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Universa Medicina
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
Arjuna Subject : -
Articles 500 Documents
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Neutrophil-lymphocyte ratio and fournier gangrene severity index are not prognostic factors of mortality in fournier gangrene patients Raizandha, Muhammad Achdiar; Hidayatullah, Furqan; Kloping, Yudhistira Pradnyan; Rizaldi, Fikri
Universa Medicina Vol. 41 No. 1 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.71-78

Abstract

Background Fournier gangrene (FG) is a life-threatening disease, commonly found in diabetic and immunocompromised patients. Recent studies suggested the use of new parameters apart from the commonly used Fournier gangrene severity index (FGSI), such as the neutrophil-lymphocyte ratio (NLR), the clinical use of which remains questionable. Therefore, we aimed to evaluate the role of the NLR and FGSI as a prognostic factor of mortality in patients with FG. MethodsThis is an analytical study with a retrospective approach involving 109 adult patients diagnosed with FG. Data were collected regarding medical history, symptoms, physical examination findings, and laboratory tests. The FGSI score and NLR were determined. Bivariate analysis was performed using chi-square test and independent t-test. Overall survival between groups was compared using Kaplan–Meier survival estimates and Cox regression test. ResultsOf the 109 patients, 90 survived (82.5%, group 1) and 19 died (17.43%, group 2). The cut-off point of NLR among the patients was 10.9, with a 73.7% sensitivity and 60% specificity. The area under curve value was 0.65 (95% CI; 0.524-0.754; p<0.05). The Kaplan Meier survival analysis showed that NLR was as an independent prognostic factor of mortality in FG patients (HR 5.177; 95% CI; 1.092-8.471; p<0.05), but Cox regression analysis showed that NLR and FGSI were not significant prognostic factors of mortality (p=0.09 and p=0.179; respectively). ConclusionThis study demonstrated that NLR and FGSI are not important as prognostic tools for FG mortality.
Death anxiety and its association with severity of mental illness in patients with depression and schizophrenia Shahraki Mojahed, Hamidreza; Nakhaei, Somayeh
Universa Medicina Vol. 41 No. 1 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.56-63

Abstract

BackgroundDeath and the anxiety of it becomes more apparent when confronted with a chronic disease. The aim of this study was to determine the level of death anxiety among patients with depression and schizophrenia, and the relationship between severity of the symptoms and death anxiety in these patients. MethodsA cross-sectional study was conducted on 29 patients with a depressive disorder, 18 with schizophrenia spectrum disorder and 31 healthy subjects, through face-to-face interviews. The general severity of the psychiatric disorder was measured using the Clinical Global Impression Scale (CGI). The severity of depressive symptoms was measured using the Beck Depression Inventory (BDI). Psychosocial performance was measured using the personal and social performance scale (PSP). To evaluate death anxiety, the Bochum Questionnaire on attitude to death and death anxiety 2.0 (BOFRETTA 2.0) was used. One-way ANOVA and Pearson correlation tests were used to analyze the data. ResultsRegarding the BOFRETTA attitude scale, the schizophrenic patients (23.1±9.12) showed significantly higher scores than healthy subjects (18.4 ±4.56) and depressive patients (19.8 ± 5.20) (p<0.050). The healthy controls achieved the least scores of BOFRETTA anxiety scale followed by depressive (30.67±10.33) and schizophrenic patients (31.30±12.18). However, there were no significant between-group differences regarding this scale. We found significant correlations of all BOFRETTA dimensions (attitude, anxiety, sum score) with CGI, PSP and BDI. ConclusionThere was a significant relationship between the severity of symptoms and death anxiety in both depressed and schizophrenic patients. However, the latter showed a more negative attitude towards death.
Gynecological and breast cancer risk factors and screenings in lesbian and bisexual women Nuriye BÜYÜKKAYACI DUMAN; Fatma Yildirim
Universa Medicina Vol. 41 No. 2 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

It is estimated that individuals with lesbian, gay, bisexual, transsexual, intersexual, and other sexual tendencies make up approximately 3-12% of the world population. The proportion of lesbian and bisexual women (LBW) varies between 1-20% of all women. Studies on the subject show that risk factors for gynecological malignancies and breast cancer are more common in lesbian and bisexual women than in heterosexual women. In LBW, it is reported that obesity or high body mass index, inactivity, smoking, alcohol and substance abuse, stress, anxiety disorders, depression, and sexually transmitted diseases are more common than in heterosexual women. In addition, sexually transmitted infections (STIs) such as genital herpes, human papilloma virus (HPV) infections, bacterial vaginosis, trichomoniasis, hepatitis A, syphilis, and HIV disease, that can be transmitted by homosexual relationships, are also common in these women. It is known that genital herpes and HPV are important risk factors especially in the development of cervical cancer. In addition, breastfeeding rates and lactation periods are known to have protective effects against gynecological malignancies and lactation periods are known to have protective effects against breast cancer. This review aims to discuss gynecological malignancy and breast cancer incidence in LBW and the risk factors for these cancers according to current literature. In this context, a total of 340 articles were accessed by entering keywords related to the subject in the PubMed database and analyzed according to their titles and abstracts, while duplicates were removed. However, reviews, qualitative studies, and summaries were not included in the study. A total of 23 research articles were examined, published between 2012-2022, whose full text can be accessed through the PubMed database, investigating gynecological cancer and breast cancer risk factors and screenings in LBW.  
Long-COVID neurological symptoms are associated with D-dimer levels in COVID-19 patients Diah Kurnia Mirawati; Pepi Budianto; Rivan Danuaji; Subandi Subandi; Ira Ristinawati; Hanindia Riani Prabaningtyas
Universa Medicina Vol. 41 No. 2 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.169-175

Abstract

Background Coronavirus disease 2019 (COVID-19) is a disease designated as a global pandemic by the WHO that can manifest clinically as neurological disorders that can occur in the acute phase or after the acute phase (long COVID-19), such as headache, myalgia, anosmia, and cognitive impairment. These neurological disorders as symptoms of long COVID-19 are presumably caused by hypercoagulable conditions characterized by an increase in D-dimer level. This study aims to determine the correlation of long COVID-19 neurological symptoms with hypercoagulable conditions and the role of D-dimer as a biomarker of long COVID-19 neurological symptoms. MethodsThis was a cross-sectional study involving 31 patients with long COVID-19 symptoms. Admitted long COVID-19 cases with recorded D-dimer levels and definitive outcomes were included consecutively. Long COVID-19 neurological symptoms were collected. D-dimer level was measured using immunofluorescence assay and reported in fibrinogen equivalent units (ìg/mL). The correlation between D-dimer levels and neurological clinical manifestations was assessed by using ordinal regression analysis. The p-value of <0.05 was considered statistically significant. ResultsThe mean age of the subjects was 38.81 ± 11.58 years and 18 (58.06%) were female. Long COVID neurological symptoms comprised myalgia, anosmia and cephalgia, and most subjects complained of myalgia (80.65%). On multivariable analysis, long-COVID-19 neurological symptoms were significantly correlated with D-dimer [odds ratio (OR) = 1.05; p=0.020]. ConclusionThe number of neurological long COVID symptoms were significantly correlated with level of D-Dimer. Ultimately, more clarity is needed on the neurological impact of COVID-19, its diagnosis, and its treatment.
Delayed asymptomatic blunt traumatic diaphragmatic hernia: an unusual case report Cylla Revata; Mulia Rahmansyah
Universa Medicina Vol. 41 No. 2 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.176-183

Abstract

IntroductionTraumatic diaphragmatic hernia (TDH) is uncommon, being encountered in around 0.8%-8% of patients with blunt abdominal trauma. Severe comorbidities such as fractures and thoraco-abdominal or head injuries that accompany TDH, are responsible for poor prognosis and often mask diaphragmatic injury itself. Objective of this case report was to highlight rare blunt TDH case to avoid missed diagnosis leading to complications. Case descriptionSixty seven-year old man presenting with right chest pain without difficulty of breathing after falling from stairs 1 hour before hospital admission. On clinical examination, vitals were stable, but with decreased breath sounds on right lower side of chest. Patient had history of trauma from being crushed by elevator 40 years ago without any proven diaphragmatic injury. Initial erect chest X-ray findings were inhomogeneous opacity shadow on lower right hemithorax suspected to be diaphragmatic hernia and 7th right rib fracture with pleural effusion. Thorax CT scan showed herniated right lobe of liver, gall bladder, and mesenteric fat on right hemithorax causing displacement of mediastinal structures. Patient was diagnosed with delayed TDH and hemothorax caused by newly fractured rib. Patient was referred to a better-equipped facility due to the limited surgical facilities in referring hospital. ConclusionDelayed TDHs are not common, but can lead to serious consequences. Blunt TDH occurs more often on left than on right side, in ratio of approximately 3:1. Traumatic diaphragmatic hernia is sometimes diagnosed many years after traumatic event due to latent phase of disease possibly ranging from days to years.
The protective effect of celery ethanol extract on oxidative stress in chronic kidney disease rat model Afifah Afifah; Fajar Wahyu Pribadi; Aulia Salsabiela; Dimo Hari Anggara; Zahra Muthmainnah Komara; Robby Al Fauzy
Universa Medicina Vol. 41 No. 2 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.114-120

Abstract

BackgroundChronic kidney disease (CKD) is a serious health problem in which oxidative stress plays an important role. Oxidative stress is an imbalance of reactive oxygen species (ROS) production and antioxidant defense, where antioxidants have the potential to inhibit CKD progression. Celery contains several substances that have an antioxidant effect. This study aimed to evaluate the administration of celery ethanol extract in the prevention of the progressive damage in CKD caused by oxidative stress in male rats. MethodsTwenty male Sprague-Dawley rats were randomly divided into 5 groups: sham operation (SO, n=4), subtotal nephrectomy (SN, n=4), SN+celery ethanol extract 200 mg/kg BW (SN+S1, n=4), SN+celery ethanol extract 250 mg/kg BW (SN+S2, n=4), SN+celery ethanol extract 300 mg/kg BW (SN+S3, n=4). The celery ethanol extract was given for 14 days before induction of CKD and 21 days after induction of the CKD rat model. Serum creatinine, malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione (GSH) were examined in this study. Data were analyzed by One way ANOVA followed by LSD test for creatinine, MDA, SOD, and Kruskal Wallis test for GSH. ResultsThere were significant between-group differences in serum creatinine, SOD, and MDA (p<0.05), but not in GSH (p>0.05). The administration of celery ethanol extract at 250 mg/kg BW was the most effective in preventing an increase in MDA and a decrease in SOD and GSH. ConclusionCelery ethanol extract has the potential to prevent oxidative stress in the CKD rat model.
The role of molecular pathology in the precision diagnosis and subclassification of hepatocellular carcinoma Kathryn Effendi; Wit Thun Kwa; Akihisa Ueno; Michiie Sakamoto
Universa Medicina Vol. 41 No. 2 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.194-206

Abstract

Hepatocellular carcinoma (HCC) remains a leading cause of cancer death worldwide despite recent advances in surveillance and therapeutic management. The outcomes for HCC patients remain poor, often as a result of late diagnosis or lack of effective treatments. Early detection and precise diagnosis are evidently crucial in improving the prognosis of HCC. However, HCC is a highly heterogeneous cancer with various clinical backgrounds and altered molecular pathways; these factors make its precise diagnosis more difficult. Approximately 25% of HCCs harbor actionable mutations, which are yet to be translated into clinical practice. In the era of precision medicine, molecular or genomic information are indispensable for HCC diagnosis and prognosis. Exploring genomic alterations has become a requirement for identifying the molecular subtypes of HCC. Recent studies have introduced molecular markers to help identify early HCC and to clarify its multistep process of carcinogenesis. The subclassification of tumors into proliferation class and nonproliferation class HCCs gives pointers to the HCC phenotype and facilitates the selection of appropriate treatments. In this review, we broadly summarize some of the latest insights into HCC subclassification from the perspective of molecular pathology. Immunohistochemistry-based subclassification allows improved characterization of HCC in daily clinical practice. Moreover, analysis of the immune microenvironment, intra-tumoral morphological heterogeneity, and imaging features gives additional information regarding the classification of HCC. Combinations of these approaches are expected to inform and advance the precision diagnosis and management of HCC.
Reversible ethambutol-induced optic neuropathy: report of a rare case Syntia Nusanti; Rasyidia Laksmita Putri; Dearaini Dearaini
Universa Medicina Vol. 41 No. 3 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.271-276

Abstract

BackgroundEthambutol (EMB) is one of the first-line anti-tuberculosis therapy. One of its precarious side effects is ethambutol-induced optic neuropathy (EON). The ocular manifestations of EON include painless loss of central vision and cecocentral scotomas in the visual field. Case DescriptionA 60-year old man presented with gradual and painless visual loss since 3 months prior to visit. The accompanying symptoms were frequent headache without double vision and photophobia. He had been diagnosed with pulmonary tuberculosis (TB) for 9 months and consumed EMB for 7 months before being advised to discontinue. There was neither history of systemic diseases nor family history of neuropathy. Examination showed reduced visual acuity with positive relative afferent pupillary defect (RAPD) on right eye. Humphrey test showed bilateral generalized visual loss. Ocular computed tomography (OCT) showed retinal nerve fiber layer (RNFL) thickness was within normal limit. Magnetic resonance Imaging (MRI) brain indicated unremarkable result for optic neuropathy. Based on the examinations listed above, this patient was diagnosed as EON and EMB was stopped immediately. Patient was given oral citicoline 1000mg and zinc supplementation for one month. After 1 st and 3 rd month follow up, patient’s visual function was gradually improved. The ophthalmic examinations indicated recovery of the visual function. ConclusionsThis case suggested that an early detection and intervention in patient with EON has promising result in visual outcome. EON is a reversible optic neuropathy if the ocular toxicity is monitored closely among the tuberculosis patients who are prescribed EMB regiment.
Relationship between depression and physical disability by gender among elderly in Indonesia Ana Satria; Yeni Yeni; Hairil Akbar; Henny Kaseger; Linda Suwarni; Abubakar Yakubu Abbani; Maretalinia Maretalinia
Universa Medicina Vol. 41 No. 2 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.104-113

Abstract

BackgroundThe increasing population of older people can be a positive impact if they could be productive, or it could be negative as a burden if they depend on others. Elderly with physical disabilities can be influenced by various factors, including depression, which can be caused by functional changes in the body due to aging, loss of work, or even the loss of a loved one. This study aimed to determine the relationship between depression and physical disabilities among the elderly in Indonesia who were stratified by gender. MethodsA cross-sectional study using a national survey dataset namely Basic Health Survey and Socio-Economic Survey for 2018 involving 85,427 elderly. Depression and disability were assessed using Mini International Neuropsychiatric Interview and Barthel Index. Chi-Square test and multiple binary logistic regression were used to analyze the data. ResultsThe results revealed that 24.75% of elderly people experienced physical disabilities. The probability of males and females with depression having physical disabilities was respectively 2.95 (95% CI = 2.74-3.17) and 2.49 (95% CI = 2.36-2.64) times higher compared to those without depression. The interaction between depression and gender was statistically significant, in that females with depression had an 11% probability of having physical disability. ConclusionThis study reaffirmed that disability is a risk factor for depression in the elderly and female gender is the effect modifier rather than the risk factor. The male depression group showed more physical disability symptoms than the female depression group. There is collaboration from various sectors to prevent depression and physical disabilities.  
The effect of purple passion fruit juice on superoxide dismutase and malondialdehyde levels in hypercholesterolemic rats Alfi Muntafiah; Johanes Hasian Siahaan; Sofyan Hardi; Dody Novrial; Hernayanti Hernayanti
Universa Medicina Vol. 41 No. 2 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.139-148

Abstract

BackgroundHypercholesterolemia due to a high cholesterol diet can increase free radicals resulting in oxidative stress. Superoxide dismutase (SOD) and malondialdehyde (MDA) have been used as the study markers of oxidative stress in cases of hypercholesterolemia. Purple passion fruit contains various compounds that may reduce free radicals. This study aimed to determine the effect of purple passion fruit juice on SOD and MDA levels in hypercholesterolemic rats. MethodsAn experimental analysis with post-test only control group design involving 28 male Wistar rats. They were divided into 4 groups: normal control (K1), hypercholesterolemic control (K2), purple passion fruit juice treatment at 4.2 mL/200 gBW/day (K3), and simvastatin treatment at 0.018 mg/200 gBW/day (K4). The purple passion fruit juice at 4.2 mL/200 gBW/day was administered for 14 days. SOD levels were examined by enzymatic colorimetric methods using the Ransod kit and MDA levels by the TBARS method. ResultsThe Kruskal-Wallis test showed a significant difference in SOD levels between the tested groups (p<0.05). One-way ANOVA test for MDA levels showed a significant difference (p<0.05). Post Hoc test (Mann-Whitney for SOD and LSD for MDA levels) also showed significant differences: K1 vs. K2, K2 vs. K3, K2 vs. K4, and K3 vs. K4 (p<0.05). ConclusionThis study demonstrated that purple passion fruit juice significantly increases the SOD and lowers the MDA level in hypercholesterolemic male Wistar rats. Consumption of purple passion fruit juice may help to modulate oxidative stress caused by hypercholesterolemia in rats.

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