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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 602 Documents
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Idiopathic thrombocytopenic purpura: laboratory diagnosis and management Alvina, Alvina
Universa Medicina Vol 30, No 2 (2011)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2011.v30.126-134

Abstract

Idiopathic thrombocytopenic purpura (ITP) or immune thrombocytopenic purpura is a disease characterized by low platelet count (<150,000/ìL) caused by autoantibody-mediated platelet destruction and the absence of other causes of thrombocytopenia. Acute primary ITP is more common in children 2-6 years of age, with similar incidence between males and females, while the chronic form is usually encountered in adults with median age of 40-45 years. The clinical signs of ITP are purpura, ecchymosis, petechiae and gastrointestinal tract bleeding, gingival bleeding, epistaxis, and urinary tract bleeding. Spontaneous mucosal, intracranial, and gastrointestinal hemorrhage may occur at platelet counts of <10000/ìL. To date, the diagnosis of ITP is still arrived at by exclusion, i.e. by elimination of other causes of thrombocytopenia. The diagnosis of ITP also requires a medical history (anamnesis), physical examination, platelet count, and examination of a peripheral blood smear. The latter examination in ITP shows low numbers of normal-sized platelets, occasionally also giant platelets, while erythrocytes and leukocytes have a normal morphology. The bone marrow is usually normal or shows increased megakaryocytes. Assessment of antithrombocyte antibody may assist in establishing the diagnosis of ITP. Management of ITP is based on platelet count and severity of bleeding. Treatment is aimed at interfering with antibodies that damage the platelets, by inhibiting the functions of macrophage Fcã receptors and decreasing the production of antiplatelet antibodies. Thrombopoietin (TPO) receptor agonists including eltrombopag and romiplostim have offered an important new option in treating ITP.
HIV antiretroviral preexposure prophylaxis Richard Tjan
Universa Medicina Vol. 32 No. 2 (2013)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2013.v32.69-70

Abstract

According to 3 field trials conducted in Africa, one among African women and two amongheterosexual couples, antiretroviral preexposure prophylaxis for prevention of HIV-1 has beenshown to be effective.(1-3) In preexposure prophylaxis, persons without HIV infection are givenan oral drug before they have sexual contact with HIV-infected partners.(4) The drug in questionis tenofovir disoproxil fumarate (TDF), a prodrug of tenofovir.(1) On the basis of the 3 field trials,the Antiviral Drugs Advisory Committee of the Food and Drug Administration has recommendeda combination of antiretroviral drugs (tenofovir/emtricitabine) for preexposure prophylaxis ofHIV.(5)TDF is currently indicated for the treatment of HIV in adults over 18 years of age orhepatitis B virus (HBV) infection in adults, or both. The drug is called a nucleotide reversetranscriptase inhibitor (NRTI), preventing the synthesis of viral copies by HIV reversetranscriptase or HBV DNA polymerase.(6) To retard the emergence of TDF resistance, the drugis usually given in combination with another antiviral, such as emtricitabine (FTC). Nucleic acidtesting for HIV virus when starting preexposure prophylaxis, may reduce the risk of resistance,but it is at present not an option in developing countries because of its high costs. Rare butpotentially serious adverse reactions to TDF are lactic acidosis and toxic effects on the liver andkidneys.(6) Because administration of TDF to healthy noninfected persons implies using the drugfor a prolonged period of many years, the long-term safety of TDF and the TDF-FTC combinationhas to be clearly established.(4)There is also a real possibility that preexposure prophylaxis may lead to relaxation of thecustomary precautions on the part of the sexual partners, such as engaging in increased riskysexual behavior or abandoning the use of conventional prophylactic measures (e.g. condoms). (4)This matter should be a problem for health educators.From a practical point of view, because of the potential of serious liver and kidney diseasecaused by TDF, the medical practitioner should prescribe preexposure prophylaxis only in highrisk cases, and not for prevention of HIV in otherwise healthy individuals, e.g. blood bankpersonnel or dental practitioners with a low risk of exposure to HIV, which are currently notindicated. Prescription should be done on an individual basis.Indeed, the old Hippocratic advice of not too readily prescribing any new modes of treatment,or in plain words - Wait and watch- still holds true. This is presumably one of the reasons for notblindly or overenthusiastically accepting HIV preexposure prophylaxis.
Multiplex nested polymerase chain reaction for Treponema pallidum using blood is more sensitive than using serum Effendi, Ida; Rosana, Yeva; Yasmon, Andi; Indriatmi, Wresti
Universa Medicina Vol 37, No 1 (2018)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2018.v37.75-84

Abstract

BackgroundSyphilis is a multistage disease transmitted primarily through sexual intercourse. Nowadays, the polymerase chain reaction (PCR) test for Treponema pallidum has been widely used and is expected to overcome problems in diagnostic tests for syphilis. The Treponema pallidum PCR is influenced by type of specimens, PCR methods and target genes. This study aimed to assess the use of blood and serum in multiplex nested PCR for Treponema pallidum, targeting the 23S rRNA.MethodsA cross-sectional study was conducted from April 2015 - April 2016. Sampling was carried out consecutively among patients with clinical features of secondary syphilis who came to Sexually Transmitted Disease (STD) clinics in Jakarta. All sera were also tested with Rapid Plasma Reagin (RPR) and Treponema pallidum Hemagglutination Assay (TPHA) assay, which was considered as the gold standard for this study. We determined the sensitivity and specificity of the multiplex nested PCR for Treponema pallidum using blood and serum.ResultsPCR test was performed on 122 clinical specimens (61 blood and 61 serum). The positive results of PCR test on blood was 22.95% and serum was 6.56%, while the positive results of serology was 68.85%. The sensitivity of Treponema pallidum multiplex nested PCR on blood was 30.95% compared to serum 9.52% (p=0.006). PCR test on blood is able to detect 3.25 times higher than serum. ConclusionThe use of blood has a higher proportion of positives compared to serum in Treponema pallidum multiplex nested PCR using 23S rRNA target gene.
Shortening tends to increase aortic foam cell count and wall thickness in male Wistar rats Lusiantari, Rokhima; Pramaningtyas, Miranti Dewi; Nurmasitoh, Titis; Pattimura, Rachmi Hidayati; Dewanti, Anggita
Universa Medicina Vol 37, No 1 (2018)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2018.v37.13-18

Abstract

BackgroundShortening is widely used as raw material for bread and other foods. Hypercholesterolemia increases aortic arch foam cell formation and abdominal aortic wall thickness. This study aimed to determine the effect of shortening on the number of aortic arch foam cells and abdominal aortic wall thickness in rats.MethodsThis study was of experimental posttest control group design. Twenty four male Wistar rats were randomized into 4 groups. The negative control group (C-) received standard feed, the positive control group (C+) standard high-fat feed, group T1 shortening and standard feed at a ratio of 1:5 and group T2 shortening and standard feed at a ratio of 1:10. The interventions were given for 6 weeks through gavage. The foam cell count in the aortic arch and the thickness of the abdominal aortic wall were measured. One-way ANOVA test was used to analyze the data. ResultsThere was no significant difference in the mean foam cell count of the aortic arch between the four groups C- (7.17 ± 4.17), C + (9.33 ± 7.01), T1 (11.83 ± 4.88) and T2 (9.33 ± 6.80) (p=0.598). The mean thickness of the abdominal aortic wall between the four groups C- (741.98 ± 60.67μm), C + (714.29 ± 90.59μm), T1 (838.90 ± 75.86 μm), and T2 (749.88 ± 99.37μm) also was not significantly different (p=0.110).Conclusion Shortening tends to increase the foam cell count of the aortic arch and the thickness of the abdominal aortic wall of rats.
Regular condom use tends to decrease cervical lesions in resident-commercial sex workers in Sub-Saharan Africa Odigie, Efosa Bolaji; Achukwu, Peter Uwadiegwu
Universa Medicina Vol 37, No 1 (2018)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2018.v37.39-49

Abstract

BACKGROUNDCervical lesions are abnormalities seen in tissues and cells examined from the uterine cervix. These abnormalities are on the increase and are ignored; thereby constituting major health problems in resident commercial sex workers (CSWs) who temporarily reside in brothels for sex business. Hence, we investigated the associations between behavioural risk factors and cervical lesions in resident commercial sex workers. METHODSWe conducted a cross-sectional study among 119 resident commercial sex workers using questionnaires as the data gathering tool, liquid-based cytology for cervical lesions screening, and microscopy for examination of slides. Statistical analyses were conducted using Epi- Info™ version 6.4 and STATISTICA (StatSoft, version 5, 2009 Edition, Atlanta, GA 30329-4027 USA). Data were analysed using multivariate and simple logistic regression analyses, while the level of significance was set at p £0.05. RESULTSThe behavioural risk factors, like smoking and hard drugs, alcohol intake, commercial sex duration, client’s daily patronage and sex frequency were not significant apart, but regular condom use tends to decrease the cervical lesions in CSWs (OR=0.91;95% C.I. 0.92-1.06), including anal and oral sex (OR = 0.99 (95% C.I. 0.29-3.60). The patterns of cervical lesions further showed acute and chronic cervicitis with a prevalence of 10.1%, including low-grade squamous intraepithelial lesion (LSIL) and atypical squamous cells of undetermined significance (ASCUS). We recorded 8/12 (66.7%) for acute cervicitis, 4/12 (33.3%) chronic, and 82.4% negative. CONCLUSIONWe suggest that behavioural risk factors are associated with cervical lesions and that regular condom use tends to decrease cervical lesions among resident CSWs.
High ferritin in homozygous and heterozygous β-thalassemia tends to decrease oxidative stress levels Maskoen, Ani Melani; Reniarti, Lelani; Sumantri, Nur Imaniati; Sahiratmadja, Edhyana
Universa Medicina Vol 37, No 2 (2018)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2018.v37.97-104

Abstract

BackgroundIneffective erythropoiesis and multiple blood transfusions may cause iron overload, leading to high level of ferritin in β-thalassemia patients. Iron has the ability to catalyze the production of reactive oxygen species (ROS), which can be prevented by an adequate activity of superoxide dismutase (SOD) and glutathione peroxidase (GPx). The aim of this study was to explore the association between high ferritin levels and oxidative stress among β-thalassemia patients by measuring SOD and GPx levels. MethodsThis was a cross sectional study among β-thalassemia major patients. Ferritin, SOD, and GPx were measured and compared between β-thalassemia patients with homozygous IVS1nt5 and heterozygous IVS1nt5/HbE mutations, which were the most prevalent mutations found in our previous study. The Spearman correlation test was used to analyze the data. ResultsThe ferritin levels in all β-thalassemia major patients were very high (range: 791-12,340 µg/L). However, no significant differences were observed (p=0.318) between homozygous IVS1nt5 (n=45) compared to heterozygous IVS1nt5/HbE (n=13). The oxidative stress markers SOD and GPx were not significantly different between homozygous IVS1nt5 and heterozygous IVS1nt5/HbE (p=0.450 and p=0.323, respectively). The correlations between ferritin and SOD and GPx oxidative stress levels were not significant in both homozygous IVS1nt5 and heterozygous IVS1nt5/HbE mutations. ConclusionHigh ferritin levels in β-thalassemia patients tend to decrease the GPx level in all thalassemia patients and SOD level in half of the patients, indicating that GPx and SOD may play a role in the occurrence of oxidative stress among thalassemia patients. The mechanism of oxidative stress in thalassemia needs to be further explored.
Inverse correlation between serum albumin and serum lactate in adults with dengue Mauleti, Ifael Yerosias; Suhendro, Suhendro; Nainggolan, Leonard; Rumende, Martin
Universa Medicina Vol 35, No 2 (2016)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2016.v35.75-80

Abstract

BACKGROUNDDengue infection is an acute viral infection, in the natural history of which plasma leakage may occur, resulting in shock followed by tissue hypoxia, with death as the final outcome if not treated properly. The purpose of this study was to determine the correlation of the hematocrit, serum albumin concentration, and the presence of pleural effusion or ascites, with hyperlactatemia in adult dengue patients.METHODSA cross-sectional study was conducted on 62 subjects. The inclusion criteria were: diagnosed dengue viral infection, age >14 years, fever during three consecutive days, and hyperlactatemia. Serum albumin was measured on an Advia 1800 analyzer using the bromocresol green method. The lactate oxidase method was used to determine serum lactate levels. Pleural effusion and/or ascites was determined using an ultrasound scanner (Xario SSA-660 A, Toshiba, Japan). The Pearson correlation test was used to analyze the data. RESULTSThere was no significant correlation between the hematocrit (r=0.11; p=0.301), serum albumin (r=0.003;p=0.981), and pleural effusion or ascites (r=0.75; p=0.692) with serum lactate levels. However, in patients aged >30 years there was a significant inverse correlation between serum albumin and lactate levels (r =- 0.663;p=0.026). CONCLUSIONThis study demonstrated a significant inverse correlation between albumin and serum lactate levels in dengue patients aged > 30 years. This can aid in the early recognition and prompt management of at-risk patients to reduce morbidity and mortality.
Guava leaf juice effect towards number of megakaryocytes in bone marrow of thrombocytopenic mice Atik, Nur; Amrullah, Al Hadi; Rahmadi, Andri Reza
Universa Medicina Vol 37, No 1 (2018)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2018.v37.19-24

Abstract

BackgroundDengue virus infection that most frequently occur in tropical and subtropical regions can cause many symptoms, one of which is a decrease in thrombocyte count. Recent studies showed that guava leaf extract can increase the thrombocyte count in rats. The present study aimed to determine the effect of guava leaf juice in increasing the number of megakaryocytes in the bone marrow of thrombocytopenic mice.MethodsThis study was of experimental design. The study subjects were 24 mice (Mus musculus). The mice were randomly divided into four groups that were subjected to intervention for 14 days. Group 1 was given guava leaf juice (56 mg/kg) and quinine (14 mg/kg), group 2 guava leaf juice (56 mg/kg) only, group 3 was given quinine (14 mg/kg) and group 4 distilled water. After 14 days, from the bone marrow of the femoral bones of each of the mice, hematoxylin eosin stained histologic preparations were made. Anova test was used to analyze the data.ResultsThe mean megakaryocyte count per field of view in group 1 (2.83), group 2 (3.30), group 3 (2.24) and group 4 (2.93). Anova test results for all groups showed significant differences between groups (p<0.05). The mean megakaryocyte count was increased in group 1 compared to group 3, but the difference was statistically not significant (p=0.206).Conclusion Guava leaf juice can increase the megakaryocyte count in the bone marrow of thrombocytopenic mice. This suggests a potential role of guava leaf juice in improving the platelet count in thrombocytopenic disorders.
Flatfoot decreases school functioning among children < 11 years of age Damayanti, Yuke; Hadisoemarto, Panji Fortuna; Defi, Irma Ruslina
Universa Medicina Vol 37, No 1 (2018)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2018.v37.50-56

Abstract

Background Flatfoot is a musculoskeletal abnormality commonly found in children that could result in a reduction of quality of life because of its related symptoms and functional abnormalities. This study aimed to determine the association between flatfoot and the quality of life among children 5-18 years of age. Methods A cross sectional design was used in this study of children aged 5-18 years. The diagnosis of flatfoot was made in accordance with the Chippaux-Smirak Index classification, whereas general and domain-specific quality of life were measured using the Indonesian version of PedsQL™ that has been previously validated. Mann Whitney test was used to compare quality of life between children with flatfoot and normal feet, along with other variables that potentially may influence a child’s quality of life. Results A total of 79 out of 120 subjects was used to analyze the data. There was a statistically significant difference in the quality of life score in the school functioning domain between children with flatfoot (64.46 ±18.22) and those with normal feet (75.90 ±17.29) in children &lt;11 years of age (p=0.029). Apart from this, the study did not find any statistically significant differences in the total quality of life score or in other quality of life domains between the two groups. Conclusions Flatfoot significantly decreases children’s quality of life in the school functioning domain. Early detection and correction of flatfoot may be necessary to improve the educational attainment of children suffering from this condition.
Bronchoscope saline injection method (ME Hejazi Method) in ruptured peripheral and central pulmonary hydatid cysts: a case series Hejazi, Mohammad Esmaeil; Tekantapeh, Sepideh Tahsini; Maddahi, Saeede
Universa Medicina Vol 37, No 2 (2018)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2018.v37.159-164

Abstract

BackgroundThis paper mainly focuses on patients with ruptured pulmonary Echinococcus granulosus infections (alveolar hydatid disease), who suffered from ruptured alveolar hydatid cyst. In this study we aimed to remove these ruptured central and peripheral pulmonary hydatid cysts by the bronchoscopic saline injection method (ME Hejazi method). Case descriptionIn this retrospective study, we evaluated eight patients from an endemic area who were non-surgically treated for ruptured pulmonary hydatid cysts at Imam Reza hospital between 2016-2017. By the bronchoscopic saline injection method (ME Hejazi method), we extracted the entire hydatid cysts of all patients by fiber optic bronchoscopy for the detachment of the underlying membrane from the cavity wall. There were three female and five male patients, with a mean age of 40 ± 23 years (range 17–63 years). Ruptured cysts were located in the peripheral (2) and central (6) parts of the lungs. All of our experiences have been successful without any complications and residual cyst membrane. During the follow-ups, clinical and radiological recovery were seen in these patients.ConclusionsIn the peripheral ruptured hydatid cysts, accurate recognition and location of the cyst is essential and the blind approach is not recommended because it needs several bronchoscopic interventions. Therefore the Hejazi method will be a beneficial and suitable alternative method for surgery in the treatment of patients with ruptured pulmonary hydatid cyst with cyst membrane adhesions.

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