Journal of the Medical Sciences (Berkala ilmu Kedokteran)
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Cytologic diagnostic approach of pleuropulmonary blastoma: a case report
No full textPleuropulmonary blastoma (PPB) is a very rare pediatric lung tumor that arises in the pulmonary parenchyma, mediastinum, and pleura. The tumor has rapid disease progression and therefore the prognosis is remarkably poor. We reported a 4-year-old girl who complained of high fever and shortness of breath for the past 8 weeks. The patient was referred from the previous hospital with a pulmonary mass. CT scan of the chest with contrast showed a solid cystic mass with necrotic areas in the 1st, 2nd, and 3rd segments of the left lung with sized 4.8 x 8.1 x 6.6 cm3. As the tumor mass was inoperable, an ultrasound-guided fine-needle aspiration biopsy (FNAB) was conducted to diagnose the pulmonary lesion. We concluded that the lung tumor was a PPB based on FNAB cytology and immunocytochemistry staining. The histopathology feature of PPB appeared similar to fetal lung tissue. Cytologic features obtained from fine-needle aspiration cytology smears and cell blocks followed by immunocytochemistry assay could provide a proper and accurate diagnosis in an inoperable surgical pathology case
Decreasing of hand colonization and sterility of refill antiseptic in Dr. Yap Eye Hospital, Yogyakarta
No full textDr. Yap Eye Hospital, Yogyakarta uses aseptic gel containing 70% ethyl alcohol to refill antiseptic containers during times of antiseptic scarcity. The study aimed to evaluate the effectiveness and sterility of the refill antiseptics in reducing the number of colonization on the hands of nurses. It was a quasi-experimental using pre- and post-control groups design involving 56 nurses who used antiseptics in a bottle sterilized by plasma device (plasma bottle) compare to those washed using detergent (detergent bottle) before being refilled. Sterility tests were performed every two wk for up to two mo. Colonization pre and post hand hygiene practices were determined as an efficacy test and compared using the Mann-Whitney test in STATA 14. Antiseptic in plasma bottles remains sterile until the week8th since refilled, longer than detergent bottles (6th weeks). The pre-handrub colorizations were 0.04-16.92 CFU/cm2 and decreased significantly post-handrub to 0.00-3.08 CFU/cm2 (p<0.0001). Significant decrease pre- vs post-handrub colonization was observed in usage of detergent bottle (0.04-31.04 vs 0.00-10.48 CFU/cm2, p=0.0007). There was no significant difference in ∆ colonization for two bottles (0.40-15.76 vs 0.04-30.92 CFU/cm2, p=0.8790). In conclusion, antiseptic in the plasma bottle remains sterile longer than in the detergent bottle since refilled. Both of them are equally effective in reducing colonization after handrub activity
Vitamin D levels of obesity and non-obesity health workers: a cross-sectional study in Dr. Sardjito General Hospital/Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada, Yogyakarta
No full textObesity is one of the causes of chronic diseases, such as diabetes, hypertension, stroke, cancer, dyslipidemia, and heart disease. It is considered a financial burden on national health insurance since it drains the largest health fund. The study aimed to determine the difference in vitamin D levels in obese and non-obese health workers and analyze the factors that influence it. This was a cross-sectional study of the obese and non-obese health workers at Dr. Sardjito General Hospital, Yogyakarta. A total of 50 subjects, including 25 obese and 25 non-obese subjects were involved. Serum vitamin D levels was determined by ELISA. There was no significant difference between the obese and non-obese groups on vitamin D status (p30 min (OR 7.061; 95% CI: 1.064-46.872; p=0.043). In conclusion, there is no significant difference in vitamin D levels between the obese and non-obese groups. Vitamin D deficiency/insufficiency is more common in non-obese subjects than in obese subjects. Outdoor activity <30 min is a risk factor for vitamin D insufficiency/deficiency despite living in a tropical country with abundant sunlight throughout the year.
Antibiotic resistance of biofilm-producing bacteria from sepsis patients in Prof. Dr. Margono Soekarjo Hospital, Purwokerto, Central Java
No full textSepsis is a life-threatening organ dysfunction induced by the body's response to infection and is a significant cause of critical illness and death in hospitals. Bacteria are the most common pathogens that cause sepsis, and their ability to form biofilms increases their resistance to antibiotics. As a result of the failure of antibiotic administration therapy, the severity and pain of sepsis worsen. The study used a descriptive research design to determine the antibiotic resistance pattern of biofilm-producing bacteria from clinical isolates of sepsis patients. Using the BacT/Blood Culture System Alert, all patients suspected of sepsis in the intensive care unit of Prof. Dr. Margono Soekarjo General Hospital Purwokerto were examined for blood cultures between March and July 2018. These were then identified and tested for antibiotic resistance with the Vitek 2 Compact. Biofilm formation was detected utilizing the microtiter plate assay method, and the data were analyzed using a frequency distribution table. The results obtained 12 bacterial isolates, with Escherichia coli (41.67%), Staphylococcus haemolyticus (33.33%), Klebsiella pneumoniae ssp pneumoniae, Enterobacter cloacae complex, and Acinetobacter baumannii complex (8.33%) as the most common bacteria. All gram-negative bacteria (more than 80%) were resistant to ampicillin, cefoxitin, ceftazidime, ceftriaxone, aztreonam, and trimethoprim but were sensitive to meropenem (100%). Gram-positive bacteria were resistant to cefoxitin, benzylpenicillin, oxacillin, ciprofloxacin, erythromycin, and clindamycin (100% each). However, they were sensitive to tigecycline, nitrofuran, quinupristin, linezolid, vancomycin, and tetracycline (100% each). Gram-negative bacteria formed 50% biofilms, and 50% did not, whereas gram-positive bacteria produced 100% biofilms. In conclusion, bacteria clinical isolates of septic patients from Prof. Dr. Margono Soekarjo General Hospital Purwokerto are multiresistant to more than six types of antibiotics and produce weak to moderate biofilms, which can promote antibiotic resistance
The use of rigid gas permeable contact lens in managing severe anisometropia caused by monocular aphakia following retinal reattachment surgery and high myopia in a 13 year old girl: a case report
No full textAnisometropia if not treated accordingly may cause other issues especially in developing pediatric eyes. This case is a 13 year old female presented with chief complaint of headache and double vision upon wearing prescribed spectacles. Patient had history of high myopia on both eye, amblyopia and spontaneous rhegmatogenous retinal detachment on the left eye. Retinal reattachment and lensectomy surgery were conducted to correct the problem. The surgery was performed without intra ocular lens (IOL) implantation, which left her left eye become high hyperope due to aphakia. Patient was treated with RGP CLs. Final best visual acuity with EDTRS chart was 6/48 on both eyes. Patient reported subjective visual improvement, no headache or double vision
The significance of glycated haemoglobin, randomized admission blood glucose, and fasting blood glucose on in-hospital adverse cardiac events in patients with ST-elevation acute myocardial infarction
No full textIn an ST-segment elevation acute myocardial infarction (STEMI), glucose metabolism undergoes disturbance secondary to acute myocardial injury, which affects the clinical outcome during the acute phase. Glucose metabolic disturbance indices are glycated haemoglobin, admission random glucose, and fasting glucose in blood circulation during STEMI. This is a retrospective cohort study, aimed to investigate whether glycated haemoglobin, admission random blood glucose, and fasting blood glucose levels are the risk factors for developing in-hospital adverse cardiac events in STEMI. The result showed that among the three glucose metabolic disturbance indices, fasting glucose was an independent predictor (adjusted OR: 1.010 (95% CI: 1.001-1.018) and the most accurate factor (AUC 64.9 %) for adverse cardiac events. Other glucose metabolic indices, namely random blood glucose and glycated haemoglobin, were associated with increased odds to develop adverse cardiac events but they did not independently predict adverse cardiac events. Therefore, fasting blood glucose was an independent predictor and the most accurate factor for adverse cardiac events in the acute event of STEMI
The type of androgenetic alopecia and quality of life (QoL) in male patients
No full textAndrogenetic alopecia (AGA) is a nonscarring baldness that mostly affects >50% men worldwide. Hair loss led to psychological difficulties and have a negative impact on the quality of life (QoL). This study aimed to evaluate the relationship between the type of AGA and QoL in male patients. A total of 67 male AGA patients were clinically assessed using the Hamilton-Norwood scale and interviewed using the Hair-Specific Skindex-29 scale to assess QoL. The patients were predominantly in the age group 31-50 years (50.7%), mean age 49.60 years, grade I obese (32.8%), mean BMI 24.93 kg/cm2, 41.8% with father’s AGA history, smoking (62.7%), smoking >100 cigarettes in last 6 months (41.8%), and have hypertension (16.4%) and diabetes mellitus (3%) as concomitant diseases. Based on Noorwood-Hamilton scale, the types of AGA were predominantly type II (25.4%) and followed by type III (16.4%). The results of the Hair Specific Skindex-29 on AGA patients were moderate (58.2%) and severe (41.8%). There were a relationship between AGA type and QoL (p = 0.041) and significant positive correlation between AGA type and QoL (p = 0.020, r = 0.282). In conclusion, patients experienced moderate to severe impact on QoL due to AGA. Thus, every increased in the type of AGA will impact patient’s quality of life.Androgenetic alopecia (AGA) is a nonscarring baldness that mostly affects >50% men worldwide. Hair loss led to psychological difficulties and have a negative impact on the quality of life (QoL). This study aimed to evaluate the relationship between the type of AGA and QoL in male patients. A total of 67 male AGA patients were clinically assessed using the Hamilton-Norwood scale and interviewed using the Hair-Specific Skindex-29 scale to assess QoL. The patients were predominantly <span style="mso-spacerun: 'yes'; font-family
Increased blood-brain barrier permeability correlate with microglial activation at hippocampal CA1 region in acute and chronic bilateral common carotid artery ligation in rats
No full textInflammatory processes might play a key role in the pathogenesis of post-stroke epilepsy. The activation of microglia and release of vascular cell adhesion molecule-1 (VCAM1) might induce blood-brain barrier (BBB) disintegration. However, the influence of such pathomechanisms in the generation of post-stroke epilepsy is still not clear. We investigated whether cerebral ischemia exerts effects on inflammation in the hippocampus by measuring the hippocampal injury score, expression of a microglial marker, and expression of VCAM1 in rats. A total of 24 Sprague Dawley rats were randomized into four groups with 6 rats in eachgroup i.e. sham operation (SO) as control, carotid ligation 1 (GCL1) as an acute model, carotid ligation 3 (GCL3) as a subacute model, and carotid ligation 7 (GCL7) as a chronic model. Immunostaining for microglia marker (CD68) was measured in rat brain tissue sections. The VCAM1 expression was evaluated by reverse transcription-polymerase chain reaction (RT-PCR). Cerebral ischemia increased the amount of microglial immunostaining and expression of VCAM1. The hippocampal injury score and microglial immunopositivity were significantly correlated with the duration of brain ischemia. We conclude that cerebral ischemia is correlated with neuroinflammatory reaction and disturbance of BBB permeability, and the correlation of those molecular impairments with the generation of post-stroke epilepsy remains to be elucidated