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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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Uncontrolled blood sugar tends to increase prevalence of dermatomycosis in diabetic type 2 patients Surja, Sem Samuel; Hermawan, Melyawati; Wijaya, Meiliyana; Pramanta, Pramanta; Yolanda, Hanna
Universa Medicina Vol 37, No 3 (2018)
Publisher : Faculty of Medicine, Trisakti University

Background The prevalence of type 2 diabetes mellitus (DM) is increasing. Diabetic patients have a higher risk of getting dermatomycosis. Dermatomycoses, although a common health problem amongst DM, is often misdiagnosed and consequently undertreated. Studies on the association between dermatomycosis and type 2 diabetes are lacking, especially in Indonesia. Therefore, the aim of this study was to determine the prevalence, etiology, and association of dermatomycosis with diabetic control of type 2 DM. MethodsA cross-sectional study was performed involving 87 subjects with type 2 DM. Demographic and clinical data, including age, sex, and blood glucose level, were collected. If a dermatomycosis lesion was found, a specimen would be taken for identification. Determination of serum glucose level was conducted using Roche c111 analyzerÂ®. Statistical analysis was performed with the chi-square test and Kolmogorov-Smirnov two-independent sample test.ResultsSeventeen (19.55%) subjects had dermatomycosis. The predominant age group affected was 51 - 60 years (42.4%). The number of clinically apparent dermatomycosis was greater in the uncontrolled than in the controlled blood sugar group, but the difference was statistically not significant (p > 0.05). The lesions were mostly found on the nails (74%) and the most common etiology was candida (50%) followed by dermatophyte (25%) and non-dermatophyte molds (25%). ConclusionUncontrolled blood sugar tends to increase the risk of dermatomycosis in type 2 DM patients. Fungal skin infections are common in type-2 DM patients, especially in those with poor glycemic control.

Hypoglycemic effect of Phaleria macrocarpa (Scheff.) Boerl dry extract in healthy adults Meiyanti, Meiyanti; Margo, Eveline; Pusparini, Pusparini; Merijanti, Lie Tanu; Lesmana, Alvina
Universa Medicina Vol 37, No 3 (2018)
Publisher : Faculty of Medicine, Trisakti University

BackgroundThe prevalence of diabetes in Indonesia continues to increase and causes many complications. Fruits of Phaleria macrocarpa (Scheff.) Boerl. (PM) are used in the traditional health system of the Indonesians, as effective remedy in the management of diabetes mellitus. The aim of this study was to evaluate the effect and magnitude of doses of PM dry fruit extract (PME) on blood glucose levels in healthy adults.MethodsThis research was of pre-posttest design involving 30 healthy volunteer subjects aged 20-55 years receiving glucose loads. At pre-test the subjects were given orally 75 g glucose, and at post-test they were given PME at doses of 125 mg and 250 mg. Data collection included anthropometric examination and blood glucose level. The area under the curve (AUC) of blood glucose levels was measured at 0, 15, 30, 60, 120 and 180 minutes. Data analysis was performed using paired t-test with p <0.05.ResultsThe percentage of reduction in AUC between pre- and post-test after administration of PME 125 mg was 12.1% and significant (p=0.000). But the percentage of reduction in AUC between pre- and post-test after administration of PME 250 mg was 4.07% and not significant (p=0.06). The reduction in AUC between post-test PME 125 mg vs PME 250 mg showed significant results (p=0.011).Conclusion This study demonstrated that a dose of 125 mg Phaleria macrocarpa (Scheff.) Boerl. dry extract has a hypoglycemic effect in healthy adults, and may therefore be suitable for use as traditional anti-diabetic drug.

Later age at menopause was associated with higher cognitive function in post-menopausal women Rachmiyani, Irmiya; Surjadi, Lily Marliany; Nirmalasari, Rully Ayu; Imran, Yudhisman
Universa Medicina Vol 37, No 3 (2018)
Publisher : Faculty of Medicine, Trisakti University

BACKGROUND Menopause is a condition in which the menstrual periods have stopped for the last 12 months due to cessation of ovarial functions causing estrogen hormones to decrease. Various studies find that many factors affect cognitive function at post-menopausal age among others the decrease in estrogens, age at menopause, duration of menopause, and education. However, the effects have been subject to controversy. The aim of this study was to determine the relationship of age, age at menopause, estradiol level, and education with cognitive function among healthy post-menopausal women. METHODS A cross-sectional study was conducted involving 31 post-menopausal women between 50 to 75 years old. Data on age, age at menopause, and education were collected using a questionnaire. The estradiol levels were measured using an electrochemiluminescent immunoassay (ECLIA). The Indonesian version of the Montreal Cognitive Assessment (MoCA INA) was used to assess the cognitive function. Multiple linear regression was used to analyze the data. A p<0.05 was considered statistically significant.RESULTS Age (b=-0.086; 95% C.I.=-0.263-0.090; p=324) and estradiol levels (b=0.106; 95% C.I.=-0.018 -0.230; p=0.092) were not significantly associated with cognitive function. However, education (b=1.537; 95% C.I.=0.176-2.898; p=0.028) and age at menopause (b=0.364;0.056-0.671; p=0.022) were significantly associated with cognitive function. Age at menopause was the most influential factor of cognitive function (Beta=0.402) compared to education (Beta=0.394).CONCLUSION Later age at menopause could increase cognitive function in post-menopausal women. Our findings are that modifiable factors that delay age at menopause should receive attention, in order to promote cognitive function. Keywords: Age at menopause, estrogens, cognitive function, post-menopausal women

Antibiotic resistance and prevalence of class 1 and 2 integrons in Escherichia coli isolated from hospital wastewater Ranjbar, Reza; Zeynali, Maryam; Sohrabi, Nooshin; Kamboh, Asghar Ali; Moshaveri, Arman
Universa Medicina Vol 37, No 3 (2018)
Publisher : Faculty of Medicine, Trisakti University

BACKGROUND Hospital wastewaters may contain antibiotic resistant bacteria such as Escherichia coli. These E. coli harbor integron genes that are responsible for antibiotic resistance. The purpose of the current study was to evaluate the frequency of class 1 and 2 integrons in environmental antibiotic resistant E. coli strains isolated from the hospital wastewaters in Tehran, Iran.METHODSAs a descriptive cross-sectional study, this research was performed from April to September 2015 on hospital wastewaters in Tehran. Bacterial isolation and identification was performed by standard biochemical and bacteriological procedures. Susceptibility testing was done by employing the disk diffusion method using different antibiotics. Total DNAs were extracted to evaluate the presence of class 1 and 2 integrons by using the polymerase chain reaction (PCR) method with specific primers. RESULTSFifty E. coli strains were isolated and identified from the wastewaters of 25 hospitals in Tehran. The phenotype results showed that 46 isolates (92%) were resistant to at least one antibiotic and 27 isolates (54%) were multidrug resistant. PCR showed that 35 (70%) and 20 (40%) of the isolates had class 1 and 2 integrons respectively and 14 isolates (28%) had both class 1 and class 2 integrons.CONCLUSIONThis study has shown a considerable presence of class 1 and class 2 integrons in E. coli strains isolated from hospital wastewaters in Tehran. Proper antibiotics prescription and appropriate hospital wastewater treatment can prevent resistance genes in E. coli from circulating in the environment.

Hashimotoâ€™s thyroiditis is not a risk factor for thyroid cancer Eshraghi, Mohsen; Mousavi, Seyed Mojtaba
Universa Medicina Vol 37, No 3 (2018)
Publisher : Faculty of Medicine, Trisakti University

BackgroundThyroid carcinoma is the most common endocrine malignancy. Chronic inflammation can be involved in tumorigenesis. It is estimated that more than 20% of all tumors are caused by persistent inflammatory conditions. The objective of the present study was to compare the inflammatory factor level of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and thyroiditis between benign and malignant thyroid nodules.MethodsA cross-sectional study was conducted involving 94 patients (47 patients with benign tumors as controls and 47 patients with malignant tumors as cases). ESR and CRP were measured and analyzed. Mean ESR and CRP in both groups was compared using independent t-test. The chi-square test was used to assess the risk of cancer in patients with Hashimotoâ€™s thyroidits and with significance level at p<0.05.ResultsThe mean age of the patients in the benign group was 42.28 Â± 13.43 years and in the malignant group 42.20 Â± 16.32 (20-85) years, which was not significantly different (p=0.350). Independent t-test results were not significantly different between mean ESR and CRP in both groups (p=0.800 and p=0.993 respectively). Hashimotoâ€™s thyroiditis was not a risk factor for thyroid cancer (OR=1.58; 95% CI:0.63-4.01).ConclusionThis study demonstrated that Hashimotoâ€™s thyroiditis was not a risk factor for thyroid cancer. Factors such as ESR and CRP are acute phase reactants and their levels increase in cases of acute inflammation, but may not increase significantly in chronic inflammatory conditions and malignancies.

Life style as a risk factor of human Papillomavirus co-infections with Trichomonas vaginalis in female sex workers Odigie, Efosa Bolaji; Okungbowa, Micheal Awol
Universa Medicina Vol 38, No 1 (2019)
Publisher : Faculty of Medicine, Trisakti University

BACKGROUNDAsymptomatic Trichomonas vaginalis (TV) and human papillomavirus (HPV) co-infection is perceived to have a devastating combined effect on victims. Hence, we investigated TV/ HPV co-infection and determined the risk factors associated with it in female sex workers (FSW).METHODSA cross-sectional study was used to recruit 338 subjects from 6 local government areas (LGAs) in Nigeria for 18 months. Agglutination tests for blood samples, and direct and wet examination of urine and vaginal swabs were conducted in the laboratory. Life style of FSWs was surveyed; data were analyzed with Chi-Square test (X2), paired and unpaired t-test and logistic regression analysis with statistical significance set at p< 0.05.RESULTSLife style characteristics were significantly associated with HPV and TV co-infection (pÂ < 0.001). The model explained 49.9% (Nagelkerke R2) of the variance in infections among FSWs and effectively classified 93.2% of cases. Those involved in oral sex were 1.795 times more likely to be infected compared to those not involved (OR: 1.795; 95% C.I.: 1.005 â€“ 33.525; p=0.001). Street and residential FSWs all have increased likelihood of being infected. Hard drug usage was also associated with an increased likelihood of being infected with the disease (OR: 3.582; 95% C.I.: 1.573 - 11.756; p=0.001).CONCLUSIONSLife style (hard drug usage and oral sex practices) was observed in association with HPV/ TV co-infection in FSWs with a preponderance of 49.9%. This study demonstrated the value of screening for genital infections in HPV positive subjects in order to reduce the probable synergistic effects of co-infections.

Progesterone decrease plasma membrane in human sperm with subnormal hypoosmotic swelling test scores Sisca, Sisca; Yunaini, Luluk; Pujianto, Dwi Ari
Universa Medicina Vol 38, No 1 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundProgesterone (P4) is known as a female hormone affecting oocyte maturation and developing uterine wall. A proteomic study identified several receptors including P4 receptors on human sperm. The role of P4 in human sperm cells remains unknown as to whether P4 has non-genomic effects on human sperm. The present study aims to determine the effect of progesterone (P4) on the hyperactivated motility and membrane integrity of human sperm cells.MethodsSemen from normal individuals was obtained from donors. The semen was washed by gradient density centrifugation. P4 was added to each semen sample to final concentrations of 0 (control), 250, 500, 750 and 1000 ng/mL. After the sample treatment was completed, the sperm membrane integrity was assessed with the hypoosmotic swelling test (sodium citrate dihydrate and D-fructose) and the hyperactivated sperm motility parameter was determined with the Computer Assisted Sperm Analyzer [CASA] (Hamilton Thorne, IVOS II, USA). The percentage was then compared between the treatment groups and the control group. The percentage differences were analyzed with the Sigmastat version 2.0 statistical program.ResultsAdministration of P4 increased sperm hyperactivated motility when compared with the control group at a concentration of 500 ng/mL, but the increase was statistically not signicant (p>0.05). In contrast, P4 decreased sperm membrane integrity significantly (p=0.042). And the mean of plasma membrane integrity in all groups was subnormal hypoosmotic swelling test score. ConclusionProgesterone administration tends to increase sperm hyperactivated motility. The integrity of plasma sperm membrane was affected by progesterone.

Cullin 1 is not associated with late-onset preeclampsia Samara, Tjam Diana; Liem, Isabella Kurnia; Prijanti, Ani Retno; Andrijono, Andrijono
Universa Medicina Vol 38, No 1 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundLate-onset preeclampsia (PE) is preeclampsia occurring after 34 weeks of gestational age or later.Â Cullin 1 (CUL1), a proangiogenic protein, is expressed in the placenta, where an imbalance between proangiogenic and antiangiogenic proteins during gestation can cause disturbance of trophoblast invasion. This defect results in vascular ischemia that may produce preeclampsia. The objective of this study was to determine the correlation between CUL1 as proangiogenic factor and late-onset preeclampsia. MethodsThis study was of analytical observational cross-sectional design and involved 44 preeclampsia patients with Â³34 weeks of gestational age (late-onset PE). The CUL1 level in the subjectsâ€™ sera, taken before they gave birth, and in homogenates of their placenta, obtained per vaginam or by cesarean section, were examined by the ELISA technique.Â Statistical analysis was performed with the Spearman correlation test with significant p value of <0.05.ResultsMedian maternal age was 31 years and median gestational age was 37 weeks.Â Median serum CUL1 was 41.78 pg/mL and median placental homogenate CUL1 was 32.24 pg per milligram of total placental tissue protein. There was no significant correlation between serum CUL1 level and late-onset preeclampsia (r=-0.281; p=0.065). There was also no significant correlation between placental CUL1 level and late-onset preeclampsia (r=-0.166; p=0.281).ConclusionSerum CUL1 and placental CUL1 were not correlated with late-onset preeclampsia. However, this study indicated that low serum CUL1 tends to prolong gestational age in preeclampsia.

Molecular characterization of methicillin-resistant staphylococci among apparently healthy students Ogefere, Helen Oroboghae; Ogunleye, Lawrence Ayodele
Universa Medicina Vol 38, No 1 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundStaphylococcus aureus are widely considered a major factor of nosocomial and community-acquired infections. This work was aimed at determining the prevalence of methicillin-resistant S. aureus (MRSA) among apparently healthy students. MethodsA cross-sectional study was conducted involving 400 nasal swab samples randomly collected from students using sterile swab sticks and processed to recover S. aureus using standard microbiological techniques. Conventional methods were used to identify the isolates and antibiotic susceptibility tests were performed using Kirby-Bauer disc diffusion method according to performance standards of Clinical and Laboratory Standard Institute guidelines. Methicillin-resistance was detected phenotypically using cefoxitin 30Âµg discs. Bacterial deoxyribonucleic acid (DNA) extraction was done on cefoxitin-resistant staphylococci isolates only using ZymoResearch (ZR) fungal/bacterial DNA MiniPrepTM kit. A polymerase chain reaction assay targeting the 16S rRNA, nuc, and mecA genes on 1.0% agarose gel electrophoresis stained with ethidium bromide was used to identify S.aureus and detect methicillin resistance. ResultsThe overall prevalence of MRSA was 5.8% using phenotypic methods. PCR amplification of the 23 phenotypically confirmed MRSA using 16S rRNA and nuc genes identified staphylococci 23/23(100%) and S. aureus 23/23(100%) at band size 886bp and 225bp respectively. However, 16(69.6%) were positive for mecA gene at band size 532bp by PCR method. Poor level of susceptibility was recorded among the MRSA namely to erythromycin (26.6%), cloxacillin (0%), augmentin (0%), cefuroxime (0%), ceftriaxone (0%) and ceftazidime (0%). Ofloxacin was the most effective antibiotic (60.9%). ConclusionActive antimicrobial surveillance of pathogenic staphylococci is important to analyze the infections and transmission rate for possible control measures.

Advanced metastatic breast carcinoma in sickle cell disease Nwagu, Marcellinus uchechukwu; Thompson, Ologo; Oyekemi, Akinola
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundBreast cancer is the leading cancer in women leading to over 400,000 deaths per year worldwide. It begins in the breast tissue and can metastasize to other organs if early diagnosis and treatment is not instituted. Women with sickle cell disease are usually spared from breast cancer and other solid tumours due to the tumoricidal effect of sickled erythrocytes. Breast cancers are rare among these group of patients. Despite its rare occurrence, this paper was to emphasize the need for breast cancer screening among female sickle cell disease patients who have positive family history of breast cancer.Case descriptionOO was a 30-year old woman with sickle cell disease who presented to the hospital one and half years ago with a seven months history of right breast swelling and pains. She had lost her mother to breast cancer about 15 years ago. Mammography and histology of breast biopsy confirmed diagnosis of invasive ductal carcinoma of the right breast. Financial constraint was a major challenge in managing this patient as she was unable to buy her chemotherapy. She developed features suggestive of metastasis such as seizures and hepatomegaly. She was stabilized and discharged home but we lost her to follow up. She died at home.ConclusionÂ Â Â Breast cancer is rare among females with sickle cell disease; any of them with a family history should be routinely screened for early diagnosis and treatment.

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