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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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Severe acute malnutrition as a major predictor for poor nutritional outcome among adult HIV patients treated with FPB program: a case-control study Abebaw, Nigest; Endeshaw, Mulualem; Ayenew, Mamaru
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

IntroductionDifferent studies had explained the treatment outcomes of the food by prescription (FBP) program among people living with HIV (PLHIV). This study aimed to assess factors affecting nutritional treatment outcome among PLHIV using FBP. MethodsAn institution-based unmatched case control study was conducted from August 1 to September 30, 2017 in public health facilities. A total of 566 samples (283 cases and 283 controls) was drawn using random sampling technique. Data were collected from FBP, ART/PRE-ART registers and client’s follow up charts. Bivariate and multivariate logistic regression analyses were conducted to estimate the relationship of the independent variables with the outcome variable, and a p-value <0.05 was considered as statistically significant at 95% confidence level. All statistical analysis was performed using SPSS version 23.ResultsIn this study severe acute malnutrition at admission (AOR=4.45. 95% CI: 2.63–7.55), moderate acute malnutrition at admission (AOR=3.8, 95% CI: 2.18–6.67), lack of regular follow up (AOR=3.81, 95% CI: 2.18–6.67), low CD4 count below 100 (AOR= 2.93, 95% CI: 1.19–7.20), hemoglobin value below 10mg/dL (AOR=2.72, 95% CI: 1.17, 6.35), and male sex (AOR=1.77, 95% CI: 1.19, 2.63) were found to be significant predictors for poor nutritional treatment outcome.Conclusions Severity of malnutrition was the major predictor for poor nutritional treatment outcome of patients who were on FBP program. The policy makers can use the information to improve HIV and nutrition interventions based on the result.

Stunting: a multisector challenges and unfinished nutrition agenda Karyadi, Elvina
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

It was a great news that during the President election campaign, both President and Vice President candidates addressed a stunting problem during the debate. It shows that stunting is placed as national priority of nutrition problems. Stunting is part of a wider nutrition crises in Indonesia: wasting, anemia and double-burden of malnutrition. According to the 2018 National Health Survey (RISKESDAS), 30.8 percent of Indonesian children under 5 years of age were stunted (almost 8 million children), 17.7 percent were underweight, 10.2 percent were wasted (low weight-for-height).Â Although the prevalence of stunting declined significantly from the 2013 (37.2%), the stunting rates remain unacceptably high. A child that is wasted faces double the risk of mortality associated with stunting. Even, a child that is both stunted and wasted faces a higher risk. Frequent episodes of wasting increase the risk of stunting. Â

Brain oximetry is not a good monitor on reducing neurological complications after cardiac surgery Amouzegar Zavareh, Seyed Mohammadreza; Araghizade, Hasan; Eskandari, Nahid; Lak, Marzieh
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundCerebral deoxygenation is related to several adverse systemic consequences. We aimed to assess the effect of noninvasive monitoring of cerebral oxygenation on reducing neurological complications after cardiac surgery.Methods In this randomized clinical trial, subjects were randomized into two groups: intervention group (111 subjects with monitoring of cerebral oximetry) and control group (112 subjects without any monitoring of cerebral oximetry). Monitoring of regional cerebral oxygen saturation (rScO2) was performed in the intervention group without any monitoring of cerebral oxygenation. The rScO2 was not recorded in the control group and no specific treatments were employed. Any neurological complications such as hallucinations, delirium, stroke, and length of stay in ICU after surgery were recorded. A p-value less than 0.05 was used as a cut-off for statistical significance.ResultsAfter surgery, in the intervention group one (1/111=0.09%) patient suffered from stroke and one patient had delirium, while in the control group three patients had stroke and three (3/112=2.6%) had delirium. There was no significant difference between the two groups regarding complications (p=0.527). The length of stay in ICU was 3.49 Â± 0.96 days in the case group and 3.40 Â± 0.80 days in the control group and there was no significant difference in the two groups (p=0.477).ConclusionMonitoring of rScO2 does not seem to be a good monitor for brain oxygenation. Further studies are needed to judge the usefulness of rScO2 for monitoring brain oxygenation.

Low 25-hydroxyvitamin D level increases carotid intima-media thickness in elderly women Imran, Yudhisman; Aswar, Andini; Rachmiyani, Irmiya; Adriani, Donna
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2019.v38.114-120

BackgroundCerebrovascular disease occurs due to atherosclerosis of the carotid artery triggered by endothelial dysfunction, which can be assessed by measuring the carotid intima-media thickness (CIMT). There are several risk factors contributing to endothelial dysfunction, such as 25-hydroxyvitamin D [25(OH)D] deficiency. A number of research studies have shown variable results on the relationship between 25(OH)D deficiency and endothelial dysfunction. The objective of the present study was to determine the relationship between 25(OH)D and CIMT in elderly women.METHODS A cross-sectional study was conducted involving 45 elderly women aged â‰¥60 years. The inclusion criteria were: able to communicate well and able to walk actively without any help. The exclusion criteria were: not having diabetes mellitus, stroke, heart disease, kidney disease, not consuming vitamin D or medicines containing corticosteroids, and not using hormone replacement therapy. Laboratory examination was conducted for fasting blood sugar, lipid profile, and 25(OH)D. CIMT was measured using carotid Doppler ultrasonography at the left carotid artery. Simple linear regression analysis was used to analyze the data.RESULTSMean 25(OH)D level was 11.753 Â± 4.027 ng/mL, and mean CIMT 0.61 Â± 0.10 mm. Simple regression analysis showed a significant relationship between 25(OH)D level and CIMT (Î²=-0.001; 95% C.I.=-0.020-0.003; p=0.009).CONCLUSION Our data suggest an inverse association between 25(OH)D level and CIMT in elderly women. This study supports the protective role of vitamin D against subclinical atherosclerosis in elderly women.

Haemostatic properties of Vernonia amygdalina and Chromolaena odorata leaf extracts using Wistar rat model Matthew, Lucy Omokhegbe; Osime, Evarista Odaburhine
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

BACKGROUNDThe leaves of African plants are widely employed in Nigeria to control bleeding from wounds. This work is aimed at evaluating the haemostatic effects of Vernonia amygdalina (VA/bitter leaf) and Chromolaena odorata (CO/sunflower) leaves on some haemostatic parameters.METHODSA laboratory study of experimental design was conducted involving 35 Wistar rats that were randomized into seven groups. Groups 1 and 2 received leaf extracts of VA at concentrations of 150 and 250mg/kg BW, respectively; groups 3 and 4 received leaf extracts of CO at 150 and 250mg/kg BW; groups 5 and 6 received combined leaf extracts of VA and CO at 150 and 250mg/kg BW, respectively, for 30 days. The last group 7 as control group received only water. Parameters investigated were clotting time (CT), fibrinogen concentration, prothrombin time (PT), activated partial thromboplastin time test (APTT), factor VII, protein C and D â€“ dimer.ResultsThere was a significant reduction in CT, fibrinogen concentration and PT in the intervention groups compared to controls (p<0.01). There was no significant difference in APTT, factor VII and protein C in the intervention groups compared to the controls (p>0.05). D-dimer levels were observed to increase significantly in rats treated with 150mg/kg BW of VA and 150mg/kgBW of the combined leaf extracts (VA/CO) compared to the controls (p<0.05).ConclusionThe VA and CO extracts reduced CT, PT, fibrinogen concentrations and increased D-dimer levels in rats. This study suggests the possible incorporation of the leave extracts of VA and CO in bleeding diathesis as well as in coagulation studies.

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.

Decreased serum homocysteine levels after micronutrient supplementation in older people Pusparini, Pusparini
Universa Medicina Vol 29, No 3 (2010)
Publisher : Faculty of Medicine, Trisakti University

Aging is associated with a gradual impairment in cognitive function. The elderly also show a high prevalence of undernutrition, whereas nutrition plays an important role in the metabolism of neuronal cells and enzymes. Homocysteine is an amino acid resulting from methionine metabolism and is dependent on intake of vitamin B12, vitamin B6 and folic acid. Homocysteine is said to play a role in cognitive function. The objective of this study was to evaluate the effect of micronutrient supplementation for 6 months on serum homocysteine levels and cognitive function in older people. This study was an experimental study of pre-post test design, carried out in Mampang subdistrict, South Jakarta. A total of 94 elderly people was recruited for this study, consisting of 44 females and 50 males. Serum homocysteine level was assessed by fluorescent polarization immunoassay and cognitive function by means of the mini mental state examination (MMSE) before and after micronutrient supplementation. Mean serum homocysteine concentration after supplementation decreased significantly to 14.8 Â± 5.8 mmol/L, compared with mean serum homocysteine level of 15.9 Â± 5.9 mmol/L before supplementation (p=0.000). Multiple regression analysis indicated that the factors influencing post-supplementation MMSE scores were gender (Ã¢=-0.350; p=0.000), education (Ã¢=0.510; p=0.000) and post-supplementation homocysteine levels (Ã¢=-0.201; p=0.000), while age, pre-supplementation homocysteine levels and BMI did not affect MMSE scores. Homocysteine concentration decreased significantly after 6 months of supplementation. The factors affecting post-supplementation MMSE scores were gender, level of education, and post-supplementation homocysteine level.

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.

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