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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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Open reduction in neglected elbow dislocation in children: a case series Irianto, Komang Agung; Parung, Raymond; Sukmajaya, William Putera
Universa Medicina Vol 38, No 1 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundElbow deformity in children due to neglected proper fracture management is a devastating condition. The stiffness and pain complicated the function in daily activity. Successful management of neglected elbow dislocation is a challenging problem for orthopedic surgeons. In this study, we aimed to evaluate results of open reduction for neglected elbow dislocation in children.Case DescriptionThis is a case series of 13-14 years old neglected elbow dislocations, for up to 15 months. Open reduction after external distractor and followed by intensive rehabilitation was implemented. Clinical and functional outcome were evaluated within 4-7 years. Initial average elbow flexion was 53,3Â°, extension was 0Â°, arc of flexion was 53,3Â°, arc of pronation-supination was 150Â° and Mayo Elbow Performance Index (MEPI) was 80. Clinical and functional outcome were evaluated within 4-7 years. At follow-up after open reduction, the improvement in whole range of movement was significant. Average elbow flexion was 118,3Â°, extension was 36,67Â°, arc of flexion was 81,67Â°, arc of pronation-supination was 133Â°. The average improvement of flexion was 65Â°, arc of flexion was 31,67Â°, and arc of pronation-supination was 8,3Â°. The average loss of flexion was 15,5%, arc of flexion was 44,2%, and arc of pronation-supination was 10,7% compared with uninjured side. The average Mayo Elbow Performance Index (MEPI) was 96,67; all with excellent results.ConclusionPlanned and well execution open reduction in pediatric neglected elbow dislocation may bring back the painless movement within normal daily function.

Psychometric properties of Persian version of Beck depression inventory in coronary patients Ahmadi, Seyed Mojtaba; Masjediarani, Abbas; Bakhtiari, Maryam; Davazdahemamy, Mohamad Hasan; Mohamadian, Rasul
Universa Medicina Vol 38, No 1 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundObtaining psychometric properties regarding specific populations increases diagnostic accuracy and reduces economic health burdens. Beck depression inventory-second version (BDI-II) is useful for the screening and assessment of depression in clinical and research settings. The aim of the present study was to investigate the psychometric properties of the Persian (Farsi) version of BDI-II in patients with coronary heart disease (CHD). MethodsA cross-sectional study was conducted on 284 patients with CHD admitted to Imam Ali Hospital in Kermanshah. They were first given a structured clinical interview (SCID-I) and then were asked to complete the Beck depression inventory-II (BDI-II), patient health questionnaire 9 (PHQ-9) and generalized anxiety disorder 7 (GAD-7). Data were analyzed by descriptive statistics, Cronbach’s á, Spearman’s correlation coefficient, exploratory factor analysis and receiver operating characteristic curve (ROC).ResultsThe internal consistency measured using Cronbach’s alpha was 0.90. The obtained correlation of BDI-II with PHQ-9 and GAD-7 was 0.74 and 0.65, respectively (p< 0.001). Factor analysis of the inventory revealed 5 factors, namely cognitive, somatic , impaired performance , negative attitude to self and ,and self punishment respectively. The cut-off point for CHD patients was 11 with sensitivity of 0.78 and specificity of 0.81 according to the Youden index and 10 with sensitivity of 0.80 and specificity of 0.77 according to the two-stage approach. The area under the curve was 0.86 (95% Confidence Interval 0.82-0.90). ConclusionThe Persian version of the BDI-II possesses the acceptable psychometric properties that can be used to screen depression in CHD patients.

High carbohydrate intake increases risk of coronary heart disease in adults: a prospective cohort study Darjoko, Sulistyowati Tuminah; Wahyuningsih, Tri; Sudikno, Sudikno
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundCoronary heart disease (CHD) ranks second after diabetes mellitus (DM) based on hazard rate, and after stroke (based on number of deaths caused). Our aim was to determine the risk factor and magnitude of CHD among adults. Methods A cohort study on risk factors of non-communicable diseases (CS-RFNCD) was conducted on subjects aged ≥25 years. Initiated by screening, follow-up (FU) was done 3 times yearly and complete health examination every 2 years. CHD cases screened by electrocardiographic examination on subjects aged ≥40 years and <40 years with history of hypertension and/or heart disease. Screening results found 840 of 5690 subjects with CHD diagnosis who were excluded from cohort study sample. Non-CHD subjects and those aged <40 years without a history of hypertension and/or heart disease, totalling 4840 people, were included in study sample and followed up for 6 years. Data were analyzed using Cox regression.ResultsCarbohydrate intake of ≥60% of total energy had a 2.8-fold higher CHD risk [HR=2.790; 95% CI: 1.962 - 3.967; p=0.000] than that of an intake of <60% of total energy. Age of ≥55 years had 2.6-fold higher CHD risk [HR=2.573; 95% CI: 1.803 - 3.671; p=0.000] than age of <55 years. Blood total cholesterol of ≥200 mg/dL had 1.9-fold higher CHD risk [HR=1.893; 95% CI: 1.319 - 2.715; p=0.001] than that of <200 mg/dL.ConclusionHigher intake of carbohydrate increases CHD incidence among adults. Efforts in controlling CHD risk factors are still needed especially in consumption behavior through a family approach.

Acupressure has not an analgesic effect in patients with renal colic: a randomized controlled trial Bolvardi, Ehsan; Zarmehri, Bahram; Mousavi Bazzaz, Seyed Mojtaba; Khorsand Vakilzadeh, Ali; Foroughian, Mahdi; Hoseini Faegh, Hasan; Mehramiz, Neema John
Universa Medicina Vol 38, No 1 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundEasing renal colic (RC) pain is of the most important issues in the emergency departments. This study was conducted to investigate the analgesic effects of intravenous paracetamol in comparison to acupressure and intramuscular diclofenac in patients with RC.MethodsThis randomized clinical trial was conducted on 96 eligible patients with RC, visiting the Emergency Department of Imam Reza Hospital of Mashhad, Iran. The participants were selected by consecutive non-random sampling method, and were randomized in three groups, each comprising of 32 participants. The first and second groups received 75 mg intramuscular diclofenac and 1g intravenous paracetamol, respectively. In the third group, three acupressure points were manually stimulated for six minutes. The pain score was measured by Visual Analog Scale for pain at baseline and after 10, 30, and 60 minutes. Collected information analyses by SPSS version 20 and interpreted using descriptive statistics (frequency, percentage) and inferential statistics (chi-square test).ResultsThe mean age was 31.60 ± 7.42 years (range:18-50). The two methods (diclofenac and paracetamol groups) were significantly better in pain reduction compared to acupressure after 10 minutes (p<0.001). Ninety four percent of participants in diclofenac group, 87% of paracetamol group and none of acupressure group were completely satisfied with their treatment method (p<0.001).ConclusionThis study demonstrated that acupressure did not effectively reduces renal colic pain. It seems that contrary to acupressure, intravenous paracetamol is a safe and effective analgesic medicine for patients with RC.

CD10 expression in gastric carcinoma is correlated with tumor grade and survival Jafarian, Amir Hosein; Kooshki Forooshani, Melika; Takallou, Leila; Mohamadian Roshan, Nema
Universa Medicina Vol 38, No 1 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundGastric carcinoma (GC) is the most common non-skin malignancy in Iranian men and the second leading cause of cancer-related mortality. Invasion and metastasis are considered as the major causes of cancer-related morbidity and mortality. Proteinases such as matrix metalloproteinases play an important role in tumor progression and mediating extracellular matrix remodeling. CD10 is a 90-110kd cell surface zinc-dependent metalloproteinase and there is evidence that this membrane protein may facilitate invasion and/or metastasis of tumoral cells. The objective of this study was to determine the frequency of CD10 expression in the stromal cells of GC and determine its relationship with survival and clinicopathological factors. MethodsA cross-sectional study was performed involving 50 patients with histopathologic diagnosis of GC. CD10 expression was determined by immunohistochemistry (IHC). Survival of the patients as well as the grade and stage of the tumors and demographic variables were documented. The Kaplan-Meier test was used for data analysis.ResultsStromal CD10 was detected in 46% of the GC stromal cells. No immunoreactivity was identified in the stromal cells of normal adjacent tissue. Stromal CD10 expression in gastric carcinoma did not correlate with the age and gender of the cases as well as the size and location of the tumor, and lymph node involvement but correlated with tumor stage (p=0.01), tumor grade(p=0.01) and patients’ survival (p=0.02). ConclusionStromal CD10 expression is correlated with tumor differentiation, clinical stage and survival in GC. CD10 expression could be considered as a negative prognostic factor for gastric carcinoma.

Single bulb garlic oil improves interleukin-6 via decreased reactive oxygen species (ROS) in high-fat diet male mice Ilmawati, Riza Rahayu; Gofur, Abdul; Lestari, Sri Rahayu
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundHigh-fat diet (HFD) is highly responsible for the development of excessive reactive oxygen species (ROS). ROS and low-density lipoprotein (LDL) then trigger macrophage activation to secrete interleukin-6 (IL-6). Single bulb garlic or in Indonesian called bawang lanang is traditional medicine that possesses strong antioxidant properties. This study aimed to evaluate the effect of single bulb garlic oil (SBGO) on ROS, IL-6, and lymphocyte density in HFD-fed male mice.MethodsThis was an experimental study on 24 male mice randomly subdivided into 6 groups: one group was fed a normal diet, whereas the remaining five groups were fed HFD for 45 days and were then treated with single bulb garlic oil 0 mg/kg, simvastatin 26 mg/kg BW, single bulb garlic oil 12.5 mg/kg BW, 25 mg/kg BW, and 50 mg/kg BW respectively for the next 35 days. At the end of treatment, the mice were dissected for collection of (i) serum in order to measure ROS and IL-6 levels using ELISA, (ii) aortas to measure IL-6 expression using immunohistochemistry-fluorescence (IHC-F) and to obtain lymphocytes from bone marrow and spleen which were then counted using a light microscope.ResultsOur results indicated that SBGO decreased the ROS level, IL-6 level, IL-6 expression, and lymphocyte density in HFD mice. SBGO 12.5 mg/kg BW is the optimum dose in our study to reduce inflammation in HFD male mice.ConclusionSBGO is useful to reduce inflammation and improve antioxidant imbalance, thus might be a potential antiatherogenic agent.

The role of occupational health services in the universal health coverage era in Indonesia Mansyur, Muchtaruddin
Universa Medicina Vol 38, No 1 (2019)
Publisher : Faculty of Medicine, Trisakti University

In accordance to Act No 24 Year 2011 on The Social Security Administrating Body, the Indonesian National Social Security program is managed byÂ two national organizations, namely: Social Security Administering Body for Health (Badan Penyelenggara Jaminan Sosial Kesehatan = BPJS Kesehatan) and Social Security Administering Body for Labor (Badan Penyelenggara Jaminan Sosial Ketenagakerjaan = BPJS Ketenagakerjaan). The former is responsible for providing health coverage for all Indonesians through the National Social Health Insurance Scheme known as the Jaminan Kesehatan Nasional/JKN. The latter is Â responsible for Â providing the worker's social security consisting of Provident Fund Benefit, Accident Benefit, Pension Benefit, and Death Benefit.1The Indonesian government has been continuously improving the health service program towards better national universal health coverage and has set the 2019 functional achievement target of 95% of the population enrolled in the program. To ensure that this target of Â the program will be achieved, Â the government pays the premium of BPJS Kesehatan of the poor and near poor.2

Mild anxiety and depression related to elevated dopamine level Fidianingsih, Ika; Nurmasitoh, Titis; Arjana, Adika Zhulhi; Devita, Ninda; Khoiriyah, Umatul
Universa Medicina Vol 38, No 1 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundDopamine is an important neurotransmitter that plays a role in the pathogenesis of anxiety and depression. Dopamine secretion occurs when there is a pleasurable stimulus. Blood dopamine levels have the potential to be developed as biomarkers of depression or anxiety, but previous studies related to the relationship between dopamine levels and levels of anxiety and depression are still controversial. The purpose of this study was to determine the correlation between anxiety and depression score with dopamine level in young adults. MethodsThis was an observational cross sectional study. A total of 43 subjects aged 18 to 40 years were recruited by consecutive non-random sampling according to inclusion and exclusion criteria. Anxiety and depression were assessed using the Beck anxiety inventory and Beck depression inventory-II questionnaire. Dopamine plasma level was measured using the enzyme-linked immunosorbent assay (ELISA). The Spearman rho correlation test was used to analyze the data and p<0.05 was considered significant.Results The median dopamine levels in respondents with mild, moderate and severe anxiety were respectively: 77.79; 63.43; 62.51 ng/mL (p=0.043). The median dopamine levels in respondents with reasonable depression, mood disorder, moderate and severe depression were respectively: 79.2; 61,32; 62,51; 60.24 (p=0.001). Correlation test results showed a weak correlation between dopamine and anxiety (r=- 0.310) and a moderate correlation for depression (r=-0.505).ConclusionMild anxiety and depression were associated with elevated dopamine level in young adults. Further studies are required to confirm the role of dopamine metabolism in anxiety and depression in young adults.

Propolis inhibited Bax expression and increased neuronal count of hippocampal area CA1 in rats receiving sodium nitrite Kuswati, Kuswati; Handayani, Ety Sari; Nugraha, Zainuri Sabta; Rahmanti, Fishella Aprista; Wicaksana, Zulfikar Loka; Zhafirrahman, Muhammad
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundSodium nitrite induces hypoxia and oxidative stress in the hippocampus, decreasing the number of neurons in the hippocampus and cognitive function. Propolis contains chrysin that has antioxidant effects that are expected to inhibit neuronal damage in the hippocampus. This study aims to determine the effects of propolis on the expression Bcl-2-associated X protein (Bax) and the number of neurons in the rat hippocampus receiving sodium nitrite.MethodsThis study of laboratory experimental design was conducted on 18 male Wistar strain rats (Rattus norvegicus), they were randomized into 3 groups: one control group (K) received sodium nitrite and two intervention groupsÂ (P1 and P2) received sodium nitrite and propolis at doses of 100 and 200 mg/kgBW. Treatment with sodium nitrite and propolis were given for 60 days, followed by termination. The number of neurons and Bax expression in the hippocampal CA1 area were measured. One-way ANOVA was used to analyze the data.ResultsThere were significant differences in Bax expression between group K and groups P1 and P2 (p<0.001). The lowest number of neurons in the hippocampal CA1 area was in the K group. There were significant differences in the number of neurons between control (K) group and groups P1 and P2 (p<0.001).ConclusionPropolis inhibited the expression of Bax and decreased the number of neurons in the hippocampal CA1 area of rats receiving sodium nitrite. This study provides information about the benefits of propolis as an antioxidant in the brain.

Adequate fluid resuscitation decreases incidence of acute renal failure in burn patients Soeselo, Daniel Ardian; Suparman, Etheldreda Alexandria Stephanie
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

BACKGROUND Burns constitute a severe health problem in many countries. In Indonesia burns rank 4th of all trauma-related diseases and are a burden on the country’s health system. Adequate fluid resuscitation is the initial management of burns that determines the success of treatment. This study aimed to determine the relationship between adequate fluid resuscitation and incidence of acute renal failure in burn patients. METHODSA retrospective study of cross-sectional design was conducted on 30 burn patients who came to the Emergency Unit (ER) from January 2015-December 2017. Medical records were reviewed to examine the data on fluid resuscitation according to the Parkland formula and the laboratory data. Acute renal failure was defined as a creatinine level of more than 2.1 mg/dL after 7 days. Hypoalbuminemia was defined as an albumin level of less than 3.4 g/dL. Fisher’s exact test was used to analyze the data.RESULTSTwenty-two subjects received fluid resuscitation according to the Parkland formula and 8 did not. Twenty-five experienced complications such as acute renal failure (ARF) (13.3%), hypoalbuminemia (46.7%) and a combination of ARF and hypoalbuminemia (23.3%). One person died. Adequate fluid resuscitation was significantly associated with decrease incidence of ARF (p=0.015), but not significantly with hypoalbuminemia (p=0.214) and with mortality (p=0.267).CONCLUSIONAdequate fluid resuscitation decreased the incidence of ARF in burn patients. Consensus protocols for initial burn resuscitation and treatment are crucial to avoid the consequences of ARF after burn injury.

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