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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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Search results for , issue "Vol 38, No 3 (2019)" : 11 Documents clear

Aspirin for primary prevention of cardiovaascular events: what are the evidances? Yenny, Yenny
Universa Medicina Vol 38, No 3 (2019)
Publisher : Faculty of Medicine, Trisakti University

Cardiovascular disease (CVD) is the leading cause of mortality in the United States, accounting for about 1 in 3 deaths.(1) In view of the healthcare and economic burdens of cardiovascular disease, the public health aim should be the prevention of cardiovascular events through risk factor optimization.

Hypoxia enhances self-renewal properties and markers of mesenchymal stem cells Yustianingsih, Vivi; Sumarawati, Titiek; Putra, Agung
Universa Medicina Vol 38, No 3 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundMesenchymal stem cells (MSCs) are multipotent stromal cells that express CD73, CD90, and CD105 surface markers, but not CD14, CD45, CD34, CD11b, and HLA-DR. MSCs under hypoxic conditions have the essential role of maintaining the stemness capacity by releasing several growth factors into their medium, known as hypoxia conditioned medium (HCM). This study was performed to compare the effect of percentage of HCM to normoxic medium (NM) in increasing MSC proliferation marked by proliferation rate and surface marker expression.MethodsThis study was of post-test only control group design using human umbilical cord-MSCs (hUC-MSCs) as subjects. The HCM treatment group was obtained by culturing MSCs under 5% O2, whereas the NM control group was grown under 20% O2. The hUC-MSCs were divided into 4 groups with different dose ratios of HCM to NM (25%:75%; 50%:50%; 75%:25% for P1, P2 and P3, respectively and 100% of NM for the controls). All of these groups were maintained at 37oC and the data was collected after 72 hours incubation. MSC marker expression of CD73, CD90 and CD105 was analyzed using flow cytometry and MSC proliferation by trypan blue assay. ResultThere were significant differences in MSC marker expression of CD73, CD90 and CD105 and proliferation at all dose ratios of HCM to NM (p<0.05).ConclusionLow oxygen concentration promotes MSC proliferation and stemness thus it might be beneficial for maintaining the MSC physiologic niche in-vitro.

Parkinsonism as an atypical primary presentation of sporadic Creutzfeldt-Jakob diseaseParkinsonism As The Atypical Primary Presentation Of Sporadic Creutzfeldt-Jakob Disease: A Case Report Mehrdel, Roghieye; Mozhdehipanah, Hossein; Paybast, Sepideh
Universa Medicina Vol 38, No 3 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundCreutzfeldt - Jakob disease (CJD) is a rare prion-related neurodegenerative disease with a rapid progression and almost definitely fatal outcome. The most common manifestation is rapidly progressive dementia with gait ataxia and visual disturbance. However there are a few reports of patients with atypical features as the initial presentation that later developed to typical characteristics in the course of the disease. Additionally there are variants of CJD in which the primary manifestation might be challenging as the ones presenting with psychiatric complaints accompanied by sensory impairment. To our knowledge, the prognosis in the classical form of the disease is poorer with a rapid deterioration leading to death. Here we aimed to focus on the diverse presentations of sporadic CJD (sCJD) especially in the early stages which might cause a conflict for proper diagnosis.Case descriptionThe patient was a 62-year old man presenting to our referral clinic with progressive gait disturbance and bradykinesia. Based on the initial examination, atypical parkinsonism was diagnosed. However, over two weeks the patient developed an acute confusional state with involuntary movement. The second examination was highly suggestive of sCJD which was confirmed by the paraclinical assessments.ConclusionSporadic CJD is a rare neurodegenerative disease with distinctive characteristics. However, there are reports of various manifestations of the disease. The present report indicates the diverse presentations of sCJD.

The role of urine albumin creatinine ratio and serum Î²2 microglobulin as biomarkers of chronic kidney disease Eguvbe, Augustine Onovuakpo; Nwagu, Marcellinus Uchechukwu; Idogun, Eshiotseme Sylvester; Akande, Adeyinka Abdulrasaq
Universa Medicina Vol 38, No 3 (2019)
Publisher : Faculty of Medicine, Trisakti University

BACKGROUNDChronic kidney disease (CKD) is an increasing burden on individuals and on the healthcare system. The need to identify more sensitive and specific markers of CKD cannot be overemphasized to facilitate detection and appropriate intervention. Î²2 microglobulin is one of such markers of CKD. The aim of this study was to investigate the sensitivities and specificities of serum Î²2 microglobulin and major biochemical markers of CKD, namely creatinine and urine albumin.Â METHODSThis was a hospital-based cross-sectional study involving 124 subjects with CKD and 124 healthy controls. Participants were categorized in two groups : group 1 the CKD based on persistent reduction in GFR <60 mL/min/1.73 m2 and group 2 healthy subjects as controls. Blood (serum) samples of participants were analyzed for serum creatinine and serum Î²2 microglobulin while their urine samples were analyzed for creatinine and albumin. Urine albumin creatinine ratio (UACR) was calculated from the results of the analyses.Â RESULTSThere was a very strong positive correlation of serum Î²2 microglobulin with serum creatinine (r=0.750; p=0.000) and UACR (r=0.775; p=0.000), respectively. Also, there was a very strong negative correlation between serum Î²2 microglobulin and eGFR (r=-0.866; p=0.000). UACR had the highest sensitivity and specificity as shown by receiver operating curve characteristics (ROC) analysis.Â CONCLUSIONIn CKD, UACR and serum Î²2 microglobulin had the best diagnostic value. Periodic renal assessment of renal patients is mandatory as they may be affected by hidden renal dysfunction.

Predicting outcomes 3 months after traumatic brain injury in patients admitted to emergency department Bolvardi, Ehsan; Ahmadzadeh, Maryam; Feiz Disfani, Hamideh; Rezaeitalab, Fariborz; Ravanshad, Yalda; Foroughian, Mahdi
Universa Medicina Vol 38, No 3 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundTraumatic brain injury (TBI) is among the leading causes of mortality and long-term disability. Prognosis assessment is a primary factor of clinical decision-making by emergency physicians. This study aimed to investigate the prognostic factors of TBI in the patients admitted to a typical emergency department.MethodsThis prospective cohort study was conducted involving 100 TBI patients. Baseline characteristics, including age, gender, Glasgow Coma Scale (GCS), and vital signs were recorded. Blood tests and brain CT scans were collected. The patients were followed-up three months after the date of admission. The observed outcomes were categorized as recovery without complication, recovery with complication, or death. Statistical analysis was performed using the simple and multivariate binary logistic regression in the software IBM SPSS version 19. ResultsThe most common brain CT scan findings were subarachnoid hemorrhage (21.0%) and epidural hemorrhage (20.0%). In the follow-up performed three months after the admission, 47 patients (47.0%) had died, 39 (39.0%) were suffering from complications, and 14 patients (14.0%) were recovering without complications. Simple binary logistic regression showed that older age (OR=3.28, 95% C.I.=1.27-8.41), minor/moderate head trauma (OR=13.93, 95% C.I.=1.73-112.11), severe head trauma (OR=54.40, 95% C.I.=5.71-517.56) and presence of deep skull fracture (OR=8.92, 95% C.I.=1.04-75.53) were statistically significant predictors of mortality. Multivariate logistic regression showed that mortality chance was higher in elderly (OR=7.45, 95% C.I.=2.02-27.36), minor/moderate head trauma (OR=26.87, 95% C.I.=2.42-298.25) and severe head trauma (OR=127.97, 95% C.I.=9.11-1796.28).ConclusionThis study demonstrated that severe head trauma was the most predicted risk factor of poorer clinical outcomes after TBI.

Limited health literacy is associated with poorer clinical outcomes in elderly with type 2 diabetes mellitus Yilmazel, Gulay; Cici, Remziye
Universa Medicina Vol 38, No 3 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundDiabetes mellitus is a significant global public health concern. Poor knowledge of disease and healthcare utilization is associated with poor health outcomes, leading to increasing burden of diabetes in many developing countries. The present study aimed to assess diabetes health literacy and clinical outcomes in elderly patients registered to the home health agency. MethodsA cross-sectional study was conducted in the city of Ã‡orum, Turkey, with 160 type 2 diabetic patients of both sexes and aged between 50-91 years. To identify health literacy, the Rapid Estimate of Adult Literacy in Medicine test was administered to the patients. Clinical parameters were based on routine medical examinations by measuring blood pressure levels, glycosylated hemoglobin, and lipoprotein levels. In order to identify the risk of depression, the Beck Depression Scale was used. ResultsOf the patients, 85.0% had limited health literacy. The majority of patients (95.0%) had poor glycemic control and limited health literacy was associated with having high level of HbA1c (p<0.05). Adequate health literacy was associated with regular foot care (p<0.05). Also patients with limited health literacy were more likely to have depression (p<0.001). Limited health literacy increased the risk of poor glycemic control (OR=6.82;95% CI=1.34-9.78) and retinopathy (OR=6.91;95% CI=1.23-9.44). ConclusionLimited health literacy is consistently associated with poorer diabetes clinical outcomes in elderly type 2 diabetes melltius Contents of diabetes education should be arranged according to patientsâ€™ health literacy level which requires visual and auditory teaching materials for patients with limited health literacy.

The benefits and physiological changes of high intensity interval training Soeria Santoso, Dewi Irawati; Boenyamin, Hafizh Ahmad
Universa Medicina Vol 38, No 3 (2019)
Publisher : Faculty of Medicine, Trisakti University

Physical inactivity have been linked with many major non-communicable diseases and as many as 27.5% of adults globally are considered inactive. Physical activity has been proven to be beneficial in the prevention of many chronic diseases and may reduce the risk of premature death. High intensity interval training (HIIT) has been gaining popularity as a time-efficient alternative for regular exercise training. Current studies show that HIIT is more efficient in improving cardiorespiratory fitness, increasing insulin sensitivity and reducing blood pressure than moderate intensity continuous training (MICT). The advantage of HIIT in fat loss compared to MICT is still unclear, but HIIT might be more efficient in the obese population. The effect of HIIT on increasing aerobic fitness could be caused by increase in stroke volume due to the increase in cardiac contractility, capillary density and mitochondrial adaptation. Fat loss during HIIT could be caused by increased fat oxidation and elevated hormones that drive lipolysis and reduce appetite. While vigorous physical activity may transiently increase the risk of cardiac events. The effect of HIIT on increasing aerobic fitness could be caused by increase in stroke volume due to the increase in cardiac contractility, increased of capillary density and mitochondrial adaptation. While fat loss during HIIT could be caused by an increased fat oxidation, elevated hormones that drives lipolysis and reduces appetite. While vigorous physical activity may transiently increase the risk of cardiac event. High intensity interval training is generally safe even in the elderly population and in people with coronary heart disease.

Detection of SHV and TEM-type Extended spectrum Î²-lactamase in bacterial isolates recovered from clinical samples of patients attending military hospitals Ogefere, Helen Oroboghae; Iriah, Samuel E.; Ibadin, Ephraim Ehidiamen
Universa Medicina Vol 38, No 3 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundMulti-drug resistant bacterial strains have been increasingly implicated in clinical infections worldwide and beta-lactamase production is one of the commonest mechanisms of resistance in these strains. This study investigated the prevalence of extended spectrum Ã¢-lactamase (ESBL)-producing isolates and determined the temoneira (TEM) and sulfhydryl variable (SHV) types implicated in two military hospitals in South-South Nigeria. MethodsThree-hundred and eighty (380) consecutive non-duplicate bacterial isolates (Gram negative bacilli) recovered from clinical samples were identified following standard techniques. Antimicrobial susceptibility tests were performed for each isolate following the Clinical Laboratory Standards Institute guidelines. Bacterial isolates recovered which comprised Escherichia coli, Klebsiella spp, Proteus spp and Pseudomonas aeruginosa were screened for ESBL using a phenotypic method (double disc synergy test). All positive isolates were screened for TEM and SHV genes by PCR method. ResultsSixty-five isolates (17.1%) were ESBL producing using phenotypic method, E. coli showed the highest ESBL prevalence (24.3%). One isolate was SHV positive (1.5%), 8 (12.3%) were TEM positive while 3 (4.6%) isolates harbored both SHV and TEM genes. Fluoroquinolone - ofloxacin showed marked activity against ESBL-producing isolates (90.8%) while the least active were ceftriaxone (9.2%), ceftazidime (3.1%) and ampicillin (1.5%). ConclusionThis study demonstrated that 17.1% of Gram-negative bacilli were ESBL producers. Screening of clinical isolates for ESBL should be implemented. The findings of this study suggest the need for caution in the use of antimicrobial agents in order to curb the incidence of antimicrobial resistance.

PREEMPTIVE ANALGESIC EFFECT OF MAGNESIUM SULFATE ON POSTOPERATIVE PAIN IN PATIENTS UNDERGOING LUMBAR FUSION SURGERY Delavari, Abasali; Lak, Marzieh; Arragizade, Hassan; Salatini, Babak
Universa Medicina Vol 38, No 3 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundReducing postoperative pain can improve patient satisfaction and hospital cost. Intravenous magnesium sulfate is one of the proposed drugs for preemptive analgesia. The study aimed to evaluate the effect of magnesium sulfate on postoperative pain in patients undergoing lumbar fusion surgery.MethodsA double-blind randomized clinical trial was conducted on candidates for vertebral fusion surgery with American Society of Anesthesiologists (ASA) class I-II. One hundred and two patients were randomized into the magnesium sulfate group and control group. The magnesium sulfate group received magnesium sulfate at a dose of 50mg/kg in 20 mL volume and infused during 15-30 minutes pre-operation, while the control group received 20 mL normal saline. The severity of the pain was assessed by the Visual Analogue Scale (VAS) at 2, 4, 6, 12 and 24 hours after patients entering the post-anesthetic care unit. After the operation, the patients? relaxation rate was assessed based on Ramsay sedation score (RSS).ResultsThere was no significant difference at 2, 4, 6, 12 and 24 hours post-operation between the two groups in the mean severity of pain (p>0.05). There was no significant difference at 2, 4, 6, 12 and 24 hours post-operation between the two groups in the mean of pethidine consumption. There was no significant difference in the relaxation of the patients according to the RSS criteria in the magnesium sulfate and control groups (p=0.162). ConclusionPre-operative administration of magnesium sulfate does not affect reduction in postoperative pain and opioid consumption of patients undergoing lumbar fusion surgery.

LOW VITAMIN B12 DIET INCREASES LIVER HOMOCYSTEINE LEVELS AND LEADS TO LIVER STEATOSIS IN RATS Sianipar, Imelda Rosalyn; Ujianti, Irena; Yolanda, Sophie; Jusuf, Ahmad Aulia; Kartinah, Neng Tine; Amani, Patwa; Murti, Krishna Aditya; Soeria Santoso, Dewi Irawati
Universa Medicina Vol 38, No 3 (2019)
Publisher : Faculty of Medicine, Trisakti University

Background Nonalcoholic fatty liver disease (NAFLD) is one of the most widespread chronic liver diseases, caused by the development of insulin resistance. One of the mechanisms involved is a disturbance in insulin signaling by certain toxic substances that interact with one of the proteins responsible for the insulin signaling pathway. Increased homocysteine level, upon disruption of the methionine pathway, is associated with insulin resistance. The aim of this study was to evaluate the effect of hyperhomocysteinemia and insulin resistance (HOMA-IR level) induced by dietary vitamin B12 restriction on liver steatosis. Methods A study of laboratory experimental design was conducted involving 18 male Sprague Dawley rats (age 36-40 weeks, BW 300-350 g), that were randomly divided into 3 groups: control, 8-week treatment, and 16-week treatment. Standard AIN-93 diet was administered to the control group, whereas rats in the treatment groups were fed vitamin B12 deficiency-AIN-93M. At the end of treatment, liver homocysteine levels were determined by ELISA, HOMA-IR values were calculated, and steatosis degree of the liver was determined histologically. Statistical analysis was performed using independent t-test. Results A significant increase in liver homocysteine levels was found between the control and both the 8- and 16-week treatment groups (p<0.001). HOMA-IR levels were significantly higher in both treatment groups compared to controls (p<0.001). The area of liver steatosis in both treatment groups was significantly larger than that of the control group (p<0.001). Conclusion Increased homocysteine levels due to dietary vitamin B12 deficiency induces liver steatosis due to insulin resistance in rats.

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