Indonesia Journal of Biomedical Science Open Access Journal of Biology, Pharmacology, Medicine, Chemistry, Biochemistry en-US <p><a href="" rel="license"><img src="" alt="Creative Commons License" /></a><br /><span>This work is licensed under a </span><a href="" rel="license">Creative Commons Attribution 4.0 International License</a><span>.</span></p> (Putra Manuaba) (Dr. Arul Kandasamy) Sun, 09 Jul 2023 00:00:00 +0000 OJS 60 Nutritional status of digestive surgery treated in Wahidin Sudirohusodo Hospital, Makassar <p><strong>Introduction</strong>: One way to assess nutritional status is to use a more comprehensive subjective global assessment (SGA) format and a structured clinical approach that reflects metabolic and functional changes. Knowing the nutritional status of patients with digestive surgery is essential for comprehensive patient therapy. In this study, we used the SGA assessment to compare the nutritional status of digestive surgery patients treated at the admission and discharge time.</p> <p><strong>Methods: </strong>This research is an observational analytic study with a cross-sectional research design. The population of this study was digestive surgery patients at Dr. Wahidin Sudirohusodo Hospital for the period August-September 2022. Univariate analysis and Wilcoxon test were carried out to compare the nutritional status outcomes at admission and discharge in digestive surgery patients at our institution.</p> <p><strong>Results</strong>: It was found that 101 patients were mainly in the old adult age group (40-59 years) of 46 patients, most of whom were male, the most diagnosed with colorectal cancer, and 81 patients were sent home. Based on SGA at discharge, the most were SGA B with 46 patients, SGA C with 30 patients, and SGA A with 25 patients. The Wilcoxon statistical test was carried out, and statistically, there was no significant difference between the nutritional status at admission and discharge (p=0.162).</p> <p><strong>Conclusion</strong>: Malnutrition or nutritional risk was present in a large percentage of hospitalized patients upon admission. These patients' nutritional risk and status remained low upon discharge, highlighting the need for follow-up monitoring and the application of suitable nutrition interventions to enhance patients' quality of life and long-term health outcomes. In general, there was no statistically significant difference between nutritional status assessed by SGA at the time of admission and discharge from the hospital.</p> Warsinggih Warsinggih, Muhammad Faruk, A. Arief Munandar Sinangka, Amirullah Abdi, Shandy Shanaya, Maryam Mayidah, Ingrid Gloria Mangiwa, Munaqisah Munaqisah, Desi Vera Buana Copyright (c) 2023 Thu, 30 Nov 2023 00:00:00 +0000 The finding of subcutaneous emphysema on chest X-rays of COVID-19 patients at Prof. Dr. I.G.N.G Ngoerah General Hospital <p><strong>Introduction: </strong>Spontaneous subcutaneous emphysema without any invasive medical procedure was a rare and severe complication related to COVID-19 infection. Extensive alveolar damage caused by COVID-19 infection and sudden increase in intrathoracic pressure by cough mechanism were some of the risk factors underlying this event. Unlike the physical examination that could be performed only with limitation, mobile chest X-RAY as one of the imaging modalities was useful and plays an important role in supporting the diagnosis of COVID-19 infection and lung-related complications such as pneumothorax, pneumomediastinum, and subcutaneous emphysema.. Thus, the purpose of this study is to evaluate the findings of subcutaneous emphysema from chest X-rays in COVID-19 patients</p> <p><strong>Methods: </strong>The research design was descriptive quantitative which was conducted on May - Sep 2023 at the radiology Department of Prof. Dr. I.G.N.G Ngoerah General Hospital. The target population was all positive confirmed COVID-19 patients who had chest x-rays at Prof. Dr. I.G.N.G Ngoerah General Hospital. The data was collected from secondary sources from SIMARS and PACS and then tabulated and analyzed for gender, PCR results, age, vaccine status, and chest X-RAY findings for all samples. All of the data was analyzed with the SPSS.</p> <p><strong>Result: </strong>There were 40 cases collected for COVID-19. Most samples aged were more than 59 years old (42,5%). The mortality rate was 82,5%. with subcutaneous emphysema, 1,08% of all COVID-19 cases. 40% of which was followed by pneumomediastinum, 22,5% by pneumopericardium, and 15% by pneumothorax. The most subcutaneous emphysema region findings were at supraclavicular 88% and anterior cervical 83%. Iatrogenic subcutaneous emphysema is mostly caused by the usage of medical devices (82%).</p> <p><strong>Conclusion: </strong>Subcutaneous emphysema was a rare complication of severe COVID-19. Subcutaneous emphysema could be life-threatening if followed by pneumocytes, esophageal rupture, and infection or necrosis.</p> Firman Parulina Sitanggang, Dewa Gde Mahiswara Sudiatmika, Faradilla Novita Anggreini, Darma Jupriadi Tampubolon Copyright (c) 2023 Fri, 13 Oct 2023 00:00:00 +0000 Characteristics of condyloma acuminata patients with HIV/AIDS at Prof. Dr. Sulianti Saroso infectious diseases hospital during 2019-2023 <p><strong>Introduction: </strong>Condyloma acuminata (CA) or genital warts is a sexually transmitted infection caused by the Human Papillomavirus (HPV). Individuals with CA are more susceptible to HIV compared to those without the condition. CA increases the risk of HIV occurrence and vice versa. This study examines characteristics of CA patients with HIV/AIDS visiting the Dermatology and Venereology Clinic of Prof. Dr. Sulianti Saroso Infectious Diseases Hospital during 2019-2023. <strong>Method: </strong>The research methodology employed in this study is a retrospective descriptive approach with a cross-sectional design. The sampling technique utilized was the total sampling method. <strong>Result: </strong>Among 22 recorded cases, 11 fulfilled the study criteria. Most patients were aged 19-44 years (86.7%), male (81.8%), with a history of homosexual relations (54.5%), and exhibited lesions primarily in the perianal region (54.5%). All patients received antiretroviral therapy (ART) (100%), and CD4 count results predominantly ranged from 101-200/mm<sup>3</sup> (63.6%). Trichloroacetic acid (TCA) therapy was the most prevalent treatment modality (81.8%).</p> <p><strong>Conclusion:</strong> The highest prevalence was noted within the age range of 19-44 years, with a majority of male patients. Unmarried status was most common among the patients. Homosexual history emerged as the predominant pattern of sexual intercourse. The perianal region was the most frequent location. The average CD4 count ranges from 101 to 200/mm3. The predominant treatment method utilized was the application of trichloroacetic acid (TCA).</p> Ni Luh Putu Pitawati, Ni Made Trismarani Sultradewi Kesuma Copyright (c) 2023 Wed, 04 Oct 2023 00:00:00 +0000 Patterns of germs before, during and after the COVID-19 pandemic in Intensive Care Unit (ICU) patients at Dr. Wahidin Sudirohusodo, Makassar, Indonesia <p><strong>Background: </strong>The intensive care unit (ICU) is a unit that cares for patients with a high risk of infection, while viral infections are one of the predisposing factors for someone being easily infected with bacteria. This research aims to see a picture of germ patterns before, during and after the COVID-19 pandemic.</p> <p><strong>Methods</strong>: This research is descriptive with a retrospective approach. The research sample used secondary data from microbial culture results of clinical specimens (blood, sputum, pus, urine, etc.) from ICU patients for the period 2019-2022 at the Clinical Pathology Laboratory of Dr. Wahidin Sudirohusodo Hospital, Makassar. Data is grouped into Gram-positive and Gram-negative bacteria, based on the highest order, and presented as tables and graphs.</p> <p><strong>Results:</strong> There were 440 isolates, 80 Gram-positive isolates (18%) and 360 Gram-negative isolates (82%). The five most common types of isolates were dominated by the Gram-negative group in the last 4 years, respectively: <em>Burkholderia cepacia</em> 92 (21%), <em>Acinetobacter baumannii</em> 89 (20%), <em>Klebsiella pneumoniae ss. pneumoniae</em> 58 (13%), <em>Pseudomonas aeruginosa</em> 37 (8%), <em>Escherichia coli</em> 37 (8%), and <em>Staphylococcus aureus ss. aureus</em> was the 6th most common, with 20 (5%) isolates. The majority of isolates identified were obtained from blood, as many as 192 (44%), sputum 136 (31%), pus 52 (12%) and urine 8 (2%). Bacteremia was the largest cause of infection by <em>Burkholderia cepacia</em>, 91 (47%), while sputum was dominated by <em>Acinetobacter baumannii</em> 49 (26%).</p> <p><strong>Conclusion: </strong>The germ pattern in the ICU before, during, and after Gram-negative bacteria dominated the COVID-19 pandemic. Bacteremia is the largest proportion of causes of infection.</p> Mustamsil, Irda Handayani, Nursin Abdul Kadir Copyright (c) 2023 Thu, 16 Nov 2023 00:00:00 +0000 Topical application of cocoa extract (Theobroma cacao L.) to prevent photoaging by increasing superoxide dismutase levels on wistar rats skin exposed to ultraviolet light A <p><strong>Background:</strong> The latest trend in anti-aging prevention is projected through the use of antioxidants derived from natural ingredients with minimal side effects compared to chemicals. Cocoa bean (<em>Theobroma cacao</em> L.) is one of the sources of natural antioxidants with high flavonoid antioxidant content. This study aims to determine the effect of topical application of cocoa extract to prevent photoaging in wistar rats exposed to ultraviolet A (UVA) light.</p> <p><strong>Methods: </strong>Experimental research with animal models using 36 wistar rats exposed to UVA and divided into 2 groups, given 10% cocoa extract cream and basic cream on the back area. The parameters assessed were superoxide dismutase (SOD) levels in skin tissue. Comparative analysis with independent T-test using SPSS version 21 to compare SOD levels of both groups.</p> <p><strong>Results: </strong>Superoxide dismutase levels in both groups were found to be normally distributed (p&gt; 0.05). The results of the comparative test with the Independent T-test found that the mean SOD levels of the treatment group were higher than those of the control group at 8.07 ± 1.99 ng/ml and 5.04 ± 1.54 ng/ml (p&lt; 0.001; 95% CI: 1.82-4.24).</p> <p><strong>Conclusion</strong>: Topical application of 10% cocoa extract cream on the skin of Wistar rats exposed to UVA light resulted in higher levels of superoxide dismutase in the rat skin tissue than the control.</p> I Gusti Ayu Elis Indira, Made Wardhana, I Gusti Nyoman Darmaputra, Nyoman Suryawati, I Gusti Ayu Agung Praharsini Copyright (c) 2023 Mon, 27 Nov 2023 00:00:00 +0000 Tinnitus characteristics and risk factors in the Bali region <p><strong>Introduction:</strong> It has been recognized that suitable external sounds can reduce or even make tinnitus impossible to hear. The working principle of sound therapy will be used to create a new tool or approach that suits the conditions of Indonesian society. This study aimed to describe the characteristics of tinnitus and its associated risk factors.</p> <p><strong>Method:</strong> This was a cross-sectional study conducted in Denpasar City, Gianyar Regency, and Badung Regency for one year. Patients who visited the ENT doctors' practices in these areas were interviewed with prepared instruments. The patients were then subjected to clinical and audiometric examinations. The data will be analyzed descriptively to get an overview of tinnitus's sociodemographic and clinical characteristics.</p> <p><strong>Result: </strong>A total of 101 participants were included in this study. Most tinnitus patients were unilateral on the left side of the ear. The most common sound is ringing, up to 70.3% of 101 research subjects, followed by sound types such as pulse and roaring sound. Furthermore, the frequency and amplitude of tinnitus sounds are quite varied, but the majority is dominated by high frequencies (3000 - 8000Hz). Based on the ear affected, the largest number of tinnitus sufferers were found in the left ear (47.0%). In this study, 82 people (81.2%) had a history of frequently using earphones, while 19 other people never used earphones in everyday life. Among all participants, 95 people (94.1%) were not exposed to noise at work.</p> <p><strong>Conclusion: </strong>The clinical characteristics of the tinnitus sound type were mostly ringing sounds, followed by pulse-like sounds and buzzing sounds. The frequency and amplitude of tinnitus sounds quite varied. Stress factors and the use of earphones occur in most tinnitus sufferers.</p> Gde Ngurah Indraguna Pinatih, Eka Putra Setiawan, Ni Putu Oktaviani Rinika Pranitasari, I Putu Santhi Dewantara, Ketut Tadeus Max Nurcahya Pinatih, I Made Nudi Arthana Copyright (c) 2023 Thu, 16 Nov 2023 00:00:00 +0000 The use of sitting grinder reduces musculoskeletal complaints disorders, workload, and increases work productivity of blacksmith in Tabanan, Bali, Indonesia <p><strong>Introduction:</strong> Blacksmithing is one of the small industries in Tabanan Regency. Their work is passed down from generation to generation as a responsibility of their ancestors. One of the processes in making household appliances is to use a grinder to smooth and sharpen knives. In this process, the worker holds the vibrating grinder, which weighs more than 1.5 kg, with one hand, and the other hand holds the knife to be smoothed. Working with hands exposed to vibration for a long period of time is a burden that will cause complaints and diseases for workers such as raynaud's syndrome, tenosynovitis, and carpal tunnel syndrome<em>. </em>The purpose of this study was to determine the effect of the use of ergonomic sitting grinders to reduce musculoskeletal disorders (MSDs), workload, and increase work productivity of blacksmith in Tabanan Regency.</p> <p><strong>Methods:</strong> This study is an experimental model. The population was blacksmith workers in Tabanan Regency. Samples were determined based on small industry groups by simple random sampling. The sample size was determined based on the score of musculoskeletal complaints so that the number of small industry groups was obtained as many as 3 groups. Each group consisted of 11 people so the sample size was 33 people. It was determined that the sample size in this study was 33 workers in 3 small industry groups.</p> <p><strong>Result:</strong> this study obtained decreased musculoskeletal complaints by 51.51% in the control group with treatment I, and by 51.75% in the control group with treatment II. There was a decrease in workload by 13.71% in the control group with treatment I and by 15.60% in the control group with treatment II. There was an increase in work productivity by 20.93% in the control group with treatment I and by 24.44% in the control group with treatment II.</p> <p><strong>Conclusion:</strong> There is a significant decrease in musculoskeletal complaints and workload between the Control group with treatment I and the control group with Treatment II (p&lt;0.05), and there is a significant increase in work productivity in the control group with treatment I and in the control group with treatment II.</p> Ida Ayu Made Sri Arjani, Cokorda Dewi Widhya Hana Sundari, Nyoman Mastra, I Made Bulda Mahayana, I Gusti Agung Ayu Putu Swastini Copyright (c) 2023 Tue, 05 Dec 2023 00:00:00 +0000 The effectiveness of using coconut husk powder as an adsorbent to enhance the wastewater quality of the cepuk textile industry in Nusa Penida, Bali, Indonesia <p><strong>Introduction:</strong> Tenun Cepuk (traditional woven) from Nusa Penida holds great potential as a traditional textile art form, cherished for its intricate patterns and cultural significance. However, the textile industry's wastewater, with its dye-related pollution, presents a significant environmental challenge that needs sustainable solutions. Coconut husk powder exhibits promising potential as an adsorbent for treating dye wastewater from the textile industry. Investigating the interplay between varying thicknesses and contact durations is crucial to maximizing coconut husk powder's adsorption capacity and efficiency for dye wastewater treatment.</p> <p><strong>Method:</strong> This study, following an Experimental research design with a Posttest Only Control Group Design, aims to assess the impact of an intervention on the experimental group compared to the control group. Coconut fibers, sourced from Nusa Penida agriculture, serve as the adsorbent. Coconut powder is added to these tanks at thicknesses of 5 cm, 10 cm, and 15 cm. Subsequently, wastewater samples from the Cepuk weaving process are introduced into each experimental tank, along with a control group. The process is left for 24 and 72 hours as varying contact times. The adsorption results are subjected to analysis for parameters, including total suspended solids (TSS), total dissolved solids (TDS), five-day biochemical oxygen demand (BOD5), and chemical oxygen demand (COD) at the Panureksa Denpasar Laboratory.</p> <p><strong>Results:</strong> The use of coconut husk powder as an adsorbent effectively lowers TDS, TSS, BOD5, and COD in Cepuk textile dye wastewater. The reduction depends on adsorbent thickness and contact time. Thicker adsorbents notably reduce TDS, TSS, BOD5, and COD, enhancing wastewater quality and environmental safety. A 15 cm-thick adsorbent effectively reduces TDS to permissible levels. Prolonged contact times also significantly lower levels.</p> <p><strong>Conclusion:</strong> Coconut husk powder can be utilized to decrease TDS, TSS, BOD5, and COD levels in textile dye wastewater. Thickness and contact time significantly impact the enhancement of wastewater quality.</p> Cokorda Dewi Widhya Hana Sundari, Ida Ayu Made Sri Arjani, Luh Ade Wilan Krisna, I Wayan Karta Copyright (c) 2023 Thu, 30 Nov 2023 00:00:00 +0000 Characteristics and Role of Apparent Diffusion Coefficient (ADC) Value in Musculoskeletal Soft Tissue Tumor <p><strong>Introduction:</strong> Musculoskeletal soft tissue tumors (STTs) consist of a group of malignant and benign tumors that present challenges in diagnosis and therapy. Adding diffusion-weighted imaging and apparent diffusion coefficient (DWI/ADC) ​​provides tissue characteristics that are different from those obtained by conventional MR techniques. Quantitative examination of the diffusion of water molecules in tissue is expressed as ADC value, which is expected to be more helpful in differentiating malignant and benign soft tissue masses. This study was carried out to determine the characteristics and role of ADC values ​​in musculoskeletal STTs.</p> <p><strong>Methods: </strong>This research was conducted retrospectively. Analysis was performed using MRI results of patients with musculoskeletal STTs who met the inclusion and exclusion criteria. Three regions of interest (ROI) were assessed in the tumor area with the strongest contrast enhancement for DWI mapping, ADC, and ROI ADC value placement. An Independent T-test test was performed to determine the mean difference of ADC in each tumor category. Receiver Operating Characteristics (ROC) were generated to find the optimal cut-off value. Then, a diagnostic test was carried out to determine the sensitivity, specificity, PPV, and NPV of the ADC value.</p> <p><strong>Results:</strong> There were 41 research subjects with musculoskeletal STTs with male predominance, in which 75.61% of cases were malignant. DWI/ADC showed that 78.05% of patients with musculoskeletal soft tissue tumors had restricted diffusion areas. In this study, the ADC cutoff value to differentiate benign and malignant musculoskeletal STT is 0,84 x 10<sup>-3</sup>mm<sup>2</sup>/s with 77.4% sensitivity and 90% specificity, 96% positive predictive value and 56.3% negative predictive value.</p> <p><strong>Conclusion: </strong>In differentiating malignant and benign musculoskeletal STTs, the ADC value provides fair sensitivity, very good specificity, good positive predictive value, and low negative predictive value.</p> Elysanti Dwi Martadiani, I Wayan Juli Sumadi, I Wayan Gede Artawan Eka Putra, Jonathan Andryanto, Anak Agung Gede Agung Priyastana, Felicia Nike Copyright (c) 2023 Fri, 08 Dec 2023 00:00:00 +0000 Comparison of the comfort of De Tinnitus music plus a sound generator compared to De Tinnitus music in healthy people <p><strong>Introduction</strong>: Tinnitus is the perception of sounds a person hears without external stimulation. Tinnitus affects 10% to 15% of the adult population, with approximately 20% experiencing symptoms that negatively affect the quality of life. There are many ways to manage tinnitus, but no significant therapy can treat tinnitus patients.</p> <p><strong>Methods: </strong>This is the phase I of a clinical trial to determine whether de tinnitus music is comfortable in the healthy population. Comfort was assessed using the Visual Analog Scale (VAS) and audiometry.</p> <p><strong>Results: </strong>There was no difference in the comfort of De Tinnitus music plus a sound generator compared to De Tinnitus music in healthy people based on audiometry and VAS (p&gt;0.05). There were no side effects such as ear ringing, blocked ears, dizziness, or other side effects. The use of a sound generator that is safe and comfortable for the ears is for 2 hours in 2 days with a maximum sound threshold of 91dB.</p> <p><strong>Discussion: </strong>A sound generator is a form of tinnitus therapy that produces sounds that mask tinnitus. De Tinnitus is a sound generator plus music developed by the authors. De tinnitus is made from the frequency of tinnitus patients to masked tinnitus, combined with variations in the tone of music that calms tinnitus sufferers. The sound is made from acoustic music, violin, keyboard, and Balinese gamelan with a soothing tempo, plus a collection of songs from the Bongol band. De tinnitus can be entered into a mobile phone application to make it easier for patients to reach.</p> <p><strong>Conclusion: </strong>Tinnitus music plus a sound generator is comparable to comfort for healthy people compared to Tinnitus music alone. There were no side effects from using de tinnitus plus generator in healthy people.</p> Made Lely Rahayu, I Made Wiranadha, Ida Bagus Made Suryatika, I Ketut Sumerjana, Putri Arihtalia Br Purba, I Made Nudi Arthana Copyright (c) 2024 Wed, 27 Dec 2023 00:00:00 +0000 Association of urine Interleukin-8 (IL-8) with renal impairment in lupus patients <p><strong>Background</strong>: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with clinical manifestations that vary between individuals with progressive and irreversible SLE organ damage. Recently, it has become known that Interleukin-8 (IL-8) levels in the blood rise in SLE patients compared to healthy people. The increase of IL-8 causes kidney inflammation by promoting the release of the Neutrophil Extracellular Traps (NET) complex, which supports further renal damage. This study aims to evaluate the association of urine interleukin-8 with renal impairment in SLE patients.</p> <p><strong>Methods</strong>: A total of 45 lupus participants—22 with and 23 without renal abnormalities—had their urine collected. The interleukin-8 concentration was measured using an enzyme-linked immunosorbent assay (ELISA)—renal impairment criteria based on renal biopsy or ACR 1997 criteria. Mann-Whitney and Spearman correlation tests were employed in the statistical analysis. Data were analyzed using SPSS version 25.0 for Windows.</p> <p><strong>Results</strong>: There was no significant difference in IL-8 urine levels between the SLE group with renal impairment (111.27±59.03 pg/ml) and the SLE group without renal impairment (125.76±66.62 pg/ml) was not significant (p=0.67). Urine IL-8 also did not significantly correlate with blood neutrophil count, leukocyte count and leukocyturia (p&gt;0.05).</p> <p><strong>Conclusion</strong>: In lupus patients, urine Interleukin-8 levels are not associated with renal impairment.</p> Emanuel Hananto, Laura Christiani, Dominica Pita Sari, Umi Kalsum, Kusworini, Hani Susianti Copyright (c) 2023 Wed, 20 Sep 2023 00:00:00 +0000 Correlation between level of vitamin d and svcam-1 towards degree of hypertension in elderly patients <p><strong>Introduction</strong>: At old age, it is often found the condition of vitamin D deficiency associated with decrease of physical performance, increase risk of fall and as the risk of hypertension. sVCAM-1 is a protein expressed on endothelium surface which being activated and also expressed in the initial event of atherosclerosis so that sVCAM-1 can be used as marker to determine the degree of severity of atherosclerosis in human. This study was aimed to evaluate the correlation between vitamin D and sVCAM-1 towards degree of hypertension in elderly patients.</p> <p><strong>Methods</strong>: This research was using cross-sectional method conducted at Geriatric Outpatient Clinic, Kidney-Hypertension and Cardiology in Prof. Dr. Ngoerah General Hospital, Denpasar, Bali, Indonesia, starting from April 2022 up to August 2022. Study sample was all of elderly population who came to clinic. Sample was taken using the means of consecutive sampling. Chi-square test was used for bivariate analysis and regression logistical multiple regression test was used for multivariate analysis.</p> <p><strong>Results</strong>: Result of bivariate analysis showed that sVCAM-1 was significantly related to the degree of hypertension, in which it obtained the value of p = 0.030, with OR = 3.3. The result was also directly proportional with relation to level of vitamin D towards degree of hypertension, in which it obtained the value of p = 0.031, with OR value = 8.0. In multivariate analysis it obtained that the level of sVCAM-1 was significant statistically towards the degree of hypertension, with p value of 0.032.</p> <p><strong>Conclusion</strong>: Based on this study, the results can become reference, in which low level of vitamin D and high level of sVCAM-1, associated with higher blood pressure in elderly patients.</p> RA Tuty Kuswardhani, Luh Oliva Saraswati Suastika, Nicholas Wijayanto Copyright (c) 2023 Tue, 22 Aug 2023 00:00:00 +0000 Application of polymerase chain reaction (PCR) methods in distinguishing pathogenic and saprophytic Leptospira from the traditional market environment in Denpasar City <p><strong>Background:</strong> Leptospirosis disease is still a health problem in Indonesia. The number of leptospirosis cases and deaths in Indonesia tends to increase. Indirect transmission of Leptospira bacteria can occur through poor environmental sanitation polluted by rat urine has the potential to cause leptospirosis. Traditional markets are good places for rats to breed. The purpose of this study was to detect the presence of contamination by pathogenic and saprophytic Leptospira bacteria in the environment around traditional markets in Denpasar City by polymerase chain reaction (PCR) method using three specific primers.</p> <p><strong>Methods:</strong> The sample is water from the market environment, taken at 19 location points from eight traditional markets in Denpasar City. After being homogenized, the sample water is filtered. Isolation of specific genes from samples by the PCR method was performed to differentiate pathogenic and saprophytic leptospira using three specific primers designed from the 16S rRNA gene. Starting from the DNA extraction stage, amplification by PCR, and detection of PCR product DNA by electrophoresis.</p> <p><strong>Results:</strong> This study found that from 19 water sampling locations, 5/19 (26.3%) point locations found specific DNA genes for pathogenic Leptospira bacteria. 10/19 (52.6%) point locations found specific genes for saprophytic Leptospira bacteria DNA, and 4/19 (21.1%) point locations found no specific genes for pathogenic or saprophytic Leptospira bacteria.</p> <p><strong>Conclusion:</strong> PCR examination using a combination of three primers could distinguish the presence of pathogenic Leptospira, saprophytic Leptospira, and the absence of pathogenic and saprophytic Leptospira simultaneously from traditional market environments in Denpasar City.</p> Made Agus Hendrayana Copyright (c) 2023 Thu, 06 Jul 2023 00:00:00 +0000 The urgency of arrangement legal facilities for health workers in public health emergency <p><strong>Background</strong>: The public health crisis that all countries around the world have experienced is the corona virus disease 2019 (COVID-19) pandemic. The COVID-19 pandemic exposed strengths and weaknesses in many legal frameworks. A public health emergency (PHE) is carried out quickly by health workers to save lives. This study intends to analyze legal certainty in adequate norms in the Health Law to fill the void in norms regarding guarantees of legal protection and access to government legal facilities for health workers related to PHE.</p> <p><strong>Methods</strong>: Using normative legal research methods with a statutory approach (statue approach) and a conceptual approach towards PHE.</p> <p><strong>Results:</strong> The results of this study indicate that the Health Law only regulates legal protection guarantees in general and does not regulate in detail the legal facilities that can be accessed by health workers when dealing with legal cases, so this will result in non-optimal legal protection guarantees.</p> <p><strong>Conclusion:</strong> In formulating future policies to help health workers resolve legal issues in PHE, the government must be able to develop provisions by adapting and adopting the guidelines of the International Federation of Red Cross and Red Crescent Societies for future legal framework readiness in public health emergencies and preparing institutions lawfully appointed to accommodate the government's responsibility for legal certainty for health workers. Keywords: legal facilities, public health emergencies, health workers</p> Ni Made Parwati, I Gusti Agung Mas Rwa Jayantiari, Sagung Putri M.E Purwani, RA Tuty Kuswardhani Copyright (c) 2023 Mon, 07 Aug 2023 00:00:00 +0000 Topical curcumin gel accelerates healing of II A – degree burns on male wistar rats (Rattus norvegicus) <p><strong>Background</strong>: Burns can happen to anyone at any time, so they require wound care, which is essential to speed up wound healing. Curcumin gel is suspected to help this process, which is administered topically. Besides being cheap, easy to find, and minimal side effects, the content of curcumin helps a series of biological processes that accelerate the recovery of II A – degree burns, which have not been studied extensively recently.</p> <p><strong>Aim</strong>: The study aims to prove that topical curcumin gel can accelerate the healing of II A-degree burns in male Wistar rats (<em>Rattus norvegicus</em>).</p> <p><strong>Methods</strong>: This true experimental study with a post-test control group design involved 28 male Wistar rats (<em>Rattus norvegicus</em>), which were initially intervened by inducing a heat probe that stimulated the formation of an area of II A – degree burns. Wound profile analysis was conducted in the control and treatment groups within 7 and 14 days, respectively. After the wound biopsy, the significance of the parametric test results on the average velocity of epithelialization, number of fibroblasts, and collagen density was assessed.</p> <p><strong>Results</strong>: Epithelialization rate (p&lt;0.001), fibroblast cell count (p=0.007), and collagen density (p=0.011) after curcumin administration were higher than controls. The curcumin treatment group at 14 days showed the greatest significance among the other comparisons (p&lt;0.05). The higher the speed of epithelialization, the higher the number of fibroblasts or collagen, respectively, in the control and treatment groups (r &gt; 0.65; p &lt;0.05).</p> <p><strong>Conclusion</strong>: Topical administration of curcumin gel has the potential to be a hope for future remedies that initiate the improvement of the healing process of II A – degree burns properly.</p> Ida Bagus Agung Indra Pramana, I Gusti Putu Hendra Sanjaya, Agus Roy Rusly Hariantana Hamid, I Made Suka Adnyana, I Gusti Ayu Sri Mahendra Dewi, Wayan Niryana, Sianny Herawati Copyright (c) 2023 Wed, 30 Aug 2023 00:00:00 +0000 Characteristics of pregnancy with placenta previa in Prof. Dr. I. G. N. G. Ngoerah General Hospital, Bali, in 2017 <p><strong>Introduction</strong>: Cesarean sections (CS) are rising annually worldwide. Globally, based on data from 121 countries, from 1990-2014, the number of CS increased by 12.4%, with an average increase of 4.4% per year. The high rate of CS increases the risk of complications in subsequent pregnancies, including placenta previa. In a study conducted in England with nearly 400,000 women with a second pregnancy, the incidence rate of placenta previa was 8.7 in 1000 births in women with previous CS history and about 4.4 in 1000 births in women with previous vaginal delivery. This study aimed to determine pregnancy characteristics with placenta previa at Prof. Dr. I. G. N. G. Ngoerah General Hospital in 2017.</p> <p><strong>Methods</strong>: This study is a cross-sectional study with a retrospective descriptive approach using medical records of patients admitted from 1st January-31st December 207. This research was conducted at Prof. I. G. N. G. Ngoerah General Hospital, Bali, from February 1 to April 1, 2018. All data from medical records were collected and processed to describe pregnancy characteristics with placenta previa.</p> <p><strong>Results</strong>: There were 49 (4.89%) cases of placenta previa from 1001 deliveries in 2017. This number was higher than the placenta previa case in other countries, around 0.3-0.5%. There were 2 cases excluded, and 47 cases were processed for data presentation. Pregnancy characteristics that dominated placenta previa cases in this research were aged 30-34 years old, second to third pregnancy, age of gestation ≥ 37 weeks, no history of vaginal bleeding, no history of curettage, and no history of CS</p> <p><strong>Conclusion</strong>: The characteristics of pregnancy in this study which dominated placenta previa cases were aged 30-34 years old, second to third pregnancy, age of gestation ≥ 37 weeks, no history of vaginal bleeding, no history of curettage, and no history of CS Further investigation is required.</p> Anak Agung Ngurah Jaya Kusuma Copyright (c) 2023 Thu, 17 Aug 2023 00:00:00 +0000 Exploration study of the interest of public health center visitors in utilizing traditional health services in Denpasar <p><strong>Introduction</strong>: Traditional health services (THS) are organized by the Public Health Center (PHC) as an alternative to disease prevention and treatment for the community. Since its launch, the number of visits to the THS has not reached its target. The purpose of this study was to explore the interest of PHC visitors in utilizing THS.</p> <p><strong>Methods</strong>: This research was qualitative research with an exploratory approach. The research was conducted at South Denpasar. Samples were selected using a purposive sampling technique. The research informants consisted of seven main informants who used THS at the PHC and private medical practices and two supporting informants, namely health workers at the PHC and traditional healers at the medical practice. Data collection used in-depth interviews and observation methods, which were then analyzed using thematic methods.</p> <p><strong>Results</strong>: The community's interest in utilizing traditional medicine consisted of 4 themes, namely, aspects of benefits, factors of trust, factors of habits, and aspects of making traditional medicine a companion or even a substitute for medical treatment methods.</p> <p><strong>Conclusion</strong>: The community’s interest in traditional medicine is quite high. Public opinion regarding the use of traditional medicine consists of several aspects, namely aspects of benefits, beliefs, habits, and aspects of companion or substitute for medical treatment. Therefore, it is suggested that THS providers always provide good and correct information about traditional medicine.</p> Komang Laksmi Widari, Luh Seri Ani, Ida Bagus Gede Fajar Manuaba Copyright (c) 2023 Wed, 04 Oct 2023 00:00:00 +0000 Antioxidant activity of kecombrang flower (Etlingera elatior) methanol extract and identification of its compounds using LC-MS/MS <p><strong>Introduction: </strong>The Kecombrang plant (<em>Etlingera elatior</em>) is a plant that has natural antioxidant potential. The antioxidant activity of a plant depends on the amount of active compound extracted and the extraction method. This study aimed to determine the active compound with LC-MS/MS.</p> <p><strong>Methods:</strong> Vacum rotary evaporator, UV-Vis Shimadzu spectrophotometer, set of tools LCMS/MS ACQUITY UPLC®H-Class System (waters, USA). Kecombrang flowers (<em>Etlingera elatior</em>) were obtained from the Soka traditional village, Tabanan and determined at the LIPI-UPT Center for Plant Conservation of the Bali "Eka Karya" Botanical Garden” Bali.</p> <p><strong>Results:</strong> Kecombrang flowers (<em>Etlingera elatior</em>) reported that the higher the methanol concentration, the higher the total flavonoids and antioxidants level. Antioxidants were carried out to determine the capacity of the active compounds in the extract to scavenge free radicals. Based on the IC<sub>50</sub> value obtained, the methanol extract of kecombrang flowers with a concentration of 99% had the highest antioxidant activity with an IC<sub>50</sub> value of 86.59 mg/L and was classified as a strong antioxidant. Kecombrang flowers macerated with 70% methanol and 50% methanol had moderate antioxidant activity, as indicated by the IC<sub>50</sub> values ​​of 100.32 mg/L and 123.91 mg/L, respectively.</p> <p><strong>Conclusion: </strong>Antioxidant activity test of kecombrang flowers (<em>Etlingera elatior</em>) methanol extract with concentration variation 99%,70%, and 50% the best antioxidant value 99 % low concentration solvent has a high boiling point, so that it evaporates slowly, resulting in a higher extract yield.</p> Ni Wayan Bogoriani, Sri Wahjuni, Maria Krissanti Ema Copyright (c) 2023 Wed, 23 Aug 2023 00:00:00 +0000 Beneficial health effects of butterfly pea (Clitoria ternatea): A literature review <p>The butterfly pea, a plant belonging to the Fabaceae family, is found extensively globally, particularly in tropical and subtropical regions. Locals often utilize butterfly pea (<em>Clitoria ternatea</em>) as a medicinal resource due to its flavonoid compounds, predominantly present in its roots, leaves, and flowers. Flavonoids, which are phenolic compounds, possess antioxidant properties that safeguard against cell damage caused by free radicals. This review of the literature aims to explore the various health benefits associated with the butterfly pea. The approach conducted in writing this article involves sourcing information from diverse journal articles available online, including Google Scholar, PubMed, and ScienceDirect. Based on the review, butterfly pea flowers are recognized for their advantageous qualities, including antioxidants, anti-inflammatory, antidiabetic, antihyperlipidemic, hypoallergenic, antitussive, anti-aging, and antidepressant properties.</p> Donabella Fortuna Santosa Copyright (c) 2023 Wed, 04 Oct 2023 00:00:00 +0000 A comparative study of UVA and UVB radiation: Mechanisms of DNA damage and repair <p>Ultraviolet (UV) radiation, comprising UVA and UVB rays, poses a significant threat to human health. This review aims to elucidate the differences between UVA and UVB radiation in their ability to induce DNA damage, shedding light on the underlying molecular mechanisms involved. Understanding these mechanisms is crucial for developing strategies to mitigate the harmful effects of UV radiation. The study analyzed histological changes in UVA and UVB-exposed skin and explored matrix metalloproteinases (MMPs) and reactive oxygen species (ROS) in UV-induced skin damage. It examined DNA lesions caused by UVA and UVB radiation. UVA radiation led to dermal integrity loss, collagen breakdown, and inflammatory infiltration, while UVB radiation primarily resulted in keratinocyte proliferation. UVA-induced MMP activation accelerated collagen breakdown, whereas UVB exposure moderately increased MMP activity. UVA caused more DNA and protein oxidation, while UVB primarily induced oxidative protein modification and endoplasmic reticulum (ER) stress. UVA-induced oxidative stress and DNA damage were associated with skin cancer, premature aging, and immune suppression. UVB radiation directly interacted with DNA, forming cyclobutane pyrimidine dimers (CPDs) and pyrimidine (6-4) pyrimidone photoproducts (6-4PPs), which are strongly associated with skin cancer development. UVA and UVB radiation have distinct characteristics and induce different DNA lesions. Repair mechanisms, such as nucleotide excision repair (NER) and base excision repair (BER), play crucial roles in maintaining genomic integrity. Understanding the mechanisms underlying UVA and UVB-induced DNA damage and repair is essential for developing targeted prevention and therapeutic approaches to combat the harmful effects of UV radiation.</p> Sienny Muliaty Sumali Copyright (c) 2023 Wed, 04 Oct 2023 00:00:00 +0000 Therapeutic effectiveness on early and delayed treatment of antiretroviral in TB-HIV patients: a literature review <p><strong>Introduction</strong>: Indonesia is one of the countries with a high TB-HIV prevalence. Antiretroviral treatment (ART) is only being administered to approximately 42% of TB-HIV patients. The low utilization of ART can be attributed, in part, to the delayed initiation of treatment. Nonetheless, starting ART in these people at an early stage poses risks, owing to the increased likelihood of drug-drug interactions and the manifestation of Immune Reconstitution Inflammatory Syndrome (IRIS) side effects when combined with anti-TB medication. Postponing ART, on the other hand, can hasten illness progression and increase the risk of death.</p> <p><strong>Methods:</strong> A literature review was conducted to assess the effects of early ART (within four weeks of getting anti-TB) against delayed ART initiation (at least eight weeks after receiving anti-TB) in individuals co-infected with TB and HIV. The data was obtained by a comprehensive electronic search using the PubMed and Science Direct databases.</p> <p><strong>Results</strong>: The findings of our study suggest that there was no statistically significant disparity in mortality rates between the early ART group and the delayed ART group. The initial ART cohort had a markedly elevated susceptibility to encountering an IRIS occurrence, particularly among individuals with a CD4 count below 50 cells per cubic millimeter.</p> <p><strong>Conclusion</strong>: In summary, the strategy of delaying the initiation of ART in patients co-infected with TB-HIV is seen as preferable when compared to the approach of early treatment. The frequency of IRIS events is a significant determinant in determining the optimal timing of ART initiation in individuals co-infected with TB-HIV.</p> Dian Natasya Rahardjo, Stefannie Sherine Santoso, Retnosari Andrajati, Ratu Ayu Dewi Sartika, Mariana Wahjudi Copyright (c) 2024 Mon, 08 Jan 2024 00:00:00 +0000 Exclusive breast milk optimizes children's development: a systematic literature review <p><strong>Background</strong>: Exclusive breastfeeding is the gold standard for child nutrition recommended by WHO and UNICEF. Exclusive breastfeeding is very beneficial for child development, and it is proven that exclusively breastfed babies experience different developmental accelerations. Many studies have been conducted on the developmental benefits of exclusive breastfeeding, but the results are inconsistent, and some even report no effect. This paper presents a systematic review of the relationship between exclusive breastfeeding and child development in terms of duration and the aspects of development affected.</p> <p><strong>Method:</strong> A search method with a systematic literature review of relevant articles was performed in four databases, Pubmed, Science Direct, Sefforra, Publish or Perish and Research Gates. The search was performed using words from the text in a variety of combinations related to the developmental benefits of exclusive breastfeeding. The main search terms were ((Exclusive breastfeeding*) (Benefits of exclusive breastfeeding), (Breastfeeding*AND Growth), (Breastfeeding AND growth) development) (benefits of exclusive breastfeeding)). From April to June 2023. Observational studies (cross-sectional and follow-up studies) written in English have investigated the relationship between breastfeeding and child development. Systematic reviews follow the preferred reporting category for systematic reviews. Assess study quality with the Critical Assessment Checklist for Cross-sectional Studies and the Newcastle-Ottawa Quality Rating Scale for longitudinal studies. Fifteen articles were selected for analysis based on the number of priority reporting items for systematic reviews and meta-analyses (PRISMA).</p> <p><strong>Result.</strong> The results of the analysis confirmed the positive effects of breastfeeding on the development of IQ, neuro-brain, language, hearing, vision, behavior and social-emotional, including exclusive breastfeeding for at least three months.</p> <p><strong>Conclusion</strong>: Exclusive breastfeeding for a minimum of three months can optimize several aspects of a child's development. This study suggests increased coverage of exclusive breastfeeding in infants.</p> Luh Mertasari, Anak Agung Ngurah Jaya Kusuma, Luh Seri Ani Copyright (c) 2023 Thu, 17 Aug 2023 00:00:00 +0000 Aesthetic outcome comparison between Millard and Fisher technique for cleft lip surgery: a literature review <p><strong>Background: </strong>Cleft lip is the most common congenital defect found in children, with a prevalence of 0.5 to 1.6 per 1000 live births. Besides causing functional problems, a cleft lip greatly affects the patient's aesthetic appearance. Therefore, several surgical techniques have been developed to produce a good clinical appearance to support the patient's social functioning. The Millard and Fisher technique is the most widely used cleft lip surgery (cheiloplasty) technique. This literature review aims to compare the aesthetic outcomes between the Millard and Fisher techniques in cleft lip surgery.</p> <p><strong>Methods: </strong>This literature review was carried out by searching studies in online databases in the form of PubMed, the Cochrane Library, and Google Scholar using the keywords "cleft lip surgery," "Millard," "Fisher," "aesthetic outcome," and "comparison." Appropriate studies were then carried out through a narrative synthesis analysis.</p> <p><strong>Discussion: </strong>The Millard technique uses the principle of rotational and advancement flaps, performed by making incisions and flaps on two sides, namely a rotational flap on the medial lip and an advancement flap on the lateral lip. Meanwhile, the Fisher technique uses the principle of anatomical subunit approximation, in which the measurement of the boundaries and extent of the surgical procedure is very accurate, resulting in a more anatomical position of the scar tissue. Regarding surgical scars, nose symmetry, vermillion, Cupid's bow and nasal, and Steffensen grading, better aesthetic results were found in Fisher's technique compared to Millard's.</p> <p><strong>Conclusion: </strong>Fisher's technique provides superior aesthetic results compared to Millard's technique in cleft lip surgery.</p> Ni Kadek Parswa Diah Pradnyandari Copyright (c) 2023 Thu, 17 Aug 2023 00:00:00 +0000 Adipose-Derived Stem Cells (ADSCs) in preconditioning of hypoxic cultures compared to normoxic cultures to prevent the formation of fibrous tissue: a review article <p><strong>Background:</strong> Stem cells are a key element in regenerative medicine for their ability to differentiate into various cell phenotypes. According to the literature review, one process that might improve the functionality of ADSCs is hypoxic culture conditions. Hypoxic oxygen culture conditions at 5% concentration are said to increase stem cell proliferation and viability after transplantation.</p> <p><strong>Methods:</strong> A comprehensive literature search was conducted by the author to obtain relevant studies from the PubMed, MEDLINE, Embase, PreMEDLINE, Embase, PsycINFO, Scopus, and Cochrane databases for the last twenty years (January 2002 – July 2022). The author used a search strategy with the following keywords: Adipose-Derived Stem Cells, hypoxic culture, normoxic culture, or pre-conditioned stem cells.</p> <p><strong>Discussion:</strong> Hypoxic culture preconditioning of ADSCs with an oxygen concentration of 5% can improve proliferation capabilities and stem cell viability post-transplantation. Hypoxic preconditioning will enhance the expression of HIF-1 Ida Bagus Putra Pramana, Gede Wirya Kusuma Duarsa, Tjokorda Gde Bagus Mahadewa, I Gde Raka Widiana Copyright (c) 2023 Mon, 10 Jul 2023 00:00:00 +0000 Caffeine's intracellular potential as anticancer and antiviral therapy <p>Coffee, as the most consumed drink globally, has an effect on human metabolism at extracellular and intracellular levels. Caffeine or trimethylxantine in intracellular has potential as an agent for antiviral and anticancer. Treatment with caffeine will affect the mechanism of DNA repair enzymes and induce premature chromatin condensation (PCC), which organizes the occurrence of mitosis at rudimentary cell cycle phase S which makes DNA integrity unattainable, and cells become apoptosis. Studies have already been conducted observing the effects of caffeine at the cellular level, by reacting <em>Escherichia coli</em> (<em>E. coli</em>) or mammalian cells to reactions that disrupt cell cycles such as arsenolysis, exposure to UV radiation, x-ray induced, and starvation with nothing to consumed accept of purines derivatives including caffeine. The result of caffeine treatment on <em>E. coli</em> and mammalian cells on UV radiation and arsenolysis least affected was inosine, acting as an inhibitor, which then can be concluded that caffeine and inosine have almost the same physiological function as substrates for substitution reactions by the most reactive cell metabolism compared to hypoxanthine, xanthine, adenine, and guanine. Additional studies explained caffeine on mammalian cells was not affecting mammalian DNA replication but only made it shorter in replication length there for giving a promised future impact for interfering mechanism of caffeine as DNA repair substrates as beneficial if it is used as a mechanism to interfere with the proliferation of cancer cells and inhibit the spread of viral virions.</p> Nanda Ariane Iskandar, Febriana Catur Iswanti, Mohamad Sadikin Copyright (c) 2023 Wed, 04 Oct 2023 00:00:00 +0000 Various plant extracts that contain polyphenols and have antidiabetic effects: A literature review <p>Diabetes mellitus (DM) is a multifactorial disease or chronic metabolic disorder characterized by elevated blood sugar levels and abnormalities in the metabolism of proteins, lipids, and carbohydrates due to inadequate insulin. Diabetes mellitus is a common condition that has a significant impact on health. Indonesia is renowned for having a variety of herbal plants high in antioxidants, notably polyphenols, which can be utilized as a promising alternative in type 2 diabetes. Most plant components have been employed as extracts, and they may have antioxidant and anti-inflammatory qualities connected to conditions like diabetes, atherosclerosis, neurodegenerative illness, or cancer. Through this review, it is hoped that we will gain a better understanding of how antioxidants in plants are a promising alternative in reducing blood glucose in a patient with diabetes mellitus.</p> Marta Wangsadinata Wong, I Gusti Ayu Artini Copyright (c) 2023 Mon, 11 Sep 2023 00:00:00 +0000 The potential of plant extracts containing flavonoids as anti-hyperlipidemia: A literature review <p>One of the risk factors that cause cardiovascular disease is hyperlipidemia. Hyperlipidemia is a condition of increased plasma fat levels consisting of increased cholesterol, triglycerides and LDL levels and decreased HDL levels. The existence of side effects on the body from antihyperlipidemic drug treatment makes herbal medicine one of the alternatives chosen as a treatment for hyperlipidemic patients. Antihyperlipidemic activity testing was carried out on various herbal plants that contain antioxidants. There are 6 types of plant extracts with activity test results that have potential as antihyperlipidemic. The literature study used a search method on the internet related to the keyword "Plants that contain flavonoid compounds and have the potential as antihyperlipidemic" on the Google Scholar page. Primary data is obtained with sources of research results that have been published in national and international journals. The result of our literature review shows that plants that have flavonoids have the potential for antihyperlipidemic. More investigation is required to determine what kind of plants, dose and side effects can improve the herb plants as a substitute for anti-hyperlipidemia treatment</p> Lisye Marrilyn Lukas Copyright (c) 2023 Wed, 04 Oct 2023 00:00:00 +0000 The efficacy of pumpkin (Cucurbita sp.) on inflammaging <p>The aging process can be delayed by antioxidant supplements such as pumpkin. It is useful for reducing oxidative stress, inflammation, and cellular aging so that older people will be fitter and happier. This literature review will investigate the effect of pumpkins on inflammaging. Google Scholar, Researchgate, and Mendeley were used as the search engine. The keywords were pumpkin &amp; inflammaging. The effect of pumpkin on geriatric beta-endorphin was analyzed from fourteen articles. Body homeostasis, organ systems, and other changes will reduce the functional capacity from the cellular to the individual level in the inflammaging process. To delay the physiological process of aging, pumpkin has the potential to improve the cognitive, endocrine, musculoskeletal, cardiovascular, and immunological organ systems. The inflammaging can be improved by the effect of pumpkin for a better quality of the aging process.</p> Citra Novianri, Ida Ayu Ika Wahyuniari Copyright (c) 2023 Wed, 04 Oct 2023 00:00:00 +0000 The potential effect of Alpha-linolenic acid against oxidative stress in non-alcoholic fatty liver disease <p>Non-alcoholic Fatty Liver Disease (NAFLD) is characterized by fat accumulation in hepatocytes without secondary causes. Oxidative stress plays an important role in forming and progressing from NAFLD to non-alcoholic steatohepatitis (NASH). Alpha-linolenic acid (ALA) is an essential omega-3 (n-3) polyunsaturated fatty acid (PUFA) that has a high antioxidant effect. The purpose of writing this article is to determine the potential of ALA on oxidative stress in NAFLD. This article was made using an online search from 2013 to 2023, and six articles were obtained. From this review, we concluded that ALA has an antioxidant effect that can reduce the impact of oxidative stress in NAFLD, especially in liver tissue, which provides a hepatoprotective effect and regulates gene expression that can reduce oxidative stress in NAFLD.</p> Clorinda Chandra, Ida Ayu Ika Wahyuniari Copyright (c) 2023 Wed, 04 Oct 2023 00:00:00 +0000 Beneficial health effects of porang (Amorphophallus muelleri): A review <p>Porang is a plant native to Indonesia that has long been recognized for its various benefits and is increasingly being researched. The high glucomannan content in porang makes porang considered a health-beneficial functional food. This review examines the various beneficial health effects of the porang plant. The method used in writing this journal is collecting data from various sources, including online research journals such as Google Scholar, Pubmed and Science Direct. Based on the journal review, porang was shown to have several beneficial health effects, such as reducing body weight and obesity parameters, lowering blood sugar levels and HOMA-IR, and improving lipid profiles. Glucomannan in porang also has the potential to provide anti-inflammatory, immunomodulatory, anti-tumor, and adjunctive therapy as a laxative and prebiotic.</p> Ade Mayra Hosiana, Gde Ngurah Indraguna Pinatih, Dewa Ayu Agus Sri Laksemi Copyright (c) 2023 Wed, 04 Oct 2023 00:00:00 +0000 The role of various laboratory parameters associated with obstructive cholestatic jaundice in pancreatic tumor: A case report and literature review <p><strong>Introduction</strong>: Obstructive jaundice can be caused by pancreatic cancer, where most tumors block bilirubin excretion, and excess bilirubin accumulation causes jaundice. Jaundice occurs in more than 65% of pancreatic cancer patients. Jaundice is caused by the location of the tumor, usually located in the head of the pancreas, suppressing the bile ducts and creating a blockage characterized by an increase in bilirubin, especially direct bilirubin. Aspartate transaminase (AST) and alanine transaminase (ALT) may also be elevated in pancreatic cancer patients but to a lesser extent.</p> <p><strong>Case Presentation</strong>: A 63-year-old male patient presented with ocular symptoms and generalized jaundice that had lasted for 2 months. Patients also complain of a bloated stomach and feel thin due to continued weight loss. The patient's stool was the color of putty and brown, like viscous urine. A physical examination revealed conjunctival jaundice in both eyes and hepatomegaly. Abdominal ultrasonography (USG) results suggest a pancreatic head mass with a dilated pancreatic duct and edema of the gallbladder with dilated extrahepatic bile duct (EHBD). Laboratory tests showed that the patient had elevated liver function, total bilirubin 11.90 mg/dl, direct bilirubin 8.29 mg/dl, SGOT 33 U/l, SGPT 54 U/l, and three positive urinary bilirubin values. It became clear that. The patient was diagnosed by observing cholestatic jaundice and the differential diagnosis of suspected pancreatic cancer of the head and cholangiocarcinoma.</p> <p><strong>Conclusion</strong>: Examining laboratory parameters such as total bilirubin, especially direct bilirubin, liver enzymes SGOT, and SGPT may help localize obstructions, such as those caused by pancreatic tumors causing post hepatic obstructive jaundice. </p> Ni Made Ratih Purnama Dewi, I Nyoman Gde Sumardika, I Putu Sista Widya Utama, Dwijo Anargha Sindhughosa Copyright (c) 2023 Fri, 13 Oct 2023 00:00:00 +0000 An anterolateral thigh free flap for reconstruction of extensive neck defect in diabetic patient: a case report <p><strong>Introduction: </strong>Reconstruction of the head and neck has challenges due to its three-dimensional structure, tissue complexity, extent of the defect, and clinical scenarios. Advances in microsurgical techniques make free tissue transfer reconstruction a popular choice to address these issues. Anterolateral thigh perforator flap (ALT) is a workhorse flap for head and neck reconstruction due to its long and reliable pedicle, large volume, versatility in composition, and low donor morbidity. However, diabetes mellitus may contribute to developing postoperative complications, such as vascular occlusions and thrombosis, that endanger free flap survival and are associated with poor wound healing. This case report demonstrates the successful utilization of this approach in the closure of extensive neck defects in a diabetic patient.</p> <p><strong>Case Presentation:</strong> A 56-year-old male was referred with a 21 cm x 15 cm defect following an odontogenic submandibular abscess. The flaw was extended from the intrabuccal, neck, and one-third of the upper anterior thorax, involving the skin, subcutaneous tissue, and exposed mandibular bone. The patient had previously uncontrolled diabetes mellitus. Surgical debridement, antibiotics, insulin for glucose control, and wound bed preparation were performed. A free fasciocutaneous ALT flap was used for defect closure. The flap was raised template-based, sized 24 × 15 cm, with a pedicle from the descending branch of a lateral circumflex femoral vessel. End-to-end anastomosis of one artery and vein of the superior thyroid vessel was performed. The donor site was closed using a split-thickness skin graft. The surgery and recovery were uneventful. Flap refinement was carried out one month later. The patient underwent a three-month follow-up period, expressing satisfaction with the aesthetic and functional outcomes.</p> <p><strong>Conclusions:</strong> Anterolateral thigh perforator flap (ALT) is a workhorse flap for reconstruction of head and neck reconstruction due to its long and reliable pedicle, large tissue volume with various compositions, and low donor morbidity. The LD flap presents as an alternative for free tissue transfer. Regional pedicled flaps can be chosen where microsurgery is not available or suitable. However, vascular compromise and flap failure remain a challenge. Identifying and managing risk factors such as diabetes mellitus are needed to minimize significant complications.</p> Rosalyn Devina Santoso, Agus Roy Rusly Hariantana Hamid, I Gusti Putu Hendra Sanjaya Copyright (c) 2023 Wed, 04 Oct 2023 00:00:00 +0000 Successful conservative treatment of pulmonary thromboembolism in unrepaired d-transposition of the great arteries with pulmonary hypertension: a case report <p><strong>Background:</strong> Unrepaired dextro-transposition of great arteries (D-TGA) is well known for long-term complications, including tricuspid valve regurgitation, arrhythmias, and coronary artery abnormalities. Pulmonary hypertension (PH) is a frequent, progressive, and fatal complication in unrepaired CHD. This chronic condition can induce pulmonary thromboembolism (PTE). Aim: To report the management of PTE in unrepaired D-TGA with PH.</p> <p><strong>Case Presentation:</strong> We present a rare case of an eleven-year-old male in unrepaired D-TGA with PH. He came with hemoptysis with no sign of acute or chronic infection. This condition was not associated with endocarditis or tuberculosis. The patient underwent a CT-pulmonary angiography examination and found a filling defect in the apical and posterior branches of the right superior pulmonary artery, suggesting a PTE that caused pulmonary parenchymal infarction. He was treated with intravenous low molecular weight heparin (LMWH) for ten days (1 mg/kg) and tranexamic acid. On follow-up, he did not experience cardiovascular collapse or hypotension; by the day, the hemoptysis had decreased in frequency and volume. He received long-term warfarin (2 mg/day) for three months. After three months of follow-up, the PTE was not visualized from CT-pulmonary angiography.</p> <p><strong>Summary:</strong> Hemoptysis is rare and life-threatening in unrepaired CHD. Heparin administration continued with warfarin, and tranexamic acid provides a good prognosis in patients with PTE with D-TGA and PH.</p> Putu Andrie Setiawan, Ni Putu Veny Kartika Yantie, Eka Gunawijaya, Ni Putu Siadi Purniti, Ida Bagus Subanada, Ayu Setyorini Mestika Mayangsari Copyright (c) 2024 Fri, 29 Dec 2023 00:00:00 +0000 Magnetic Resonance Imaging Features of Spinal Tumor: A Case Series <p><strong>Background: </strong>Spinal tumors are one of the rarest tumors from the Central Nervous System. The location is essential in determining the differential diagnosis of a spinal tumor. MRI plays a central role in the imaging of spinal tumors and makes it easier to classify spinal tumors as extradural, intradural-extramedullary, or intramedullary. Thus, in this study, we provided several cases that had spinal tumor and MRI role in diagnosing the disease</p> <p><strong>Case Description: </strong>This study had four cases with similar chief complaints of weakness in the lower extremity. The first case was a woman, 42 years old, with lower limb weakness for four years, without a history of trauma. The second case was a woman 26 years old with a chief complaint of weakness in her right leg over two years and a history of trauma. The third case was a man, 41 years old, with lower back pain and weakness in both of his legs since two years ago. The last case was a man, 51 years old, with lower limb weakness since eight days ago without a history of trauma. According to the physical examination of all of the patient, there was a decrease in motor strength in their lower limb, followed by sensory problems from hypoesthesia, paresthesia, anesthesia, and numbness. All of the cases underwent the Spine MRI examination. We found a solid mass in extra and intra-medullary that cause compressions to the spinal cord the spinal canal.</p> <p><strong>Conclusion: </strong>In spinal tumours, a radiology examination is crucial in determining the mass's location, size, and extent. MRI is the best imaging modality because it can identify and localise tumours and classify spinal tumours as extradural, intradural-extramedullary, or intramedullary, thereby narrowing the differential diagnosis.</p> Wilson Nugraha, Made Widhi Asih , Pande Putu Yuli Anandasari Copyright (c) 2023 Wed, 27 Dec 2023 00:00:00 +0000 A patient with suspect of Fahr syndrome caused by secondary hypoparathyroid after total thyroidectomy <p><strong>Background:</strong> Hypoparathyroid is an endocrine disorder that is characterized by hypocalcemia and hyperphosphatemia due to insufficient secretion of parathyroid hormone. Mostly, this disease is secondary caused by neck surgery and it is responsible for almost all cases of hypoparathyroid. Parathyroid hormones responsibles for maintaining homeostasis of calcium. Fahr syndrome is a neurodegenerative disorder characterized by bilateral basal ganglia calcification that is caused by endocrine disorder such as hypoparathyroid.</p> <p><strong>Case Presentation:</strong> In this case report, we reported a 70 years old woman with secondary hypoparathyroidism presenting with Fahr's syndrome after total thyroidectomy. Besides hypocalcemia and hyperphosphatemia as signs of secondary hypoparathyroidism, specific clinical signs with Fahr's syndrome in this case is presence of multiple calcifications in several parts of the brain and specifically in the bilateral of basal ganglia. Management of this disease mainly focused on supplementation of calcium and vitamin D.</p> <p><strong>Conclusion:</strong> Fahr syndrome is a rare, genetically dominant, inherited neurological disorder that should be considered as the main problem in several patients with post total thyroidectomy.</p> Putu Amanda Widiada, Made Ratna Saraswati Copyright (c) 2023 Sat, 09 Dec 2023 00:00:00 +0000