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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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Articles 602 Documents

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Tumor necrosis factor-α-activated mesenchymal stem cells accelerate wound healing through vascular endothelial growth factor regulation in rats Aditya Nugraha; Agung Putra
Universa Medicina Vol. 37 No. 2 (2018)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2018.v37.135-142

BackgroundWounds are areas of physical or thermal damage of the epithelial layer of skin or mucosa. The wound healing process consists of hemostasis, inflammation, proliferation, and remodeling. Mesenchymal stem cells (MSCs) play a role in wound healing by suppressing potent pro-inflammatory molecules, such as tumor necrosis factor-α (TNF-α), leading to macrophage polarization from the pro-inflammatory type to the pro-regeneration type characterized by increasing vascular endothelial growth factor (VEGF) production. MSCs are able to increase VEGF level in-vivo correlated with collagen synthesis. The objective of this study was to assess the role of TNF-α-activated MSCs on VEGF in rat wounds. MethodsAn experimental animal study with post-test only control group design was performed involving 24 Wistar rats. The rats were randomized into four groups consisting of one control (K) and three treatment groups (P) (activated MSCs at doses of 3x105, 6x105, and 12x105 cells, respectively). The measurement of VEGF levels was done using ELISA assay while the collagen analysis was performed by light microscopy. One way ANOVA and Post Hoc LSD were used to analyze the data.ResultsThe results showed a significant increase in VEGF levels (p <0.05) on day 3 and then a significant decrease on day 5 along with a significant increase in the amount of collagen on day 7 (p<0.05).ConclusionThis study demonstrated that TNF-α-activated MSCs were able to regulate VEGF levels and collagen synthesis in wound healing in rats. The molecular mechanism by which TNF-α-activated MSCs stimulate cutaneous wound healing should be clarified further.

New tuberculosis vaccine to support tuberculosis elimination Chondro, Fransisca
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.v37.85-87

The Sustainable Development Goals have prioritized ending the epidemic of tuberculosis by 2030.(1) Around one-third of the world population is infected with Mycobacterium tuberculosis (MTBC), but is asymptomatic, a conditon known as latent TB.According to the global tuberculosis report, in 2017 there were 5-15% of 1.7 billion Â persons infected with MTBC, who will develop TB in their lives. Around 10% of latent TB will develop into active TB disease, with a higher risk in patients with immunodeficiencies such as HIV, undernutrition, diabetes mellitus, smoking, and habitual alcohol consumption. As a result there are annually an estimated 8.8 million new TB cases, with a TB mortality of 1.1 million and deaths from TB and HIV coinfection of 350 thousand cases.The World Health Organization has planned a number of strategies for TB elimination in the year 2030, such as developing rapid and accurate diagnostic tests, new regimens for the treatment of drug-susceptible or drug-resistant TB, prevention of transmission of M. tuberculosis through infection control, new vaccine candidates to prevent the development of TB, and to help improve the outcomes of treatment for TB disease.

Males tend to come earlier for eye care with the National Health Coverage Programme in private hospitals Simanjuntak, Gilbert WS; Tan, Jannes F; Christine, Reinne Natali
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.v37.127-134

BackgroundCataract is the leading cause of blindness in Indonesia, and poverty is a major barrier to having cataract surgery. Increasing the proportion of adults that have regular, comprehensive eye examinations for cataract and other common eye health problems is one of the National Health Insurance (JKN) objectives. The objective of this study was to determine the impact of vision insurance on eye care utilization of cataract patients in private hospitals with the JKN system as social intervention. MethodsA cross-sectional study was conducted involving 230 cataract patients in a private hospital. Inclusion criteria were patients with cataract surgery, diagnosis and follow up visit minimally two months after surgery. A multiple logistic regression was used to analyse the data.ResultsInitial visual acuity (VA) was 0.13 Â± 0.15 and final VA was 0.91 Â± 0.15. Two patients had final VA of 0.2 and 0.15, respectively, in which the first was associated with persistent corneal edema and diabetes mellitus, and the other with corneal scar. Age, gender, and level of education were not associated with VA at the first visit (p>0.05). Further analysis using a multiple logistic regression model was found to be significant (p=0.0104), with gender being associated with preoperative vision, where males tend to come earlier to undergo cataract surgery/treatment.ConclusionMales tend to come earlier than females for cataract surgery with the National Health Insurance (JKN) programme, despite the social intervention of the programme.

Centella asiatica ethanol extract increases hippocampal brain derived neurotrophic factor in male Wistar rats Handayani, Astri; Yolanda, Sophie; Kodariah, Ria
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.v37.143-149

BackgroundSynaptic plasticity, which primarily takes place in the hippocampus, is the molecular basis of long- term memory formation. Brain derived neurotrophic factor (BDNF), a member of the neurotrophin family, plays a significant role in synaptic plasticity and memory formation. When BDNF is released, it binds to its receptor and activates various intracellular signal transduction pathways leading to synaptic plasticity. Several methods to improve memory function in humans have been studied, one of which is the use of herbal compounds, such as Centella asiatica (CeA), an herbaceous plant that has been used for improving memory. This study aims to examine the effects of CeA ethanol extract on BDNF protein expression in the CA1 hippocampal region in adult male rats.MethodsA randomized experimental design was performed involving 18 adult male Wistar rats. The rats were randomized into three groups: one control/distilled water group and two groups treated with doses of CeA ethanol extract of 300 mg/kgBW (CeA300) and 600 mg/kgBW (CeA600), respectively. CeA ethanol extract was administered orally for 28 consecutive days with weekly weight-adjusted dose. After 28 days, the rats were decapitated, and the hippocampus was isolated from the brain. BDNF protein expression was assessed using immunohistochemistry. Data was analyzed using Kruskal-Wallis test and continued with post-hoc analysis. ResultsThere was a significant increase in BDNF protein expression in the CeA600 group compared to the control group (p<0.001). ConclusionAdministration of CeA ethanol extract increased BDNF protein expression in the CA1 hippocampal region of adult male rats.

Cervical consistency index is a valid predictor of preterm birth in low-risk pregnant women Pooransari, Parichehr; Salehi, Fatemeh; Afrakhteh, Maryam; Mirzamoradi, Masoumeh; Saleh Gargari, Soraya; Ghatreh Samani, Omid
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.v37.150-158

Background Preterm birth (PTB) remains a global problem associated with perinatal morbidity, including low birth weight, growth retardation and irreversible damage to the nervous system. The objective of this study was to determine the predictive value of cervical consistency index (CCI) to indicate the occurrence of PTB in mid trimester screening of low risk pregnant women. MethodsThis was a prospective study conducted on low-risk pregnant women at 14-28 weeks of pregnancy. The cervical length (CL) and AP cervical diameter were measured and the CCI determined according to the formula AP2/AP1*100. The ROC curves were drawn according to gestational age and the sensitivity and the specificity were calculated for optimal cut-off for 1st, 5th, 10th, 21th, and 24th centiles of CCI. The inter-observer agreement was validated by interclass correlation coefficients (ICC).ResultsA total of 149 participants were enrolled in this study. Among them, 12.08% had PTB (<37weeks) and 87.92% had normal birth. Mean CCI for all subjects was 68.60%, but was lower in PTB (48.9%). The best cutoff for predicting PTB based on CCI was 59.46% with 99.18% sensitivity and 85% specificity. The AUC for CCI for prediction of PTB <37weeks was 0.936. There was no inter-observer difference in measurement of CCI and CL (ICC values for CCI and CL were 0.997 and 0.990 respectively).ConclusionIn women with normal CL the CCI could predict PTB in the second trimester in low risk women. So, CCI is a valid predictor of PTB in low risk women.

Successful treatment of a patient with herbal drug-induced immune thrombocytopenic purpura using freshly donated blood Nwagu, Marcellinus Uchechukwu
Universa Medicina Vol 37, No 3 (2018)
Publisher : Faculty of Medicine, Trisakti University

BackgroundDrug-induced thrombocytopenia (DITP), which also includes thrombocytopenia induced by beverages, foods, and herbal remedies, is an important clinical problem for haematologists. Drug-induced thrombocytopenia is often misdiagnosed as immune thrombocytopenic purpura with resulting inappropriate treatment. Immune thrombocytopenic purpura (ITP) is a clinical disorder that leads to easy bruising (purpura), excessive bleeding or extravasation of blood from capillaries into skin and mucous membranes (petechiae). The bleeding tendency is due to decreased number of circulating platelets (thrombocytopenia). There is production of antibodies against the platelets by the patientâ€™s immune system. This case report was conducted to introduce the effectiveness of freshly donated blood and steroids on patients with immune thrombocytopenic purpura (ITP) after ingestion of herbal drugs.Case descriptionDT was a 30-year old female who presented with bleeding per vagina, gum bleeding and weakness. The patient did not have any systemic disease that would cause any spontaneous hemorrhage. The patient was referred to a hematologist urgently and her thrombocyte count was found to be 2000/Ã¬L. Other test results were in normal range. Full blood count revealed severe thrombocytopenia. Freshly donated whole blood was given to the patient and then the changes in her general condition were analyzed, as well as the blood test results.ConclusionIn the absence of platelet concentrate especially in rural settings and resource-poor countries, freshly donated whole blood can be used in the management of a case of severe thrombocytopenia from ITP.

Highly active antiretroviral therapy increases fibrinolytic and protein activity in pregnant women Osime, Evarista Odaburhine; Obar, Catherine
Universa Medicina Vol 37, No 3 (2018)
Publisher : Faculty of Medicine, Trisakti University

BACKGROUNDVarious studies have examined optimal methods for Prevention of Mother to Child Transmission (PMTCT) of human immunodeficiency virus (HIV) and subsequent outcome of response to highly active antiretroviral therapy (HAART) as well as the impact of pregnancy on outcomes of HIV in the Pre-HAART era. Little is known of the impact of pregnancy in response to HAART in Africa. This study is aimed to evaluate euglobulin lysis time (ELT), protein C and protein S in HIV-positive pregnant women on HAART.Â METHODSThis was a cross-sectional study comprised of 150 participants attending Ante-Natal Clinic (ANC) in Central Hospital, Benin City. Pregnant women on HAART (Test subjects) (n=50, mean age 34 years), 50 pregnant newly diagnosed HIV-positive women that had not yet commenced HAART (n=50, mean age 31 years) and 50 pregnant HIV-negative women (n=50, mean age 30 years) which served as controls. The ELT was determined by methods described by Bain, protein C and protein S were determined using Enzyme Linked Immunosorbent Assay (ELISA).Â RESULTSThere was a significant increase in ELT in both pregnant women on HAART and not on HAART) when compared to HIV-negative pregnant women (p<0.05). There was a significant decrease in protein C in test subjects when compared with controls (p<0.05) and protein S increased significantly in HIV-positive pregnant women on HAART when compared to those not on HAART and HIV-negative pregnant women (p<0.05). Â CONCLUSIONThere are changes in ELT, protein C and protein S parameters with the introduction of HAART in pregnancy.

WNT7A (rs104893832) polymorphism increases the risk of recurrent spontaneous abortion in Iranian women Mazdapour, Manouchehr; Ashkezari, Mahmood Dehghani; Seifati, Seyed Morteza
Universa Medicina Vol 37, No 3 (2018)
Publisher : Faculty of Medicine, Trisakti University

BACKGROUNDRecurrent spontaneous abortion is defined as the occurrence of three or more clinical miscarriages in one woman. Several factors, including genetics and environmental factors, are involved in this kind of infertility, in which WNT7A (rs104893832) polymorphism plays a major role. The aim of the present study was to determine the association between a common polymorphism of WNT7A (rs104893832) with recurrent spontaneous abortion in females. METHODSIn the present case-control study, the WNT7A (rs104893832) polymorphism was investigated in 70 women with recurrent spontaneous abortion as cases and 100 women with at least one child and no history of infertility or abortion as controls. Polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) was used to investigate the WNT7A (rs104893832) polymorphism in both case and control groups. The data were subsequently analyzed using the chi-square and logistic regression tests by SPSS software (version 18.0). RESULTSA significant association was found between the WNT7A (rs104893832) polymorphism and recurrent spontaneous abortion (OR=25.00, 95% CI=5.52-157.09; p<0.0001). Our finding showed that G allele frequency in women with recurrent spontaneous abortion was significantly different compared to the control group. (OR=6.42, 95% CI=2.82-15.16; p<0.0001).Therefore, genetic variation in WNT7A (rs104893832) polymorphism may play a role in recurrent spontaneous abortion. ConclusionThis study revealed that WNT7A (rs104893832) polymorphism increased the risk of recurrent spontaneous abortion. Knowledge of these mutations and polymorphisms can provide an insight into the prognosis for individual patients. Therefore, further studies are necessary to establish the association of WNT7A (rs104893832) polymorphism with recurrent spontaneous abortion in a larger population.

Duration of dialysis increases risk of hepatitis C virus infections among hemodialysis patients in Anambra state, Nigeria Chizoba, Okeke Okechukwu; Chibuogwu, Ajulu A
Universa Medicina Vol 37, No 3 (2018)
Publisher : Faculty of Medicine, Trisakti University

Background Sexually transmitted infections and syphilis are a major public health concern. Hemodialysis patients are at an increased risk of acquiring hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. The aim of this study was to determine the seroprevalence of HBV, HCV, syphilis, and the association between these infections and hemodialysis among hemodialysis patients.MethodsA cross-sectional study was conducted involving 90 hemodialysis patients. Blood samples were collected and analysed for HBV, HCV and syphilis using immunochromatographic test kits. All subjects completed a questionnaire on demographic characteristics and other risk factors. A chi-square test was used to analyse the data.ResultsThe prevalence of HBV, HCV and syphilis infections was 4.4%, 6.7% and 2.2% respectively. Highest prevalence of HBV, HCV and syphilis were found in patients whose duration of dialysis were >1 year, >1 year, and 4 months to 1 year, respectively. Similarly, those who had undergone dialysis for > 10 times had the highest prevalence of these infections. The major risk factor the patients was exposed to was blood transfusion (100%), with those who had been transfused for 5 times having the highest prevalence of HBV and HCV and those transfused twice for syphilis. A significant association was seen between duration of dialysis and HCV infection (p<0.05).ConclusionThis study has demonstrated that duration of dialysis increased HCV infection in hemodialysis patients. The prevalence of HBV, HCV and syphilis in the hemodialysis unit is a warning that universal precautions will be the next challenge for decentralised hemodialysis services.

Ageing, longevity and fitness: towards new paradigms in healthy ageing Abikusno, Nugroho
Universa Medicina Vol 37, No 3 (2018)
Publisher : Faculty of Medicine, Trisakti University

We have nearly reached the end of the second decade of the Millennium. Within 5 years we hope the Third Ageing Summit will be held to discuss lessons learned and future directions in the field of Ageing and Longevity. 1) I mention the word Longevity since many countries especially in the Asia Pacific region, the second Hub of Ageing after the Western world countries, have experienced this phenomenon since the early years of this Millennium.

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