Jurnal Kedokteran Brawijaya

Aphrodisiac Activity of Beligo (Benincasa hispida (Thunb.) Cogn.) Seeds of Ethanol Extract in Mice

Nur Alim, Jasmiadi Jasmiadi, Nadia Nadillah, Ira Indrawaty Kadir , Nur Afirah — Fri, 30 Aug 2024 00:00:00 +0000

Beligo (Benincasa hispida (Thunb.) Cogn.), is empirically used by the people of South Sulawesi-Indonesia as an aphrodisiac. Beligo seeds contain alkaloids, phenolics, flavonoids, and unsaturated fatty acids, which have the potential to act as aphrodisiacs. The primary objective of this research is to determine the aphrodisiac activity of an ethanol extract from beligo seeds in mice. The procedure entails extraction and aphrodisiac evaluation using introduction, climbing, and coitus test parameters. Aphrodisiac testing was carried out for seven days using 25 mice as experimental animals, divided into five groups. Each group consists of four males and one female. Group I was given Sod. CMC 1% as a negative control; II, III, and IV were given ethanol extracts of beligo seeds at doses of 350mg/kg, 700mg/kg, 1400mg/kg BW, and group V, as a positive control, was given Yohimbine. The results showed that the ethanol extract of beligo seeds at doses of 350mg/kg BW, 700mg/kg BW, and 1400mg/kg BW had aphrodisiac activity (p=0.0001) compared to Sod. CMC 1% based on data on the amount of introduction and climbing. However, based on data on the number of coitus, it showed that the ethanol extract of beligo seeds at doses of 350mg/kg BW (p=0.072) had no aphrodisiac activity, 700mg/kg BW (p=0.007), 1400mg/kg BW (p=0.0001) had aphrodisiac activity compared to Na-CMC 1% and only a dose of 1400 mg/kg BW had the same aphrodisiac activity compared with Yohimbine (p=0.967). It is concluded that the ethanol extract of beligo seeds had aphrodisiac activity.

The Effect of Lipopolysaccharide Challenge in RAW 264.7 Cells on Nitric Oxide Release and Cell Viability

Ratih Paramita Suprapto, Inggita Kusumastuty, Ardian Rizal, Dwi Adi Nugroho — Fri, 30 Aug 2024 00:00:00 +0000

Lipopolysaccharide (LPS) is a major component of a gram-negative bacterial wall that is widely used and well-established to induce inflammation in vitro. In addition, the in vitro model using RAW 264.7 cells is the most commonly applied in screening the anti-inflammatory and elucidating the pathophysiology of inflammation-based disease, as well. However, there is still limited data on the efficacy of different doses of LPS in inducing inflammation in RAW 264.7 cells. This study aimed to evaluate the effect and safety of LPS at various doses in RAW 264.7 cells. RAW 264.7 cells were exposed to LPS at different dose ranges (10ng/mL-10µg/mL) for 24 hours. The nitric oxide (NO) release as inflammatory responses and viability test were evaluated using Griess assay and CCK-8 assays, respectively. The result showed that NO production was increased at different doses of LPS compared to the control although not significant. Whereas, All LPS-treated RAW 264.7 cells tended to increase but not significantly compared to the control groups. This study showed that the LPS treatment effectively induced inflammation in RAW 264.7 cells as shown by NO production and was considerably safe as the viability was comparable between LPS and control group for RAW cells 264.7 at least up to 10µg/mL for 24 hours.

Effectiveness of Earthworm Extract on the Lipid Profile of Diabetic Wistar Rats

Suandy Suandy, Linda, Angel — Fri, 30 Aug 2024 00:00:00 +0000

Various metabolic diseases, such as diabetes mellitus, are characterized by hyperglycemia, stemming from decreased insulin action, secretion, or both. The use of chemical medicines for diabetes mellitus, especially acarbose, involves regulating the digestion and absorption of complex carbohydrates. However, acarbose may disrupt liver function, prompting exploration into alternative sources for treatment, such as earthworm extract. The purpose of this study was to identify the effectiveness of ethanol extract and coelomic fluid from earthworms (E. eugeniae) on the lipid profile of male diabetic wistar rats (R. norvegicus) in vivo. The research hypothesis is that earthworm extracts could effectively lower the lipid profile of diabetic Wistar rats. This research is experimental research with pre-test and post-test control study group design, using an in vivo method. The results of the one-way ANOVA test of HDL were p=0.441; p=0.441; p=0.000; for LDL were p=0.691; p=0.101; p=0.049; for total cholesterol were p=0.107; p=0.347; p=0.486; and for triglycerides were p=0.028; p=0.926; p=0.553 on days 0, 7, and 14, respectively. Based on the research data, both ethanol extract and a combination of ethanol extract and coelomic fluid were able to reduce lipid profile levels on the 7^th and 14^th days. Earthworm extract has the potential to promote repair of β cells and is anti-inflammatory which can be used to reduce lipid profile levels.

Correlation of Wellness Program Against Degenerative Indicators Through Experimental Pre-Posttest

Suandy Suandy, Susianto Susianto, Erwin Handoko, Kevin Luwis, Vindelin Sanoesi — Fri, 30 Aug 2024 00:00:00 +0000

The incidence of degenerative diseases, such as hyperuricemia, hypercholesterolemia, obesity, hypertension, and diabetes mellitus, is increasing, primarily due to unhealthy lifestyles. Holistic treatment, involving pharmacology and lifestyle modification, is recommended. The Wellness program, covering diet, exercise, and relaxation techniques like meditation and yoga offers a holistic approach to reduce the incidence of degenerative diseases. Adopting a Wellness program could have positive outcomes, including cost-effectiveness, nutritional balance, and improvements in both physical (through yoga) and mental (through meditation) well-being, but the potential downsides include lack of control groups, inadequate consideration of age and gender, insufficient sample sizes, limited observation days, and an excessive number of measured parameters. This study aims to see the effectiveness and influence of the Wellness program on reducing uric acid levels, cholesterol, blood sugar levels, systolic and diastolic blodd pressure. The intervention is designed for women aged 30-60 who experience rage. However, individuals who are consuming medications or supplements, pregnant, breastfeeding, or not following a prescribed diet are excluded. This study used the quasi-experimental pre-posttest design to see the Wellness program’s effectiveness on uric acid, blood pressure, blood sugar levels, and total cholesterol. Sample size calculation was performed using G*Power version 3.1.9.7, and data analysis utilized the T-paired sampled test. The findings from a 3-day study involving 47 participants revealed significant differences post-implementation of the Wellness program, indicating a reduction in uric acid levels and an increase in blood sugar levels with a p-value<0.05.

Identification of Gram Negative Bacteria in the Urine of Catheterized Patients at Referral Hospital in Ternate

Septiana Waraningsih, Wahyunita Do Toka, Muhammad Dahlan, Ismail Rachman — Fri, 30 Aug 2024 00:00:00 +0000

Infections can occur anywhere and often occur usually sourced from hospitals. Nosocomial infection is an infection caused by various microorganisms, one of which is bacteria originating from the hospital environment. Gram-negative bacteria, especially the Enterobacteriaceae family, are the main bacteria that cause nosocomial infections. One of the common infectious diseases in health care is urinary tract infection and some UTIs are caused by catheter insertion. This research aimed to identify gram-negative bacteria in the urine of catheterized patients at RSUD Dr. H. Chasan Boesoirie, a referral hospital in Ternate. The research method is descriptive observational with a cross sectional approach using a total sampling technique obtained 83 samples from November 14, 2023 to December 17, 2023. The results showed that 7 samples (8.4%) were identified as positive for gram-negative bacteria with 7 types of bacterial species and the highest percentage of bacteria was Escherichia coli (33.4%). The use of urinary catheters was mostly female (55.4%) with the highest age in the age group 56-65 years (34.9%) and the duration of urinary catheter use was mostly in samples with a duration of <72 hours (90.4%). In conclusion, gram-negative bacteria were identified in the urine of catheterized patients.

The Impact of Obesity on Dysmenorrhea and Lower Urinary Tract Symptoms in Adenomyosis Patients

Asih Anggraeni, Yudhistya Ngudi Insan Ksyatria, Ikhwan — Fri, 30 Aug 2024 00:00:00 +0000

Obesity poses a substantial health challenge globally, affecting various aspects of reproductive health, including adenomyosis. Adenomyosis, characterized by the presence of endometrial tissue within the myometrium, commonly affects women during their reproductive years, leading to symptoms such as dysmenorrhea and lower urinary tract symptoms (LUTS). This study aimed to investigate the influence of obesity on dysmenorrhea and LUTS severity in adenomyosis patients, considering demographic factors such as age and educational levels as potential moderators. Forty-four adenomyosis patients participated in a cross-sectional study at Dr. Moewardi General Hospital in Surakarta City of Indonesia, between April and September 2023. Diagnosis was confirmed using 2D Transvaginal Ultrasound (2D-TVUS). Obesity was defined using Body Mass Index (BMI) categories, and dysmenorrhea and LUTS were assessed using the Numerical Rating Scale (NRS) and modified International Prostate Symptom Score (IPSS) questionnaire, respectively. Statistical analyses included Pearson correlation. Results indicated a significant positive correlation between obesity and dysmenorrhea (rho = 0.256, P = 0.049) and LUTS (rho = 0.292, P = 0.029). Age and educational level did not significantly moderate these relationships, emphasizing the independent influence of obesity on symptom severity. In conclusion, obesity significantly impacts the severity of dysmenorrhea and LUTS in adenomyosis patients, highlighting the need for tailored management strategies that address both hormonal and inflammatory pathways.

The Study of Congestive Heart Failure as a Risk Factor of Cardiac Arrest in ICU

Ardi Pramono, Andhika Rajendra Hernawan — Fri, 30 Aug 2024 00:00:00 +0000

Cardiovascular disease, especially congestive heart failure, is the second most common cause of death after stroke In Indonesia, current data on cardiac arrest in the ICU, especially those related to CHF, are still limited. This study aimed to determine the relationship between congestive heart failure and cardiac arrest in Intensive Care Unit (ICU) inpatients. The study used an analytic observational method with a cross-sectional research design. To find the relationship between the two variables, a regression test was performed on subjects with congestive heart failure and cardiac arrest in the ICU. Data was collected from 316 subjects, including 111 Congestive Heart Failure (CHF) subjects and 205 without CHF. Of the 111 CHF subjects, 51 subjects (45.9%) experienced cardiac arrest, and 60 subjects (54.1%) did not experience cardiac arrest. In comparison, the 205 subjects without CHF comprised 125 subjects (61.0%) who experienced cardiac arrest, and 80 subjects (39.0%) did not experience cardiac arrest. There is a relationship between congestive heart failure (CHF) and cardiac arrest, but CHF is not the only risk factor for cardiac arrest (p<0.05; OR 0.75). Congestive heart failure is associated with cardiac arrest in ICU patients with a relative risk of 0.75 times compared to subjects without congestive heart failure. Future research is needed to find the cause of congestive heart failure leading to cardiac arrest.

C-Reactive Protein (CRP) Value and Platelet Counts in Pediatric Dengue Patients at RSUP Dr. Hasan Sadikin Bandung

Indri Irawati, Nina Tristina, Basti Andriyoko — Fri, 30 Aug 2024 00:00:00 +0000

Plasma leakage, thrombocytopenia, and cytokines play roles in pathogenesis of dengue infection. Thrombocytopenia correlates with severity of the disease. Dengue virus infection produces cytokines that stimulate C-Reactive Protein (CRP). This study aims to describe the results of CRP and platelet counts with severity of dengue infection in paediatric inpatient at Hasan Sadikin Hospital Bandung. This is a descriptive observational study with retrospective, cross-sectional data collection in January 1-December 31, 2021 at Hasan Sadikin Hospital. From 32 total subjects, there were 24(75%) non-severe dengue infections compared to severe dengue 8(25%). Non-severe dengue 19(79.2%), had the most platelet counts of 50,000-150,000/L, while platelets count 20,000-50,000/µL was mostly in severe dengue 4/8(50%). CRP value was mostly normal (<0.3mg/dl) as many as 18/24(75%) in mild dengue, whereas in severe dengue CRP was mostly high as many as 6/8(75%). CRP examination is mostly done in critical phase, both in severe and non-severe dengue. Severe dengue infection was found mostly in platelet counts of 50,000-150,000/µL and normal CRP level as many as 14(58.3%). In severe dengue infection, platelet counts was found mostly in 20,000-50,000/µL and high CRP (≥0.3mg/dl) as many as 3(37.5%). Most cases of dengue fever infections in children at Hasan Sadikin General Hospital in 2021 were of mild severity, with platelet counts ranging from 50,000 to 150,000/µL and normal CRP levels. Examinations were typically carried out during the critical phase.

Examining the Relationship between Infection Control Practices and ESBL Bacterial Carriage in Healthcare Workers

Fri, 30 Aug 2024 00:00:00 +0000

The Enterobacteriaceae family widely produces Extended Spectrum Beta-Lactamase (ESBL), and infection by ESBL-producing bacteria can significantly increase morbidity, complicate therapeutic difficulties, escalating healthcare costs, and increase mortality rates. Transmission of these bacteria within the hospital environment may lead to the prevalence of ESBL-producing bacterial carriers among healthcare workers. Health workers' infection prevention and control (IPC) behavior plays a role in transmitting these pathogenic bacteria. This study aimed to determine the relationship between IPC behavior and the incidence of ESBL-producing bacterial carriers in health workers at Banjarnegara Islamic Hospital. This research used an observational analytic approach with a cross-sectional method. The sampling technique involved purposive sampling, resulting in a total sample of 61 people. Data were obtained by completing an IPC behavior questionnaire and collecting rectal swab samples cultured on CHROM ESBL Agar media. Statistical analysis was done using the Mann-Whitney test. The research identified a prevalence of 13.1% (8/61) ESBL-producing bacterial carriers among health workers at Banjarnegara Islamic Hospital. However, based on statistical analysis, the p-value was 0.664, leading to the rejection of the hypothesis (accepted if p-value <0.05). In conclusion, there is no significant relationship between IPC behavior and the incidence of ESBL-producing bacterial carriers in health workers at Banjarnegara Islamic Hospital.

Effectiveness of Social Skills Training to Improve Social Functioning Scores in Schizophrenia Patients at X Lawang Mental Hospital

Dwi Ratna, Irwan Supriyanto, Budi Pratiti — Fri, 30 Aug 2024 00:00:00 +0000

Disability can cause social dysfunctions that affect daily activities, social interaction, and work, which has a significant impact on the quality of life of schizophrenics so that they depend on other people. The use of pharmacotherapy alone is not enough; psychosocial interventions such as social skills training (SST) is needed to improve social functioning in schizophrenic patients. Incorporating social skills training (SST) into a multifaceted treatment and rehabilitation program is deemed significant. The study aimed to determine the effect of social skills training to improve social functions in schizophrenia patients in X Lawang Mental Health. This study used a pre-experimental design with one group pre-test and post-test. Of 40 patients with schizophrenia who were admitted to X Lawang Mental Health fulfilled the inclusion and exclusion requirements. Social function scores were measured using the Personal and Social Performance (PSP) instrument before and after the social skills training intervention. The level of significance of statistical tests is stated at p<0.05. Data analysis used the Wilcoxon test and linear regression. There was significant difference in social functioning scores between before and after social skills training with a value of p=0.000 (p<0.05). The results of the multivariate linear regression test showed that social skills training had a statistically significant effect to improve social function scores with a value of p=0.000. Social skills training has a significant effect to improve social functioning scores in schizophrenics at X Lawang Mental Health.

Thromboelastography Profile of Covid-19 Patients Before and After Convalescent Plasma Therapy Administration

Fri, 30 Aug 2024 00:00:00 +0000

In Covid-19 patients, coagulopathy disorder is commonly characterized as hypercoagulable, although hemorrhagic complications can arise. However, thromboelastography (TEG) is an examination tool with the ability to assess the complete hemostasis process, including primary, secondary, and fibrinolysis stages, closely resembling the in vivo coagulation process. Therefore, this study provides a descriptive analysis of the hemostatic state of Covid-19 patients before and after administration of convalescent plasma therapy using TEG. In this study, the blood sample was collected from 21 Covid-19 patients at RSSA Malang from June to November 2020, followed by a TEG examination, which was performed on the first day of admission and after convalescent plasma therapy administration. The results were analyzed descriptively. Before convalescent plasma therapy, coagulation index (CI) analysis of TEG results in 21 patients showed that 62% exhibited normocoagulability, 23.8% were hypercoagulable, and 14.2% used hypercoagulability. While TEG results after convalescent plasma therapy showed that 71.4% were normocoagulable, 4.7% hypocoagulable, and 23.9% hypercoagulable. Based on TEG parameters, R, K, and MA, before administration of convalescent plasma therapy showed decreased platelet function by 38%, primary fibrinolysis by 5%, secondary fibrinolysis by 10%, platelet hypercoagulability 5%, and 43% was normal. Coagulopathy profile after convalescent plasma therapy showed decreased platelet function by 24%, secondary fibrinolysis by 10%, platelet hypercoagulability by 10%, enzymatic hypercoagulability by 5%, enzymatic and platelet hypercoagulability by 5%, and 48% was normal. TEG in Covid-19 patients showed a hypercoagulable state before and after administration of convalescent plasma therapy

The Role of Plasma Osmolarity in the Mortality of Patients with Covid-19

Dewi Indiastari, Didi Candradikusuma, Heri Sutanto, Niniek Budiarti, Nur Samsu — Fri, 30 Aug 2024 00:00:00 +0000

Covid-19 (Coronavirus disease 2019) is a new infectious disease that attacks the respiratory tract and is caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), causing multiorgan failure, often requiring temporary support such as the use of a ventilator or hemodialysis equipment. This condition is related to an imbalance in fluid distribution associated with changes in osmolarity or hyperosmolarity. This research aims to explain the role of plasma osmolarity in Covid-19 patients at dr. Saiful Anwar Hospital, Malang, in patient outcomes, especially death outcomes. The sample for this study was 205 medical records of Covid-19 patients, recorded from September 2021 to May 2022. This study used a retrospective cohort design to describe plasma osmolarity in Covid-19 patients and the outcome of hospitalized patients. There were 205 patient data obtained, with 85 patients dying aged <65 years. Sixty-eight patients of Covid-19 with comorbidities (DM, HT, AKI, CKD, combination) died. There was no difference in plasma osmolarity for living and deceased patients. Repeated plasma osmolarity (retest) had a good degree of accuracy in predicting the outcome of Covid-19 patients, where sensitivity was 71.3% and specificity was 73.4% at a cut-off value of 277.32mOsm/L. The repeat plasma osmolarity value of ≥277.32 had a PPV value of 75%, while plasma osmolarity <277.32 had an NPV value of 69.3%. The OR value was 6.77, meaning that Covid-19 patients with repeated plasma osmolarity levels ≥277.32 would have 6.77 times the risk of mortality compared to Covid-19 patients with repeated plasma osmolarity levels <277.32.

Clinical Profile and Prognostic Factors of Mortality in Elderly Covid-19 at Ansari Saleh Hospital

Wiwit Agung SNC, Ana Khairina, Erni Erianty — Fri, 30 Aug 2024 00:00:00 +0000

Morbidity and mortality of elderly with Covid-19 are higher than in adults. This study aimed to determine the prognostic factors of mortality in elderly with Covid -19. This research was a retrospective cohort study in patients aged 60 years and older with a PCR-confirmed diagnosis of Covid -19 admitted to Ansari Saleh Hospital, South Kalimantan, Indonesia between January to July 2021. Data on age, sex, comorbidities, symptoms, physical examinations, laboratory examinations, chest x-rays, and Covid severity degree were collected, univariate and multivariate analyses performed to determine the independent prognostic factors. The research results showed 209 samples met the criteria. The average age was 66,94 years, dominated by men (57.9%). The most common comorbidities were hypertension (48.8%), diabetes mellitus (35.4%), and chronic heart failure (8.1%). The most frequent symptoms were dyspnea (79.9%), cough (74.2%), and fever (56.5%). Patients treated mostly had severe/critical degree of Covid -19 (140 patients, or 67%). The results of multivariate logistic regression analysis on the variables of respiratory rate (p=0.009; OR=1.1), NLR level (p=0.002; OR=1.081), age (p=0.025; OR=2.479) and Covid severity degree (p=0.008; OR=8.206) showed significant results as independent prognostic factors of mortality. Covid severity degree variable has the highest prognostic level; patients with severe Covid degree have an 8.206 times higher chance of death than mild-to-moderate degrees. In conclusion, respiratory rate, NLR level, age, and Covid severity degree can act as prognostic factors of mortality in elderly suffering from Covid-19.

Correlation between De Ritis Ratio with Severity of Covid-19 Patients Severity

Tiene Rostini, Khairunnissa Khairunnissa, Dewi Kartika Turbawaty — Fri, 30 Aug 2024 00:00:00 +0000

SARS COV-2 is the causative agent of the infectious disease Corona Virus Illness-19 (Covid-19). Covid-19 can cause damage to multiple organs, including the liver. The de Ritis ratio is a ratio between AST and ALT in blood serum, which may be a useful indicator for assessing liver damage in Covid-19 patients. The aim of this study is to determine the association between the severity of liver injury and an increase in the de Ritis ratio in Covid-19. The study population included patients with acute Covid-19 disease whose infection was validated using real-time PCR. A retrospective cross-sectional study was conducted. There were 1.983 subjects included, and 1.123 belonged to the moderate, 673 severe, and 181 to the critical groups. Calculations using Spearman rank revealed a strong significant association between De Ritis ratio and Covid-19 grade severity (rs=0.624, p<0.001). The more severe Covid-19, the higher de Ritis ratio values. The ROC curve of de Ritis ratio with Covid-19 severity shows AUC of 0.771 (P<0.001), sensitivity of 63.5%, specificity of 90.6%, PPV of 98.5% and an NPV of 20.02%. In conclusion, the severity of Covid-19 symptoms increases proportionally with the de Ritis ratio.

Risk Factors Analysis for Rapid In-Hospital Mortality among Covid-19 Patients in a Tertiary Care Hospital in Indonesia

Fri, 30 Aug 2024 00:00:00 +0000

Systemic inflammation plays an important role in pathogenesis of Covid-19, especially in development of ARDS which is characterized by decrease of PaO2/FiO2 ratio. CRP and procalcitonin are inflammatory markers that are closely associated with severity and mortality of Covid-19. Although several studies have addressed benefit of CRP and procalcitonin as markers on Covid-19 severity, the benefit of these inflammatory markers for in-hospital mortality remain inadequately understood. The aim of this study was to analyze PaO2/FiO2 ratio,comorbidity,CRP,and procalcitonin as risk factors that affect time of in-hospital mortality Covid-19 patient. This was a retrospective observational cohort study of 250 Covid-19 patients who died during hospitalization and data was retrieved from medical record. Laboratory data was collected from three different times, including at time of admission,third day of hospital care,and before patient’s death. Data were analyzed using Chi square test,Mann Whitney test,Wilcoxon test, Friedman test, and binary logistic regresion. There were significant differences between CRP and procalcitonin at admission and time of in-hospital mortality (p<0.001; p=0.007). Binary logistic regression analysis revealed significant relationship between CRP and time of in-hospital mortality with p=0.007. ROC curve showed optimal threshold of 11.75mg/L with sensitivity 72.3%; specificity 59.6%, RR 3.24(95% CI: 1.84-5.70). Significant changes were observed regarding PaO2/FiO2 ratio,CRP,and procalcitonin at admission as compared to before patient’s death with p<0.001;p=0.017;p<0.001 respectively. This study showed significant decrease of PaO2/FiO2 ratio, elevated CRP and procalcitonin at admission as compared to before patient’s death. The increase of CRP could serve as predictor for time of in-hospital mortality for Covid-19 patient.

The Effectiveness of Silicon Wound Dressing for the Healing Process of Contaminated Abrasions

Fri, 30 Aug 2024 00:00:00 +0000

Wounds are skin disorders caused by pathological processes. Abrasion wounds are a type of acute injury. One of the contributing factors is traffic accidents. More than 1.2 million people died as a result of traffic accidents, while 20-50 million others suffered injuries. Choosing the proper dressing can determine wound healing. This case study aims to determine the effectiveness of silicone wound dressing in the healing process of contaminated abrasion wounds. Contaminated abrasion wounds are contaminated by dirty materials, which potentially cause infection. This case report describes four patients, Mrs. W, Mrs. K, Mr. Y, and Mr. M., who suffered abrasions on the face. Their wounds were cleaned in the operating room under general anesthesia. A silicone wound dressing is applied as the primary dressing. The secondary dressing depends on the amount of the exudate. On the 3rd day after the surgery, the wounds looked dry, so they were cleaned and reapplied with the silicone dressing. On the 7th day, after applying silicone wound dressing, the wound had epithelialized. Silicone wound dressing is a modern type of dressing that is effective for acute wounds as it provides a barrier against external contamination. Our sample shows that wound are abrasion contaminated. The result of silicone wound dressings applied was shown accelerate the wound healing process. Modern dressings accelerate wound healing 20% to 40% faster than conventional dressings, such as gauze, tulle, or gauze.

Case Series: Two Cases of Critical Pulmonary Artery Stenosis Focusing on the Timing of Diagnosis and Management

Dyahris Koentartiwi, Ardhanis Ramadhanti, Monica Damayani Susilo — Fri, 30 Aug 2024 00:00:00 +0000

Critical stenosis of the pulmonary valve in neonates is related to ductus-dependent pulmonary circulation. Percutaneous transcatheter balloon valvuloplasty (PTBV) is the treatment of choice for critical pulmonary stenosis. Unfortunately, many children in developing countries are usually diagnosed late and seldom get immediate care, which leads to delayed growth and development and, ultimately, higher morbidity and mortality. We present two cases of critical pulmonary artery stenosis in a 17-year-old boy and a 4-day-old girl who received PTBV procedures, but had different outcomes. We underline the importance of early diagnosis and intervention in critical pulmonary stenosis for the patient’s prognosis.

Imperforata Hymen: Secondary Urinary Retention due to Hematocolpos Compression in a 13-Year-Old Woman

I Gede Bagus Sentosa, Rommy — Fri, 30 Aug 2024 00:00:00 +0000

Imperforate hymen is a rare congenital anomaly in which the hymen completely covers the vaginal opening, caused by the failure of vaginal plate canalization during the embryonic period. This article reported a 13-year-old girl with a chief complaint of cyclic monthly lower abdominal pain, suprapubic pain, and inability to urinate. She denied prior menstruation. Cystic mass was palpated in the suprapubic area, and the hymen was seen covering the entire vaginal introitus. Hematometra and hematocolpos were found on abdominal ultrasonography and the patient was diagnosed with imperforate hymen. Hymenectomy was performed and she had regular menstruation afterwards. If left untreated, it can lead to morbidities such as infection, endometriosis, subfertility, and kidney failure. It is essential for clinicians to consider imperforate hymen as the differential diagnosis and examine the external genitalia, especially in adolescents with cyclic monthly lower abdominal pain and amenorrhea.

Congenital Orbital Teratoma of the Newborn: A Rare Case Report

Fri, 30 Aug 2024 00:00:00 +0000

Congenital orbital teratoma is a rare and complex congenital anomaly due to abnormal tissue growth within the orbit. This case report aims to highlight the significance of early prenatal screening in identifying congenital orbital teratoma and its potential complications. A 6-day-old male newborn presented with macrocephaly and a unilateral massive protrusion of the left eye. Prenatal ultrasonography performed at 36 weeks gestation showed a suspicion of fetal craniofacial mass. Further brain CT scan revealed an orbital heterogeneous mass, with calcified components dominantly in the anterior and middle cranial fossa into the left orbit, which was subsequently diagnosed as congenital orbital teratoma associated with non-communicating hydrocephalus. This finding prompted an urgent ventriculoperitoneal (VP) shunt. Unfortunately, despite prompt intervention, the patient passed away after the procedure. Pathological examination was compatible with an immature teratoma. Multidisciplinary management is warranted to improve diagnostic screening and refine management strategies for better outcomes in such cases.

Left Lobe Hepatocellular Carcinoma in Non-Alcoholic Fatty Liver Disease Patient: A Case Report

Fri, 30 Aug 2024 00:00:00 +0000

Hepatocellular Carcinoma (HCC) is the second most common cause of death from cancer worldwide, affecting more men than women with a ratio of 2:1. Approximately 70–90% of HCC patients have risk factors such as chronic liver disease and liver cirrhosis. Another significant risk factor is non-alcoholic fatty liver disease (NAFLD). We report a case of left lobe hepatocellular carcinoma in a 54-year-old woman who presented with heartburn and shortness of breath, with a history of hypertension but no alcohol consumption. Chest X-ray revealed cardiomegaly without pulmonary congestion. A whole abdominal CT scan identified a left lobe hepatic tumor measuring ± 11x12x13 cm. Pathology examination revealed an epithelial mass with infiltrative, trabecular, acinar, and solid arrays, indicative of a malignant liver tumor.