Journal of the Medical Sciences (Berkala ilmu Kedokteran)
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Hearing loss in pediatric patients with congenital rubella syndrome
No full textCongenital rubella syndrome (CRS) is caused by rubella infection in pregnant women. It was estimated 100.000 children with CRS, with 46% found in developing countries. The CRS consists of symptoms like sensorineural hearing loss (SNHL), congenital heart disease, cataract or congenital glaucoma, and other symptoms. Sensorineural hearing loss is the commonest symptoms compared with others. This study aimed to determine the hearing loss in CRS in Dr. Kariadi Central Hospital, Semarang, Central Java. This was a descriptive study using data from medical records from CRS pediatric patients who had BERA examination from January 2019 until December 2020. The CRS was characterized with one or more symptoms: SNHL, congenital cataract, congenital heart disease, and laboratory IgG and/or IgM Rubella (+). The SNHL was described from refer OAE result, tympanometry A, and BERA with hearing threshold ≥40 dB. Follow-up evaluation was performed with Google form questionnaire. There were 55 CRS cases with 70.9% had bilateral SNHL, mostly with very severe hearing loss. Normal hearing was found in 16 children (28.1%). From 30 children who were followed up, there were 20 children who had bilateral SNHL with 30% were moderate-severe degree and 70% profound. With further multidisciplinary management in children with CRS and parental support, 65% children used hearing aid and 40% had auditory-verbal therapy (AVT). Evaluation of the AVT showed progress in 30% children. In conclusion, SNHL is found in 70.9% children with CRS. Further management using hearing aid and AVT shows progress on few children
Sudden weakness due to thyrotoxic periodic paralysis: a case report
No full textThyrotoxic periodic paralysis (TPP) is a complication of hyperthyroidism. Lead to sudden hypokalemia and muscle weakness. In most cases, it is found mainly in young adult males of the Asian race. The paralysis is temporary and will return with potassium correction. There are very few cases reported in Indonesia regarding these cases of TPP. In our case, a 44-year old man complained of weakness that started later in the limbs but quickly improved. This case was diagnosed late at first, and uncorrected potassium levels led to recurrent paralysis. Laboratory test results showed severe hypokalemia (potassium level 1.81 mmol/L). The thyroxine level (T4) was 44.12 pmol/L and low serum thyroid-stimulating hormone (TSH) <0.0025 IU/mL
An increase in mean platelet volume (MPV) as a predictor of mortality in children with sepsis
No full textSepsis is associated with increased morbidity and mortality in children worldwide, mainly in developing countries. This fatal risk emphasizes the importance of finding accessible and inexpensive parameters to be used as predictors for mortality in children with sepsis. The aim of this study was to determine the role of increased mean platelet volume (MPV) as a predictor for mortality in children with sepsis. A case control study was applied using medical records of all in-patients aged 1 mo -18 y diagnosed with sepsis at Dr. Sardjito General Hospital, Yogyakarta from January 2015-December 2016. Bivariate and multivariate analyses by Chi-square and logistic regression to evaluate the correlations between increased MPV within the first 24-72 h (ΔMPV>0) and mortality were applied. Eighty-one eligible subjects met the inclusion/exclusion criteria with the mortality was 52%. Chi-square analysis showed significant correlations between increased MPV and mortality (p=0.005). Multivariate analysis showed increased MPV within the first 24-72 h after sepsis diagnosis as a predictor for mortality after controlling for sex and AKI (adjusted OR 3.851; 95% CI:1.354-10.948; p= 0.011). In conclusion, an increase in MPV within the first 24-72 h after diagnosed is an independent predictor for mortality in children with sepsis
Effect of Robusta coffee extract gel on fibroblast and collagen during proliferative phase of IIB degree-burn on Long Evans rats
No full textIIB Degree-burn takes longer to heal because only a small epithelium component remains. It requires a topical agent that can accelerate the wound healing process. One of the wound healing signs is the increased collagen formation as an extracellular matrix produced by fibroblast in the proliferative phase. This study aimed to prove the effect of Robusta coffee extract gel as a topical agent on increasing the number of fibroblasts and collagen density in IIB degree-burn treatment on Long Evans rats. This study used 24 Long Evans rats which were divided into three groups, namely positive control (silver sulfadiazine), negative control (gel base), and treatment group (2.5% of Robusta coffee extract gel). The results showed a higher number of fibroblast (p<0.05) and a denser collagen density (p<0.05) of the Robusta coffee extract gel compared to the control group on day 8 and day 14. These results indicated that the number of fibroblasts and collagen increases that can scavenge free radicals and stimulate the release of cytokines that play a role in increasing fibroblast proliferation. Robusta coffee affects expanding the number of fibroblasts and collagen density to be an alternative topical agent of second-degree burns treatment
Effect of Citrullus lanatus seed oil on xerosis in leprosy patients
No full textXerosis in leprosy patients may result from defects in sweat gland function.Red watermelon (Citrullus lanatus) seed oil a lot of contains linoleic acid,which can hydrate the skin and reduce trans-epidermal water loss (TEWL).This study aimed to evaluate the effect of C. lanatus seed oil administrationin leprosy patients with xerosis. It was a clinical study with one group pretestposttest control group design involving 30 leprosy patients with xerosis at theDepartment of Dermatology and Venereology, Dr. Pirngadi Medan Hospital, thePolyclinic of Dermatology and Venerology, Universitas Sumatera Utara Hospitaland the Department of Dermatology and Venerology, H. Adam Malik GeneralHospital, Medan, Indonesia. Patients were asked to topically administration of2 mL C. lanatus seed oil to the right and left legs for two times daily for 4 weeks.Specified symptom sum score (SRRC) and skin capacitance (SCap) were thenmeasured before the intervention at the first visit (week 0), week 2, and week 4.A significantly different on SRRC and SCap of the leprosy patients was observedon the 2nd and 4th week after C. lanatus oil administration compared to week 0(p<0.001). No side effects of erythema, blistering, and burning were observed.However, a mild degree itching was observed in 2 (6.7%) patients. Majority ofleprosy patients feel good satisfaction (83.4%), followed by a moderate (13.3%)and a low satisfaction (3.3%). In conclusion, topically administration of redwatermelon (C. lanatus) seed oil can reduce the xerosis degree in leprosypatients as indicated by the decrease of SRRC and the increase of SCap. Theseed oil is well tolerated and gives a good satisfaction on the patients
Effect of hormonal contraceptives on the ocular surface and the tear film
No full textDry eye syndrome (DES) is a common multifactorial disease of the tears andocular surface associated with sex hormones. Hormonal contraception is arisk factor for DES, but its relationship with DES exacerbations in womenof childbearing age is still unclear. This study aimed to evaluate changesof the tear film and ocular surface of young women using the hormonalcontraceptive agent. It was a case-control study involving 56 healthywomen aged 20 to 45 y.o. Subjects was divided into two groups i.e. thehormonal contraceptives group and the control group without hormonalcontraceptive. Subjects were interviewed with the ocular surface diseaseindex (OSDI) questionnaire. Tear secretion and tear stability were measuredusing Schirmer’s I test and fluorescein tear break-up time test (TBUT).Ocular surface impression cytology with cellulose acetate filter paper wastaken from inferonasal bulbar conjunctiva and was stained with periodicacid- Schiff (PAS) and counterstained with hematoxylin and eosin (HE). Nosignificantly decrease in tear secretion and tear stability in the hormonalcontraceptives group compared with the control groups was observed (p >0.05). However, a statistically significant decrease in goblet cell density andconjunctival epithelium metaplasia was observed, where 25% of the hormonalcontraceptives group had an abnormal impression cytology result comparedwith the control group (p 0.05). The hormonal contraceptives group had a signifificanteffect on the ocular surface in which it induced squamous metaplasia andinflflammation of conjunctival cells and the reduced number of goblet cellsp<0.05). The slightly decreased tear film volume and stability accompaniedby an increase in OSDI score found in the hormonal contraceptives groupsupport the possibility of hormonal contraceptive use as one of the riskfactors in the occurrence of dry eye syndrome
A report of two cases of type 2 diabetes mellitus (T2DM): happy and longevity
No full textChronic hyperglycemia in patients with type 2 diabetes mellitus (T2DM) is associated with the development of complications and the increase of risk of mortality. Patients with T2DM have a shorter life expectancy than non-diabetic population. It is attributed to cardiovascular disease, stroke, renal disease, and infection. Depression secondary to T2DM worsens the quality of life. On the contrary, positive emotions correlated strongly with long life expectancy. A number of mechanisms might explain this correlation. We reported two geriatric patients over 80 y.o. with T2DM comorbidity for more than 20 years. Discussion point of these cases is the subject’s longer life span compared to the average diabetic patient’s life expectancy and great quality of life despite the disease burden of chronic hyperglycemia in T2DM and cardiovascular risk
Development of a SYBR Green real-time PCR-based assay system for detection of Neisseria gonorrhoeae
No full textDiagnosis of Neisseria gonorrhoeae infection is needed for patient therapy and for reducing this bacterial transmission in the population. The culture method is a gold standard method for N. gonorrhoeae detection, however it has low sensitivity. Among molecular methods with high sensitivity and specificity, SYBR Green real-time PCR is the potential method for N. gonorrhoeae detection. In this study, we developed an SYBR Green real-time PCR-based system assay for N. gonorrhoeae detection. Several PCR conditions were optimized and analyzed including primer annealing temperature, DNA template volume, the limit of detection (LoD), cross-reaction with others (bacteria, viruses, fungus, protozoa), and quality assurance. The results showed that the annealing temperature and DNA template volume were 60oC and 5 µL, respectively. The LoD was 29 DNA copies corresponding to 3 bacterial cells per reaction. No cross-reaction was detected for other bacteria, viruses, fungus and protozoa. The external quality assurances enrolled in 2019 and 2021 showed 100% concordance. The preliminary testing for clinical samples was also 100% concordance. In conclusion, the SYBR Green real-time PCR-based system assay developed in this study is promising for application in clinical laboratories
Analysis of systemic risk factors of occipital stroke-related vision loss
No full textOccipital stroke is associated with visual field defects and other visual perceptual deficits that might lead to detrimental effects on health-related quality of life. This study aimed to evaluate the possible association between systemic risk factors and the features of occipital stroke. It was a retrospective observational study involving patients diagnosed with occipital stroke in Dr. Yap Eye Hospital, Yogyakarta, Indonesia, between 2013 and 2014. A total of 72 patients with occipital stroke proven with CT/MRI who underwent detailed evaluation of ocular and systemic risk factors were included in this study. The patients were divided into two groups with or without risk factors. The risk factors were hypertension, diabetes mellitus, and cardiac diseases. The effect of risk factors on sex, age groups (≤40, >40 and ≤60, >60 y.o.), stroke lesions (left occipital, right occipital, bilateral), and visual field defects (homonymous hemianopia, homonymous quadrantanopia, and others) were analyzed. Out of 72 patients, there were 56 males (77.8 %), and 16 females (22.2 %), with a mean age of 58.46 ± 11.83 y.o. The study found there was a significant difference in age with risk factors compared with those without risk factors (p = 0.025), as well as visual acuity with age groups (p = 0.005) and stroke lesions (p = 0.024). Analysis of risk factors showed that hypertension was significantly correlated with stroke lesions, whereas cardiac disease was significantly associated with age groups (p<0.05). Predictive analysis was performed using a linear regression model, and it showed that risk factors could predict the occurrence of stroke lesions. In conclusion, patients’ systemic risk factors are significantly associated with the older onset of occipital stroke and lower visual acuity, although not significantly associated with stroke location and visual field defect characteristics