eJournal Kedokteran Indonesia
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The Prevalence of Skin Diseases and its Association with Hygiene Behavior and Level of Education in a Pesantren, Jakarta Selatan 2013
No full textSkin diseases are very common in places where the society lives in a crowded area. Pesantren is anIslamic school with a dormitory for its students, thus making the spread of skin infection easier to occur. Theobjective of this research was to identify the association between the prevalence of skin diseases with the hygienebehavior and level of education of santris (students of pesantren). This cross-sectional study was conducted in apesantren in South Jakarta. Data collection was carried out through a questionnaire consisting of ten questionsabout hygienic behaviors and history of previous dermatological examinations from July until September 2013.Results showed that out of 98 santris, 88 of them had skin diseases (89.7%). The most frequent skin infectionwas scabies with 67 cases (49.3%). Furthermore, 78 (88.6%) out of all santris who had skin diseases, werecategorized to have poor hygienic behaviors. There were only 10 santris that did not have any skin disease, 3of them had good hygienic behaviors. There was no significant difference between hygienic behaviors of santrisand the prevalence of skin disease (p=0.350). Associated with the level of education, ibtidaiyah had the highestnumber of santris (51.2%) affected by skin diseases. There was a significant difference between the level ofeducation and the prevalence of skin diseases (p<0.001). In coclusion, the prevalence of skin diseases in thepesantren was 89.7%; there was no association between skin diseases and hygienic behaviors. However, therewas an association between skin diseases and level of education
The Role of Imaging in Uveitis Diagnosis
No full textUveitis is an inflammatory disease affecting iris, ciliary body, pars plana, vitreous, choroid and retina.Inflammation process can be either limited in uveal tract or as part of systemic inflammation caused byautoimune, infection or cancer. Uveitis can cause phophobia, pain, reduced visual accuity and blindness if notproperly treated. Therefore, right diagnosis and prompt treatment should be given immediately to reduce themorbidity. Diagnosis of uveitis is made based on anamnesis, ophtalmic and physical examination, followedby imaging to confirm the patologic changes in the eyes. Slit lamp and simple photography can be usedto evaluate sign of inflammation in anterior chamber and outer part of the eye. Inflammation marker canbe counted using laser flare photometry (LFP) and fundus fotography can visualize pathologic changes inposterior part of the eyes. Fundus fluorescein angiography (FFA), indocyanine green angiography (ICG), andfundus autofluorescence (FAF) can be used to evaluate the integrity of vascular part in retina and choroid.Ultrasound (USG), optical coherence tomography (OCT), and multimodal imaging visualize retina, choroid,optic nerve and nerve fiber layer of retina using non-contact and non-invasif technique. MRI also used toevaluate inflammatory process in the eye. These imaging modalities are usefull to confirm the diagnosis ofuveitis, monitor the disease progression and evalute the treatment
Effect of 70% Ethanol Extract Ointment of Karamunting Leaves on Re-epitelisation Incision Wound Healing on Wistar Rat’s Skin
No full textRecent researches indicate that traditional plant may act as a wound healing agent, one of them is Karamunting leaves. The aim of this research is to find out the effect of 70% ethanol extract ointment of karamunting leaves on re-epithelialization of incision wound healing on wistar rat’s skin. This research was an experimental research with post-test only control group design. The research subjects were twenty male wistar rats in which further divided to five groups; positive control group (sanoskin® ointment), negative control group (placebo ointment), experimental group 1 (2,5% karamunting leaves ointment), experimental group 2 (5% karamunting leaves ointment) and experimental group 3 (10% karamunting leaves ointment). All groups underwent 2 cm long incision at the back with 0,2 cm depth, parallel with os.vertebrae, within 5 cm from the ear.On the tenth day, wound tissue were taken from all groups sample and processed into histological blood smears stained with H&E to check the thickness and the width of the slit skin epithelium observed with 10x objective lens magnification. The 70% ethanol extract ointment of leaves Karamunting decreased slit thickness epithelium (p<0,05) and minimized slit width epithelium (p<0.05) compared to negative control. 70% ethanol extract ointment of leaves Karamunting increased wound re-epithelialization of incision wound on wistar rat’s skin with an effective concentration of 5%. 
Maternal Micronutrient Deficiency during the First Trimester among Indonesian Pregnant Women Living in Jakarta
No full textRestricted fetal growth and development is supported by the adequacy of several micronutrients, andmostly by iron, zinc, calcium, folate and B12 vitamin. This study aims to evaluate the maternal micronutrientstatus from dietary intake and blood sample. A cross-sectional study as part of the micronutrient interventionstudy was carried out in 143 healthy pregnant women during their first visit to the two maternity clinics inJakarta Indonesia (August 2013 – July 2014). Twenty-four hour dietary recall and semi-quantitative foodfrequency questionnaire were used to collect micronutrient intake data, while standard laboratory procedureswere applied to analyze micronutrient status from the blood sample. The dietary assessment data showedinsufficiency of iron, zinc, calcium, vitamin D, folate and vitamin B12 intake (less than its RDA) among 88.8%,95.1%, 97.9%, 100%, 90% and 78.3%, respectively. In relation iron status, 11.2% of the subjects were anemicand 20.3% had low ferritin level. Zinc deficient was found among 35% of the subjects. Deficiency of calciumand vitamin D were found among 25.2% and 90.2% of the subjects, respectively. Furthermore, deficiency ofboth folate and vitamin B12 were found to be 2.8%. Nutrition counseling and education, and the provision ofmulti-micronutrient fortified food as well as multi-micronutrient supplement specifically designed for mothersshould be started in the earliest time, i.e. starting from the peri-conception period.  
Diagnosis and Treatment of Uveitis to Prevent Blindness
No full textUveitis is an inflammation of the uvea which may result in blindness. Uveitis may be caused by limited inflamation of the uveal tract, manifestation of systemic diseases (autoimmune, infection, cancer), expansion of inflammation in the cornea and sclera, trauma or idiopathic. Anterior uveitis is an inflammation of the iris and cilliary body with symptoms of pain, red eye, photophobia, and decrease in visual acuity. Intermediate uveitis is the inflammation of the pars plana and frequently involves anterior vitreous and posterior uveitis. Clinical manifestation of intermediate uveitis is usually mild without red eye and pain, however vision may decrease due to macular edema and cell aggregation in vitreous. Posterior uveitis is an inflammation involving choroid layer, which is common in developing countries due to high prevalence of infectious diseases (toxoplasmosis, tuberculosis, HIV, syphilis). Patient may complain of blurry vision but not accompanied by pain, red eye, and photophobia. Complications of posterior uveitis are cataract, glaucoma, macular edema, keratopathy, turbidity of vitreous, retinal detachment, and optic nerve atrophy. The prognosis of posterior uveitis is worse than anterior uveitis. Panuveitis is an inflammation of the uvea and surrounding structures (retina, vitreous). Diagnosis is made based on anamnesis, ophthalmic examination, laboratory examination, and imaging. Treatment of uveitis is intended to reduce inflammation, minimize structural destruction, prevent blindness, reduce pain and photophobia. Corticosteroid and immunosuppresant are the drugs of choice to manage the inflammation, where NSAID is used to reduce pain and cyclopegic administration to prevent posterior synechiae. Antimicrobial is given if uveitis is caused by infection. Underlying diseases of uveitis must be treated comprehensively to prevent further progression, complications and blindness. 
Pre-anesthetic Anxiety Level in Children with Congenital Heart Disease: Comparison between Maternal Presence during Anesthetic Induction and Midazolam Premedication
No full textGeneral anesthesia was needed by children with congenital heart disease (CHD) who underwent cardiaccatheterization procedure and surgery. Pre-anesthetic anxiety in children with CHD can cause significantproblems during induction of anesthesia which leads to negative postoperative outcomes. This studycompared the role of maternal presence during anesthesia induction with midazolam premedication onpre-anesthetic anxiety level in children with CHD. Dr. Cipto Mangunkusumo National Hospital on April toSeptember 2014. Forty-five CHD patients aged 2-5 years old who underwent cardiac invasive procedurewere divided into P group (received midazolam premedication) and M group (had maternal presence duringanesthesia induction). Modified Yale Pre-anxiety Scale (MYPAS) was used for measuring anxiety level ineach patient during preoperative visit, on the time patient entered the procedure room and during induction ofanesthesia. There was no significant difference of MYPAS scores between the two groups in all measurementtimes. The MYPAS score results were non-anxious (median score 23.4) and the highest was at induction ofanesthesia. Inter-rater agreement test between 2 observers was good (k>0.5). In conclusion, there was nosignificant difference between the effect of maternal presence during induction of anesthesia and midazolampremedication on pre-anesthetic anxiety level in children with CHD
Mangiferin Effects against Doxorubicin Toxicity in Rat Testis
No full textThe use of doxorubicin (DOX) as an anti-cancer agent might cause side effects to other organs suchas testicle due to increased oxidative stress. This study was aimed to investigate the antioxidant effect ofmangiferin inside Mangifera indica for lowering testicle toxicity. A total of 24 sprague dawley male rats wasdivided into 4 groups. The normal group was injected with 0.9% of NaCl, the negative control group receivedDOX with dosage of 15 mg/BW while DOX treated group received mangiferin with dosage of 30 mg/BW and60 mg/BW. After 7 weeks, all rats were killed and testicles from every rats were subsequently collected foroxidative stress parameter analysis which were measuring the rate of malonedyaldehide (MDA), superoxidedysmutase activity, histological changes, and apoptosis of caspase-9 and caspase-12. Administration ofmangiferin with dosage of 30 mg/BW and 60 mg/BW for 7 weeks decreased the destruction of spermatogeniccells and sertoli cells of seminiferous tubule, decreased the rate of MDA, and lowered the expression ofcaspase-9 in the group which received DOX and mangiferin. Improvement in those parameters indicated thatmangiferin had a protective effect towards spermatogenic and sertoli cells of seminiferous tubule destructionin rats which were given DOX
The Relationship between Participation of Health Insurance with BloodPressure Control in Adult with Hypertension
No full textThis evidence based case report aimed to investigate the relationship between participation of healthinsurance with blood pressure control in adult with hypertension. Literature review was conducted on May19th, 2016 using Pubmed’s Clinical Queries, Proquest, and EBSCO, which resulted in 6 useful articles to becritically appraised. The result of critical appraisal was uninsured patients with hypertension increased the riskof failure in blood pressure control by 1,23-2,89 times compared with insured patients. It can be concludedthat participation in national health insurance is very important to make sure every hypertensive patientsreceive regular anti-hypertensive drugs and hence target blood pressure can be achieve
Comparison of Antioxidant Activity and Tannin Level of Pegagan Extract to Commercially Available Product
No full textCentella asiatica (pegagan) is a well-known traditional medicinal plant that has been processed into many commercial herbal products. Those herbal products were claimed to have antioxidant effects which were beneficial to overcome free radicals in the body. Antioxidant activity of those commercial products compared to the extracts has not been studied yet. The aim of this study is to compare the antioxidant activity and tannin levels of water and ethanol extracts of C.asiatica compared to three herbal products of C.asiatica. Water extract is made by infusion while ethanol extract is made by maceration. Three brands of C.asiatica products were obtained from the market. Levels of antioxidants were measured by comparing the EC50 value using 2,2-diphenyl-1-picrylhydrazyl (DPPH). Tannin levels were measured qualitatively and semiquantitatively using FeCl3. Results showed that antioxidant activity of the water and ethanol extract of C.asiatica wer significantly higher than the commercial products (p≤0.05). Tannin’s semiquantitative test showed that all samples contained tannins but the amount was very low. 
The Physician Tendency in Stereotactic Radiosurgery Dose Prescription in Benign Intracranial Tumor at dr. Cipto Mangunkusumo National Hospital, Jakarta
No full textStereotactic radiosurgery (SRS) is one of the treatment modalities for benign intra-cranial tumor, especiallyfor the tumor located next to the critical neural structure. The prescribed dose for radiosurgery depends onthe maximal tumor diameter and surrounding normal tissue tolerance dose. This cross sectional study wasconducted to evaluate the physician’s tendency in radiosurgery dose prescription. We observed treatmentplanning data of 32 patients with benign intra-cranial tumor, which had been treated with SRS at Dr. CiptoMangunkusumo National Hospital in 2009-2010. The peripheral dose, organ at risk (OAR) dose limitiationand maximum tumor diameter were recorded. We compared our SRS dose with dose limitation, whichallowed safer dosing based on maximal tumor diameter perspective and the nearest OAR dose constraint.From maximal tumor diameter perspective, we prescribed mean±SD radiosurgery doses, which were11.63±2.21Gy, 10.21±1.29Gy and 9.88±1.07Gy for the tumor size ≤2cm, 2.01-3cm and 3,01-4cm respectively.Our radiosurgery dose was the lowest than dose limitation based on the nearest OAR perspective, followedby maximal tumor diameter perspective. It was concluded that radiosurgery dose had the tendency to beinfluenced by surrounding healthy tissue tolerance rather than maximal tumor diameter