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Jurnal Kedokteran Brawijaya
Published by Universitas Brawijaya
ISSN : 02169347     EISSN : 23380772     DOI : http://dx.doi.org/10.21776/ub.jkb
Core Subject : Health,
JKB contains articles from research that focus on basic medicine, clinical medicine, epidemiology, and preventive medicine (social medicine).
Articles 715 Documents
Correlation between Atherogenic Index of Plasma and Various Domains of Cognitive Function in Type 2 Diabetes Mellitus Patients Fasihah Irfani Fitri; Pahala Simanjuntak
Jurnal Kedokteran Brawijaya Vol. 32 No. 3 (2023)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.03.6

Abstract

Cognitive impairment in patients with Type 2 Diabetes Mellitus (T2DM) is related to the lack of blood supply to the brain. Previous studies showed that the atherogenic index of plasma (AIP) is a predictor of vascular abnormalities, but studies investigating its association with cognitive functions in T2DM patients younger than 60 years remain limited. This study aimed to determine the correlation between AIP and various domains of cognitive function in T2DM patients. This study was a cross-sectional study involving 75 T2DM patients selected using a consecutive sampling technique at Haji Adam Malik General Hospital Medan from July 2021 to January 2022. Cognitive function was examined using the Visual Cognitive Assessment Test Indonesian Version (VCAT-INA) on several cognition domains. The AIP value of each patient was measured and categorized into high (AIP>0.21), intermediate (AIP between >0.11 and ≤0.21), or low (≤0.11). The mean triglyceride level was 176±108.3mg/dl, the HDL-C level was 38.3±12.1mg/dl, and the mean AIP value was 0.191±0.25. The mean score of the VCAT-INA was 21.7±2.3, which was lower than normal. The AIP value showed significant negative correlation with global cognition (r=0.432, p<0.001) and various cognitive domains, namely memory (r=-0.375, p=0.001), attention (r=-0.383, p=0.001), executive function (r=-0.051, p=0.663), visuospatial (r=-0.306, p=0.008), and language (r=-0.352, p=0.002). In short, there is a significant correlation between AIP value and domains of cognitive function, such as memory, attention, visuospatial, and language domains, but not with executive domains.
The Role of Soluble Costimulatory Molecules as the Biomarkers for Aging Predictors Kusworini Handono; Mirza Zaka Pratama; Hani Susianti; Cesarius Singgih Wahono; Nimas Eka Firdaningrum; Siti Roziah Ria Famuji; Norma Hanifah Sumarta; Ade Wildan Rizky Fachry; Levrita Nindya Poetri; Handono Kalim
Jurnal Kedokteran Brawijaya Vol. 32 No. 3 (2023)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.03.4

Abstract

This study aimed to determine the role of the soluble costimulatory molecules in aging and the association with the presence of comorbid in aged individuals. Thirty-two elderly and twenty healthy subjects were included in this study. The soluble costimulatory molecules sCD28, sCD80, sCD86, sCD163, and sCTLA4 were measured using ELISA. The presence of comorbid was documented from medical records. Charlson Comorbidity Index (CCI) was measured to evaluate the survival/mortality risk for the subjects. The levels of the majority of soluble costimulatory molecules significantly increased in the elderly participants, while the level of sCD86 was comparable. There were weak positive correlations between the subject's age and levels of sCD28 (R=0.214, p=0.048), sCTLA4 (R=0.238, p=0.041), and sCD80 (R=0.317, p=0.012). sCD80 were discovered to be the best to predict immune aging in the elderly with AUC 0.71 [0.57-0.86], sensitivity 53,1%, specificity 80.0%, and cut off 129ng/ml. Most of the elderly participants had at least one comorbid, in which approximately 25.0% and 3.1% of the subjects were classified as mild and moderate CCI. Multivariate analysis showed that comorbidities in elderly individuals have been associated with levels of sCTLA4 ≥26.5ng/ml and sCD80 ≥129.0ng/ml. Furthermore, subjects with comorbid (CCI ≥1) were associated with sCD80 ≥129.0ng/ml (OR 12.44 [95% CI 1.32–117.03], p=0.027). Considering these results, sCD28, sCTLA4, and sCD80 can be developed as biomarkers for predicting immune aging and elderly comorbidities, respectively.
Octreotide Treatment for Hypoglycemic Refractory Case Caused by Sulfonylureas with Impaired Renal Function Taufiq Abdullah; Ali Haedar; Budi Soenarto
Jurnal Kedokteran Brawijaya Vol. 32 No. 4 (2023)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2023.032.04.11

Abstract

Hypoglycemia is an emergency case that is caused by antidiabetic drugs from the sulfonylurea class. Prolonged and refractory hypoglycemia can increase mortality and morbidity. Renal impairment can result in recurrent hypoglycemic symptoms and require special treatment. In this study case, a 47-year-old woman with newly impaired renal function presented in a coma caused by hypoglycemia due to the use of glibenclamide (sulfonylurea drugs) that did not respond to standard hypoglycemic treatment. Treatment of refractory hypoglycemia is a challenge in itself. Octreotide may be considered in cases of refractory hypoglycemia that does not respond to standard glucose treatment, where in this case refractory hypoglycemia is caused by accumulating sulfonylurea because of impaired renal function.
Emphysematous Cystitis with Bladder Mass caused by Colovesical Fistula: A Rare Case Report Yosi Rizal; Eka Yudha Rahman
Jurnal Kedokteran Brawijaya Vol. 32 No. 4 (2023)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2023.032.04.10

Abstract

Emphysematous cystitis (EC) is a rare manifestation of a complicated urinary tract infection, and its pathognomonic feature is a gas appearance inside the bladder wall and lumen. Emphysematous cystitis with bladder mass is an extremely rare finding. In this case study, a 59-year-old female presented with dysuria and pneumaturia for two months before admission. Following history taking and physical examination, a CT scan was performed to establish the diagnosis, which revealed thickening bladder wall with free gas appearance, impressing emphysematous cystitis. Urine culture showed no bacterial growth, cystoscopy revealed posterosuperior bladder mass, a biopsy was done followed by fulguration of the bladder and showed no malignancy, and MRI implied emphysematous cystitis with bladder dome adhesions of colon mass with colovesical fistula. After resection of colon anastomosis, colitis was found as the etiology of the colovesical fistula. An accurate diagnosis of the disease and correct treatment would result in a good prognosis and outcome.
The Profile of Osteogenesis Imperfecta in Dr. Moewardi General Hospital Year 2020-2021: A Retrospective Study Udi Heru Nefihancoro; Ricat Hinaywan Malik
Jurnal Kedokteran Brawijaya Vol. 32 No. 4 (2023)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2023.032.04.6

Abstract

Osteogenesis imperfecta (OI) is a heritable bone dysplasia characterized by bone fragility and long bone deformities. This study aims to report the profile of osteogenesis imperfecta in Dr. Moewardi General Hospital. The patients were searched from the medical record, registered from January 1, 2020, to December 31, 2021, in Dr. Moewardi General Hospital, a tertiary hospital in Surakarta, Indonesia. The data were recorded and described in tables as age, sex, type of OI according to Sillence, clinic, ward admission, signs and symptoms, bisphosphonate therapy and its discipline, as well as the surgical/non-surgical treatment. The quantity of male patients is higher than that of females, OI type IV is the most common, the most common sign/symptoms are fracture and blue sclera, and the most common bone to be fractured is the femur. More than half of patients received bisphosphonate therapy, but only a quarter received it routinely. More than half of patients have performed surgery as the treatment of fractures. Osteogenesis imperfecta patients require an interdisciplinary and tailored treatment that involves both medical and surgical components.
Aloe vera Extract Sheet and Egg Albumin (Gallus domesticus) Reduce the Number of Lymphocytes on Gingival Incision Wound Wizni A'dila A'ziza; Christiana Cahyani Prihastuti; Mutia Rochmawati; Alya Ghina Rosyada; Myrna Evana Amanda Putri
Jurnal Kedokteran Brawijaya Vol. 32 No. 4 (2023)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2023.032.04.2

Abstract

An incision in the oral cavity is a dental procedure performed in surgical procedures. Suturing is the gold standard in primary wound closure care, however, suturing can cause tissue trauma, scars, and secondary infections. Cyanoacrylate adhesive is one of the alternative tissue glue for wound closure but it has inflammatory risk as suturing, potential toxicity, and accidental adhesion risks. Aloe vera extract sheet based combined with free-range chicken egg albumin is expected to be an alternative method for wound healing of gingival incisions. This study aimed to investigate the effect of administration of Aloe vera extract wound healing sheet (WHS) and free-range chicken egg albumin on the number of lymphocytes in the gingival incision wound as the inflammatory response. Experimental laboratory research with a posttest-only control group design was conducted in 24 male rats (Rattus norvegicus Wistar strain) with an incised gingiva, divided into four groups, namely T1 (50% WHS concentration and chicken egg albumin), T2 (100% WHS concentration and chicken egg albumin), PC (positive control with suturing), NC (negative control without treatment). The treatment was carried out for seven days. The data obtained were analyzed statistically using One-way ANOVA and Post Hoc LSD. The use of Aloe vera extract WHS and free-range chicken egg albumin (T1 and T2) reduced the number of lymphocytes compared to control groups (PC and NC; p<0.05). WHS and chicken egg albumin can shorten the inflammatory process in wound healing which is characterized by lower lymphocyte counts compared to the control groups.
The Correlation between Sleep Quality and Level of Stress among Students in Islamic Boarding School Bogor Bety Semara Lakshmi; Irena Ujianti; Fahrozi Fahrozi; Ibnu Albantani; Ananda Putri; Nofrizal Nofrizal; Agus Rahmadi; Endin Nokik Stujanna; Zahra Nurusshofa; Wawang S Sukarya
Jurnal Kedokteran Brawijaya Vol. 32 No. 4 (2023)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2023.032.04.7

Abstract

Sleep period and performance affect mental health. Multiple studies have linked sleep quality and duration to mental health in metabolic patients, but studies on sleep patterns and mental health symptoms in healthy people, especially in Islamic boarding schools, are limited. The goal of this research is to look into the relationship between sleep patterns and performance in relation to mental health in students who attend Islamic boarding schools. In this cross-sectional study, a self-administered questionnaire consisting of the Pittsburgh Sleep Quality Index (PSQI) and the Depression, Anxiety, and Stress Scale-21 (DASS21) was distributed to students at the Wadi Mubarok Islamic boarding school. Total blood sugar and cholesterol levels were measured using EasyTouch glucometer. Fasting glucose levels are used to support the results of stress conditions in the body, which are indicated by an increase in fasting blood glucose levels, which are normally less than 100mg/dl. To see the relationship, a Spearman rank correlation test was carried out. From the results of the examination, plasma glucose levels were 118.1±4.03mg/dl, and plasma uric acid levels were 5.54±0.24 mg/dl. There is a weak correlation between sleep quality and depression (r=0.341; p<0.05) and a fairly strong correlation between sleep quality and anxiety (r=0.437; p<0.05). In this study, poor sleep quality and short sleep duration were linked to an increased incidence of depression and anxiety symptoms. These findings imply that inadequate sleep duration and performance could be a contributor to the development of mental disorders.
The Potency of Polyphenols Extract of Robusta Coffee Bean (Coffea robusta) on COX-2 Inhibition in Neutrophil Cells Tantin Ermawati; Qurratul Aini Wahyu Pratiwi; Zahara Meilawaty; Happy Harmono
Jurnal Kedokteran Brawijaya Vol. 32 No. 4 (2023)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2023.032.04.1

Abstract

Inflammation is a physiological response to various stimuli including infection and tissue injury. One cause of inflammation is gram-negative bacteria that release various toxins, e.g. lipopolysaccharide endotoxin (LPS). The first body defense response is neutrophils. Body defense response is expressed by the cyclooxygenase (COX) enzyme that functions to transform arachidonic acid into prostaglandin. Polyphenols extract from Robusta coffee bean is known to play an anti-inflammatory role, but the mechanism for inhibiting COX-2 remains unknown. This study aimed to determine the potential of polyphenols extracted from Robusta coffee beans on COX-2 inhibition in neutrophils exposed to E. coli LPS. The research design was experimental in vitro with a post-test-only control group design. The sample consisted of 6 treatment groups, neutrophil isolates was incubated in concentrations of Robusta coffee polyphenols extract of 3.13%, 6.25%, 12.5%, and 25% and exposed to E. coli LPS. Measurement of COX-2 expression was conducted using immunohistochemical methods. ANOVA and LSD test results showed COX-2 expression in the treatment groups, namely neutrophils which were incubated with Robusta coffee polyphenols extract and exposed to E. coli LPS, was lower than the neutrophil group exposed only to E. coli LPS. The conclusion of this study is that the polyphenols extract of the Robusta coffee bean can inhibit COX-2 expression on neutrophils exposed to E. coli LPS.
The Effect of Personality Types on Blood Pressure in Female Patients Over 17 Years of Age Bunga Fardah Nahdiyah Achmada; Dian Mutiasari; Abi Bakring Balyas; Lia Sasmithae; Helena Jelita
Jurnal Kedokteran Brawijaya Vol. 32 No. 4 (2023)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2023.032.04.8

Abstract

Hypertension is non-communicable and one of the main sources of premature death in the world, but the cause of this disease generally is still unknown. It is important to note that personality types are included among the suspected influencing factors due to being related to controlling behavior, emotions, and stress. According to Hippocrates-Galenus, they are divided into sanguine, melancholy, choleric, and phlegmatic. Therefore, this research aimed to determine respondents' characteristics, differences in blood pressure (BP) between personality types, and the effect of personality types on BP. The design employed was descriptive-analytic with a cross-sectional approach, and the sample used was 56 respondents, selected by purposive sampling technique. The data on personality types were collected by filling out a questionnaire, while BP data were obtained through BP measurement with a digital tensimeter, and the analysis was conducted with Fisher's Exact, Kruskal-Wallis, and one-way ANOVA tests. The results showed that most respondents, i.e. 62.5% were aged 17-29 years, 20% had BMI ≥27 or Obesity, 10.7% had SBP/DBP=140-149/90-99 or hypertension stage 1, 37.5% were married, 26.8% had birth control history, alcohol consumption history =0%, smoking history =1.8%, 35.7% had phlegmatic personality type, and 10.7% suffered hypertension. The results showed that there was a significant difference between personality types and systolic and diastolic blood pressure, respectively p=0,03 and 0,045. There is no effect of each personality type on blood pressure (p>0,05). In conclusion, despite the different SBP and DBP values of personality types, no effect is created on BP.
The Effect of Antiretroviral Therapy (ART) Duration on CD4 Counts in Human Immunodeficiency Virus (HIV) Patients in dr. Doris Sylvanus Regional Hospital Oberson Nainggolan; Lia Sasmithae; Ratna Widayati
Jurnal Kedokteran Brawijaya Vol. 32 No. 4 (2023)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2023.032.04.5

Abstract

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