HILT with analgesic dosage 10 J/cm2 and biostimulation dosage 120 J/cm2. The LLLT group was given LLLT with dosage 6 J/cm2. All treatments were given for ten sessions in 2 weeks. Combined sensory index (CSI), sensory nerve conduction velocity (SNCV), and distal motoric latency (DML) were recorded before and three days after the last treatment. The mean decrease of CSI was more significant in HILT group (-0.37±0.37 ms; p=0.03). There were no significant differences in the mean increase of SNCV (HILT = 3.16±3.15 m/s, LLLT= 2.74±1.42 m/s; p=0.73) and mean decrease in DML between two groups (HILT = - 0.20 ± 0.18 ms , LLLT = - 0.14 ± 0.21 ms; p=0.52). In conclusion, the HILT is more effective than LLLT in improving the CSI values in moderate CTS patients