eJournal Kedokteran Indonesia
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Association of Hematocrit and Thrombocyte Concentration with Hypoalbuminemia in Patient with Dengue Infection
No full textHypoalbuminemia is the hallmark of plasma leakage in patients with dengue infection. However, serum albumin measurement is not routinely performed. This study was conducted to determine the role of hematocrit and thrombocyte concentration as a predictor of hypoalbuminemia in dengue infection. This retrospective study was conducted in private hospital in Jakarta from January 2015 until June 2016. Patients older than 17 years old who were infected with dengue were included in this study. Subjects were classified as dengue infection with hypoalbuminemia and without hypoalbuminemia. Mann-Whitney test was performed to analyze the different concentration of hematocrit and thrombocyte in both group. The area under the curve was used to determine the optimal cut-off point of hematocrit and thrombocyte concentration in predicting hypoalbuminemia. Multivariate analysis was used to analyze the association of hematocrit and thrombocyte concentration with the two dengue groups. One hundred and twenty patients with dengue infection were included in this study, in which 50 patients (41.7%) were women and 70 patients (58.3%) were men. Thirty nine patients (32.5%) without hypoalbuminemia and 81 (67.5%) patients had hypoalbuminemia. Hemoconcentration with a cut-off point of ≥9.77% had an accuracy of 67.8% (95% confidence interval (CI), 58.2−77.4), with a sensitivity of 72.8%, and specificity of 46.2% in predicting hypoalbuminemia. Thrombocyte levels with a cutoff point of ≤44×103/μL had an accuracy of 80% (95% CI, 71.7−88.4), with a sensitivity of 70%, and specificity of 74.4% in predicting hypoalbuminemia. Multivariate analysis showed that thrombocyte concentration ≤44×103/μL was a predictor of hypoalbuminemia with an odd ratio (OR) of 6.49 (95% CI, 2.75−15.34). In conclusion, thrombocytopenia in patients with dengue infection is a predictor for hypoalbuminemia
Role of Genetic Testing in Male Infertility
No full textMale-factor infertility is responsible for 30-55% of all infertility cases. The causes of male infertility include varicocele, endocrine disorders, genital tract infections, genetic disorders and idiopathic. It is estimated that genetic abnormalities contribute to 50% of male infertility. In daily practice, the diagnosis of male infertility has been based on history taking, relevant physical examination, hormone tests and basic semen analysis with a strong emphasis on the assessment of sperm concentration, motility, and morphology. Although recent development in assisted-reproductive technologies such as in vitro fertilization and intrauterine insemination increases the chance of clinical pregnancy and live birth, genetic counseling and testing should always beperformed whenever genetic risks are related to the cause of infertility for the identification of possible genetic abnormalities and to assess the risk of transmitting the genetic defects to future generations. Genetic defects affect male infertility by disrupting hormonal homeostasis, spermatogenesis, and sperm quality. These genetic defects include chromosomal abnormalities (e.g. Klinefelter Syndrome), Y chromosome deletions, and cystic fibrosis transmembrane conductance regulator gene mutations. The utilization of genetic counseling and testing is also important to predict the success of sperm retrieval in men with certain genetic abnormalities. Toname a few, genetic analysis at the chromosomal level (karyotyping), androgen receptor gene mutations test, cystic fibrosis test, and Y chromosome microdeletions analysis should be considered in the diagnosis of male factor infertility where genetic risks are present
Effectiveness of Double Dose Mebendazole in Treating Soil-Transmitted Helminths Infections in Perokonda, Southwest Sumba
No full textTreatment of trichuriasis with single dose of albendazole or mebendazole gives low cure rate (CR). The purpose of this study aimed to know the effectiveness of double doses 500 mg mebendazole againts soil transmitted helminths (STH) infection in children aged 2-15 years. This study used a pre post design, conducted on July 2016-February 2017 in Perobatang village, Southwest Sumba. Effectiveness is assessed from CR and egg reduction rate (ERR). Stool samples were examined microscopically with Kato-Katz method. In total of 89 subjects, prevalence of STH, Ascaris lumbricoides and Trichuris trichiura infections were 79.8%, 46.1% and 76.4%. After administration of double dose 500 mg mebendazole the prevalence decresed to 39.3%, 2.2%, 39.3%. CR of A.lumbricoides was 95.1% and T.trichiura was 48.5% while ERR of each infection was 97.98% and 69.73%. There were significant difference in prevalence and ERR before and after treatment (p<0.001). In conclusions double doses 500 mg mebendazole was effective in treating A.lumbricoides but was not for T.trichiura. However, CR and ERR of double dose 500 mg mebendazole againts T.trichiura are higher than single doses.  
Exercise Effect on Learning Ability and Memory of Mus musculus Exposed Monosodium Glutamate
No full textGlutamate is a main component of Monosodium Glutamate. It is excitatory neurotransmitter but it leads to excitotoxicity in brain nerve cells when consumed in large doses. It also has negative impact in learning ability and memory. The aim of this study is to determine exercise effect in protecting learning ability and memorycaused by MSG exposure. This study used pretest-posttest control group design and was conducted in Animal Laboratory of Faculty of Medicine Airlangga University in November 2015. Thirty mice males were tested for learning ability and memory using Morris Water Maze before and after treatment. They were divided into three groups, they are one control group/K (without treatment) and two treatment group were given different treatment for 21 days. Group P1 was given 2,5 mg/gBW MSG intraperitoneal injection, group P2 was given 2,5 mg/gBW MSG intraperitoneal injection and swimming exercise with a span of 30 minutes/day on 5 days/week for 3 weeks with a load individual 4% of body weight. The result showed latency time and frequency between pretest and posttest group at P1 group there is no significant difference either in latent or frequency while P2 was a significant difference of latency time (p=0,010) but no significant difference of frequency (p=0,645). Our study suggested that exercise (swimming) can protect learning ability caused by MSG exposure, but not protect memory retention
Profile of Infanticide at the Department of Forensic Medicine and Medicolegal RSUD Dr. Soetomo
No full textInfanticide is the murder of a baby by the mother at birth or shortly after birth. The aim of this study is to describe the number and detail of the cause of death, the area where the victim was found and the gender of the victims of infanticide cases recorded in The Department of Forensic Medicine and Medicolegal (IKFML) FK UNAIR, RSUD Dr. Soetomo, Surabaya from January 2013 - December 2015. This is an observasional analysis study, which describe the number and detail of the cause of death, the area where the victim was found and the gender of the victims. The data are presented in tables and diagrams to give clear explanation of the big picture of the infanticide amongst other child’s homecide (Microsoft Excel, 2007). There are 49 child’s homecides recorded with 25 of them have clear data of victim’s age. Among the latest, only 8 cases have a positive and lung float test. The most alleged mechanism of death is asphyxiation. The victims were found mostly from South Surabaya
Chest X-ray evaluation of cavitary lesions among pulmonary MDR-TB patients in Kariadi Hospital, Semarang, Indonesia
No full text The objective of this study is to know the relationship between MDR-TB treatment to the changes in diameter and thickness of cavity wall on chest X-ray (CXR) 6 month and 12 months post treatment. This study was conducted in MDR-TB clinic in Kariadi Hospital, Semarang on January 2013-December 2016. We examine cavitary lesions, evaluated with CXR in pulmonary MDR-TB patients before and after 6 and 12 months of treatment course. Subjects who had been diagnosed as pulmonary MDR-TB and had received MDR-TB treatment for at least 12 months were chosen. Subjects characteristics and cavities features i.e. cavity number, diameter and wall thickness from initial and follow-up CXR 6 and 12 months of treatment were retrieved. A total of 43 patients of MDR-TB, consisted of 22 males and 21 females, was recruited. Most of the subjects aged 31-50 year old and presented with single cavity. The cavitary lesions showed significant reduction over 6 and 12 months of follow up based on CXR (p<0.001) for both diameter and wall thickness. Both diameter and wall thickness changed significantly from initial to 6 months (r=-0.87, p<0.001), initial to 12 months (r=-087, p<0.001), and 6 months to 12 months (r=-0.84, p<0.001), respectively. In conclusion, CXR as a useful diagnostic instrument that can be used to evaluate pulmonary TB, in primarily low resource setting.  
The Effect of Graded Doses of Oral Trihexyphenidyl on Lumen Diameter of Mus musculus Renal Kidney
No full textTrihexyfenidyl is a class of anticholinergic drugs used, among others, to treat the symptoms of Parkinson’s disease and to control extrapyramidal disorders due to central nervous system drugs. However, the use of high dose trihexyfenidyl may cause renal impairment. Until now, the understanding of the pathologies of renal disorders due to trihexyfenidyl is unclear. This research was conducted to look at the histologic features and changes in the renal tubules associated with the doses used. This research was an experimental study which used 36 mice (Mus musculus) and they were divided into 4 groups. Control group was given a standard feed while the treatment group consisted of three groups were given a dose of trihexyphenidyl with 0.0208mg/20grBW/day, 0.0416mg/20grBW/day and 0.0624mg/20grBW/day for 14 days. The research was done on October-November 2016 at Pharmacology, Anatomy and Histology laboratory, Faculty of Medicine Universitas Airlangga. The results showed that the average proximal tubule diameter in control goup was 24.4±2.13μm, group 1 was 21.1± 2.98μm, group 2 was 16.2± 4.1μm, and group 3 was 11.5±0.79μm. In the treatment group, the diameter of the proximal tubule decreased in proportion to the dose administered. The smallest proximal tubular lumen diameter was seen in the highest dose-treated group
Comparison of Selenium Sulfide 1% and Zinc Pyrithione 1% and Combination of them in Overcoming Malassezia Globosa in Vitro
No full textDandruff is a scalp disorder that is affected by three factors, namely the fungus Malassezia globosa, sebaceous gland activity, and individual susceptibility. Selenium sulfide (SeS2) and Zinc Pyrithion (ZPTO) is used as an antidandruff shampoo active ingredient because it has anti-fungal properties. The study was conducted to determine the potentiality of shampoo with active ingredient SeS2 1% and ZPTO 1% to M.globosa in vitro. The colonies of M.globosa (CBS 7966 ATCC 96 807) were exposed to a non-antifungal base shampoo, shampoo containing 1% SeS2, shampoo containing 1% ZPTO and shampoo containing combination of 1% SeS2 and 1% ZPTO. Fungal contact time with shampoo is 3 and 5 minutes. Fungal colonies are grown on Sabourraud Dextrose agar (SDA) medium coated with olive oil. Incubation was carried out at 37° C for 5 days. After fiveday, assessment was performed to observe whether the fungal culture was grown, and then the colony growth is calculated. The research was conducted at Clinical Parasitology Laboratory, Parasitology Department, Faculty of Medicine, University of Indonesia from November 2011 until April 2012. Data were analyzed using ANOVA and LSD Fisher test. Shampoo containing 1% SeS2 inhibited fungal growth in 5 min contact time (p = 0,000 <0.05), whereas 1% ZPTO shampoo fungal growth was inhibited either in 3 min or 5 min contact time (p = 0,000 <0,05), and combination of 1% SeS2 and 1% ZPTO shampoo in both contact times (p = 0,000 <0.05). In conclusion, combination of 1% SeS2 and 1% ZPTO shampoo has the most potency in inhibiting the growth of M.globosa colonies in vitro
Trauma and Injury Severity Score in Predicting Mortality of Polytrauma Patients
No full textTRISS (Trauma and Injury Severity Score) is one of the most commonly used trauma score. Currently, there is no data about using TRISS in the care of polytrauma patients at emergency department of dr. Cipto Mangunkusumo Hospital (CMH). This research was intended to evaluate whether TRISS can predict the mortality of polytrauma patients at CMH. This was an analytic descriptive study with retrospective cohort design. Data was collected from medical records of polytrauma patients who were admitted to emergency department of CMH from 2011-201 4 then we analyzed the relationship between TRISS and patient's prognosis. Furthermore, we conducted bivariate and multivariate analysis by SPSS 20 software. Seventy medical records were included in this study. The majority of patients were male (65%) in young age. There were 69 patients who experienced blunt trauma, with the majority (94.3%) were caused by motor vehicle accident. After receiving trauma care, there were 26 deaths, while other 44 patients survived. From bivariate and multivariate analysis, we found a significant difference between TRISS and patient's prognosis. TRISS strongly predicts polytrauma patient's mortality (AUC 0,899; IK95% 0,824-0,975). TRISS has 84,6% sensitivity and 81.8% specificity with optimal intersection point ≤ 90,5. TRISS is able to predict the mortality of polytrauma patients at CMH. 
Reflective Writing Skills of Undergraduate Medical Students
No full textReflective writing skills is linked to lifelong learning. There are still few studies about reflective writing skills of undergraduate medical students in Indonesia, so it is necessary to investigate the reflective writing skills of undergraduate medical students. A qualitative design using content analysis method was conducted at Faculty of Medicine, Gadjah Mada University on June-August 2016. Written reflections (156) were taken from 54 third year medical students in Jogjakarta, Indonesia using random sampling technique. Every group of student encountered different problems in community as the trigger to write reflective tasks about their experiences when interacting with community. Every student has to write a reflection in three occasions, at the beginning of the program, after the first meeting with the mentor, and at the end of the program. Students’ reflective writing were analyzed by three coders using a REFLECT criteria to investigate the level of reflection. 33.3% of students at 1st level (habitual action), 48.2% reached 2nd level (thoughtful action), and 18.5% reached 3rd level (reflection). The ability of undergraduate medical student in reflective writing skills were in the range of 1st to 3rd level, of 4 levels. It is concluded that undergraduate medical students require more training in writing a critical reflection.