Jurnal Kedokteran Brawijaya https://jkb.ub.ac.id/index.php/jkb <p>Jurnal Kedokteran Brawijaya, ISSN (online): 2338-0772, is a communication media and a scientific publication in the field of medical science published by Faculty of Medicine, Universitas Brawijaya.</p> <p>Jurnal Kedokteran Brawijaya is a <strong>B accredited national journal</strong> based on the Decree of the Directorate General of Strengthening Research and Development of the Ministry of Research, Technology, and Higher Education Republic of Indonesia No. <strong>040/P/2014 dated February 14, 2014. </strong></p> <p>The accreditation status has been renewed base on the Decree of Director General on Strengthening Research and Development of the Ministry of Research, Technology, and Higher Education Republic of Indonesia <strong>23/E/KPT/2019, August 8, 2019</strong>, accredited as <strong>SINTA 2.</strong></p> <p>Jurnal Kedokteran Brawijaya contains articles from research focused on basic medicine, clinical medicine, epidemiology, and preventive medicine (social medicine).</p> <p>Jurnal Kedokteran Brawijaya is regularly published twice in one year (at the end of February and at the end of August). Jurnal Kedokteran Brawijaya was first published in April 1984.</p> <p>Brawijaya Medical Journal has been indexed in <a title="Google Scholar" href="https://jkb.ub.ac.id/index.php/jkb/management/settings/context//index.php/jkb/manager/setup/Jurnal%20Kedokteran%20Brawijaya%20is%20published%20twice%20a%20year,%20at%20the%20end%20of%20February%20and%20at%20the%20end%20of%20August.%20Jurnal%20Kedokteran%20Brawijaya%20was%20first%20published%20in%20April%201984.%20ISSN%20(print)%200216-9347,%20ISSN%20(online)%202338-0772.">Google Scholar</a>, <a title="Portal Garuda/Inonesian Publication Index (IPI)" href="http://id.portalgaruda.org/?ref=browse&amp;mod=viewjournal&amp;journal=4387">Portal Garuda / Indonesian Publication Index (IPI)</a>, <a title="SINTA" href="http://sinta2.ristekdikti.go.id/journals/detail?id=759">SINTA Science and Technology Index</a>, and <a title="CrossReff" href="https://search.crossref.org/?q=jurnal+kedokteran+brawijaya">CossReff</a>.</p> <p>Citation Profile at <a title="Google Scholar" href="https://scholar.google.co.id/citations?user=SEmvMR4AAAAJ&amp;hl=id&amp;authuser=1">Google Scholar</a> as of August 2022:</p> <p>Number of citations: 3679</p> <p>h-index: 25</p> <p>index i10: 100</p> Fakultas Kedokteran Universitas Brawijaya en-US Jurnal Kedokteran Brawijaya 0216-9347 Authors who publish with this journal agree to the following terms:<br /><br /><ol><li>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a <a href="http://creativecommons.org/licenses/by/3.0/" target="_new">Creative Commons Attribution License</a> that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li><li>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li><li>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See <a href="http://opcit.eprints.org/oacitation-biblio.html" target="_new">The Effect of Open Access</a>).</li></ol> Predictor Factor for Severity Degree of Pediatric Hydronephrosis in Tertiary Hospital https://jkb.ub.ac.id/index.php/jkb/article/view/3061 <p><em>Pediatric hydronephrosis is often hideous, and its severity highly correlates with a significantly increased incidence of pathological condition and outcome. The management of this disease is based on the severity level by identifying the clinical manifestation, so performing an early detection is crucial to prevent the disease progression. This research aimed to determine the predictor factors for the severity degree of pediatric hydronephrosis to give better treatments for patients. This study retrospectively reported 51 data of hydronephrosis cases that were collected from January 2012 to August 2019</em><em>. Severity degree was evaluated using SFU (Society of Fetal Urology) scoring system and divided into two groups, mild-moderate (first and second degree) and moderate-severe (third and fourth degree). Data including age, gender, number of kidneys affected, etiology, and antenatal care were collected and statistically analyzed using Pearson’s Chi-square and Fischer Exact test. The research result </em><em>from 51 pediatric patients, 72.55% were categorized as moderate-severe hydronephrosis while the remaining 27.45% were categorized ad mild-moderate hydronephrosis. Ureteropelvic junction (UPJ) stenosis (37.25%) is the most common cause of pediatric hydronephrosis. Significant correlations are noted among severity degree and gender, the number of kidneys affected, etiology, and chosen antenatal care between obstetrician-gynecologist and midwife (p&lt;0.05). In short, gender, number of kidneys affected, etiology, patient’s choice on antenatal care can be the predictor factors for pediatric hydronephrosis. Thus, these findings are essential for urologists in pediatric hydronephrosis management.</em></p> Hamdan Yuwafi Naim Besut Daryanto Pradana Nurhadi Copyright (c) 2022 Jurnal Kedokteran Brawijaya 2022-08-31 2022-08-31 Effect of Simvastatin Administration on ALP (Alkaline Phosphatase) Level in Wistar Rat’s Femur Fracture https://jkb.ub.ac.id/index.php/jkb/article/view/3122 <p><em>Metabolism of the bone healing process can be monitored by Bone formation marker, such as alkaline phosphate (ALP). Simvastatin is known to increase bone marker formation in the repair phase, but its effects on the ALP level have not been known yet. This study aimed to determine the effect of oral simvastatin administration on the expression of ALP level in femur fracture healing in a rat model of femur fracture. The research method was experimental post-test only using 18 Rattus norvegicus rats which were divided into 3 groups, namely the control group for femur fracture (Control), femoral fracture group and giving simvastatin 0.36 mg/day for 2 weeks (Treatment I), and femur fracture group and administration of simvastatin 0.36 mg/day for 4 weeks (Treatment II). ALP levels were measured at 0, 2, and 4 weeks. The results showed an increase in ALP levels in the simvastatin treatment group compared to the control group (p&lt;0.05). It can be concluded that the administration of simvastatin increased ALP levels in rat femoral fractures.</em></p> Hery Susilo Edi Mustamsir Wanda Gusta Rai Copyright (c) 2022 Jurnal Kedokteran Brawijaya 2022-08-31 2022-08-31 Antioxidant Properties of TeNan Herbal Tea Formulation “Telang (Clitoria ternatea) and Pineapple (Ananas comosus)” https://jkb.ub.ac.id/index.php/jkb/article/view/3177 <p><em>Herbal teas </em><em>was are</em><em> widely consumed </em><em>by </em><em>people around the world </em><em>have</em><em> high</em> <em>antioxidant</em><em> activities</em><em>. </em><em>The flavor and color combination of specific teas </em><em>enrich</em><em>es</em><em> the aroma and appearance of the tea, producing</em><em> a </em><em>tea with </em><em>fresh</em><em> color and tast</em><em>ier flavor</em><em>. </em><em>This study determines the antioxidant activity of telang flower tea (Clitoria ternatea), pineapple tea (Ananas comosus), and the formula of the combination of telang flower tea and pineapple tea called TeNan. The antioxidant activities of herbal teas were measured by </em><em>2</em><em>,</em><em>2 Diphenyl-1-picrylhydrazyl</em><em> (</em><em>DPPH</em><em>)</em><em>, </em><em>Hydrogen Peroxide (</em><em>H<sub>2</sub>O<sub>2</sub></em><em>)</em><em>, 2,2′-Azino-bis(3-ethylbenzthiazoline-6-sulfonic acid)</em><em> (</em><em>ABTS</em><em>)</em><em>, Ferric Reducing Antioxidant Power</em><em> (</em><em>FRAP</em><em>)</em><em> assay</em><em>. The total phenol measurement used Gallic Acid Equivalent (GAE), while the flavonoid content measurement used Quercetin Equivalent (QE). The DPPH scavenging activities of telang flower tea, pineapple tea, and TeNan tea (IC<sub>50</sub>: </em><em>17.07%, 11.81%, and 22.22%), H<sub>2</sub>O<sub>2 </sub>scavenging activities (IC<sub>50</sub>: 26.62%, 41.81%, and 96.22%), ABTS-reducing activities (IC<sub>50</sub>: 2.51%, 3.39%, and 1.02%), and FRAP activities (IC<sub>50</sub>: 5.56%, 18.67%, and 7.48%). The total phenolic and flavonoid contents of TeNan tea were lower (9.44 </em><em>μg </em><em>G</em><em>AE</em><em>/</em><em>100%</em><em>; 3.46</em><em> μg </em><em>Q</em><em>AE/100%</em><em> sample concentration) than those of telang flower tea (</em><em>16.20</em> <em>μg </em><em>G</em><em>AE</em><em>/</em><em>100%</em><em>; 4.88 </em><em>μg </em><em>Q</em><em>AE/100%</em><em> sample concentration) </em><em>but higher than those of pineapple tea (0.82 </em><em>μg </em><em>G</em><em>AE</em><em>/</em><em>100%</em><em>; 0.17 </em><em>μg </em><em>Q</em><em>AE/100%</em><em> sample</em><em> concentration). TeNan tea has the higher in ABTS and FRAP activities but lower in H<sub>2</sub>O<sub>2</sub> and DPPH scavenging activities compared to telang flower tea and pineapple tea. In summary, telang tea has stronger antioxidant activity compared to pineapple and TeNan tea in FRAP and H<sub>2</sub>O<sub>2 </sub>assays.</em></p> Wahyu Widowati Teresa Liliana Wargasetia Meganita Marthania Tazkia Salma Hanifa Teddy Marcus Zakaria Michael Sebastian Gunadi Natanael Halim Sheryl Santiadi Copyright (c) 2022 Jurnal Kedokteran Brawijaya 2022-08-31 2022-08-31 Comparative Assessment of the Safety between Pazopanib and Sunitinib for Metastatic Renal Cell Carcinoma https://jkb.ub.ac.id/index.php/jkb/article/view/3182 <p><em>Renal cell carcinoma (RCC) is the most common kidney lesion with approximately 90% of all kidney malignancies and 30% of people with RCC have developed metastasis at the time of diagnosis. Based on European Association of Urology (EAU) guideline, therapy for metastatic RCC (mRCC) patient who cannot tolerate immune checkpoint inhibitor is pazopanib or sunitinib. However, these drugs cause several uncomfortable side effects for the patient. Therefore, this meta-analysis was made, based on the available evidence base, to compare the safety of pazopanib and sunitinib as the treatment of mRCC. Systematic reviews were made in accordance with the PRISMA guideline requirements, a literature review was conducted in January 2022 used PubMed, ScienceDirect, Cochrane Library, publishing year of at least 10 years with an adult population. And the data is analyzed using RevMan V.5.4. In total 1.665 participants, there were 431 patients taking pazopanib and 1.234 patients taking sunitinib from 8 studies. The result shows that sunitinib has more frequent result of side effects than pazopanib in several occasion like hand-foot syndrome, nausea/vomiting, skin rash, stomatitis &amp; mucosal inflammation, leucopenia and thrombocytopenia. Meanwhile, there are no significant differences between pazopanib and sunitinib in causing other side effect such as fatigue, diarrhea, hypertension, anemia, and increased liver enzymes. The conclusion is that pazopanib is better and has less frequent side effects than sunitinib.</em></p> Eka Yudha Rahman Choirin Nur Deddy Rasyidan Yulizar Copyright (c) 2022 Jurnal Kedokteran Brawijaya 2022-08-31 2022-08-31 Demographic, Clinical, and Laboratory Characteristics of HIV Patients with Cerebral Toxoplasmosis at Haji Adam Malik General Hospital Medan https://jkb.ub.ac.id/index.php/jkb/article/view/3257 <p>Cerebral toxoplasmosis is one of the frequent opportunistic infections of the central nervous system of Human Immunodeficiency Virus (HIV) patients in the presence of Toxoplasma Gondii infection. In Indonesia, the incidence of HIV patients with cerebral toxoplasmosis is 45%. This study was done to determine the demographic, clinical, and laboratory characteristics of HIV patients with cerebral toxoplasmosis at Haji Adam Malik Hospital, Medan, based on medical record data in 2022. The total sample was 23 patients with time periods from January to March 2022. Demographically, the data showed that most of the HIV patients with cerebral toxoplasmosis were male (91.3%), a mean age of 36.48±5.74 years, married (87%), high school graduates (69.6%), and working (91.3%). The most common clinical characteristics were headache (69.6%) and cognitive impairment (56.5%). Laboratory characteristics found were (56.5%) non-reactive (&lt;0.8 COI) and (43.5%) reactive (≥1 COI) anti toxoplasma IgM, while reactive anti-toxoplasma IgG (≥3 IU/ml) was obtained in all research samples (100%).</p> Alfansuri Kadri Eko Yandra Copyright (c) 2022 Jurnal Kedokteran Brawijaya 2022-08-31 2022-08-31 Effect of Simvastatin on Eosinophilic Inflammation of Bladder Tissue in Interstitial Cystitis Rat Model https://jkb.ub.ac.id/index.php/jkb/article/view/3106 <p class="Englishversionofabstract">In the urogenital system, simvastatin is associated with interstitial cystitis adverse effects, but the exact mechanism is not yet clearly defined. This study aims to determine the effect of simvastatin on eosinophilic inflammation of bladder tissue in vivo. Laboratory experimental research design with the post-test only control group using 24 female Wistar rats aged 8-10 weeks were randomly divided into simvastatin 50mg/kg BW (n=12) or placebo carboxymethylcellulose 0.5% (n=12). All groups received treatment through oral gavage for thirty days. After that, each group was divided equally into three subgroups: control rat, day 0 Interstitial Cystitis (IC) rat (IC0), and day 3 IC rat (IC3). Control or IC0 rats each received intravesical instillation of buffered saline or protamine sulfate (PS), respectively, and were terminated immediately less than 3 hours after instillation. The IC3 rats received intravesical PS instillation and were terminated three days post-instillation. The bladder tissue was made in Hematoxylin-Eosin histology preparations. As in previous studies, the results showed successful desquamation of the urothelium after PS instillation. Tissue eosinophil counts were significantly higher in the simvastatin group than in the placebo group in the IC3 model (15.50±5.92 vs. 4.00±2.83, p=0.013).It can be concluded that the mechanism of the adverse effect of simvastatin on bladder tissue is through increased tissue inflammation mediated by eosinophils along with urothelial layer destruction by the protamine sulfate<span style="font-style: normal;">.</span></p> Muhamad Nur Syukriani Yusuf Abdi Dzul Ikram Hasanuddin Zuhriana K Yusuf Trinny Tuna Nurani Ibrahim Marshanda Tiara Posumah Ridho Tianggara Copyright (c) 2022 Jurnal Kedokteran Brawijaya 2022-08-31 2022-08-31 Chromosome Aberration on Growth and Developmental Disorder https://jkb.ub.ac.id/index.php/jkb/article/view/3181 <pre><em>Growth and development in humans begin at conception, which shows progress and interdependence. Normal children show the characteristic of growth and development. In children with growth and development disorder, chromosomal abnormality may be found. This study aimed to determine chromosomal abnormality in patients with growth and development disorder. The samples were taken from karyotype results of patients in the Medical Genetics Laboratory, Faculty of Medicine, Universitas Wijaya Kusuma Surabaya, from 2010-2020. The inclusion criteria were infants to adolescents aged 24 years and unmarried who experienced impaired growth and development, including sexual development. Chromosomal abnormalities were obtained from cytogenetic analysis using the G-banding method. From 75 samples with growth and development disorders, there were abnormalities in the number of autosomal chromosomes and sex chromosomes found in patients with Down syndrome, Turner syndrome, Klinefelter syndrome, and Edwards syndrome. Chromosomal structural abnormalities found were deletion, translocation, inversion, duplication, marker chromosome, and heteromorphism. This study showed the importance of karyotyping in children and adolescents with growth and developmental disorders.</em></pre> Eva Diah Setijowati Herni Suprapti Maria Widijanti Sugeng Retno Dwi Wulandari Copyright (c) 2022 Jurnal Kedokteran Brawijaya 2022-08-31 2022-08-31 Perceived Family Functionality based on APGAR Family Function Questionairre among Elderly Patient with Covid-19 Infection: A Perspective from Developing Country https://jkb.ub.ac.id/index.php/jkb/article/view/3192 <p><em>Family is a basic social unit of senior citizen. Relationship family members was considered as source of emotional comfort. Meanwhile, economic, political, and social changes during pandemic has an impact on the family and the support they provide which may manifested among vulnerable group as is the case of elderly person. Prolonged stress due to isolation care of Covid-19 infection might increase psychological distress by reducing family support. This study aimed to explore perceived family function among elderly patients after Covid-19 infection. A cross sectional study was conducted among 33 elder patients with history of Covid-19 infection in Saiful Anwar General Hospital, Indonesia. Perceived family functionality evaluated using APGAR family score. Data was analyzed using descriptive analyses, independent T test, correlation and regression. Mean total APGAR score was 9.610.70 with joint pain had significant association with APGAR score (p 0.021) indicating full family support in elder person with symptoms. Gender female was associated with ‘Resolve’ (p 0.038) which might correlate with bigger role of elder female in Indonesian family. Length of stay was significantly associated with ‘Partnership’ (p 0.012) and ‘Growth’ (0.043) with inverse correlation. It showed prolonged hospital stay affected family relationship especially in communication. Perceived family supports remained high in elderly during Covid-19 isolation in Indonesia. Specific symptoms such as joint pain, even strengthen the family support for elder member of family. Prolonged stay in the hospital during Covid-19 infection, might become a communication barrier between elder person and the family which affect decision sharing and emotional expression.</em></p> Sri Sunarti Didi Candradikusuma Dewi Indiastary Siti Prehatiningsih Bogi Pratomo Affa Waafi Copyright (c) 2022 Jurnal Kedokteran Brawijaya 2022-08-31 2022-08-31 Corpus Alienum Intrauterine Device with Calculus Formation in Bladder https://jkb.ub.ac.id/index.php/jkb/article/view/3261 <p><em>Migration of the intrauterine device (IUD) into the bladder has been a rare case. There were reported 31 cases of IUD migration into the bladder until 2006. Although IUD migration is asymptomatic, it should be removed to prevent complications such as pelvic abscess, bladder or intestinal rupture, and adhesion. A 52-year-old woman came to the urology clinic with pyuria since the previous 3 months. She had a history of IUD insertion in 1982; and two months later, she got pregnant. Since 2015, she has suffered from dysuria but has never been treated and has worsened in the past 3 months. On physical examination, tenderness was found in the suprapubic region. The results of urinalysis showed pyuria and hematuria. The ultrasonography findings, there were large bladder stones. An abdominal x-ray revealed the presence of a bladder stone with the IUD tail. Vesicolithotomy was performed and the IUD was found attached to an 11x7 cm bladder stone. The patient had a good postoperative condition without any special complications. The IUD in the bladder is a medium for forming secondary bladder stones. Most cases of IUD migration are caused by a lack of evaluation after the installation procedure. This case suggested that the physician should be more careful in carrying out the installation procedure. It is necessary to evaluate the location of the IUD after installation to prevent further patient complications.</em></p> Mangkubumi Putra Wijaya Kurnia Penta Seputra Besut Daryanto Taufiq Nur Budaya Copyright (c) 2022 Jurnal Kedokteran Brawijaya 2022-08-31 2022-08-31 46 XX Congenital Adrenal Hyperplasia (CAH) after Clitoroplasty, Labioplasty, and Vaginoplasty: A Case Report https://jkb.ub.ac.id/index.php/jkb/article/view/3166 <p><em>Congenital adrenal hyperplasia (CAH) is the most common cause (60%) of Disorder of Sex Development (DSD), which causes three problems: symptoms and conditions arising due to adrenal endocrine disorders, long-term treatment, and quality of life due to genital ambiguity. An 18-year-old female patient was diagnosed with simple virilizing CAH and had genital ambiguity from birth. The patient was raised as a male. Overall, the examination results indicated a female. Physical examination before surgery showed virilization, such as external genital pigmentation, precocious pubic hair, and bilateral </em><em>impalpable </em><em>testis. The karyotype genetic examination confirmed female: 46, XX. Eventually, the patient decided as a female and underwent surgical management consisting of clitoroplasty, labioplasty, and vaginoplasty, followed by long-term corticosteroid therapy. Observations were made for three years after surgery to see the progress of the patient’s condition. After undergoing glucocorticoid therapy and surgery, the patient had not experienced menstruation. Her breasts did not enlarge, and mustache and beard were still growing on her face. The patient was concerned about her condition, especially about the risk of infertility and inappropriate physical changes. The management of virilization in CAH with genital ambiguity should be seen from psychological and surgical perspectives. Understanding the disease, the goals of surgery, long-term treatment, and social adaptation help improve quality of life and reduce negative stigma.</em></p> Rahmat Husein Besut Daryanto Paksi Satyagraha Pradana Nurhadi Copyright (c) 2022 Jurnal Kedokteran Brawijaya 2022-08-31 2022-08-31 A Two-Year-Old Boy with Diphallia and Multiple Congenital Anomalies: A Case Report https://jkb.ub.ac.id/index.php/jkb/article/view/3259 <p><em>Diphallia is </em><em>a rare urogenital defect and varies from a small accessory penis or duplication of the glans to complete penile duplication. Its incidence is 1 in 5.5 million live births. Only 100 cases were reported from 1609 until 2021. A two-year-old boy with diphallia and multiple congenital anomalies had an uncircumcised penis with two glans penis and two </em><em>complete </em><em>urethral orifices, accompanied by scrotum bifidum, asymmetric right buttock, with normal anorectal position. Spina bifida with lipomyelocele, tethered cord at the level of vertebra lumbar 3-4, scrotum bifidum, and left mild hydronephrosis were observed using Magnetic Resonance Imaging (MRI). Urethrocystoscopy of both </em><em>complete </em><em>urethra revealed meatal stenosis and bulbar urethral stricture, normal posterior urethral, and no verumontanum in the right urethral orifice</em><em> and did dilatation</em><em>. Whereas normal urethral orifice, anterior urethra, posterior urethra and verumontanum were found in the left side. Management for diphallia must consider associated anomalies and the goal of patient satisfaction. In this case, conservative treatment is the best choice.</em></p> Rizal Trianto Pradana Nurhadi Besut Daryanto Copyright (c) 2022 Jurnal Kedokteran Brawijaya 2022-08-31 2022-08-31