Jurnal Kedokteran Brawijaya

Comparison of Methanolic Extract of Piper Betle to Amikacin against the Growth of Pseudomonas aeruginosa

Azalia Ayu Rysaputri — 2023-02-27

Pseudomonas aeruginosa is one of the most common pathogens that cause Healthcare-Associated Infections (HAIs). A previous study stated that Piper betle L. extract has antibacterial activity against certain bacteria, including Pseudomonas aeruginosa. This study has the objective of comparing antibacterial activity of the methanolic extract of Piper betle L. and amikacin on the growth of Pseudomonas aeruginosa. This study used the tube dilution method with a sample of Pseudomonas aeruginosa from Microbiology Laboratory Dr. Saiful Anwar General Hospital, Malang. The results of this study showed that the value of MIC and MBC from the methanolic extract of the Piper betle L. treatment was 4800μg/mL. Meanwhile, the amikacin treatment resulted in 0.4μg/mL for MIC and 0.45μg/mL for MBC. From linear regression, it was found that the methanolic extract of Piper betle L. had a β-coefficient value closer to -1 compared to amikacin. Therefore, it can be concluded that the methanolic extract of Piper betle L. has a greater inhibiting effect on the growth of Pseudomonas aeruginosa.

Antibiotic Use Study in ICU/HCU of Muhammadiyah University General Hospital Malang using DDD and Gyssens Methods

Hidajah Rachmawati — 2023-02-27

Infection is a condition caused by the propagation of harmful microorganisms with or without clinical symptoms. Improper use of antibiotics can lead to antibiotic resistance. The Ministry of Health of the Republic of Indonesia recommended a quantitative evaluation of the use of antibiotics using the Defined Daily Dose (DDD) method and a qualitative evaluation using the Gyssens method. This study evaluated antibiotics usage using DDD and Gyssens methods in ICU/HCU of the Muhammadiyah University General Hospital Malang. Employing retrospective observational method, data were collected from patient medical records hospitalized during January-December 2020. Results of the DDD quantitative analysis showed that the most widely used antibiotic was Ceftriaxone with a 35.79 DDD/100 patient-days. The Gyssenss qualitative analysis showed that the category VI (incomplete patient's medical record data) was 3%, category IVa (antibiotic use is more effective) (2%), category IIIb (duration of antibiotic use is too short) (3%), category IIb (antibiotic use is not at the right interval) (3%).

Survival Rate of Lung Adenocarcinoma Patients Receiving EGFR - Tyrosine Kinase Inhibitor Targeted Therapy

Ungky Agus Setyawan — 2023-02-27

Globally, lung cancer is by far the leading cause of death by cancer-which contribute to 2.094 million death-with the highest toll from cancer being 1.8 million. Currently, lung cancer therapy has developed from chemotherapy to targeted therapy, such as Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor (EGFR-TKI). This study aimed to assess the survival rate of adenocarcinoma cell lung cancer patients who received EGFR-TKI therapy at the Pulmonary Clinic of Dr. Saiful Anwar General Hospital Malang. This study was a retrospective study using patient medical records between 2017 and 2020. The data were processed and analyzed using the Chi-Square test. The number of samples was 117 patients consisting of 63 patients receiving Gefitinib therapy, 36 patients receiving Afatinib therapy, and 18 patients receiving Erlotinib therapy. There were no significant differences between variables of age, sex, smoking history, stage, and exon mutations with 1-year survival. Gefitinib therapy has a higher average survival time than Afatinib and Erlotinib. However, the 1-year survival rate (YSR) was highest on Afatinib. The Middle Survival (MS) of the three regimens is almost the same, about 300 days. Statistical data showed no relationship between survival and the treatment regimen given (p=0.187). The most common side effect of TKI is skin rash. This research should be carried out with a larger sample to minimize bias.

Correlation between Atherogenic Index of Plasma and Various Domains of Cognitive Function in Type 2 Diabetes Mellitus Patients

Fasihah Irfani Fitri — 2023-02-27

Cognitive impairment in patients with Type 2 Diabetes Mellitus (T2DM) is related to the lack of blood supply to the brain. Previous studies showed that the atherogenic index of plasma (AIP) is a predictor of vascular abnormalities, but studies investigating its association with cognitive functions in T2DM patients younger than 60 years remain limited. This study aimed to determine the correlation between AIP and various domains of cognitive function in T2DM patients. This study was a cross-sectional study involving 75 T2DM patients selected using a consecutive sampling technique at Haji Adam Malik General Hospital Medan from July 2021 to January 2022. Cognitive function was examined using the Visual Cognitive Assessment Test Indonesian Version (VCAT-INA) on several cognition domains. The AIP value of each patient was measured and categorized into high (AIP>0.21), intermediate (AIP between >0.11 and ≤0.21), or low (≤0.11). The results showed that the mean age of the patients was 51.5±5.9 years. The mean triglyceride level was 176±108.3mg/dl, the HDL-C level was 38.3±12.1mg/dl, and the mean AIP value was 0.191±0.25. The mean score of the VCAT-INA was 21.7±2.3, which was lower than normal. The AIP value showed significant negative correlation with global cognition (r=0.432, p<0.001) and various cognitive domains, namely memory (r=-0.375, p=0.001), attention (r=-0.383, p=0.001), executive function (r=-0.051, p=0.663), visuospatial (r=-0.306, p=0.008), and language (r=-0.352, p=0.002). In short, there is a significant correlation between AIP value and domains of cognitive function, such as memory, attention, visuospatial, and language domains, but not with executive domains.

Anti-Inflammatory Effects of Ripe Areca Nut Ethyl Acetate Fraction in Wistar Rats with Knee Joints Osteoarthritis

Daffa Akrama Yuda — 2023-02-27

Osteoarthritis (OA) adalah bentuk artritis yang paling umum. Meloxicam adalah salah satu Non-Steroidal Anti-Inflammatory Drugs (NSAID) yang umum digunakan yang memiliki banyak efek samping. Pinang kuning (Areca Catechu L) yang mengandung flavonoid dapat memberikan efek anti inflamasi. Penelitian ini bertujuan untuk mengetahui potensi efek anti-inflamasi fraksi etil asetat biji pinang matang pada model tikus OA. Dua puluh lima tikus dewasa, Rattus Novergicus Strain Wistar diinduksi OA dengan Monosodium Iodoacetate (MIA), kemudian dibagi menjadi lima kelompok yang masing-masing kelompok diberi fraksi etil asetat pinang kuning dosis 15mg/kgBB, 30mg/kgBB, dan 60mg/kgBB, meloxicam 1,35mg/kgBB dan aquadest sebagai kontrol negatif selama 14 hari. Diameter sendi lutut diukur dengan kaliper metrik digital untuk menilai edema sendi. Pemeriksaan histopatologi dengan pewarnaan Haematoxyllin-Eosin untuk menilai derajat inflamasi pada sinovial. Di antara kelompok pinang, dosis 30mg/kgBB memiliki pengurangan diameter sendi lutut yang paling baik dan skor sinovitis yang paling rendah. Kesimpulannya, fraksi etil asetat kelompok pinang kuning memiliki efek anti inflamasi pada model OA tetapi tidak tergantung dosis.

Clitoria ternatea Flower Extract-Based Gel Elevates TGF-β1 Gene Expression and Collagen Density in UVB-Induced Collagen Loss Rat Skin

Christine Magdalena Hutapea — 2023-02-27

Ultraviolet B (UVB) irradiation in the skin induces collagen loss by the ROS pathways and pro-collagen factors, mainly the TGF-β family. Antioxidant compounds in Clitoria ternatea have been studied in decreasing ROS production, in the collagen loss process. However, the molecular mechanism of action is still not clearly studied thereby inducing the TGF-β1 activation and regulating collagen deposition is required. This study aimed to investigate the effect of Clitoria ternatea flower extract-based gel on TGF-β1 gene expression and collagen density in UVB-induced rat skin. A randomized control group post-test-only design was conducted on 20 male Wistar rats aged 8-10 weeks (150-250 grams). Rats were divided into four groups: Untreated group (Healthy Control), UVB+Based gel group (Negative Control), 5% Clitoria ternatea flower extract-based gel group (T-5%), and 10% Clitoria ternatea flower extract-based gel group (T-10%). Rats were exposed to UVB for 5 consecutive days and administrated with gel every day for two weeks. At week 3, rat skins were isolated for TGF-β1 gene expression using qRT-PCR, and Masson Trichrome-collagen specific staining. Comparative analysis of qRT-PCR showed that the lowest mean TGF-β1 expression were seen in the Negative Control group (0.01±0.00), followed by T-5% (0.11±0.22), Healthy Control group (1.01±0.01) and T-10% (2.32±2.46). According the MT staining, the highest amount of collagen is in the Healthy Control group (43.83±5.3), followed by T-10% (38.39±3.1), T-5% (29.04±3.2) and Negative Control group. (13.87±2.7). Clitoria ternatea flower extract-based gel may increase TGF-β1 gene expression and collagen deposition in the UVB-induce collagen loss rat skin.

Pattern of Pharyngitis and Tonsillitis Patients at ENT Clinic of Wlingi Hospital in 2019-2021

Samuel Prasetyo — 2023-02-27

A survey conducted by the Ministry of Health in 2010-2012 in seven provinces in Indonesia found that the number of ENT disease sufferers in Indonesia was approximately 35.6 million, or 16.8% of the total population. Pharyngitis and tonsillitis are examples of ENT cases often faced in daily practice. Both diseases indicate symptoms that resemble Covid-19, which has become a problem recently. This study aimed to analyze pharyngitis and tonsillitis patient visits at the ENT clinic of Wlingi Hospital during the Covid-19 in 2019-2021. Benefit of this study is to know pattern of pharyngitis and tonsillitis at the ENT clinic of Wlingi hospital in 2019-2021 during Covid-19 time. This research used a descriptive statistics method with an epidemiological cross-sectional design. The data in this study were secondary data from the medical records of ENT clinic patients at Wlingi Hospital and were analyzed univariately. Sampling in this study was done using the total sampling method. Based on medical record data at the ENT clinic of Wlingi Hospital in 2019-2021, there were 2292 visits in 2019, 1811 visits in 2020, and 1255 visits in 2021. Based on medical record data for pharyngitis and tonsillitis cases at the ENT clinic of Wlingi Hospital in 2019-2021, there were 247 pharyngitis and tonsillitis case visits in 2019, 114 pharyngitis and tonsillitis case visits in 2020, and 69 pharyngitis and tonsillitis case visits in 2021. There was a decrease in the number of pharyngitis and tonsillitis case visits in the ENT clinic of Wlingi Hospital during 2019-2021.

The Role of Soluble Costimulatory Molecules as the Biomarkers for Aging Predictors

Kusworini Handono — 2023-02-27

This study aimed to determine the role of the soluble costimulatory molecules in aging and the association with the presence of comorbid in aged individuals. Thirty-two elderly and twenty healthy subjects were included in this study. The soluble costimulatory molecules sCD28, sCD80, sCD86, sCD163, and sCTLA4 were measured using ELISA. The presence of comorbid was documented from medical records. Charlson Comorbidity Index (CCI) was measured to evaluate the survival/mortality risk for the subjects. The levels of the majority of soluble costimulatory molecules significantly increased in the elderly participants, while the level of sCD86 was comparable. There were weak positive correlations between the subject's age and levels of sCD28 (R=0.214, p=0.048), sCTLA4 (R=0.238, p=0.041), and sCD80 (R=0.317, p=0.012). sCD80 were discovered to be the best to predict immune aging in the elderly with AUC 0.71 [0.57-0.86], sensitivity 53,1%, specificity 80.0%, and cut off 129ng/ml. Most of the elderly participants had at least one comorbid, in which approximately 25.0% and 3.1% of the subjects were classified as mild and moderate CCI. Multivariate analysis showed that comorbidities in elderly individuals have been associated with levels of sCTLA4 ≥26.5ng/ml and sCD80 ≥129.0ng/ml. Furthermore, subjects with comorbid (CCI ≥1) were associated with sCD80 ≥129.0ng/ml (OR 12.44 [95% CI 1.32–117.03], p=0.027). Considering these results, sCD28, sCTLA4, and sCD80 can be developed as biomarkers for predicting immune aging and elderly comorbidities, respectively.

Perceptions and Experiences of Survivors of Mount Semeru Eruption in Getting Health Services during Covid-19 Pandemic

Sri Sunarti — 2023-02-27

Disaster events pose challenges for health workers in overcoming health problems in refugee camps. The eruption or hot clouds of Mount Semeru that occurred during the Covid-19 pandemic made sick survivors have to continue to receive health services, even though they were in refugee camps. Survivors' experiences in receiving health services and their illnesses varied widely. Perceptions of survivors in obtaining health services showed that most of them were well served and experienced a good referral system to higher-level hospitals. Home care was carried out by health workers to survivors after returning from refuges.

Serous Retinal Detachment in Pre-Eclampsia: A Systematic Review of Case Report

Haikal Hamas Putra Iqra — 2023-02-27

Serous Retinal Detachment is one of the preeclampsia complications which may be identified during the third trimester of pregnancy or postpartum period that may be related to pregnancy condition. We review case reports related to serous retinal detachment in preeclamptic patients from online databases such as MEDLINE/Pubmed and Science Direct from 2011 to 2021 in accordance with PRISMA guidelines. Authors independently screened abstracts of articles retrieved articles that were considered potentially relevant, and extracted the articles obtained. From 17 articles, serous retinal detachment is higher in severe preeclampsia and HELLP syndrome (88%). Most patients were indicated to do caesarean section (71%) as their mode of delivery due to managing severe preeclampsia. Although most patients (94%) reported retinal detachment involving the macular area, complete resolution was observed in all the patients (94%). Early detection of serous retinal detachment may increase awareness of early detection of severe preeclampsia and HELLP syndrome.

Infected Urachal Cyst in Adult

Aditya Airlangga Ekaputra — 2023-02-27

Infected urachal cyst is one of urachal spectrum abnormalities. It usually presents in children because obliteration normally happened at early infancy. Rare case occurs in adult either can be small incidence or unrecognized symptoms until adulthood. Only small numbers of literature reported. The urachus is a tube extending from the anterior roof of the vesica urinaria to the umbilicus along the midline. The urachus is a vestigial fibromuscular structure located anterior to the fascia transversalis and posterior to the peritoneum. The presence of an embryonic urachal remnant can result in a variety of clinical complications. Due to the rarity of urachal residual disorders and the possibility of vague stomach or urinary symptoms, it is difficult to make a firm preoperative diagnosis. A 32-year-old female was referred to Saiful Anwar General Hospital after suffering abdominal pain for two months; the perineum felt the pain. There was a history of dysuria and nausea since the previous month, but no history of fever or change in bowel habits. Abdominal ultrasound showed an abscess at the anterior bladder and MRI showed an infected cyst mass in the suprapubic pointing to the left umbilical. Partial cystectomy and uterus biopsy were performed. The histopathologic result showed chronic inflammation tissue, and no malignancy was found. Misdiagnosis may lead to many complications such as progressive infection until malignancy therefore early detection of this case is important.