Journal of the Medical Sciences (Berkala ilmu Kedokteran)
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Expression of circulating miR-200c and vascular endothelial growth factor-A (VEGF-A) mRNA as potential biomarker in human hepatocellular carcinoma
No full textHepatocellular carcinoma (HCC) is a common liver disease that causes significant publichealth problems throughout the world, including in Indonesia. The HCC is the six mostcommon cancers and second cancer-related deaths among men in the world. Recentlyit was reported that the microRNA is an important player in hepatocarcinogenesis. Theexpression of MiRNA-200c is often regulated in primary HCC and HCC cell lines. Vascularendothelial growth factor-A (VEGF-A) is a regulator of angiogenesis that has been reportedas miR-200c target gene. This study was conducted to measure expression levels in miR-200c and mRNAVEGF-A and their potential role as biomarkers at HCC. A total of 36HCC patients and 36 healthy subjects were included in this study. The relative expressionof miRNA-200c and mRNA VEGF-A was quantified using reverse transcription real timequantitative PCR (qRT PCR). Relative expression was calculated using . Unpaired t-testwas used to compare the expression levels of circulating miRNA-200c and mRNA VEGF-Ain HCC patients and healthy subjects. Pearson test was used to determine correlationbetween circulating miR-200c expression and mRNA VEGF-A expression levels. Theexpression levels of circulating miR-200c in HCC patients were lower compared to healthysubjects although it was not significant (p = 0.258). Conversely, the expression levelsof circulating mRNA VEGF-A in HCC patients were significantly higher compared tohealthy subjects (p = 0.001). The relative expression levels of circulating miR-200c werenegatively correlated with mRNA VEGF-A in HCC patients. In conclusion, the expressionlevels of mRNA VEGF-A in HCC patients are significantly deregulated in compared tothat in healthy subjects. Negative correlation between circulating miRN-200c and mRNAVEGF-A expression levels are reported in HCC patients
Soursop fruit (Annona muricata Linn.) consumption does not increase serum potassium levels and not significant in cardiovascular risk improvements of prehypertension subjects
No full textPatients with chronic kidney disease (CKD) tend to have hyperkalemia. They worry about the consumption of fruit for fear of increased serum potassium levels and therefore require a restricted potassium diet. Soursop fruit (Annona muricata Linn.) is believed to be beneficial for CKD and cardiovascular risk. This study was conducted to investigate the effect of soursop fruit supplement consumption on serum potassium levels and cardiovascular risk in prehypertension subjects from Mlati, Sleman District, Yogyakarta Special Region, Indonesia. A total 143 samples that met to the inclusion and exclusion criteria were subsequently randomized into two groups. Group I was given 2 x 100 g/day of soursop and Group II was without soursop. A laboratory examination from both groups was conducted including potassium, total cholesterol, low density lipoprotein (LDL), high density lipoprotein(HDL), and triglyceride levels at weeks 0; 7; and 13. Regular soursop consumption was evaluated every 2 weeks for 3 months. Data analysis was performed using an independent t test, a nonparametric Mann–Whitney test, and a chi-square test. No significantly different in serum potassium levels between the soursop and non-soursop groups at week 7 and 13 (p=0.073 and p=0.108) was observed. Furthermore, no significantly different in total cholesterol (p=0.254 and p=0.932), LDL (p=0.221 and p=0.710), HDL (p=0.400 and p=0.960), triglycerides (p=0.423 and p=0.580) of both groups was also obsereved. However, in subjects with hypercholesterolemia and hypertriglyceridemia, the mean cholesterol and triglyceride levels decreased compared to no soursop consumption at week 7 and 13. In conclusion, consumption of a soursop fruit supplement of 2 x 100 g/day for 13 weeks does not affect the serum potassium levels of prehypertension subjects. Moreover, the consumption of a soursop fruit supplement is not significantly different compared to those without soursoup in improving cardiovascular risk
Abnormal electroencephalographyas predictor of mortality in meningoencephalitis
No full textAlthough the incidence of meningoencephalitis has decreased,howeverits mortality remainshigh. Electroencephalography (EEG) has an important role in the management of meningoencephalitis although the imaging modalities have replaced its position. Abnormality in EEG may appear earlier than in imaging so it is expected to predict mortality.The study aimed to investigate the prognostic role of EEG results in predicting mortality of meningoencephalitis.This was an observational prospective cohort study involvingmeningoencephalitis patients in Dr. Sardjito General Hospital,Yogyakartafrom July 2016 to January 2017 who underwent EEG examination.The patients who met the inclusion and exclusion criteria were divided into abnormal and normal EEG groups. The outcomewas the mortality during hospitalization. Furthermore, the type of EEG abnormalities associated with mortality were evaluated.Thirty-eight patients with the mean age was 33.61±20.37 yearwere involved in this study. Twenty-eight patients (73.7%) had abnormal EEG result and 10 patients (26.3%) death.Bivariate analysis showed that abnormal EEG result (p =0.028) and Glasgow Coma Scale (GCS) score (p =0.005) were significantly associated with mortality. Analysis for the type of EEG abnormalities found that only diffuse slowing (p =0.001) was significantly associated with mortality. Multivariate analysis showed either abnormal EEG result or GCS score were independently predictor of mortality. Abnormal EEG and GCS score were interrelated in affecting mortality.In conclusion, abnormal EEG resultin meningoencephalitis, diffuse slowing in particular, is predictor of mortality during hospitalizatio
Vascular endothelial growth factor (VEGF) serum levelsof patients with Helicobacter pylori gastritis with cytotoxin-associated gene A positive (CagA+)status
No full textHelicobacter pylori (H.pylori) is an agent that causes gastritis and the ulcer of gaster, which are ultimately caused gastric tumors. The prevalence is about 80 % average in developing country and 20-50 % in developed countries. One of the virulence factor iscytotoxin-associated gene A (CagA) that plays a role in the inflammation process,cell proliferation and metaplasia in gastric mucosa. Vascular endothelial growth factor (VEGF)is one of angiogenic factors that plays a role in the process of making new mucosal tissue after the inflammation by H.pylori. The escalation of VEGF expression levels contribute to the beginning of gastric carcinogenesis. The studywas aimed to analyze of VEGF serum levels between CagA(+) and CagA(-) in patients with H.pylori gastritis. Cross sectional study was conducted on 30 patients with H.pylori gastritis after conducted gastroscopy,biopsy and CLO test, which were continued with VEGF serum examination using ELISA test and perfomed PCR test to determinethe CagA status.The data was analyzed with SPSS 22 version andp value <0.05 was considered significant.The results of this study were18 men (60 %) and 12 women (46%) from 30 total subjects, with a median age average was 53.5 years old.Majority ethnic was Batak with 16 subjects (53.3%). Helicobacterpylori gastritis with CagA(+) was about 21 subjects (70%) and H.pylori gastritis with CagA(-) was about 9 subjects (30%). We found that median VEGF serum levels of patients with H.pylori gastritis with CagA(+)[480.3 pg/dL (115.5-2185.2)] significantly higher compared to thatwith CagA(-) [291.1 pg/dL (158.4-556.7)] (p<0.05).In conclusion, the VEGF serum levels ofpatients withH.pylori gastritis with CagA(+) is higher compared to that withCagA(-)
Prediction model of dengue hemorrhagic fever transmission to enhance early warning system in Gergunung Village, Klaten District, Central Java
No full textThe dengue virus that causes dengue hemorrhagic fever (DHF) in principle is transmitted to humans through the bites of Aedes sp. In Indonesia, the disease is endemic in most provinces, including in Gergunung Village in Klaten District, Central Java. The village has shown the highest incidence of DHF for the last 5 years. Changes in demographical conditions, environment, and climate condition are predictors of dengue fever. This study aimed to demonstrate the association among human behavioral variables, physical environmental factors, and climate elements with DHF transmission to develop active surveillance model of DHF outbreak by the analysis of potential predictors. The research was an observational analytic study with case control design. Study population was selected from households with DHF case in 2016 through 2017 and the controls with ratio of 1:2. In total, 34 households were labeled as case and 68 households were labeled as control. Data collection was performed by observations, direct measurements, and interviews. Data were analyzed using appropriate statistical analysis with probability value of p0.05). In contrast, houses closer to each other tended to have more DHF cases (p<0.05; OR: 2.96; 95% CI: 1.01–8.67). Physical environmental factors and climate elements did not demonstrate significant associations with DHF case occurrence in this study. Human behavioral variables, physical environmental factors, and climate elements may serve as potential predictors of DHF outbreak, hence should be put into the model to enhance early warning system
Prognostic factors for mortality in patients with severe traumatic brain injury in Yogyakarta, Indonesia
No full textDetermining an accurate prognosis in patients with severe traumatic brain injury (TBI) still becomes a difficult challenge for neurologists. Clinical and laboratory findings have been used as important parameters to establish clinical decisions or even predict future prognosis including death in these patients. We studied the clinical, laboratory and neuroimaging parameters in predicting mortality in patients with severe TBI. This study used the medical records of severe TBI cases in Dr. Sardjito General Hospital, Yogyakarta, Indonesia from January 2015 until July 2016. We evaluated the clinical, laboratory, and neuroimaging examinations of seventy patients with severe TBI in association with mortality. The result showed among 70 patients involved, 35 were dead. Clinical findings of age 140 mmHg (OR=3.852; p=0.008) were associated with mortality. Laboratory and neuroimaging parameters of hyponatremia (OR=3.667; p=0.027), hyperkalemia (OR=1.771; p=0.030), and the presence of traumatic subarachnoid hemorrhage (SAH) (OR=6.526; p=0.003) in head CT-scan were significantly associated with mortality. In conclusion, our study showed that productive age <40 y.o. multiple injuries, hyponatremia, hyperkalemia and the presence of traumatic SAH increase the mortality risk in patients with severe TBI
Phacomatosis pigmentokeratotica: two cases series of a neurocutaneous rarity from Indonesia
No full textPhacomatosis pigmentokeratotica (PPK) is a distinct epidermal naevus syndrome. The syndrome is characterized by the coexistence of an organoid naevus with sebaceous differentiation arranged along Blaschko's lines, a papular naevus spilus arranged in a checkerboard pattern, in association with other extracutaneous anomalies. We report on two cases of PPK. The first case was an 11-year-old girl with sebaceous naevus on the right side of the body following the lines of Blaschko present since birth, whereas a papular naevus spilus involving the dorsal area of the neck was noted at 8 years of age. The second case was a 15-year old girl presented with sebaceous naevus on her face and neck and papular naevus spilus involving left side of her chest. Electroencephalography (EEG) of both cases revealed abnormal irritative epileptiform waves, and brain mapping showed symmetrical structures and no focus. The diagnoses of our two cases were based on clinical pictures of the coexistence of sebaceous naevus arranged along Blaschko's lines, a papular naevus spilus arranged in a checkerboard pattern, and EEG anomalies. To our knowledge, these cases were first reported in Indonesia. The association with various extracutaneous manifestation is often, as well as the possibility of malignant transformation.Hence a close follow-up of PPK patients is important, which may help in early recognition of the development of extracutaneous anomalies and the possibility of malignant transformation
Infective endocarditis as a morbidity predictor in patients who underwent mitral valve surgery
No full textInfective endocarditis (IE) often develops into rheumatic heart disease (RHD) that has many perioperative complications during the evolution of the disease. Cardiac surgery in patients with IE is often followed by post-operative morbidities that can decrease the quality of life. This study aimed to investigate the correlations between preoperative IE and the emergence of various morbidities in patients undergoing heart valve surgery. This was a cross-sectional study with secondary data analysis of the medical record in 60 patients with mitral valve surgery at Dr. Sardjito General Hospital, Yogyakarta from 2012 to 2017. As much as 30 of 60 patients were suffered IE before mitral valve surgery. The most common valve disease in the IE group was mitral stenosis (60%). IE was significantly associated with arrhythmia and cardiac event with p=0.002 (PR: 6.91), prolonged ICU stay with p=0.011 (PR: 5.68), prolonged ventilator use with p=0.015 (PR: 12.43) and severe pulmonary arterial hypertension (PAH) with p=0.033 (PR: 0.192) post mitral valve surgery. As many as 26 (87%) and 29 (96.7%) of patients with IE had a prolonged ICU stay and prolonged ventilator after mitral valve surgery respectively. The incidence of severe PAH postoperatively in the IE group was lower than in the non-IE group (10% vs 36.7%). IE was significantly associated with the increased risk of arrhythmia, prolonged ventilator use and prolonged ICU stay after mitral valve surger
The effect of human saliva compared to Aloe vera on wound healing of 2nd degree burn injury in animal models
No full textBurn injury is one of the common causes of injury that has relatively high morbidity and mortality. Several studies using herbal and traditional medicine from different countries have been documented in burn injury management. Human saliva that contains antibacterial, antifungal, antiviral and analgesic components as well as growth factors can induce re-epithelialization process in 2nd degree burn injury. Whereas, Aloe vera that influence a physiological moist condition was proven can induce re-epithelialization process lead to faster wound healing. This study aimed to compare topical application of human saliva and A. vera on wound healing process of 2nd degree burn injury. This was an experimental study using post-test only control group design using 27 white rats (Rattus novergicus) of Sprague Dawley strain divided into 3 groups with 9 rats in each group. Group I were applied 1 mL of human saliva, Group II were applied A. vera and Group III as control were applied NaCl. Change in body weight and macroscopic clinical assessment were observed every day for 14 days, whereas histological examination was observed on day 14. The data were presented as mean ± standard error of the mean (SEM) and analyzed using one-way analysis of variance (Anova). The result showed that the wound healing process at each treatment showed different level. The human saliva application tended to show faster wound healing process of 2nd degree burn injury compare with A. vera or NaCl (
The effect of L-arginine therapy on hepatocyte cells damage in mice (Mus musculus) model of preeclampsia
No full textPreeclampsia is one of the main contributors on morbidity and mortality of mother and fetus. Imbalance of body antioxidants and oxidants has a role on endothelial destruction causing endothelial dysfunction which leads to preeclampsia. L-arginine administration is indicated to be able to fix the remodelling process of hepatocytes which was damaged on preeclampsia. The aim of this study was to investigate the effect of L-arginine on hepatocyte cells damage on mouse (Mus musculus) model of preeclampsia. Experimental study was conducted in the Experimental Animal Warehouse and Biomedical Laboratory, Faculty of Veterinary Medicine, Airlangga University, Surabaya. A total of 30 pregnant mice were divided into three groups with 10 mice in each group i.e. normal, preeclampsia model and preeclampsia model with L-arginine therapy pregnant mice. Preparates were taken from dissected mice liver, with prior paraffin block and were then stained with hematoxylin-eosin. Results were analyzed semi quantitatively with Manja Roenigk hepar histology scoring method. Data were analyzed using Kruskal-Wallis and Man-Whitney test. Mean of hepar histopathology score of preeclampsia model with L-arginine therapy (40.80±1.17/µm2) was significantly lower compared with preeclampsia model pregnant mice (58.80±4.23/µm2) (p<0.05), however it was significantly higher compared with normal pregnant mice (18.40±2.41/µm2) (p<0.05). It was indicated that the L-arginine therapy on preeclampsia mouse model can reduce the score of hepar histopathology. In conclusion, L-arginine administration can reduce the hepatocyte cells damage of mouse due to preeclampsia