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Descent of Fetal Head into The Pelvic Inlet in Primigravida: Systematic Review Sihotang, Imanuel; Sitepu, Makmur; Rusda, Muhammad
Sumatera Medical Journal Vol. 4 No. 2 (2021): Sumatera Medical Journal (SUMEJ)
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/sumej.v4i2.5845

Abstract

Background: Skilled care before, during and after delivery can save the lives of women and newborns. Antenatal care is useful for detecting problems in pregnancy and childbirth, as well as preparing for labor. It is estimated that labor will begin 2-3 weeks after the entry of the fetal head on pelvic inlet. Objective: This study was conducted to determine the prevalence of descending of the fetal head at the pelvic inlet in the primigravida of 34-36 weeks of gestation. Methods: This study uses a systematic review study method with the data used are the results of research that have been circulating in the world. Results: In Weekes and Flynn's (1975) study, the entry of the fetal head into the pelvic cavity and having passed the pelvic inlet with a sample of 422 primigravidas, the prevalence was 34 weeks (2%), 35 weeks (1%). Of the three studies analyzed at 36 weeks' gestation, a prevalence was 4.22%.
Proprotein convertase subtilisin/kexin type 9 (PCSK9) as a marker of coronary lesion severity in stable coronary artery disease (CAD) patients Andra, Cut A.; Rambe, Aldy S.; Hasan, Refli; Sembiring, Rosita; Firman, Doni; Eyanoer, Putri C.; Mukhtar, Zulfikri; Sungkar, Taufik; Rusda, Muhammad; Amin, Mustafa M.
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.409

Abstract

Coronary artery disease (CAD) remains a significant global health concern with considerable high morbidity and mortality and its development is influenced by various genetic and environmental factors. Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a vital regulator of low-density lipoprotein receptor (LDLR) metabolism, directly impacting serum cholesterol levels. However, its role in development of CAD is not fully understood. The aim of this study was to assess the association between the level of PCSK9 and coronary lesion severity in patients with CAD. A case-control study using consecutive sampling was conducted among CAD patients at H. Adam Malik General Hospital and Murni Teguh Memorial Hospital, Medan, Indonesia. A total of 200 CAD patients were divided into two groups based on the SYNTAX score: control (score ≤22, n=100) and case (score >22, n=100). Plasma PCSK9 levels were measured from venous blood using quantitative sandwich enzyme immunoassay. The Chi-squared test was used to analyze the data. Our data suggested that PCSK9 level was associated with coronary lesion severity (p<0.001) of which high PCSK9 level was associated with severe coronary lesion. We also found that hypertension (p<0.001), smoking (p=0.072), diabetes (p<0.001), dyslipidemia (p<0.001), obesity (p=0.023), and family history (p=0.001) were associated with lesion severity. Using the receiver operating characteristic (ROC) curve analysis, the cut-off 70.35 ng/mL of PCSK9 had sensitivity 75% and specificity 78% to predict severe coronary lesion. This study highlights that PCSK9 level has moderate sensitivity and specificity to predict the coronary lesion severity among CAD patients.
Anti-dandruff effects of butterfly pea flowers (Clitoria ternatea)-based shampoo: A pretest-posttest control study Assegaf, Tengku SDIS.; Jusuf, Nelva K.; Pane, Yunita S.; Rusda, Muhammad; Darmani, Endang H.; Amin, Mustafa M.; Lubis, Ramona DS.; Bachtiar, Adang
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.876

Abstract

Butterfly pea flower (Clitoria ternatea) may serve as an alternative anti-dandruff treatment; however, its effects on Malassezia spp. remain unexplored. The aim of this study was to explore the effects of C. ternatea as an herbal-based anti-dandruff treatment on Malassezia spp. DNA expression, plakoglobin levels, IL-8 levels, sebum levels, dandruff severity scores, adverse effects, and patient satisfaction. An experimental study with a pretest-posttest control design was conducted at Outpatient Clinic of Dermatology and Venereology, Arifin Achmad Hospital, Pekanbaru, Indonesia, from November 2023 to January 2024. The flower of C. ternatea was used to formulate the shampoo. The study involved 70 female patients aged 18–25 with dandruff, who were divided into two groups: (a) experimental group using 20% C. ternatea shampoo; and (b) control group using 2% ketoconazole shampoo. The present study found that 2% ketoconazole shampoo significantly reduced Malassezia spp. DNA expression compared to 20% C. ternatea shampooo (Clitoria ternatea: ΔCq=1.76±3.18; ketoconazole: ΔCq=3.77±2.90; p=0.008). No significant difference was observed in plakoglobin levels (C. ternatea: ΔCq=1.98±3.63; ketoconazole: ΔCq=2.50±2.36; p=0.427) or IL-8 levels (C. ternatea: ΔCq=3.46±4.00; ketoconazole: ΔCq=4.16 ± 3.62; p=0.459). C. ternatea significantly reduced sebum levels more than ketoconazole (C. ternatea: 1.16±0.98%; ketoconazole: 0.22±0.38%; p<0.001). Dandruff scores and patient satisfaction were similar for both shampoos (p=0.115 and p=0.336, respectively). Adverse effects were more common in the 2% ketoconazole shampoo group, affecting 21.2% of the patients. In conclusion, 2% ketoconazole shampoo is more effective in reducing Malassezia spp. DNA expression, while 20% C. ternatea shampoo offers better sebum control. Both shampoos are similarly effective in ameliorating dandruff severity and are well-tolerated, with fewer adverse effects reported for C. ternatea.
Mesenchymal stem cells for immune modulation in systemic lupus erythematosus: From bench research to clinical applications Ginting, Andi R.; Munir, Delfitri; Amin, Mustafa M.; Darlan, Dewi M.; Putra, Agung; Rusda, Muhammad; Mutiara, Erna; Mayasari, Evita; Rozi, Muhammad F.
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.994

Abstract

Systemic lupus erythematosus (SLE) is a prevalent autoimmune disease affecting multiple organ systems. Disease progression is inevitable as part of its natural course, necessitating aggressive therapeutic strategies, particularly with the use of immunosuppressants. Long-term use of steroids and other immunosuppressants is associated with significant adverse effects. Mesenchymal stem cells (MSCs) have been shown to modulate the immune response, leading to immunosuppressive effects against self-antigens. MSCs have demonstrated the ability to modulate several immune cell populations, contributing to favorable outcomes in controlling immune and inflammatory conditions. Recent evidence has shown an increase in Treg and Breg cell subsets following MSC administration, along with modulation of other immune cells, including dendritic cells, B cells, and T cells. However, the balance between MSC pro-inflammatory and anti-inflammatory phenotypic activation remains a critical factor in determining therapeutic outcomes. Various covariates also influence the efficacy of MSC therapy. The aim of this study was to provide a comprehensive overview of the utilization of mesenchymal stem cells (MSCs) in SLE treatment, leveraging their immunomodulatory and immunosuppressive capabilities. Understanding the fundamental preclinical effects of MSCs and recent findings from clinical studies may enhance the potential of MSC therapy in the management of SLE patients.
Secretome from hypoxic mesenchymal stem cells as a potential therapy for ischemic stroke: Investigations on VEGF and GFAP expression Silvana, Sisca; Japardi, Iskandar; Rusda, Muhammad; Daulay, Rini S.; Putra, Agung; Mangunatmadja, Irawan; Darlan, Dewi M.; Sofyani, Sri; Andreas, Yana
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1181

Abstract

Ischemic stroke is a sudden onset of neurological deficit resulting from a blockage in cerebral blood vessels, which can lead to brain tissue damage, chronic disability, and increased risk of mortality. Secretome from hypoxic mesenchymal stem cells (SH-MSC) is a potential therapy to improve neurological deficit by increasing the expression of vascular endothelial growth factor (VEGF) and reducing glial fibrillary acidic protein (GFAP). These effects can reduce the infarction area of ischemic stroke. Therefore, the aim of this study was to analyze the effect of 150 μL and 300 μL SH-MSC injection on VEGF and GFAP expression as well as the improvement of infarction area in ischemic stroke animal model. A post-test-only experimental design with consecutive sampling was used, with Rattus norvegicus as subjects. Stromal mesenchymal stem cells (S-MSCs) were isolated from the umbilical cords of rats at 21 days of gestation. Secretome production by the S-MSCs was induced under a hypoxic condition, and subsequently isolated. The resultant secretome was administered to rats subjected to middle cerebral artery occlusion (MCAO) at doses of 150 μL (P1 group) and 300 μL (P2 group). The results showed that the infarction area was reduced in P1 (p<0.001) and P2 groups (p<0.001). SH-MSC at a dose of 300 μL increased the expression of VEGF (p=0.028) and reduced the expression of GFAP (p=0.001). In conclusion, secretome from hypoxic S-MSC could potentially improve ischemic stroke by upregulating VEGF expression and downregulating GFAP expression.
Neuroprotective and inflammatory biomarkers in pediatric drug-resistant epilepsy: Interplay between GDNF, IL-1β and vitamin D 25-OH Saing, Johannes H.; Sari, Dina K.; Supriatmo, Supriatmo; Fithrie, Aida; Rusda, Muhammad; Amin, Mustafa M.; Pratama, Muhammad A.
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1581

Abstract

Drug-resistant epilepsy in pediatric patients is associated with neuroinflammation and neurodegeneration. Vitamin D 25-OH exerts neuroprotective effects, while glial cell line-derived neurotrophic factor (GDNF) and the proinflammatory cytokine interleukin-1β (IL-1β) are implicated in the mechanisms of neuroinflammation and epileptogenesis. The aim of this study was to investigate the relationship between vitamin D 25-OH, IL-1β, and GDNF levels with seizure severity and frequency in children with drug-resistant epilepsy. A cross-sectional study was conducted at Adam Malik Hospital, Medan, Indonesia, among children with drug-resistant epilepsy. Vitamin D 25-OH, IL-1β and GDNF levels were measured using enzyme-linked immunosorbent assay (ELISA). Epilepsy severity was assessed using the Hague Seizure Severity Scale (HASS), while seizure frequency was assessed using the Global Assessment of Severity of Epilepsy (GASE). The present study identified a significant correlation between GDNF levels and epilepsy severity, as measured by the HASS score (r=0.318; p=0.006). However, no significant correlation was observed between vitamin D 25-OH or IL-1β levels and epilepsy severity or seizure frequency (p>0.05). IL-1β levels correlated significantly with GDNF levels (r=0.525; p=0.001), but IL-1β did not directly correlate with seizure frequency or epilepsy severity. In conclusion, GDNF levels significantly correlated with epilepsy severity, suggesting that GDNF may serve as a potential biomarker for assessing epilepsy severity. However, further studies investigating the role of GDNF as a potential neurotrophic factor in the pathophysiology of epilepsy and its possible application as a therapeutic target are important.
Probiotics-derived butyric acid may suppress systemic inflammation in a murine model of chronic obstructive pulmonary disease (COPD) Pradana, Andika; Sari, Dina K.; Rusda, Muhammad; Tarigan, Amira P.; Wiyono, Wiwien H.; Soeroso, Noni N.; Eyanoer, Putri C.; Amin, Mustafa M.
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1332

Abstract

Systemic inflammation in chronic obstructive pulmonary disease (COPD) contributes to multimorbidity and a diminished quality of life. Probiotics, through the gut-lung axis, have shown potential to mitigate systemic inflammation; however, their specific role in COPD-related inflammation remains unclear. The aim of this study was to evaluate the efficacy of probiotics in reducing serum interleukin-6 (IL-6) levels by enhancing butyric acid production in a murine model of COPD. An in vivo experimental study with a post-test-only control group design was conducted using 30 C57BL/6 mice randomized into five groups: non-COPD healthy control, untreated COPD, COPD treated with bronchodilator, COPD treated with probiotics, and COPD treated with a combination of bronchodilator and probiotics. COPD was induced by six weeks of cigarette smoke exposure, followed by six weeks of treatment while continuing the smoke exposure. Caecal butyric acid and serum IL-6 levels were measured using enzyme-linked immunosorbent assay (ELISA) and gas chromatography, respectively. Caecal butyric acid levels were lowest in untreated COPD mice (1.2±0.28 mmol/L) and significantly increased with probiotic administration (6.6±4.43 mmol/L, p=0.010), exceeding levels observed in healthy controls (3.9±2.05 mmol/L). Serum IL-6 levels were highest in COPD-induced mice (19.4±6.71 pg/mL) and significantly reduced with administration of probiotics (13.5±0.43 pg/mL, p=0.035), approaching levels of healthy controls (13.0±2.24 pg/mL, p=0.847). A negative correlation was observed between butyric acid and serum IL-6 levels (r=-0.420; p=0.021), suggesting that higher butyric acid levels were associated with reduced systemic inflammation. These findings demonstrated that probiotics, via their metabolite butyric acid, effectively reduced systemic inflammation in a COPD mouse model, highlighting their potential as a therapeutic approach for managing COPD-related inflammation.
Effect of Nigella sativa seed extract on estradiol, FSH levels, and vaginal maturity index in menopausal women: A randomized controlled trial Sukatendel, Khairani; Hasibuan, Reni H.; Siregar, Muhammad FG.; Faradina, Dwi; Edianto, Deri; Lintang, Letta S.; Rusda, Muhammad; Inriani, Vega
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1399

Abstract

Nigella sativa seed extract has been shown to have a significant effect on endometrial thickness and vaginal cytology in ovariectomized animal models, suggesting potential benefits for managing menopausal symptoms. However, to the best of the author’s knowledge, no human studies have been done to support these conclusions. The aim of this study was to investigate the effects of N. sativa seed extract on estradiol, follicle-stimulating hormone (FSH), and the vaginal maturity index (VMI) in postmenopausal women. A single-blinded, randomized placebo-controlled experiment was carried out at Haji Adam Malik Hospital, Medan, Indonesia, with 50 eligible postmenopausal women patients randomized into three groups. Group 1 received a placebo, while groups 2 and 3 were given N. sativa seed extract at 910 mg/day and 1,365 mg/day, respectively. All participants were blinded to the treatment they received. The study used Shad Nigella Plus, an Indonesian herbal medicine containing 455 mg of N. sativa seed extract per capsule. Before the treatments, estradiol levels, FSH levels, and VMI were measured at baseline and remeasured after eight weeks of treatment. Two participants in the intervention group withdrew due to nausea, a reported side effect of N. sativa seed extract consumption. Both treatment groups showed significant increases in estradiol levels (p=0.01 and p=0.001) and VMI (p=0.004 and p=0.001) after eight weeks of daily N. sativa seed extract administration compared to the placebo group. However, no significant differences were found between the two doses in estradiol levels and VMI (p=0.12 and p=0.673, respectively). Moreover, FSH levels showed no significant difference throughout both interventions (p=0.53 and p=0.96, respectively). In conclusion, twice-daily N. sativa seed extract at 910 mg/day or 1,365 mg/day for eight weeks significantly increased estradiol levels and VMI in menopausal women but had no significant effect on FSH levels. These findings support the potential role of N. sativa seed extract as a natural treatment for menopausal symptoms.
Ivermectin and dexamethasone combination induces apoptosis in SUP-B15 cell line Siregar, Olga R.; Wahyuni, Arlinda S.; Pasaribu, Ayodhia P.; Edianto, Deri; Ugrasena, I DG.; Amelia, Rina; Lubis, Inke ND.; Rusda, Muhammad
Narra J Vol. 5 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i2.1975

Abstract

The development of glucocorticoid resistance has complicated the management of acute lymphoblastic leukemia (ALL), leading to increased mortality rates. Ivermectin, a low-cost and well-established anthelmintic, exhibits anticancer potential and may enhance glucocorticoid toxicity in ALL, offering a possible strategy to overcome resistance. The aim of this study was to evaluate the apoptotic effect of combining ivermectin with dexamethasone in ALL. ALL SUP-B15 cells were cultured under standard conditions before treatment with dexamethasone (200 nM) alone or combined with ivermectin (5, 10, and 20 µM), with an untreated group serving as the control.  Cytotoxicity was assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay by measuring cell viability and inhibition. Apoptosis was evaluated through BAX, BCL-2, and CASP3 gene expression analysis using reverse transcription-polymerase chain reaction (RT-PCR). The findings revealed that the combination of ivermectin and dexamethasone was superior in the repression of ALL cell viability compared to control (p<0.001). The combination of dexamethasone 200 nM + ivermectin 20 μM demonstrated the most significant cell inhibition of 38.16±0.04% (p<0.001) and produced the lowest cell viability of 61.84±0.05% (p<0.001). Moreover, the combination of dexamethasone 200 nM + ivermectin 20 μM demonstrated superior upregulations of BAX (p<0.001) and CASP3 (p<0.001). In conclusion, the addition of ivermectin (5 µM) to dexamethasone regimen (200 nM) increases its cytotoxic and apoptotic activities against SUP-B15 cell line as observed by the CASP3 and BAX upregulation. Studies to confirm the enhanced anticancer activity by this combination by observing the protein levels and animal studies are warranted.
RHEUMATIC HEART DISEASE SCREENING USING HANDHELD ECHOCARDIOGRAPHY: A STUDY AMON`G JUNIOR HIGH SCHOOL STUDENTS IN INDONESIA Ardini, Tengku Winda; Muttaqien, Chairiza; Sitompul, Opim Salim; Hasan, Refli; Effendy, Elmeid; Rusda, Muhammad
Jurnal Al Ulum LPPM Universitas Al Washliyah Medan Vol. 13 No. 2 (2025): Jurnal Al Ulum: LPPM Universitas Al Washliyah Medan
Publisher : UNIVERSITAS AL WASHLIYAH (UNIVA) MEDAN

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47662/alulum.v13i2.1007

Abstract

Considering the high burden of morbidity and mortality associated with Rheumatic Heart Disease (RHD) in Indonesia, there is increasing interest in assessing cost-effective screening modalities, particularly the application of handheld echocardiography. Our study aimed to determine the prevalence of Rheumatic Heart Disease (RHD) in Batu Bara, North Sumatra, Indonesia. Our descriptive observational study was carried out in the Batu Bara region of North Sumatra in May 2025. The study population comprised junior high school students aged 10 to 15 years from a selected school in Batu Bara. Data collection included sociodemographic variables, parental characteristics, environmental and household factors, anthropometric measurements, physical examination findings, auscultation results, and echocardiographic evaluations. All data were analyzed using descriptive statistical methods. A total of 190 children were assessed in this study, with a median age of 13 years, and females comprised 54.7% of the participants. Echocardiographic screening detected Rheumatic Heart Disease (RHD) in three participants, corresponding to a prevalence of 1.6%. Within our study population, the prevalence of RHD was 1.6%. Expansion of echocardiographic screening programs is warranted to comprehensively establish RHD prevalence, accurately evaluate disease burden, and facilitate earlier detection to mitigate adverse clinical outcomes.