Jurnal Kedokteran Brawijaya

The Potency of Polyphenols Extract of Robusta Coffee Bean (Coffea robusta) on COX-2 Inhibition in Neutrophil Cells

Tantin Ermawati — 2023-08-31

Inflammation is a physiological response to various stimuli including infection and tissue injury. One cause of inflammation is gram-negative bacteria that release various toxins, e.g. lipopolysaccharide endotoxin (LPS). The first body defense response is neutrophils. Body defense response is expressed by the cyclooxygenase (COX) enzyme that functions to transform arachidonic acid into prostaglandin. Polyphenols extract from Robusta coffee bean is known to play an anti-inflammatory role, but the mechanism for inhibiting COX-2 remains unknown. This study aimed to determine the potential of polyphenols extracted from Robusta coffee beans on COX-2 inhibition in neutrophils exposed to E. coli LPS. The research design was experimental in vitro with a post-test-only control group design. The sample consisted of 6 treatment groups, neutrophil isolates was incubated in concentrations of Robusta coffee polyphenols extract of 3.13%, 6.25%, 12.5%, and 25% and exposed to E. coli LPS. Measurement of COX-2 expression was conducted using immunohistochemical methods. ANOVA and LSD test results showed COX-2 expression in the treatment groups, namely neutrophils which were incubated with Robusta coffee polyphenols extract and exposed to E. coli LPS, was lower than the neutrophil group exposed only to E. coli LPS. The conclusion of this study is that the polyphenols extract of the Robusta coffee bean can inhibit COX-2 expression on neutrophils exposed to E. coli LPS.

Aloe vera Extract Sheet and Egg Albumin (Gallus domesticus) Reduce the Number of Lymphocytes on Gingival Incision Wound

Wizni A'dila A'ziza — 2023-08-31

An incision in the oral cavity is a dental procedure performed in surgical procedures. Suturing is the gold standard in primary wound closure care, however, suturing can cause tissue trauma, scars, and secondary infections. Cyanoacrylate adhesive is one of the alternative tissue glue for wound closure but it has inflammatory risk as suturing, potential toxicity, and accidental adhesion risks. Aloe vera extract sheet based combined with free-range chicken egg albumin is expected to be an alternative method for wound healing of gingival incisions. This study aimed to investigate the effect of administration of Aloe vera extract wound healing sheet (WHS) and free-range chicken egg albumin on the number of lymphocytes in the gingival incision wound as the inflammatory response. Experimental laboratory research with a posttest-only control group design was conducted in 24 male rats (Rattus norvegicus Wistar strain) with an incised gingiva, divided into four groups, namely T1 (50% WHS concentration and chicken egg albumin), T2 (100% WHS concentration and chicken egg albumin), PC (positive control with suturing), NC (negative control without treatment). The treatment was carried out for seven days. The data obtained were analyzed statistically using One-way ANOVA and Post Hoc LSD. The use of Aloe vera extract WHS and free-range chicken egg albumin (T1 and T2) reduced the number of lymphocytes compared to control groups (PC and NC; p<0.05). WHS and chicken egg albumin can shorten the inflammatory process in wound healing which is characterized by lower lymphocyte counts compared to the control groups.

The Effect of Psychotria malayana Extract on Wound Healing in Male White Rats (Rattus Novergicus) Sprague Dawley Strain

Fairuz Fairuz — 2023-08-31

Normal wounds are a complex and dynamic process, but they have a predictable pattern, and untreated open lesions are potentially infectious. According to the CDC (Centers for Disease Control), the incidence of surgical site infection (SSI) in the United States in 2018 was 157,500, with an estimated mortality rate of 8,205. Psychotria malayana plant contains flavonoids, alkaloids, and tannins, which play a role in the inflammatory phase and proliferation of wound healing. Many pharmacology effects of alkaloid and flavonoid activities include anti-inflammatory properties. The aim of this study was to determine the effect of Psychotria malayana extract ointment on wound healing in male white rats (Rattus norvegicus) of the Sprague-Dowley strain. This study is a laboratory experiment using the randomized post-test control only group design. Subjects were 25 male white rats (Rattus norvegicus) of the Sprague-Dowley strain. The rats were divided into five groups. The treatment was carried out for 14 days, and the wounds were shaved under anesthesia, and the skin was taken for histopathological evaluation after it had been examined macroscopically. An independent test showed that there is no significant difference macroscopically between control groups and treatment groups with a p-value >0.05. The Mann Whitney test showed a significant comparison microscopically at the level of angiogenesis, fibroblasts, and collagen in group negative control with group I (10% Psychotria malayana extract ointment) with a P value 0.05%. The conclusion is that 10% Psychotria malayana extract ointment increases fibroblast levels, angiogenesis, and collagen production in wound healing.

The Relationship between APGAR Score and Delivery Mode with Neonatal Sepsis in Ulin Regional Hospital Banjarmasin

Monica Anggriana Salim — 2023-08-31

Neonatal sepsis is one of the most common causes of neonatal death worldwide, affecting up to 3 million neonates each year. Deaths related to neonatal sepsis are more common in developing countries with lower middle incomes. This study aims to find a relationship between APGAR scores at the 1st, 5th, and 10th minutes and delivery mode on the incidence of neonatal sepsis. This research is a retrospective study with a cross-sectional approach at High-Risk Neonatal Installation (INRiT) of Ulin Regional Hospital Banjarmasin, South Kalimantan, conducted from January to December 2022. The total sample was 200 babies divided into the sepsis and the control group. APGAR score data at the 1st, 5th, and 10th minutes and delivery mode were taken through medical records. In this study, the average APGAR score at 1st minute in the sepsis group was 5.11; at 5th minute was 6.56; and at 10th minute was 7.65. The results of APGAR score analysis at the 1st, 5th, and 10th minutes in the sepsis and control groups using the Mann -Whitney test obtained a p-value of 0.000. In the sepsis group, 30 babies were born spontaneously, and 70 babies were born with tools (caesarean section/vacuum extraction). The results of the delivery mode analysis in the sepsis and control groups using Fisher's test obtained a p-value of 0.000 (OR: 3.807) which means that there is a relationship between the APGAR score at the 1st, 5th, and 10th minutes and the delivery mode with the incidence of neonatal sepsis.

The Effect of Antiretroviral Therapy (ART) Duration on CD4 Counts in Human Immunodeficiency Virus (HIV) Patients in dr. Doris Sylvanus Regional Hospital

Oberson Nainggolan — 2023-08-31

Human Immunodeficiency Virus (HIV) attacks white blood cells, thereby reducing the immunity of infected patients. It attacks Cluster of Differentiation 4 (CD4) lymphocyte cells which have a role in the immune system. It has killed 36.3 million people worldwide. There were reported 222 cases in Central Kalimantan Province in 2019. The therapy given to suppress HIV is antiretroviral (ARV) which gradually recover CD4 cells of the patients. This study aims to determine the effect of duration of the antiretroviral therapy (ART) duration on CD4 counts in patients with HIV at the VCT (Voluntary, Counselling, and Test) Polyclinic, dr. Doris Sylvanus Hospital during 2019-2020. It is a descriptive retrospective study, extracting data from patients medical record data. Following total sampling and selected based on inclusion and exclusion criteria i.e. aged ≥18 years and diagnosed with HIV during 2019-2020, with complete CD4 count records prior and after ART, there were 45 patients included. The results showed that CD4 counts increased in patients with fixed dose combination (FDC) Tenofovir, lamivudine and efavirenz, with average value of 190.36± 220.92 cells/mm3 prior ART, became 259.93± 203.74 cells/mm3 at 12 month ART, and 310.82± 22.,53 cells/mm3 at 24 month ART (p = 0.000). Thus, the longer ART duration the higher CD4 counts and recover the normal range.

The Profile of Osteogenesis Imperfecta in Dr. Moewardi General Hospital Year 2020-2021: A Retrospective Study

Udi Heru Nefihancoro — 2023-08-31

Osteogenesis imperfecta (OI) is a heritable bone dysplasia characterized by bone fragility and long bone deformities. This study aims to report the profile of osteogenesis imperfecta in Dr. Moewardi General Hospital. The patients were searched from the medical record, registered from January 1, 2020, to December 31, 2021, in Dr. Moewardi General Hospital, a tertiary hospital in Surakarta, Indonesia. The data were recorded and described in tables as age, sex, type of OI according to Sillence, clinic, ward admission, signs and symptoms, bisphosphonate therapy and its discipline, as well as the surgical/non-surgical treatment. The quantity of male patients is higher than that of females, OI type IV is the most common, the most common sign/symptoms are fracture and blue sclera, and the most common bone to be fractured is the femur. More than half of patients received bisphosphonate therapy, but only a quarter received it routinely. More than half of patients have performed surgery as the treatment of fractures. Osteogenesis imperfecta patients require an interdisciplinary and tailored treatment that involves both medical and surgical components.

The Correlation between Sleep Quality and Level of Stress among Students in Islamic Boarding School Bogor

Bety Semara Lakshmi — 2023-08-31

Sleep period and performance affect mental health. Multiple studies have linked sleep quality and duration to mental health in metabolic patients, but studies on sleep patterns and mental health symptoms in healthy people, especially in Islamic boarding schools, are limited. The goal of this research is to look into the relationship between sleep patterns and performance in relation to mental health in students who attend Islamic boarding schools. In this cross-sectional study, a self-administered questionnaire consisting of the Pittsburgh Sleep Quality Index (PSQI) and the Depression, Anxiety, and Stress Scale-21 (DASS21) was distributed to students at the Wadi Mubarok Islamic boarding school. Total blood sugar and cholesterol levels were measured using EasyTouch glucometer. Fasting glucose levels are used to support the results of stress conditions in the body, which are indicated by an increase in fasting blood glucose levels, which are normally less than 100mg/dl. To see the relationship, a Spearman rank correlation test was carried out. From the results of the examination, plasma glucose levels were 118.1±4.03mg/dl, and plasma uric acid levels were 5.54±0.24 mg/dl. There is a weak correlation between sleep quality and depression (r=0.341; p<0.05) and a fairly strong correlation between sleep quality and anxiety (r=0.437; p<0.05). In this study, poor sleep quality and short sleep duration were linked to an increased incidence of depression and anxiety symptoms. These findings imply that inadequate sleep duration and performance could be a contributor to the development of mental disorders.

The Effect of Personality Types on Blood Pressure in Female Patients Over 17 Years of Age

Bunga Fardah Nahdiyah Achmada — 2023-08-31

Hypertension is non-communicable and one of the main sources of premature death in the world, but the cause of this disease generally is still unknown. It is important to note that personality types are included among the suspected influencing factors due to being related to controlling behavior, emotions, and stress. According to Hippocrates-Galenus, they are divided into sanguine, melancholy, choleric, and phlegmatic. Therefore, this research aimed to determine respondents' characteristics, differences in blood pressure (BP) between personality types, and the effect of personality types on BP. The design employed was descriptive-analytic with a cross-sectional approach, and the sample used was 56 respondents, selected by purposive sampling technique. The data on personality types were collected by filling out a questionnaire, while BP data were obtained through BP measurement with a digital tensimeter, and the analysis was conducted with Fisher's Exact, Kruskal-Wallis, and one-way ANOVA tests. The results showed that most respondents, i.e. 62.5% were aged 17-29 years, 20% had BMI ≥27 or Obesity, 10.7% had SBP/DBP=140-149/90-99 or hypertension stage 1, 37.5% were married, 26.8% had birth control history, alcohol consumption history =0%, smoking history =1.8%, 35.7% had phlegmatic personality type, and 10.7% suffered hypertension. The results showed that there was a significant difference between personality types and systolic and diastolic blood pressure, respectively p=0,03 and 0,045. There is no effect of each personality type on blood pressure (p>0,05). In conclusion, despite the different SBP and DBP values of personality types, no effect is created on BP.

Study of Dysgeusia and Anosmia Frequency and Risk Factors in Pre-Elderly Post-Covid-19

Ari Tri Wanodyo Handayani — 2023-08-31

Covid-19 is a respiratory obstruction caused by infection with SARS-CoV-2. The appearance of dysgeusia and anosmia can be a sign that someone has contracted this virus. This study aims to review the frequency and risk factors that cause dysgeusia and anosmia in pre-elderly post-Covid-19. This type of research is descriptive observational with a cross-sectional approach. In this study, only 5.15% of respondents experienced anosmia, 10.31% of dysgeusia alone, and 28.86% of dysgeusia accompanied by anosmia. Dysgeusia and anosmia can be found in every vaccination status. Respondents with ≥1 dominant comorbid were found in respondents who experienced dysgeusia accompanied by anosmia. Symptoms of fever, cough, rhinorrhea, and pneumonia are common in dysgeusia and anosmia disorders. The time of appearance of the disturbance ranges from 1-7 days, with the duration of the disruption 1-14 days. Symptoms of dysgeusia accompanied by anosmia in the pre-elderly post-Covid-19show a higher frequency than dysgeusia alone and anosmia alone. In pre-elderly, men were found to be more at risk than women. Several risk factors, including the aging process, co-morbidities, smoking habits, and vaccination status, support the emergence of these symptoms.

Emphysematous Cystitis with Bladder Mass caused by Colovesical Fistula: A Rare Case Report

Yosi Rizal — 2023-08-31

Emphysematous cystitis (EC) is a rare manifestation of a complicated urinary tract infection, and its pathognomonic feature is a gas appearance inside the bladder wall and lumen. Emphysematous cystitis with bladder mass is an extremely rare finding. In this case study, a 59-year-old female presented with dysuria and pneumaturia for two months before admission. Following history taking and physical examination, a CT scan was performed to establish the diagnosis, which revealed thickening bladder wall with free gas appearance, impressing emphysematous cystitis. Urine culture showed no bacterial growth, cystoscopy revealed posterosuperior bladder mass, a biopsy was done followed by fulguration of the bladder and showed no malignancy, and MRI implied emphysematous cystitis with bladder dome adhesions of colon mass with colovesical fistula. After resection of colon anastomosis, colitis was found as the etiology of the colovesical fistula. An accurate diagnosis of the disease and correct treatment would result in a good prognosis and outcome.

Octreotide Treatment for Hypoglycemic Refractory Case Caused by Sulfonylureas with Impaired Renal Function

Taufiq Abdullah — 2023-08-31

Hypoglycemia is an emergency case that is caused by antidiabetic drugs from the sulfonylurea class. Prolonged and refractory hypoglycemia can increase mortality and morbidity. Renal impairment can result in recurrent hypoglycemic symptoms and require special treatment. In this study case, a 47-year-old woman with newly impaired renal function presented in a coma caused by hypoglycemia due to the use of glibenclamide (sulfonylurea drugs) that did not respond to standard hypoglycemic treatment. Treatment of refractory hypoglycemia is a challenge in itself. Octreotide may be considered in cases of refractory hypoglycemia that does not respond to standard glucose treatment, where in this case refractory hypoglycemia is caused by accumulating sulfonylurea because of impaired renal function.

Iatrogenic Penile Amputation Due to Circumcision Clamp in an Eight-Year-Old Boy

Muhammad Baihaqy Ibnu Hakim — 2023-08-31

The circumcision clamp has been the primary alternative to the traditional surgical circumcision procedure since its invention in 1934. The circumcision clamp has the following advantages such as improved wound healing, shorter operation time, and no stitch removal pain. However, the clamp technique has a disadvantage where the operator cannot visualize the glans penis. Many studies have already reported the incidence of trauma or psychiatric disorders related to penile amputation, but the case of circumcision clamp-related penile amputation in Indonesia had never been reported. An eight-year-old boy was taken to the emergency department with post-circumcision bleeding. The patient had been circumcised using an Anastomat® circumcision device in the clinic, two hours prior and then referred to the emergency department. We perform penile exploration, and a defect in the ventral part of the glans penis was found, with the source of bleeding coming from the glans penis, and the urethra remained intact. Penile degloving with urethral spatulation and catheterization with a 10 Fr 2-way foley catheter was installed, continued with penile reconstruction and skin closure. The operation lasted for about sixty minutes. After six months of follow-up, the patient could urinate normally and spontaneously without any clinical complaint. Even though circumcision using a circumcision clamp is considered a safe procedure and preferable to surgical circumcision nowadays, it is necessary to emphasize that the use of a circumcision clamp still has a risk rate for penile amputation.

Management of Iatrogenic Ureteral Trauma Post Caesarean Section

Prilian Akbaril Satryo Pamungkas — 2023-08-31

Trauma in the ureter occurs in 1-2.5% of all urogenital trauma, and the most common causes of iatrogenic ureteral trauma come from the Obstetrics Gynecology field (59%). One of the causes of delayed diagnosis of ureteral trauma is the lack of operator awareness. This case report described a 29-year-old woman suspected of ureteral trauma after urine-like fluid was found during a cesarean section operation. After 12 days, a clear-yellowish fluid was obtained from the abdominal drain, so the patient was referred to urologists. The abdominal drain produced fluid approximately 250-300cc/24 hours, clear yellow color. IVP and left RPG inferred left distal ureter laceration AAST grade III. Re-exploration, ureteroneocystostomy using Boari Flap technique, and DJ-Stent insertion were done. On the second day postoperative, the abdominal drain production was < 25cc/24 hours in red color. Ureteral trauma is rare, often unnoticed, and often diagnosed late due to a lack of operator alertness.