Journal of the Medical Sciences (Berkala ilmu Kedokteran)
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Preventive actions to minimizing the coronavirus disease 19 (COVID-19) transmissions among health workers: a systematic review
No full textOn mid February 2020, the World Health Organization declared an outbreak of a new type of respiratory disease originated from Wuhan, China, which was identified as coronavirus disease 19 (COVID-19). After a long-standing status of COVID-19-free, on March 2nd, 2020, Indonesia finally broke its first cases. This study aimed to systematically review preventive actions to minimizing the COVID-19 transmissions among health workers. The articles were selected from Google Scholar, World Cat, PROQUEST, PUBMED journal databases published from January to April 2020. The keywords for this review included “COVID-19” or “Corona” and “health behavior” or “health promotion” or “wash hands” or “health workers”. A total of 2,809 articles generated from the databases, the authors identified seven articles of preventing the COVID-19 virus outbreak among the health care workers in the world around 2019-2020. The studies reported that health care workers tried to prevent the COVID-19 transmission by doing social distancing, using the right personal protective equipment (PPE), handwashing, screening for in-person visit, and telemedicine. Health care workers have additional responsibility of protecting the patients and their self. Some issues may be unique to different health care workers departments, the majority of challenges faced by health care workers globally are similar
The potential of meropenem and piperacillin-tazobactam combination to Acinetobacter spp clinical isolates in vitro
No full textAcinetobacter spp is one of the most common causes of nosocomial infection, especiallysepsis. A lot of antibiotics resistance happen related to Acinetobacter-related sepsis treatment. This study aimed to evaluate the potential of meropenem and piperacillin-tazobactam combination against Acinetobacter spp in in vitro by using paper strip test. This was experimental study conducted in September to December 2015 at Departement of Microbiology, Faculty of Medicine, Public health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia. Clinical isolates of Acinetobacter samples were obtained from collections of the Department of Microbiology. The data were analyzed using post-test analysis which was conducted by observation over 24 h after the paper strip test was applied in bacterial culture. The MIC value of the antibiotic combination was recorded based on observation. The result showed 12 of 17 clinical isolates were synergistic potential (70.59%) and 5 others were indifferent potential (29.41%). Two of five clinical isolates that show indifferent potential were A. baumannii and all of the clinical isolates that show synergistic potential were Acinetobacter spp. It can be concluded that the combination of meropenem and piperacillin-tazobactam showed more synergistic dominantly than the single use of each of them
Effects of ciprofloxacin concentrations on the resistance of uropathogen Escherichia coli: in vitro kinetics and dynamics simulation mode
No full textCiprofloxacin is recommended for complicated urinary tract infection (UTIs) caused by multidrug-resistant pathogens included Escherichia coli. However, its optimum dose for UTIs remains uncertain that may cause the bacterial resistance. This study was conducted to evaluate the effects of ciprofloxacin concentrations on the resistance of E. coli. The in vitro pharmacokinetic/pharmacodynamic (PK/PD) models of ciprofloxacin 750 mg oral dose twice a day for one daywas compared to that dose of 500 mg twice a day for three days.Pharmacokinetic parameters i.e.AUC0-24 and Cmax. and pharmacodynamic parameter i.e. MIC of ciprofloxacin against E. coli which previously had MIC of 0.5 µg/mL were determined. The PK/PD parameters combination of ciprofloxacin included AUC0-24/MIC, Cmax/MIC, and T>MIC ratio were used to evaluate its antimicrobial activities which was measured based on kill and re-growth rates of bacterial colony after the ciprofloxacin administration. The result showed that MIC value against E. coli increase to 8-16 and 32-64 µg/mL after ciprofloxacin 750 and 500 mg administration, respectively, indicating the emergence of resistance. Both doses of ciprofloxacin were able to reduce the number of bacterial colony in the first two hours administration. However, after two hours administration, those both doses could make re-growth of bacterial colony. The value of AUC0-24/MIC (120.42±1.27 vs.92.62±9.36), Cmax/MIC (4.75±0.21 vs. 3.26±0.30), and (T>MIC 89.58±7.22 vs. 76.39±9.39) after ciprofloxacin administration at dose of 750 mg were higher than those at dose of 500 mg. The increase of AUC0-24/MIC and Cmax/MIC values could reduce the number of bacteria colony, however could not for T>MIC value. In conclusion, the AUC0-24/MIC and Cmax/MIC parameters of ciprofloxacincan be used to evaluate its activity. In addition, ciprofloxacin twice per day at dose 500 mg for three days and 750 mg for one day are not different in the inhibition of E. coli resistance emergence
Clinical cardiac manifestations in patients with coronavirus disease 2019 (COVID-19)
No full textThe pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected more than 2 million people worldwide with case fatality rates between 3-15%. The pathophysiology of this newly emerging disease in affecting cardiovascular system is poorly understood. This review aimed to understand from various retrospective studies and case reports that have been published and updated during the pandemic of COVID-19 related to the underlying mechanism and cardiovascular interaction with coronavirus. A literature search was done with Google search, PubMed, European Society of Cardiology (ESC) and Journal of American Medical Association (JAMA) network since the early days of COVID-19 pandemic. Clinical presentation may be asymptomatic or the severe cases will have acute respiratory distress syndrome (ARDS). Protein spikes of SARS-CoV-2 virus use the angiotensin-converting enzyme 2 (ACE2) as viral entry to host cells. Due to the upregulation of ACE2, people with any pre-existing cardiac diseases are more vulnerable to the infection and more likely to have a severe condition of COVID-19 infection with a higher risk of mortality. On the other hand, ACE2 has protective effects against myocardial inflammation and lung injuries. Several cases of COVID-19 infection may have cardiac manifestations as a chief complaint or acute cardiac injury as the complication. Recent case reports show that acute cardiac injury, myocarditis, cardiogenic shock, thromboembolism, and arrhythmias could be the complications of COVID-19 even without history or risk factors of cardiovascular disease. There are several hypotheses related to the mechanism of acute cardiac injury in COVID-19 patients, including damage through ACE2 receptors, hypoxia, cardiac microvascular damage, and inflammatory response.COVID-19 infection can cause many interactions in the cardiovascular system, whether the patients already had chronic heart disease or not. Considering the lack of evidence of the RAS inhibitor in COVID-19, the use of ACE inhibitor/ARB should be continued unless contraindicated and may be beneficial in patients with hypertension, heart failure and diabetes mellitus. Early recognition of cardiac manifestations from COVID-19 infections will be the key to prevent short and long term cardiac adverse events
Differentiation of body fat composition between skinfold caliper (SKF) and bioelectrical impedance analysis (BIA) methods among professors
No full textBody fat composition reflected by body fat percentage (BF%) is one of the important components in disease risk evaluation. Among the methods available to measure BF%, skinfold calipers (SKF) and bioelectrical impedance analysis (BIA) are the most commonly used. The study was conducted to evaluate the difference in body fat composition measurement between SKF and BIA methods among professors. This study analyzed secondary data from the health evaluation of Universitas Padjadjaran (UNPAD) professors. This study involved 72 professors (50 male, 22 female) after fitted into the inclusion and exclusion criteria. BF% was measured among UNPAD professors using SKF and BIA. After obtaining agreement by Bland-Altman Plot, the data were analyzed by muliple paired-t test according to gender, physical activity level and body mass index (BMI) categories. The study showed no significant difference in BF% between SKF and BIA in overall population, between gender and physical activity level (p>0.05). For BMI, the only category that showed significant difference in BF% between the 2 methods was obese I group (p=0.001). In conclusion, there is no significant difference in BF% between SKF and BIA methods according to gender, physical activity levels and BMI categories except for obese I group
Moderate-intensity interval exercise but not high-intensity interval exercise improves the spatial memory of ovariectomized rats
No full textPhysical exercise exerts beneficial effects on the spatial learning and memory. High-intensity interval exercise (HIIE) has been proposed as a time-efficient physical exercise regimen. On the other hand, there were evidences that HIIE increased oxidative stress biomarkers and reduced antioxidant capacity, which resulted in oxidative damage. The present study aimed to investigate the effects of high-intensity interval exercise and moderate-intensity interval exercise on oxidative stress biomarkers and oxidative enzymes activity in the hippocampus and the spatial memory of ovariectomized rats. A total of 16 female Sprague Dawley rats aged 12 weeks were randomly assigned into 4 groups, i.e. the sham-operated (SO), ovariectomized without exercise (O), ovariectomized with high-intensity interval exercise (HIIE), and ovariectomized with moderate-intensity interval exercise (MIIE) groups. Rats of the exercise groups (HIIE & MIIE groups) performed 6 sessions of interval exercise per week for 6 weeks. The spatial memory of rats was measured using the Morris water maze procedure. The malondialdehyde (MDA) levels and activity of catalase (Cat) as well as glutathione peroxidase (GPx) in hippocampus were determined using spectrophotometry method. The spatial learning and memory retention of the moderate-intensity interval exercise group was significantly better than that of the high-intensity interval exercise group. The GPx activity of MIIE group was higher than any other groups. The SO group had the lowest hippocampal MDA level and highest Cat activity among groups. Moderate-intensity interval exercise reduces the ovariectomy induced-oxidative stress in the hippocampus and improves spatial learning and memory retention of ovariectomized rats
Comparative histochemical study of the kidney of six mammalian species
No full textComparative anatomy describes the similarities and differences in the anatomy of different species. Comparative anatomical studies do not only provide evidence for evolution but also indicate that various organisms originate from a common ancestor. They assist scientists in classifying these organisms based on similar characteristics of their anatomical structure. The aim of this study was to compare histochemical of the kidney of six mammalian species. The animals were grouped into three based on their dietary patterns i.e herbivores (Capra aegagrus and Bos taurus), carnivores (Canis lupus and Felis catus) and omnivores (Rattus norvegicus and Sus scrofa). Tissues were obtained from each of the studied species and preserved in 10% formal saline for one week until analysis. The tissues were then subsequently processed and stained using general and specific histochemical techniques. It was observed from this study all the mammalian kidneys consisted of similar histological features which explained that these studied mammals undergo the same evolutionary trend, adaptational changes and phylogenic relationship that exist between the kidneys of the studied species. Despite their differences in dietary patterns, the studied species have similar histological features with little observed variation. However, they have little differences in histochemical staining pattern for glycogen and glycoprotein but in reticulin they all stain intensely. This study has established a strong relationship in the histology of the kidney in six mammalian species
Validity of narrow-band imaging (NBI) nasoendoscopy on nasopharyngeal carcinoma post therapy biopsy
No full textNasopharyngeal carcinoma (NPC) is the most common malignancy found in the head and neck. It is a unique head and neck cancer due to its radiosensitivity. Therefore, radiotherapy becomes the main modality of therapy. Post-treatment evaluation of NPC is important to assess prognosis. Biopsy that is the gold standard for the evaluation can be performed with a narrow-band imaging (NBI) nasoendoscopy guide. This study aimed to determine the validity of NBI nasoendoscopic examination of NPC post-treatment biopsy. This study was a cross-sectional design for all post-treatment NPC patients who would undergo response assessment at the Department of Otorhinolaryngology, Head and Neck Surgery, Dr. Sardjito General Hospital, Yogyakarta. A total 40 patients during May-June 2018 period who underwent examination sequentially. Biopsy examination was carried out with NBI nasoendoscopy guidance and the results of biopsy were performed histopathological examination. Forty patients showed the results of NBI nasoendoscopic validity on NPC biopsy after treatment included sensitivity (85.7%), specificity (87.8%), positive predictive value (60%), negative predictive value (96.6 %), positive trend ratio (7.07), negative trend ratio (0.16), and accuracy (87.5%). Postoperative NBI nasoendoscopy features appear homogeneous (75%) and inhomogenous (25%). In conclusion, NBI nasoendoscopic validity on postoperative NPC biopsy is good
Accuracy of fine needle aspiration biopsy to diagnose lymphadenopathy in Dr.Sardjito General Hospital, Yogyakarta, Indonesia
No full textLymphadenopathy is a non-specific enlargement of lymph nodes which may be caused by infection, cancer, or autoimmune disease. To date, only a few studies reported the diagnostic value of fine-needle aspiration biopsy (FNAB) in lymphadenopathy. This study was performed to evaluate diagnostic reliability of FNAB for benign and malignant lymphadenopathy. This was a retrospective cross-sectional study. The obtained data were statistically analyzed for its sensitivity, specificity, and accuracy. Out of 126 collected FNAB cases with histopathological confirmed results in Dr. Sardjito General Hospital, Yogyakarta, 85 (67.4%) were malignant lymphadenopathy, consisting of 42 metastatic tumor cases, 38 non-Hodgkin lymphoma (NHL) cases, and 4 Hodgkin lymphoma (HL) cases.The overall diagnostic sensitivity, specificity, and accuracy of FNAB in lymphadenopathy was 85.88, 70.73, and 80.95%, respectively. In diagnosing metastatic tumors, FNAB had sensitivity of 83.33%; specificity of 89.28%; and accuracy of 87.3%. The sensitivity, specificity, and accuracy of FNAB in diagnosing NHL was 60.52, 94.31, and 84.12%, respectively. FNAB had a sensitivity of 25%, specificity of 95,90%, and accuracy of 93.65% to diagnose HL. Meanwhile, the accuracy of FNAB in diagnosing malignancies in generalized lymphadenopathy, head-neck lymphadenopathy, and inguinal lymphadenopathy was 90.90; 81.39 and 44.44%, respectively. In conclusion,FNAB has moderate diagnostic value in diagnosing overall malignant lymphadenopathy, including metastatic tumors. FNAB also has some limitations in diagnosing NHL and HL, with sensitivity less than 70% for both diseases. However, it has high accuracy to diagnose generalized lymphadenopathy
Vitamin D suppresses inflammatory responses in insulin resistance
No full text Vitamin D has been known as a vitamin for bone health and mineral homeostasis. However, since the discovery of vitamin D receptor (VDR) in various types of cell, that statement has changed. Immune cells are known to express VDR and enzyme 1α-hydroxylase that could convert vitamin D into its active form, 1.25 dihydroxyvitamin D. In immune cells, vitamin D works as an immunomodulator which affects various levels of immune response. The net effects of vitamin D are increasing mucosal immunity, but dampening the adaptive immune system. Vitamin D deficiency is commonly found in people with diabetes mellitus (DM) and obesity. It is also associated with increased insulin resistance and poor glucose control. This review will explain how vitamin D as immunomodulator dampens insulin resistance. In immune cells from subjects with insulin resistance, administration of vitamin D could reduce the expression of pro-inflammatory cytokines through the NF-κB and MAPK pathways, thus the levels of pro-inflammatory cytokines such as TNFα, IL-1β, and IL-6 are decreased. The same thing happens in preadipocytes and mature adipocytes cells. In these cells, vitamin D suppresses the expression of pro-inflammatory mediators such as IL-6 and MCP-1. Although in the invitro studies, the administration of vitamin D showed a promising effect in modulating the immune system, the clinical effect of vitamin D supplementation in reducing insulin resistance in individuals with type 2 DM (T2DM) and prediabetes is still inconclusive