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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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Predicting outcomes 3 months after traumatic brain injury in patients admitted to emergency department Bolvardi, Ehsan; Ahmadzadeh, Maryam; Feiz Disfani, Hamideh; Rezaeitalab, Fariborz; Ravanshad, Yalda; Foroughian, Mahdi
Universa Medicina Vol 38, No 3 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundTraumatic brain injury (TBI) is among the leading causes of mortality and long-term disability. Prognosis assessment is a primary factor of clinical decision-making by emergency physicians. This study aimed to investigate the prognostic factors of TBI in the patients admitted to a typical emergency department.MethodsThis prospective cohort study was conducted involving 100 TBI patients. Baseline characteristics, including age, gender, Glasgow Coma Scale (GCS), and vital signs were recorded. Blood tests and brain CT scans were collected. The patients were followed-up three months after the date of admission. The observed outcomes were categorized as recovery without complication, recovery with complication, or death. Statistical analysis was performed using the simple and multivariate binary logistic regression in the software IBM SPSS version 19. ResultsThe most common brain CT scan findings were subarachnoid hemorrhage (21.0%) and epidural hemorrhage (20.0%). In the follow-up performed three months after the admission, 47 patients (47.0%) had died, 39 (39.0%) were suffering from complications, and 14 patients (14.0%) were recovering without complications. Simple binary logistic regression showed that older age (OR=3.28, 95% C.I.=1.27-8.41), minor/moderate head trauma (OR=13.93, 95% C.I.=1.73-112.11), severe head trauma (OR=54.40, 95% C.I.=5.71-517.56) and presence of deep skull fracture (OR=8.92, 95% C.I.=1.04-75.53) were statistically significant predictors of mortality. Multivariate logistic regression showed that mortality chance was higher in elderly (OR=7.45, 95% C.I.=2.02-27.36), minor/moderate head trauma (OR=26.87, 95% C.I.=2.42-298.25) and severe head trauma (OR=127.97, 95% C.I.=9.11-1796.28).ConclusionThis study demonstrated that severe head trauma was the most predicted risk factor of poorer clinical outcomes after TBI.

Limited health literacy is associated with poorer clinical outcomes in elderly with type 2 diabetes mellitus Yilmazel, Gulay; Cici, Remziye
Universa Medicina Vol 38, No 3 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundDiabetes mellitus is a significant global public health concern. Poor knowledge of disease and healthcare utilization is associated with poor health outcomes, leading to increasing burden of diabetes in many developing countries. The present study aimed to assess diabetes health literacy and clinical outcomes in elderly patients registered to the home health agency. MethodsA cross-sectional study was conducted in the city of Ã‡orum, Turkey, with 160 type 2 diabetic patients of both sexes and aged between 50-91 years. To identify health literacy, the Rapid Estimate of Adult Literacy in Medicine test was administered to the patients. Clinical parameters were based on routine medical examinations by measuring blood pressure levels, glycosylated hemoglobin, and lipoprotein levels. In order to identify the risk of depression, the Beck Depression Scale was used. ResultsOf the patients, 85.0% had limited health literacy. The majority of patients (95.0%) had poor glycemic control and limited health literacy was associated with having high level of HbA1c (p<0.05). Adequate health literacy was associated with regular foot care (p<0.05). Also patients with limited health literacy were more likely to have depression (p<0.001). Limited health literacy increased the risk of poor glycemic control (OR=6.82;95% CI=1.34-9.78) and retinopathy (OR=6.91;95% CI=1.23-9.44). ConclusionLimited health literacy is consistently associated with poorer diabetes clinical outcomes in elderly type 2 diabetes melltius Contents of diabetes education should be arranged according to patientsâ€™ health literacy level which requires visual and auditory teaching materials for patients with limited health literacy.

The benefits and physiological changes of high intensity interval training Soeria Santoso, Dewi Irawati; Boenyamin, Hafizh Ahmad
Universa Medicina Vol 38, No 3 (2019)
Publisher : Faculty of Medicine, Trisakti University

Physical inactivity have been linked with many major non-communicable diseases and as many as 27.5% of adults globally are considered inactive. Physical activity has been proven to be beneficial in the prevention of many chronic diseases and may reduce the risk of premature death. High intensity interval training (HIIT) has been gaining popularity as a time-efficient alternative for regular exercise training. Current studies show that HIIT is more efficient in improving cardiorespiratory fitness, increasing insulin sensitivity and reducing blood pressure than moderate intensity continuous training (MICT). The advantage of HIIT in fat loss compared to MICT is still unclear, but HIIT might be more efficient in the obese population. The effect of HIIT on increasing aerobic fitness could be caused by increase in stroke volume due to the increase in cardiac contractility, capillary density and mitochondrial adaptation. Fat loss during HIIT could be caused by increased fat oxidation and elevated hormones that drive lipolysis and reduce appetite. While vigorous physical activity may transiently increase the risk of cardiac events. The effect of HIIT on increasing aerobic fitness could be caused by increase in stroke volume due to the increase in cardiac contractility, increased of capillary density and mitochondrial adaptation. While fat loss during HIIT could be caused by an increased fat oxidation, elevated hormones that drives lipolysis and reduces appetite. While vigorous physical activity may transiently increase the risk of cardiac event. High intensity interval training is generally safe even in the elderly population and in people with coronary heart disease.

Detection of SHV and TEM-type Extended spectrum Î²-lactamase in bacterial isolates recovered from clinical samples of patients attending military hospitals Ogefere, Helen Oroboghae; Iriah, Samuel E.; Ibadin, Ephraim Ehidiamen
Universa Medicina Vol 38, No 3 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundMulti-drug resistant bacterial strains have been increasingly implicated in clinical infections worldwide and beta-lactamase production is one of the commonest mechanisms of resistance in these strains. This study investigated the prevalence of extended spectrum Ã¢-lactamase (ESBL)-producing isolates and determined the temoneira (TEM) and sulfhydryl variable (SHV) types implicated in two military hospitals in South-South Nigeria. MethodsThree-hundred and eighty (380) consecutive non-duplicate bacterial isolates (Gram negative bacilli) recovered from clinical samples were identified following standard techniques. Antimicrobial susceptibility tests were performed for each isolate following the Clinical Laboratory Standards Institute guidelines. Bacterial isolates recovered which comprised Escherichia coli, Klebsiella spp, Proteus spp and Pseudomonas aeruginosa were screened for ESBL using a phenotypic method (double disc synergy test). All positive isolates were screened for TEM and SHV genes by PCR method. ResultsSixty-five isolates (17.1%) were ESBL producing using phenotypic method, E. coli showed the highest ESBL prevalence (24.3%). One isolate was SHV positive (1.5%), 8 (12.3%) were TEM positive while 3 (4.6%) isolates harbored both SHV and TEM genes. Fluoroquinolone - ofloxacin showed marked activity against ESBL-producing isolates (90.8%) while the least active were ceftriaxone (9.2%), ceftazidime (3.1%) and ampicillin (1.5%). ConclusionThis study demonstrated that 17.1% of Gram-negative bacilli were ESBL producers. Screening of clinical isolates for ESBL should be implemented. The findings of this study suggest the need for caution in the use of antimicrobial agents in order to curb the incidence of antimicrobial resistance.

Natural honey reduced atherogenic and coronary risk indices in Wistar rats Olukanni, Olumide David; Alagbe, Yewande O.; Akande, Oreoluwa T; Olukanni, Adedayo T.; Daramola, Gbenga G.; Adeyemi, Oluyomi S.
Universa Medicina Vol 39, No 1 (2020)
Publisher : Faculty of Medicine, Trisakti University

BACKGROUNDThe biochemical mechanism underlying the nutraceutical effects of honey is poorly understood, thus making its functions more a matter of speculations. In this study, we investigated the effects of honey on the atherogenic and coronary risk indices in Wistar rats.METHODSAn experimental design comprising two groups of rats fed with normal rat chow but with the experimental group receiving 10% honey in water and the control group water alone, for five weeks. Blood samples were collected weekly from each group, and the level of superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH) and total protein were determined. The lipids profile (total cholesterol, total triglycerides, LDL and HDL) were also determined, and the atherogenic and coronary indices were estimated. Data were analyzed, and p<0.05 was considered significant.RESULTSThere were no significant changes in both groupsâ€™ serum SOD and CAT across the weeks of study. The LDL cholesterol of the honey-treated rats, however, decreased significantly (9.95 mg/dL) compared to the controls (27.07 mg/dL) (p=0.000). In contrast, honey intake elevated the HDL cholesterol (18.37 mg/dL) relative to 12.25 mg/dL in the control group (p=0.003). Consequently, honey treatment caused significant depletion of atherogenic and coronary risk indices (76.13%, p=0.001) and (50.37%, p=0.023) respectively. CONCLUSIONWe show evidence that the regular intake of honey, at a concentration as low as ten percent of total water intake, may lower factors for the onset of hypertension and coronary diseases.

GLUTATHIONE S TRANSFERASE AND CATALASE GENE POLYMORPHISMS DID NOT TEND TO INFLUENCE THE SEVERITY OF HEMOGLOBIN E/Î²-THALASSEMIA Rujito, Lantip; Widodo, Yundandhika Rizki; Sakina, Ghaida; Santosa, Qodri; Hapsari, Ariadne Tiara
Universa Medicina Vol 39, No 1 (2020)
Publisher : Faculty of Medicine, Trisakti University

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BackgroundThalassemia, a monogenic genetic disease of red blood cells, is spread widely throughout the world. Glutathione S transferase (GST) enzymes have an antioxidant role in detoxification processes of toxic substances This study aimed to determine the role of the genetic modifier genes GSTT1 and GSTM1, and the catalase (CAT) gene in clinical degrees of hemoglobin (Hb)E/? thalassemia. MethodsSixty HbE/? Thalassemia patients were examined to determine their clinical pictures. Clinical score was based on age when thalassemia symptoms appeared, time of diagnosis, time of first blood transfusion, pre-transfusion hemoglobin concentration, frequency of transfusions, and enlargement of spleen. Ferritin concentration was also obtained from medical records. Gene polymorphisms of GSTT1, GSTM1, and CAT were measured using PCR and PCR-RFLP methods. Clinical scores were categorized into mild (0-3.5), moderate (4-7), and severe (7.5-10) degrees, while ferritin level was expressed in mg/dL. One way Anova was used to analyze the data. ResultsThe clinical appearance showed that severe, moderate, and mild degrees accounted for 42%, 45%, and 13%, respectively. The majority had a high ferritin level of more than 5000 mg/dL (67%). GSTT1 null, GSTM1 null, and CAT minor allele genotypes were 21.7%, 33.3%, and 12.1%, respectively. GSTT1, GSTM1, and CAT genotypes had no impact on the severity of thalassemia patients (p=0.091, p=0.082, and p=0.141, respectively).ConclusionGSTT1, GSTM1, CAT gene polymorphisms tend to be a minor aspect of severity of clinical outcome for HbE/â thalassemia patients and should be not considered a routine laboratory check.

PREEMPTIVE ANALGESIC EFFECT OF MAGNESIUM SULFATE ON POSTOPERATIVE PAIN IN PATIENTS UNDERGOING LUMBAR FUSION SURGERY Delavari, Abasali; Lak, Marzieh; Arragizade, Hassan; Salatini, Babak
Universa Medicina Vol 38, No 3 (2019)
Publisher : Faculty of Medicine, Trisakti University

BackgroundReducing postoperative pain can improve patient satisfaction and hospital cost. Intravenous magnesium sulfate is one of the proposed drugs for preemptive analgesia. The study aimed to evaluate the effect of magnesium sulfate on postoperative pain in patients undergoing lumbar fusion surgery.MethodsA double-blind randomized clinical trial was conducted on candidates for vertebral fusion surgery with American Society of Anesthesiologists (ASA) class I-II. One hundred and two patients were randomized into the magnesium sulfate group and control group. The magnesium sulfate group received magnesium sulfate at a dose of 50mg/kg in 20 mL volume and infused during 15-30 minutes pre-operation, while the control group received 20 mL normal saline. The severity of the pain was assessed by the Visual Analogue Scale (VAS) at 2, 4, 6, 12 and 24 hours after patients entering the post-anesthetic care unit. After the operation, the patients? relaxation rate was assessed based on Ramsay sedation score (RSS).ResultsThere was no significant difference at 2, 4, 6, 12 and 24 hours post-operation between the two groups in the mean severity of pain (p>0.05). There was no significant difference at 2, 4, 6, 12 and 24 hours post-operation between the two groups in the mean of pethidine consumption. There was no significant difference in the relaxation of the patients according to the RSS criteria in the magnesium sulfate and control groups (p=0.162). ConclusionPre-operative administration of magnesium sulfate does not affect reduction in postoperative pain and opioid consumption of patients undergoing lumbar fusion surgery.

LOW VITAMIN B12 DIET INCREASES LIVER HOMOCYSTEINE LEVELS AND LEADS TO LIVER STEATOSIS IN RATS Sianipar, Imelda Rosalyn; Ujianti, Irena; Yolanda, Sophie; Jusuf, Ahmad Aulia; Kartinah, Neng Tine; Amani, Patwa; Murti, Krishna Aditya; Soeria Santoso, Dewi Irawati
Universa Medicina Vol 38, No 3 (2019)
Publisher : Faculty of Medicine, Trisakti University

Background Nonalcoholic fatty liver disease (NAFLD) is one of the most widespread chronic liver diseases, caused by the development of insulin resistance. One of the mechanisms involved is a disturbance in insulin signaling by certain toxic substances that interact with one of the proteins responsible for the insulin signaling pathway. Increased homocysteine level, upon disruption of the methionine pathway, is associated with insulin resistance. The aim of this study was to evaluate the effect of hyperhomocysteinemia and insulin resistance (HOMA-IR level) induced by dietary vitamin B12 restriction on liver steatosis. Methods A study of laboratory experimental design was conducted involving 18 male Sprague Dawley rats (age 36-40 weeks, BW 300-350 g), that were randomly divided into 3 groups: control, 8-week treatment, and 16-week treatment. Standard AIN-93 diet was administered to the control group, whereas rats in the treatment groups were fed vitamin B12 deficiency-AIN-93M. At the end of treatment, liver homocysteine levels were determined by ELISA, HOMA-IR values were calculated, and steatosis degree of the liver was determined histologically. Statistical analysis was performed using independent t-test. Results A significant increase in liver homocysteine levels was found between the control and both the 8- and 16-week treatment groups (p<0.001). HOMA-IR levels were significantly higher in both treatment groups compared to controls (p<0.001). The area of liver steatosis in both treatment groups was significantly larger than that of the control group (p<0.001). Conclusion Increased homocysteine levels due to dietary vitamin B12 deficiency induces liver steatosis due to insulin resistance in rats.

Heavy mental workload increase poor sleep quality in informal garment workers Merijanti, Lie T; Pusparini, Pusparini; Meiyanti, Meiyanti; Alvina, Alvina; Sudharma, Novia I; Tjahjadi, Muljadi
Universa Medicina Vol 38, No 3 (2019)
Publisher : Faculty of Medicine, Trisakti University

Background Sleep is needed by the human body so that the performance of body remains optimal when the body is awake, especially during work. Informal workers often work without clear regulations, with inadequate equipment and poor work environment, and pay little attention to occupational health and safety factors. The existence of large work demands with unclear work system arrangements will certainly result in a mental workload in these workers. The objective of this study was to determine the relationship between mental workload and sleep patterns of workers in the informal garment sector. MethodsA cross-sectional study involving 225 informal garment workers was conducted between December 2018 and May 2019. Data collection included respondentsâ€™ demographics, job characteristics, measurement of mental burden and disturbances in sleep patterns. The sleep pattern used the PSQI (Pittsburgh Sleep Quality Index) instrument and the mental burden used the Rating Scale Mental Effort (RSME). A multiple linear regression analysis was used to analyze the data. ResultsThe mean sleep quality was 5.40 Â± 2.54. Multiple linear regression test found that mental workload correlated significantly with sleep quality of workers (Î²=0.016, p=0.012).ConclusionThis study demonstrated that heavy mental workload decreases the quality of sleep in informal garment workers. A good work system management is required so that workers are assigned that portion of the task that is commensurate with their capacity.

Smoking habit as a risk factor in tuberculosis: a case-control study Sahiratmadja, Edhyana; Nagelkerke, Nico
Universa Medicina Vol 30, No 3 (2011)
Publisher : Faculty of Medicine, Trisakti University

Indonesia is fifth in the tuberculosis (TB) prevalence globally and this country is one of the largest tobacco producers. Smoking has been reported to be an important risk factor for TB and a reduction in smoking could be expected to have a significant impact on TB incidence and prevalence. However, studies from various countries yielded conflicting results. Our study aims to explore the association between smoking and TB in Indonesia as TB-endemic country. In two major cities of Indonesia, Jakarta and Bandung, a case-control study had been conducted. TB was diagnosed based on WHO criteria including clinical presentation, and chest X-ray (CXR) examination, and confirmed by microscopic detection of acid-fast bacilli in Ziehl-Nielsen stained sputum smears or by culture of M. tuberculosis. Newly diagnosed smear-positive pulmonary TB patients (n=802) and their spouses (n=253) or sex-matched neighborhood controls (n=534) were interviewed about their smoking habits. An extensive questionnaire was used to collect data about smoking habits of both patients and controls. Smoking categories were grouped into ever (for current/past smokers) and never. Our study result showed that smoking appears not to be strongly associated with TB (OR=0.99, 95% CI 0.76-1.31). The reasons for the effect heterogeneity remain to be elucidated as smoking is a lethal habit and should be well controlled. The need to incorporate tobacco cessation programs into TB treatment is strongly recommended to improve TB control.

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