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Universa Medicina

medicina
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Published by Universitas Trisakti

ISSN : 19073062 EISSN : 24072230 DOI : -

Core Subject : Health, Science,

Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

Universa Medicina (univ.med) is a four-monthly medical journal that publishes new research findings on a wide variety of topics of importance to biomedical science and clinical practice. Universa Medicina Online contains both the current issue and an online archive that can be accessed through browsing, advanced searching, or collections by disease or topic

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Articles 10 Documents

Search results for , issue "Vol 38, No 2 (2019)" : 10 Documents clear

Advanced metastatic breast carcinoma in sickle cell disease Nwagu, Marcellinus uchechukwu; Thompson, Ologo; Oyekemi, Akinola
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundBreast cancer is the leading cancer in women leading to over 400,000 deaths per year worldwide. It begins in the breast tissue and can metastasize to other organs if early diagnosis and treatment is not instituted. Women with sickle cell disease are usually spared from breast cancer and other solid tumours due to the tumoricidal effect of sickled erythrocytes. Breast cancers are rare among these group of patients. Despite its rare occurrence, this paper was to emphasize the need for breast cancer screening among female sickle cell disease patients who have positive family history of breast cancer.Case descriptionOO was a 30-year old woman with sickle cell disease who presented to the hospital one and half years ago with a seven months history of right breast swelling and pains. She had lost her mother to breast cancer about 15 years ago. Mammography and histology of breast biopsy confirmed diagnosis of invasive ductal carcinoma of the right breast. Financial constraint was a major challenge in managing this patient as she was unable to buy her chemotherapy. She developed features suggestive of metastasis such as seizures and hepatomegaly. She was stabilized and discharged home but we lost her to follow up. She died at home.ConclusionÂ Â Â Breast cancer is rare among females with sickle cell disease; any of them with a family history should be routinely screened for early diagnosis and treatment.

High carbohydrate intake increases risk of coronary heart disease in adults: a prospective cohort study Darjoko, Sulistyowati Tuminah; Wahyuningsih, Tri; Sudikno, Sudikno
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundCoronary heart disease (CHD) ranks second after diabetes mellitus (DM) based on hazard rate, and after stroke (based on number of deaths caused). Our aim was to determine the risk factor and magnitude of CHD among adults. Methods A cohort study on risk factors of non-communicable diseases (CS-RFNCD) was conducted on subjects aged ≥25 years. Initiated by screening, follow-up (FU) was done 3 times yearly and complete health examination every 2 years. CHD cases screened by electrocardiographic examination on subjects aged ≥40 years and <40 years with history of hypertension and/or heart disease. Screening results found 840 of 5690 subjects with CHD diagnosis who were excluded from cohort study sample. Non-CHD subjects and those aged <40 years without a history of hypertension and/or heart disease, totalling 4840 people, were included in study sample and followed up for 6 years. Data were analyzed using Cox regression.ResultsCarbohydrate intake of ≥60% of total energy had a 2.8-fold higher CHD risk [HR=2.790; 95% CI: 1.962 - 3.967; p=0.000] than that of an intake of <60% of total energy. Age of ≥55 years had 2.6-fold higher CHD risk [HR=2.573; 95% CI: 1.803 - 3.671; p=0.000] than age of <55 years. Blood total cholesterol of ≥200 mg/dL had 1.9-fold higher CHD risk [HR=1.893; 95% CI: 1.319 - 2.715; p=0.001] than that of <200 mg/dL.ConclusionHigher intake of carbohydrate increases CHD incidence among adults. Efforts in controlling CHD risk factors are still needed especially in consumption behavior through a family approach.

Single bulb garlic oil improves interleukin-6 via decreased reactive oxygen species (ROS) in high-fat diet male mice Ilmawati, Riza Rahayu; Gofur, Abdul; Lestari, Sri Rahayu
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundHigh-fat diet (HFD) is highly responsible for the development of excessive reactive oxygen species (ROS). ROS and low-density lipoprotein (LDL) then trigger macrophage activation to secrete interleukin-6 (IL-6). Single bulb garlic or in Indonesian called bawang lanang is traditional medicine that possesses strong antioxidant properties. This study aimed to evaluate the effect of single bulb garlic oil (SBGO) on ROS, IL-6, and lymphocyte density in HFD-fed male mice.MethodsThis was an experimental study on 24 male mice randomly subdivided into 6 groups: one group was fed a normal diet, whereas the remaining five groups were fed HFD for 45 days and were then treated with single bulb garlic oil 0 mg/kg, simvastatin 26 mg/kg BW, single bulb garlic oil 12.5 mg/kg BW, 25 mg/kg BW, and 50 mg/kg BW respectively for the next 35 days. At the end of treatment, the mice were dissected for collection of (i) serum in order to measure ROS and IL-6 levels using ELISA, (ii) aortas to measure IL-6 expression using immunohistochemistry-fluorescence (IHC-F) and to obtain lymphocytes from bone marrow and spleen which were then counted using a light microscope.ResultsOur results indicated that SBGO decreased the ROS level, IL-6 level, IL-6 expression, and lymphocyte density in HFD mice. SBGO 12.5 mg/kg BW is the optimum dose in our study to reduce inflammation in HFD male mice.ConclusionSBGO is useful to reduce inflammation and improve antioxidant imbalance, thus might be a potential antiatherogenic agent.

Propolis inhibited Bax expression and increased neuronal count of hippocampal area CA1 in rats receiving sodium nitrite Kuswati, Kuswati; Handayani, Ety Sari; Nugraha, Zainuri Sabta; Rahmanti, Fishella Aprista; Wicaksana, Zulfikar Loka; Zhafirrahman, Muhammad
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundSodium nitrite induces hypoxia and oxidative stress in the hippocampus, decreasing the number of neurons in the hippocampus and cognitive function. Propolis contains chrysin that has antioxidant effects that are expected to inhibit neuronal damage in the hippocampus. This study aims to determine the effects of propolis on the expression Bcl-2-associated X protein (Bax) and the number of neurons in the rat hippocampus receiving sodium nitrite.MethodsThis study of laboratory experimental design was conducted on 18 male Wistar strain rats (Rattus norvegicus), they were randomized into 3 groups: one control group (K) received sodium nitrite and two intervention groupsÂ (P1 and P2) received sodium nitrite and propolis at doses of 100 and 200 mg/kgBW. Treatment with sodium nitrite and propolis were given for 60 days, followed by termination. The number of neurons and Bax expression in the hippocampal CA1 area were measured. One-way ANOVA was used to analyze the data.ResultsThere were significant differences in Bax expression between group K and groups P1 and P2 (p<0.001). The lowest number of neurons in the hippocampal CA1 area was in the K group. There were significant differences in the number of neurons between control (K) group and groups P1 and P2 (p<0.001).ConclusionPropolis inhibited the expression of Bax and decreased the number of neurons in the hippocampal CA1 area of rats receiving sodium nitrite. This study provides information about the benefits of propolis as an antioxidant in the brain.

Adequate fluid resuscitation decreases incidence of acute renal failure in burn patients Soeselo, Daniel Ardian; Suparman, Etheldreda Alexandria Stephanie
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

BACKGROUND Burns constitute a severe health problem in many countries. In Indonesia burns rank 4th of all trauma-related diseases and are a burden on the country’s health system. Adequate fluid resuscitation is the initial management of burns that determines the success of treatment. This study aimed to determine the relationship between adequate fluid resuscitation and incidence of acute renal failure in burn patients. METHODSA retrospective study of cross-sectional design was conducted on 30 burn patients who came to the Emergency Unit (ER) from January 2015-December 2017. Medical records were reviewed to examine the data on fluid resuscitation according to the Parkland formula and the laboratory data. Acute renal failure was defined as a creatinine level of more than 2.1 mg/dL after 7 days. Hypoalbuminemia was defined as an albumin level of less than 3.4 g/dL. Fisher’s exact test was used to analyze the data.RESULTSTwenty-two subjects received fluid resuscitation according to the Parkland formula and 8 did not. Twenty-five experienced complications such as acute renal failure (ARF) (13.3%), hypoalbuminemia (46.7%) and a combination of ARF and hypoalbuminemia (23.3%). One person died. Adequate fluid resuscitation was significantly associated with decrease incidence of ARF (p=0.015), but not significantly with hypoalbuminemia (p=0.214) and with mortality (p=0.267).CONCLUSIONAdequate fluid resuscitation decreased the incidence of ARF in burn patients. Consensus protocols for initial burn resuscitation and treatment are crucial to avoid the consequences of ARF after burn injury.

Severe acute malnutrition as a major predictor for poor nutritional outcome among adult HIV patients treated with FPB program: a case-control study Abebaw, Nigest; Endeshaw, Mulualem; Ayenew, Mamaru
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

IntroductionDifferent studies had explained the treatment outcomes of the food by prescription (FBP) program among people living with HIV (PLHIV). This study aimed to assess factors affecting nutritional treatment outcome among PLHIV using FBP. MethodsAn institution-based unmatched case control study was conducted from August 1 to September 30, 2017 in public health facilities. A total of 566 samples (283 cases and 283 controls) was drawn using random sampling technique. Data were collected from FBP, ART/PRE-ART registers and client’s follow up charts. Bivariate and multivariate logistic regression analyses were conducted to estimate the relationship of the independent variables with the outcome variable, and a p-value <0.05 was considered as statistically significant at 95% confidence level. All statistical analysis was performed using SPSS version 23.ResultsIn this study severe acute malnutrition at admission (AOR=4.45. 95% CI: 2.63–7.55), moderate acute malnutrition at admission (AOR=3.8, 95% CI: 2.18–6.67), lack of regular follow up (AOR=3.81, 95% CI: 2.18–6.67), low CD4 count below 100 (AOR= 2.93, 95% CI: 1.19–7.20), hemoglobin value below 10mg/dL (AOR=2.72, 95% CI: 1.17, 6.35), and male sex (AOR=1.77, 95% CI: 1.19, 2.63) were found to be significant predictors for poor nutritional treatment outcome.Conclusions Severity of malnutrition was the major predictor for poor nutritional treatment outcome of patients who were on FBP program. The policy makers can use the information to improve HIV and nutrition interventions based on the result.

Stunting: a multisector challenges and unfinished nutrition agenda Karyadi, Elvina
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

It was a great news that during the President election campaign, both President and Vice President candidates addressed a stunting problem during the debate. It shows that stunting is placed as national priority of nutrition problems. Stunting is part of a wider nutrition crises in Indonesia: wasting, anemia and double-burden of malnutrition. According to the 2018 National Health Survey (RISKESDAS), 30.8 percent of Indonesian children under 5 years of age were stunted (almost 8 million children), 17.7 percent were underweight, 10.2 percent were wasted (low weight-for-height).Â Although the prevalence of stunting declined significantly from the 2013 (37.2%), the stunting rates remain unacceptably high. A child that is wasted faces double the risk of mortality associated with stunting. Even, a child that is both stunted and wasted faces a higher risk. Frequent episodes of wasting increase the risk of stunting. Â

Brain oximetry is not a good monitor on reducing neurological complications after cardiac surgery Amouzegar Zavareh, Seyed Mohammadreza; Araghizade, Hasan; Eskandari, Nahid; Lak, Marzieh
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundCerebral deoxygenation is related to several adverse systemic consequences. We aimed to assess the effect of noninvasive monitoring of cerebral oxygenation on reducing neurological complications after cardiac surgery.Methods In this randomized clinical trial, subjects were randomized into two groups: intervention group (111 subjects with monitoring of cerebral oximetry) and control group (112 subjects without any monitoring of cerebral oximetry). Monitoring of regional cerebral oxygen saturation (rScO2) was performed in the intervention group without any monitoring of cerebral oxygenation. The rScO2 was not recorded in the control group and no specific treatments were employed. Any neurological complications such as hallucinations, delirium, stroke, and length of stay in ICU after surgery were recorded. A p-value less than 0.05 was used as a cut-off for statistical significance.ResultsAfter surgery, in the intervention group one (1/111=0.09%) patient suffered from stroke and one patient had delirium, while in the control group three patients had stroke and three (3/112=2.6%) had delirium. There was no significant difference between the two groups regarding complications (p=0.527). The length of stay in ICU was 3.49 Â± 0.96 days in the case group and 3.40 Â± 0.80 days in the control group and there was no significant difference in the two groups (p=0.477).ConclusionMonitoring of rScO2 does not seem to be a good monitor for brain oxygenation. Further studies are needed to judge the usefulness of rScO2 for monitoring brain oxygenation.

Low 25-hydroxyvitamin D level increases carotid intima-media thickness in elderly women Imran, Yudhisman; Aswar, Andini; Rachmiyani, Irmiya; Adriani, Donna
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2019.v38.114-120

BackgroundCerebrovascular disease occurs due to atherosclerosis of the carotid artery triggered by endothelial dysfunction, which can be assessed by measuring the carotid intima-media thickness (CIMT). There are several risk factors contributing to endothelial dysfunction, such as 25-hydroxyvitamin D [25(OH)D] deficiency. A number of research studies have shown variable results on the relationship between 25(OH)D deficiency and endothelial dysfunction. The objective of the present study was to determine the relationship between 25(OH)D and CIMT in elderly women.METHODS A cross-sectional study was conducted involving 45 elderly women aged â‰¥60 years. The inclusion criteria were: able to communicate well and able to walk actively without any help. The exclusion criteria were: not having diabetes mellitus, stroke, heart disease, kidney disease, not consuming vitamin D or medicines containing corticosteroids, and not using hormone replacement therapy. Laboratory examination was conducted for fasting blood sugar, lipid profile, and 25(OH)D. CIMT was measured using carotid Doppler ultrasonography at the left carotid artery. Simple linear regression analysis was used to analyze the data.RESULTSMean 25(OH)D level was 11.753 Â± 4.027 ng/mL, and mean CIMT 0.61 Â± 0.10 mm. Simple regression analysis showed a significant relationship between 25(OH)D level and CIMT (Î²=-0.001; 95% C.I.=-0.020-0.003; p=0.009).CONCLUSION Our data suggest an inverse association between 25(OH)D level and CIMT in elderly women. This study supports the protective role of vitamin D against subclinical atherosclerosis in elderly women.

Haemostatic properties of Vernonia amygdalina and Chromolaena odorata leaf extracts using Wistar rat model Matthew, Lucy Omokhegbe; Osime, Evarista Odaburhine
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

BACKGROUNDThe leaves of African plants are widely employed in Nigeria to control bleeding from wounds. This work is aimed at evaluating the haemostatic effects of Vernonia amygdalina (VA/bitter leaf) and Chromolaena odorata (CO/sunflower) leaves on some haemostatic parameters.METHODSA laboratory study of experimental design was conducted involving 35 Wistar rats that were randomized into seven groups. Groups 1 and 2 received leaf extracts of VA at concentrations of 150 and 250mg/kg BW, respectively; groups 3 and 4 received leaf extracts of CO at 150 and 250mg/kg BW; groups 5 and 6 received combined leaf extracts of VA and CO at 150 and 250mg/kg BW, respectively, for 30 days. The last group 7 as control group received only water. Parameters investigated were clotting time (CT), fibrinogen concentration, prothrombin time (PT), activated partial thromboplastin time test (APTT), factor VII, protein C and D â€“ dimer.ResultsThere was a significant reduction in CT, fibrinogen concentration and PT in the intervention groups compared to controls (p<0.01). There was no significant difference in APTT, factor VII and protein C in the intervention groups compared to the controls (p>0.05). D-dimer levels were observed to increase significantly in rats treated with 150mg/kg BW of VA and 150mg/kgBW of the combined leaf extracts (VA/CO) compared to the controls (p<0.05).ConclusionThe VA and CO extracts reduced CT, PT, fibrinogen concentrations and increased D-dimer levels in rats. This study suggests the possible incorporation of the leave extracts of VA and CO in bleeding diathesis as well as in coagulation studies.

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