Journal of the Medical Sciences (Berkala ilmu Kedokteran)
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Neonatal outcomes in In vitro fertilization (IVF) pregnancies
No full textsmall-for-gestational age (SGA), and low birth weight (LBW) rates are approximately twiceas high in IVF pregnancies than in natural pregnancies. The IVF procedures have becomemore routine in recent years in Indonesia, but there have been few assessments ofneonatal outcomes. The study aimed to evaluate the risk of preterm birth, SGA, and LBWin IVF infants. This was a retrospective cohort study performed in Dr. Sardjito GeneralHospital, Yogyakarta from January 2012 to December 2016. Pre-coded questionnaireswere used to collect data from medical records. The relative risk of preterm birth, SGA,and LBW among IVF infants were calculated and compared to naturally conceived infants.A total sampling method was used for the IVF infants and a simple random samplingmethod was used for naturally conceived infants, who were born on the same day as aninfant in the IVF group.A total of 108 infants were recruited, consisting of 54 IVF infants and 54 naturallyconceived infants. The IVF infants had increased risk of preterm birth (RR = 2.0; 95%CI0.52 - 7.58) and LBW (RR = 1.25; 95%CI 0.53 - 2.92). However, the IVF infants didnot have an increased risk of SGA (RR = 1.0; 95%CI 0.21 - 4.73). In conclusion, therisk of preterm birth and LBW in IVF infants are higher than in naturally conceived infants,but not statistically significant. However, there is no increased risk of SGA in IVF infants
Cervical cancer screening coverage in urban and rural areas: its determinants
No full textCervical cancer is a woman’s health problem that is still widespread throughtout the world, especially in developing country such as Indonesia. The high incidence of cervical cancer related with early detection program. Visual inspection of acetic acid (VIA) is used as an alternative screening method because it is easier, cheaper and effectiveness is not much different from the Pap test. The most participant in urban and rural areas was the age group 31-40 years old, low parity, and first intercourse at ≥ 17 years old. There was asscociation between cervical cancer screening coverage with education level, knowledge and distance of service facilities. There were significant difference of education level (p = 0.000), knowledge (p = 0.000) and distance of service facilities of urban and rural participant (p = 0.000). There was no significant differences in family support of urban and rural participant (p = 0.224)
Cervical cancer screening coverage in urban and rural areas in Southeast Sulawesi: its determinants
No full textCervical cancer is a woman’s health problem that is still widespread throughout the world, especially in developing countries such as Indonesia. The high incidence of cervical cancer is related with early detection program. Visual inspection of acetic acid (VIA) is used as an alternative screening method because it is easier, cheaper and its effectiveness is not much different from the Pap test. There are differences on coverage of VIA test in urban and rural areas. This study aimed to identify determinants of cervical cancer screening coverage in urban and rural areas. The study was a cross sectional study. Total of 372 women who did the VIA test in urban areas of Kendari and rural areas of South Konawe in January to June 2016 were included in this study. Coverage of cervical cancer screening was examined in relation to the level of education, knowledge, distance of health facilities and family support. The data was analyzed using Chi-square test with a significance value p < 0.05. The majority of respondents were the age groupof 31-40 years old, low parity, and first intercourse at ≥ 17 years old. There were significant difference of education level (p=0.000), knowledge (p=0.000) and distance of health facilitiesin urban and rural areas (p=0.000). There was no significant differences between family support in urban and rural areas (p=0.224). In conclusions, education level, knowledge, and distance of health facilities are determinants of cervical cancer screening coverage in urban and rural areas in Southeast Sulawesi
Correlation between micro-RNA-21 expression and inflammation cytokine in rabbits implanted with bare metal stent with the incidence of neo intimal hyperplasia
No full textIn-stent restenosis after stenting in vascular occurs secondary to the accumulation of smooth muscle cell and extracellular matrix. This condition is a major complication caused by the occurrence of neointimal hyperplasia (NIH). The study aimed to prove the role of miRNA-21 as a risk predictor of the NIH event in aorta of rabbits animal model who underwent bare metal (BM) type stent implantation and to know the miRNA-21 role in IL-6 and IL-8 expressions. This study was quasi experimental, coducted in Catheterization Laboratory Dr. Sardjito General Hospital Yogyakarta. Stent implantation was observed intravascular ultrasonography. Blood vessel which was already deployed by stent taken as sample for pathologic examination. Rabbit blood samples were collected on day 0, 7, and 28. Quantification miRNA-21 expression has been done with qPCR and ELISA approach. These 10 rabbits divided into two groups in which one group as control (without stent deployment, 4 models) and another group as intervention (with BM type stent deployment, 6 models). The increase in expression of miRNA-21 on the day 7 and day 28 in the intervention group compared to the control group. Neointimal hyperplasia increased in intervention group on day 7, and 28 were from mild grade to moderate, and severe respectively. In addition, levels of IL-6 and IL-8 increased on day 28 compared with on day 7. This study showed increase of miRNA-21 expression on day 7 and NIH rise from the mild to moderate. Furthermore, on day 28, that increases of miRNA-21 expression and NIH rose from to moderate to severe. The increase of miRNA-21 was also shown on day 7 and 28 followed by the increase of IL-6 and IL-8 levels
Surgical outcome of scoliosis in Marfan syndrome: a case series report
No full textScoliosis in marfan syndrome (MFS) manifests on 60% patients. Moreover, the scoliosisnoticeable in earlier age is more progressive, refracted, and rigid compared to idiopathicadult scoliosis. The surgical correction provides notorious higher perioperative risk,whereas conservative treatment using brace is not effective to prevent progressivityof the scoliosis. In this a case report, we reported the surgical outcome of MFS scoliaispatients with MFS who operated using posterior fusion instrumentation by mean of thequality of life SF-36 questioner. This was a retrospective case series involving five MFSscoliosis patients who underwent posterior fusion instrumentation with initial Cobb angleof 87.417.57o and initial kyphotic angle of 32.8 ± 14.52o. Clinical, radiological andquality of life of the patients based on SF-36 questionnaire were evaluated within 6-36months follow up. Post-operative showed the Cobb angle become 46.2 ± 16.3o and thekyphotic angle become 21.6 ± 9.94o. No intraoperative or post-operative complicationswere observed. After 6-36 months follow up, the Cobb angle became 45.2 ± 17.48oand the kyphotic angle became 21.6 ± 9.94o. In addition, all patients had physical andmental health scored similar to 2 years post-surgery scoliosis scoring according to SF-36 orthopedic scoring guidelines. I conclusion, the surgical outcome of posterior fusioninstrumentation in MFS scoliosis showed good correction of Cobb angle and Kyphoticangle. The quality of life of the patients based on physical and mental health questionnaireis satisfactory
Life style risk factors for femoral neck fracture in Dr. Sardjito Hospital
No full textAs life expentancy improved, the incidence of femoral neck fracture, as one of the mostcommon traumatic injuries in the elderly, has also increased. Risk for fracture is not onlydetermined by age and sex but also by the degree of osteoporosis and certain life-styles.The purpose of this study was to investigate life-style risk factors for femoral neck fracturein Dr. Sardjito General Hospital, Yogyakarta. In this case-control study, all patients withfemoral neck fractures admitted to the Orthopedic Division and Traumatology, Departmentof Surgery in 2013 – 2014 was included as cases. Controls were subjects withoutfracture of similar age and sex. Data of corticosteroid use, habitual coffee consumption,visual acuity disorders, habitual use of slippers and engagement in routine sport activitywere collected with questionnaires. We invited 63 patients (51 females and 12 males)and 63 controls. Corticosteroid use, habitual coffee consumption, visual acuity disorderand habitual use of slippers were risks factors for fractures, OR (95% CI) = 7.5 (2.9-21.6), p < 0.001; 7.5 (2.9-21.6), p < 0.001; 3.2 (1.6-6.8), p < 0.001 and 5.7 (2.7-12.6), p < 0.001, respectively. Engagement in routine sport activity was a protectingfactor, OR (95% CI) = 0.10 (0.02-0.33), p < 0.001. In conclusion, corticosteroid use,habitual coffee consumption, visual acuity disorder and habitual use of slippers are riskfor fractures, while engagement in routine sport is a protecting facto
The quality of patients chronic rhinosinusitis after functional endoscopicsinus surgery at Dr Sardjito General Hospital, Yogyakarta, Indonesia
No full textChronic Rhinosinusitis (CR) is disease by incidence and prevalence of high and is expected to rise to load against the economy and lowering the quality of life of patients.with CR involved many factors and an impact of highly significant on the quality of life and affect the economy.The quality of life patients done to assess the effects and result of surgery.Sino nasal outcome test-20 ( snot-20 ) was one of the instruments specific measurement the quality of life of patients CR. 10 patients who surgery action , obtained improving the quality of life based on snot-20 observed 28 days after done the act of surgery. Rate the SNOT- 20 before surgically obtained 37,3 with DS ± 7,87 and 28 days after done surgically obtained rata-rata snot-20 is 6 with DS ± 2,49. The SNOT-20 pre and post action there are different of significant (p = 0,024 )
Outcomes of surgical management of intracerebral hemorrhagic stroke at a tertiary care center in Yogyakarta, Indonesia
No full textHemorrhagic stroke remains a significant cause of morbidity and mortality worldwide. However, the role of surgical treatment for hemorrhagic stroke remains controversial. Previous studies had proposed surgery can prevent herniation, lowering intracranial pressure (ICP) and reducing mass effect and cellular toxicity. Outcome in previous studies are conflicting. Studies concerning outcomes of surgical management of hemorrhagic stroke in Indonesia are limited. This study aimed to compare the outcome of hemorrhagic stroke treatment between surgical evacuation and conservative management in Dr. Sardjito General Hospital, Yogyakarta, Indonesia. Retrospective cohort study was conducted. Eighty spontaneous intracerebral hemorrhagic (ICH) stroke patients involved in this study during January 2014 to August 2015. Of whom 36 (45%) male and 44 (55%) female. There were 45 and 35 patients underwent surgical treatment and conservative management, respectively. Surgical treatment group survival was 74%, whereas the survival in the conservative group was 26%. There was a statistically significant difference between surgery group and conservative group (
Prolonged Kidney Ischemia-Reperfusion Injury Associates with Inflammation, Vascular Remodelling, and Myofibroblast Formation
No full textProlonged kidney ischemia-reperfusion injury (IRI) is the important risk factor for leading to chronic kidney disease (CKD). Persistent hypoxia and inflammation are considered as the main pathogenesis of chronic injury, followed by myofibroblast expansion and fibrosis process. Tubular injury, cell proliferation, and vasoconstriction, as acute compensatory responses, are restored in chronic phase. The aim of the study was to investigate the relation between inflammation, vascular remodeling, and myofibroblast formation as response to ischemia injury after prolonged kidney ischemia-reperfusion (I/R). Fifteen male Swiss mice aged 3-4 months were used as kidney I/R injury model after bilateral pedicle renal clamping. Rats were divided into 3 groups with five rats in each group i.e. control group (sham operation/SO), acute I/R model (IR1), and chronic I/R model (IR12). PAS staining was used for scoring tubular injury. Fibrosis was assessed using sirius red and a-SMA immunostaining for myofibroblast expansion. PCNA and CD68 immunostaining were used for identifying cell proliferation and macrophage infiltration. RT-PCR was conducted for assessing MCP-1, HIF-1a, and ppET-1 expression, which were quantified using ImageJ software. Data were analyzed using one way ANOVA and Kruskal-Wallis test with significance level of p<0.05. Significantly increase of tubular injury score (p<0.001) and PCNA positive cell (p<0.001) in IR1 group compared to SO were observed, otherwise HIF-1a of IR12 enhanced (p<0.05). Macrophage cell count (p<0.01) and MCP-1 expression (p<0.05), were significantly increase in IR1 and IR12 injury, compared to SO. Wall thickness of arteries was significantly increase (p<0.05) as well as decrease of vascular lumen area (p<0.05), followed by enhancement of ppET-1 expression (p<0.01) in IR1 group and restored significantly (p<0.05) in IR12 group. Fibrosis fraction-area and myofibroblast expansion were significantly increase gradually from IR1 to IR12 injury (p<0.01). In conclusion, prolonged kidney I/R injury induces the sustainability of hypoxia and inflammatory response, which promotes myofibroblast formation, and decrease the response of vascular remodelling.
The influence of acetylation status of tuberculosis patients on the isoniazid serum concentrations and sputum conversion after intensive phase therapy
No full textIsoniazid (INH), one of the major antituberculosis drugs, is metabolized by acetylation. Previously study proved the significant differences of serum INH concentration between subject with fast and slow acetylation status. However, the correlation of acetylation status with treatment outcome after fixed-dose combination antituberculosis therapy (FDC-ATT) was not explained. The aim of this study was to evaluate the influence of acetylation status on the treatment outcome and the serum INH concentrations in the adult tuberculosis patients underwent FDC-ATT. A cross sectional study was carried out on 31 tuberculosis patients. Acetylation status was measured by spectrophotometer and serum INH concentration was measured by high performance liquid chromatography (HPLC). Sputum conversion assay was conducted by Ziehl Nelsen method. t-Test, chi square, Mann-Whitney, and Fisherman were used to analyze the data. The proportion of the fast acetylator was 61.3%, whereas the slow acetylator was 38.7%. The proportion of success and failure sputum conversion were 83.9% and 16.1%, respectively. The mean serum INH concentration in the fast acetylator groups (1.52 ± 0.15 μg/mL) was significantly lower than that in the slow acetylator groups (3.84 ± 0.35 μg/mL). The failure conversion risk of the fast acetylator group was about two folds higher than the slow acetylator group, although it was not significantly different (RR=2.53; 95% CI=0.32-20.00; p>0.05). Moreover, the mean serum INH concentration in success (2.46 ± 0.31 μg/mL) and failure (1.89 ± 0.20 μg/mL) sputum conversion was not significantly different (p>0.05). In conclusion, the acetylation status does not influence the sputum conversion in adult tuberculosis patients after FDC-ATT although the serum INH concentration on slow acetylation status is higher than that fast acetylation status.