eJournal Kedokteran Indonesia
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Genetic Variation at 5'-UTR of CD40 Gene and Patients Characteristics: Associated with Relapse in Graves' Disease
No full textMore than 50% patients graves' disease (GD) can relapse after remission period. This can be influenced by treatment, gender, age of diagnosis and genetic. One of the genes that regulate immune response is CD40 gene, which is found on the surface of Lymphocyte B. The aim of this research was to determine genetic variation at 5'-UTR of CD40 gene and the role of age and gender that influence the risk for relapse. This study was conducted in Dr Cipto Mangunkusumo Hospital from August to December 2014. This study was a case-control study comparing 30 relapse patients and 30 non-relapse patients after treatment with anti-thyroid drug was terminated. Genetic variation was analyzed with PCR-RFLP and clinical characteristic by medical record. In this research, we found that both genotype and alleles 5'-UTR of CD40 gene variation have no association with risk for relapse (p>0.05), but age of diagnosis was considered significant with risk for relapse (p=0.001). In conclusion, genetic variation in 5'-UTR CD40 gene is not risk for relapse but age of diagnosis may be a risk for relapse in GD patients
Correlation between Fasting Glucose, Erectile Dysfunction, and Lower Urinary Tract Symptoms in Benign Prostate Hyperplasia Patients
No full textThis study is aimed to determine the correlation between fasting glucose level, erectile dysfunction,and lower urinary tract symptoms (LUTS) in patients diagnosed with benign prostatic hyperplasia (BPH). Weenrolled patients with BPH-related LUTS aged over 50 years old. LUTS and erectile dysfunction (ED) wereevaluated using International Prostate Symptom Score (IPSS) and International Index of Erectile Function-5(IIEF-5). Diabetes mellitus was established if fasting glucose level was above 126mg/dL. Forty-two patientswere enrolled in this study from outpatient clinic in Kardinah Hospital, Tegal during January–March 2015.Patients’ mean age was 68.8±8.6 years old with most of them suffered from ED (83.3%) and also suffered fromsevere LUTS (80.96%). Mean fasting glucose level was 108.3 + 21.1 mg/dl. However, diabetes mellitus wasobserved in 26.2% subjects with mean fasting glucose level was 136.8+7.8mg/dl. IPSS score was correlatedwith fasting glucose level (r=0.879, p<0.001) and IIEF-5 score (r= -0.346, p=0.025). IIEF-5 score showednegative correlation with age (r=-0.31, p=0.046) and fasting glucose level (r=-0.305, p=0.049). Higher fastingglucose level in a man older than 50 years with BPH would increase severity of LUTS and ED
Pharmacologic Rhythm Control versus Rate Control in Heart Failure and Atrial Fibrillation
No full textHeart failure (HF) with atrial fibrillation (AF) is correlated with worse prognosis requiring special approach.Rate control has been the first line of treatment in cases of HF and HF. On the other hand, rhythm controlhas been proven to be effective in returning sinus rhythm resulting in better prognosis for patients with HFbut not HF. Its role in cocurring cases of HF and AF is not fully understood. Thus, this study aims to analysewhether pharmacologic rhythm control can be applied to cases of HF and AF to reduce mortality. A searchwas conducted via PubMed, Medline, ProQuest, and Cochrane Database on January 2016. One study wasselected after filtering process by inclusion and exclusion criteria and critical appraisal was performed. It wasfound that there was rhythm control and rate control do no have favouring effect towards mortality shown byRR 1.03 (95% CI 0.90-1.17, p=0.69). Rate control has protective effect towards hospitalizations by RR of 0.92(95% CI 0.86 – 0.98, p=0.008, NNT=19). To conclude, rhythm control is not superior to rate control in reducingmortality and rate control should be still be considered as first line treatment of HF and AF
The Effect of Single-Dose Albendazole on the Prevalence of SoilTransmitted Helminth Infections and Nutritional Status of Children in Perokonda Village, Southwest Sumba
No full textPerokonda Village located in Sumba Island is one of the most underdeveloped regions in Indonesia with high risk of soil-transmitted helminthes (STH) infections. These parasites could affect nutritional status of the subjects. This study was aimed to know the nutritional status and to evaluate the effectiveness of treatment using singledose albendazole on the prevalence of STH infections in Perokonda Village. This study used a pre-post design. Data were collected twice on August 2015 and January 2016. Data of STH infections were obtained from stool samples examined under light microscope. Nutritional status was assessed by determining Z-score in accordance with WHO chart. A total of 66 children were included ranging between 1-12 years old. This study showed that before treatment, subjects with normal nutritional status were 84,8% and 15,2% were underweight. After treatment, subjects with normal nutritional status declined to 75,8%, subjects who were underweight increased to 19,7%, and 4,5% were severely underweight. The result also showed that prevalence of STH was still high after treatment. Prevalence of A.lumbricoides infections significantly decreased (McNemar test, p=0,001), while prevalence of T.trichiura and hookworm infections increased. In conclusion, single dose albendazole significantly reduced the infections of A.lumbricoides, but it did not reduce the prevalence of T.trichiura and hookworm infections. Further study is needed to measure the effectiveness of treatment using triple dose albendazole for STH infection and its association with children’s nutritional status in Perokonda Village
Antioxidant Activity of Ethanolic-Extract Mixture of A.indica and C.asiatica in Comparison with Ethanolic-Extract of A.indica
No full textExcessive production of free-radicals may induce oxidative stress, which is the basis of many diseases pathogenesis. Exogenous antioxidant supply is needed to support the function of endogenous antioxidant in preventing oxidative stress. The ethanolic-extract of A.indica and C.asiatica possess the antioxidant activity. This study was aimed to know the antioxidant activity of ethanolic-extract mixture of A.indica and C.asiatica in comparison with ethanolic-extract of A.indica. The combination of extract was expected to improve the antioxidant activity and therefore to reduce the dosage. The 2,2-diphenyl-2-picrylhydrazyl hydrate (DPPH) assay test with spectrophotometry was performed to measure the antioxidant activity. This study was conducted at the Department of Pharmacy Faculty of Medicine Universitas Indonesia, from June to October 2015. Vitamin C as the positive control exhibited EC50 score as much as 0.012 mg/mL. The EC50 score of the ethanolic-extract mixture was 13.68 mg/mL, while the ethanolic-extract of A.indica's was 39.65 mg/mL. The lower the EC50 score indicates the higher antioxidant activity. Thus, the ethanolic-extract mixture of A.indica and C.asiatica has lower antioxidant activity compared to the ethanolic-extract of A.indica
E-cadherin and Vimentin as Predictors of Resistance to Preoperative Systemic Therapy in Patients with Advanced Breast Cancer
No full textLoss of E-cadherin and increased vimentin expression are associated with epithelial-mesenchymal transition andcancer stemness which are responsible for treatment resistance. The study aims to evaluate the role of E-cadherin andvimentin as predictors of resistance to preoperative systemic therapy in patients with advanced breast cancer. This wasa cross-sectional analytical study in patients with stage III-IV breast cancer in Dharmais Cancer Hospital and dr. CiptoMangunkusumo National Hospital from July 2015 to April 2016. Patients had biopsy specimens embedded in paraffinblocks. Expressions of E-cadherin and vimentin proteins were done immunohistochemically. Treatment response wasevaluated histopathologically using Miller-Payne criteria on mastectomy specimens. A total of 65 patients were enrolled.Five patients with invasive lobular carcinoma were excluded. Thirty one had chemotherapy and 29 had hormonaltherapy. After treatment, 46 patients were eligible for mastectomy. E-cadherin and vimentin were positive in 28 (60.9%)and 11 (20.3%) of specimens. Twenty-three (50%) patients showed no response. Treatment resistance were associatedwith type of therapy (OR=4.4; 95% CI=1.27-15.41; p=0.017) and vimentin expression (OR=6.75; 95% CI=1.27-30.02;p=0.016). Hormonal therapy (ORadj=6.26; 95%CI=1.59-24.6; p=0.009) and positive vimentin (ORadj=8.75; 95%CI=1.43-57.4; p=0.019) were independent predictors of treatment resistance. In conclusion, E-cadherin and vimentin can beused as predictors of resistance to preoperative systemic therapy in patients with advanced breast cancer
Viral Conjunctivitis: Diagnosis and Therapy in Primary Health Care
No full textConjunctivae is a transparent thin mucosal membrane covering the outer anterior eye and inner palpebrae. This structure is vital for eye defense from inflammation and infection. Inflammation occurring on the conjunctivae is called conjunctivitis and virus is one of the most common etiologic agent. Such viruses are adenovirus, herpes simplex virus, herpes zoster virus, poxvirus, myxovirus, paramyxovirus and arbovirus. It mostly occurs along or after respiratory tract infection as well as after contact with patients suffering from viral conjunctivitis. Clinical manifestations include redness, watery discharge, and pre auricular lymph enlargement. The manifestations are usually mild, self-limiting, and do not impair visual acuity thus viral conjunctivitis can be managed in primary health centers. However, there are cases which threaten visual acuity thus require referral to ophthalmologists or higher eye care services. Due to its high infectivity, patients should be educated to avoid of direct and indirect contact thus they would not spread the infection to environment. Although it is self-limiting, administration of artificial tears, topical antihistamine or cold compress, could reduce the manifestation. Antiviral agents are not required for conjunctivitis viral, unless for herpetic conjunctivitis. 
Comparison of 2D and 3D Co-Culture with Hanging Drop Method to Produce a More Clinically Relevant Microenvironment
No full text2-dimensional (2D) co-cultures show limited resemblence with in vivo microenvironment while 3-dimensional (3D) co-cultures form a micromass which is more similar with in vivo microenvironmentthus it would be more useful in biomedical research. This study was intended to compare 2D co-cultures with 3D co-cultures of stem cells derived from umbilical cord blood vessels and hepatic stellate cells, conducted with hanging drop method to assess the cell morphology and the formation of spheroid from the micromass.. This in vitrostudy was conducted at Institute of Human Virology and Cancer Pathobiology (IHVCB) UI and histology laboratory from September 2015 to October 2016 using stem cells which were isolated from human umbilical cord blood (UCB) and LX-2 cell line (human hepatic stelate cells). Human umbilical cord blood was sorted with MACS CD34 and percentage of CD34+ cells were analyzed by flowcytometry. Stem cell co-cultures (UCB) or umbilical cord and L2 was did by hanging drop methods for 2D co-culture and 3D co-culture. Triplicates experiments were performed for each set of co-culture. The results showed the difference in the morphology of 2D co-culture and 3D hanging drop compared to monoculture. In the 2D co-culture there was a micromass formation, whereas in the 2D monoculture, the micromass was not formed. In the 3D hanging drop there was a smaller spheroid compared to the 3D hanging drop monoculture. The morphology of 2D and 3D co-culture cells with hanging drop method in comparison with monoculture cells showed phenotypic changes of cells which were incorporated together in the micromass
The Association Between Biliary Atresia and Cytomegalovirus Infection
No full textPerinatal infection of cytomegalovirus (CMV) may cause cholestasis resembling biliary atresia. CMV infection is found in patients with biliary atresia. This simultaneous occurrence of biliary atresia and CMV infection prompted speculation that CMV may contribute to the progression of biliary atresia. This report has the objective to obtain the evidence regarding the association between biliary atresia and CMV infection. Two databases were searched to obtain the evidence: PubMed and Scopus. The study design which was selected for this report was case control due to its relevance to answer the clinical question. There were two case control studies which are appropriate to answer the clinical question. Both studies showed that biliary atresia is associated with CMV infection (OR>1). Biliary atresia is associated with CMV infection at the time of diagnosis, therefore the presence of CMV infection in neonatal cholestasis should not delay the investigation towards biliary atresia
SMART APPLICATION : One Stop Services to Bridge The Gap Between Doctor and Patients
No full textA doctor's communication is a way to gather information in order to facilitate accurate diagnosis, give therapeutic instructions, counsel appropriately and establish caring relationships with patients. SMART (sophisticated, modern, affordable, reproductive technology) in vitro fertilization(IVF)created a mobile application that allows registered users to access all information related to their IVF cycle. The software required to create SMART application was the Android 4.0.3 Ice Cream Sandwich. The hardware required to create the SMART apps were 4.0 inch screen, 512 mb random-access memory (RAM), and central processing unit (CPU) with dual core 1.2 Ghz. The application is built using the android software development kit (SDK), the android apps creator. This application has been tested on several android devices such as asus zenfone 5 and samsung galaxy grand prime. This application uses android studio software to transfer the application file into the testing devices. SMART IVF application works well. The SMART application consists of some example features, such as feature doctors profile and information on how to make appointment with doctors.SMART app designed to help parents get directly involved during all the phases of IVF process and reduce their stress during the treatment and pregnancy. Since now this application not yet ready to launch, but hopefully in few months ahead, we can launch soon in google playstore as the first Indonesian IVF application