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Universa Medicina
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
Arjuna Subject : -
Articles 602 Documents
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Coronavirus disease 2019: a revolution in biological triage in the emergency setting Manoochehry, Shahram; Saboori, Fatemeh; Faraji, Mehrdad; Behzadnia, Mohammad Javad
Universa Medicina Vol. 39 No. 3 (2020)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2020.v39.212-223

Abstract

Triage is a familiar concept for all who work at the forefront of the treatment of patients and the emergency medical staff know their duty in different situations including crisis and epidemics. Accordingly, the coronavirus outbreak has also a major effect on the emergency department (ED) as it changes the routine ED function. Our main question was what are the main triage challenges in the recent pandemic and how we could overcome these challenges? Therefore, a search of the main Web databases was performed for articles published till May 1st, 2020 using various related keywords. In various steps, the title, summary, methodology, results, and discussion of the selected studies were assessed to find out the recent triage strategies in the COVID-19 outbreak. Hence, all the available and related English review articles, case series, and experimental studies were evaluated. Among 200 studies initially reviewed, 59 met the study criteria for the final assessment. COVID-19 puts a significant load on public health services and potential damage to social and psychiatric situations by marked morbidity and mortality. In line with the various presentations and according to the changing of the COVID-19 epidemic to a worldwide pandemic problem, the management and treatment protocols changed several times. Accordingly, the local and even global hospital protocols were changed as well. The first simple concept of coronavirus triage in an emergency department is the separation of COVID-19 infected patients from the others. This approach has been practiced around the world. Changing the ED layout from a usual triage or fast track set to an isolated room is necessary for such a pandemic situation. It is very important to consider staff communication and the application of PPE. All the efforts should be taken to protect patients as well as the medical staff from unnecessary exposure and infection; this serves to keep the health facilities working well in the outbreak and diffusion of SARS-CoV-2.
Body mass index as the most influential factor of high-sensitivity C-reactive protein in non-diabetic adults Mulyamin, Winda; Kurniawan, Liong Boy; Adnan, Endy; Widaningsih, Yuyun; Idris, Irfan; Santoso, Arif; Yustisia, Ika
Universa Medicina Vol. 40 No. 1 (2021)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2021.v40.22-28

Abstract

BACKGROUNDHigh-sensitivity C-reactive protein (hsCRP) has been widely accepted as a predictor of future cardiovascular risk that reflects a microinflammatory state. Obesity linked to microinflammation increases the prevalence of metabolic disorders and cardiovascular diseases. This study aimed to determine the association between several obesity indices namely body mass index (BMI), waist circumference (WC), body fat percentage (fat), and visceral fat (VF) with hsCRP in non-diabetic adults. METHODSThis was a cross-sectional study performed on 80 non-diabetic adults with ages ranging from 20-40 years. The obesity indices BMI, WC, body fat percentage, and VF were measured. We then measured the hsCRP levels using an immunoturbidimetric method. Simple and multiple linear regression tests were used to analyze the association between obesity indices and hsCRP levels. RESULTSMean of log BMI, log WC, and log VF was 1.41 ± 0.08 kg/m2, 1.93 ± 0.06 cm, and 0.95 ± 0.27 units, respectively. Simple linear regression tests showed that log BMI (â=3.506; p<0.001), log WC (â=3.672; p<0.001), log VF (â=0.833; p<0.001), and log systolic blood pressure (â=3.739; p=0.024) had a significant positive correlation with log hsCRP levels. Further multiple linear regression test showed that log BMI (â=3.772; Beta=0.674; p<0.001) had the greater effect on log hsCRP levels compared to other indices. CONCLUSIONS    BMI had a greater influence on hsCRP levels compared to other obesity indices in non-diabetic adults. Body mass index can be used as a better index in predicting hsCRP levels compared to other indices.
Pediatric skull bone defect due to epidermoid cyst Sinurat, Robert; Gultom, Fajar Lamhot
Universa Medicina Vol. 40 No. 1 (2021)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2021.v40.52-56

Abstract

BackgroundTumors of the skull usually affect adult patients and less than twenty percent of pediatric patients. As the tumors grow, the surrounding bone may undergo destruction and erosion. When the tumors are located in the fontanel, the timely closure of the fontanel may be inhibited. Epidermoid cysts are benign tumors that are intracranially located and very rarely in the midline of the cranium. Meanwhile about 32% of stratified-squamous epithelial epidermoid cysts affect the head and neck region and only 6.7% occur in the scalp. We report an unusual epidermoid cyst located and growing in the anterior fontanel of a pediatric patient and inhibiting fontanel closure.Case Description A 21-month-old boy and his parents visited our polyclinic because there was a lump on his anterior fontanel since four months before they came to the hospital. The lump was initially the size of a peanut and had grown to become as large as a quail’s egg. The physical examination was normal and the brain CT-scan showed bone destruction without any intracranial lesion. The tumor was excised on the preoperative diagnosis of dermoid cyst. Histopathology examination showed the characteristics of an epidermoid cyst. The cyst had a wall and was full of keratin flakes without hair follicles or sebaceous glands. Follow-up one year after complete excision did not reveal any recurrence. ConclusionEpidermoid cysts in the skull of pediatric patients must be completely excised as soon as possible because their growth can damage the bone and inhibit the closure of the sutures.
Mandatory universal use of cloth mask for prevention of coronavirus disease 2019 transmission Yenny, Yenny; Herwana, Elly; Wratsangka, Raditya
Universa Medicina Vol. 40 No. 1 (2021)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2021.v40.57-68

Abstract

Since the outbreak in Wuhan City, China, in late December 2019, the Coronavirus Disease 2019 (COVID-19) has spread to nearly the whole world, so that it was declared a pandemic by the Word Health Organization. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative organism of COVID-19, is extremely infectious and can adhere to droplet nuclei of < 5 mm diameter and become airborne (aerosol). Since COVID-19 was declared a pandemic, there has been controversy on the use of cloth masks by the public, because of the still inconclusive evidence of the efficacy of cloth masks in protecting against COVID-19 transmission. Universal masking as a healthcare intervention in the community is currently made mandatory by local governments of most countries, since they follow the recent recommendation by the World Health Organization. The issuing of the WHO recommendation on the public use of masks was based on a study demonstrating that COVID-19 transmission does not occur only through droplets but also through aerosols. In addition, there was a study showing that COVID-19 transmission does not only occur from patients with clinical symptoms but also through asymptomatic and pre-symptomatic subjects, so that universal masking is of benefit in providing protection when used by healthy people and as source control to prevent cross-transmission to other people. This review article aims to discuss the mechanism of COVID-19 transmission, the evidence related to the efficacy of cloth masks, and the guidelines related to the selection and use of masks by the general population.
Protective effect of ethanolic Feronia elephantum Correa fruit extract on high-fat diet induced steatohepatitis in rats Diarti, Maruni Wiwin; Harmi, Khoviya Yuwina Selinada; Ahsani, Dwi Nur
Universa Medicina Vol. 40 No. 1 (2021)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2021.v40.36-44

Abstract

BACKGROUND A high-fat diet can lead to hyperlipidemia which will end up as liver damage (steatohepatitis). Ethanolic Feronia elephantum Correa fruit extract (EFEC) has an antioxidant activity which is expected to overcome hyperlipidemia in the liver. The objective of this study was to determine the effects of EFEC on liver function and morphological changes in rats.METHODSThis was an experimental study with a post-test only group design. A total of 20 male Wistar rats aged 2-4 months were randomized into 5 groups, A= negative control, B= positive control (high fat diet + 10 mg/kgBW simvastatin), C = high fat diet + 500 mg/kgBW EFEC fruit extract, D = high fat diet + 600 mg/kgBW EFEC, and E = high fat diet + 700 mg/kgBW EFEC). High-fat diet was given for 4 weeks (quail egg yolks, 10ml/200gBW). EFEC was administered for 4 weeks after induction of hypercholesterolemia. Examination of liver serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) was performed on rat blood serum and histopathological examination was carried out using steatohepatitis grading. One way ANOVA test and Post-Hoc Tamhane’s test were used to analyze the data. RESULTSAdministration of EFEC at 700 mg/kgBW improved the liver enzymes (p=0.00 for SGPT and SGOT) and steatohepatitis grading in high-fat diet induced rats (mild condition, E = 75% vs A = 100% mild)CONCLUSIONEthanolic Feronia elephantum Correa fruit extract at 700 mg/kgBW was able to improve steatohepatitis in high-fat diet induced rats.
Primary health care for all: lessons from its failure to achieve its goal and COVID-19 Yusuf, Erlangga
Universa Medicina Vol. 40 No. 1 (2021)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2021.v40.1-2

Abstract

According to the World Health Organization (WHO), primary health care (PHC) can be defined as a whole-of-society approach to health and well-being, centered on the needs and preferences of individuals, families and communities. In the last five years, several major events occurred that emphasize the importance of and the need for PHC. First, the publication of the United Nations Sustainable Development Goals (SDGs) in 2015. One of the SDGs is to achieve universal health care (UHC). UHC means that all people can get access to health service without it resulting in financial hardship, and  the WHO believes that PHC is fundamental to achieving UHC. Second, a new international declaration on PHC has been released in Astana, Kazakhstan, in 2018. This is a new declaration and global commitment on PHC, four decennia after the first declaration on PHC in Alma-Ata, in the former Soviet Union
Serum apolipoprotein B increased among tuberculosis patients compared to healthy subjects Ihim, Augustine Chinedu; Meludu, Samuel Chukwuemeka; Onyenekwe, Charles Chinedum; Anyabolu, Arthur Ebelenna; Akujiobi, Comfort N
Universa Medicina Vol. 40 No. 1 (2021)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2021.v40.45-51

Abstract

BackgroundThe burden of tuberculosis (TB) and cardiovascular disease (CVD) is enormous worldwide. Public health programs have been challenged with the overlapping of TB and CVD epidemics.Mycobacterium tuberculosis (MTB) is also a main driver of atherogenesis, suggesting a potential pathogenic role of tuberculosis in cardiovascular disease. The objective of this study was to compare the serum levels of apolipoprotein B (apo B), apolipoprotein B48 (apo B48) and apolipoprotein B100 (apo B100) between patients with tuberculosis and healthy subjects. Methods A cross-sectional study was conducted involving 251 subjects consisting of 120 treatment naïve active TB patients [26 HIV co infected (TB+HIV+) and 82 TB+), 12 malaria parasite co-infected (TB+MP+)], 26 latent TB infected (LTB) and 105 healthy controls. Their body mass index (BMI) was calculated. Mycobacterium tuberculosis infection was determined by Ziehl-Nelseen (ZN) sputum smear microscopy and confirmed positive using GeneXpert. Latent TB was determined by Mantoux test, MP was evaluated by microscopy while HIV by immunochromatographic techniques using serial algorithm. Apolipoproteins were determined using spectrophotometry. A one-way ANOVA test and LSD’s post hoc multiple comparisons were used for statistical analyses. ResultsSignificantly lower mean levels of BMI were observed in LTB, TB+, TB+HIV+ and TB+MP+ compared with the controls (p<0.005). The mean serum levels of apo B, apo B48 and B100 were significantly higher in LTB, TB+, HIV+TB+ and TB+MP+ compared with apparently healthy controls (p<0.05). Conclusion Elevated levels of apolipoproteins among infected TB individuals might predispose them to cardiovascular disease.
The role of mental health to overcoming the coronavirus disease-19 pandemic Dania, Ira Aini; Novziransyah, Nanda
Universa Medicina Vol. 40 No. 1 (2021)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2021.v40.69-76

Abstract

The current coronavirus disease-19 (COVID-19) pandemic has changed the order of social life; the efforts made to tackle this pandemic have sometimes raised various obstacles related to norms, ethics and culture. An increased risk of COVID-19-associated mental disorders is found in many communities, causing excessive emotional reactions such as feelings of pressure, leading to unhealthy behavior. This situation confirms that health care providers have a key role in dealing with emotional disturbances that occur as a form of pandemic response. Public health emergencies can affect the health, safety and well-being of every individual as well as the social stigma in connection with the COVID-19 pandemic. Various mental health studies related to disasters have determined that emotional distress is widespread and can also be found in populations related to COVID-19. There are various kinds of risk factors that have an impact on health workers during the COVID-19 pandemic, including social isolation, lack of support, and concerns about safety of family members. We included published, observational and experimental studies that reported the mental health effects on health workers during the COVID-19 pandemic. Efforts made by policy holders, especially in the health sector, have greatly contributed to the response to the pandemic, but not all of them can run smoothly, several steps and policies in the health sector must involve many stakeholders in order to realize the expected efforts. The main purpose of this review paper was to not only focus on health workers, but include the communities in overcoming the COVID-19 pandemic.
Suppression of transforming growth factor-β by mesenchymal stem-cells accelerates liver regeneration in liver fibrosis animal model Sa’dyah, Nur Anna C; Putra, Agung; Dirja, Bayu Tirta; Hidayah, Nurul; Yasmine Azzahara, Salma; Candra Satria Irawan, Risky
Universa Medicina Vol. 40 No. 1 (2021)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2021.v40.29-35

Abstract

IntroductionLiver fibrosis (LF) results from the unregulated chronic wound healing process in liver tissue. Transforming growth factor-beta (TGF-β) is the major contributing cytokine of LF promotion through activation of quiescent hepatic stellate cells (HSCs) into myofibroblasts (MFs) and increased extracellular matrix (ECM) deposition such as collagen leading to scar tissue development. Mesenchymal stem cells (MSCs) have an immunomodulatory capability that could be used as a new treatment for repairing and regenerating LF through suppression of TGF-β. This study aimed to examine the role of MSCs in liver fibrosis animal models through suppression of TGF-β levels without scar formation particularly in the proliferation phase.MethodsIn this study, a completely randomized design was used with sample size of 24. Male Sprague Dawley rats were injected intraperitoneally (IP) with carbon tetrachloride (CCl4), twice weekly, for eight weeks to induce LF. Rats were randomly assigned to four groups: negative control, CCl4 group, and CCL4 + MSC-treated groups T1 and T2, at doses of 1 x 106 and 2x106 cells, respectively. TGF-β levels were analyzed by enzyme-linked immunosorbent assay (ELISA). One-way ANOVA and a least significant difference (LSD) was used to analyse the data. ResultsThe TGF levels of LF rat models decreased on day 7 after MSC administration. The levels of TGF-β in both MSC groups T1 and T2 decreased significantly compared with the control group (p<0.05). The TGF-β suppression capability of T2 was optimal and more significant than that of T1.ConclusionMSCs can suppress TGF levels in liver fibrosis induced rats.
Blood cell count is not a significant predictor of survival in bladder cancer after radical cystectomy Andy, Andy; Prapiska, Fauriski Febrian; Siregar, Ginanda Putra; Warli, Syah Mirsya; Sihombing, Bungaran
Universa Medicina Vol. 40 No. 2 (2021)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2021.v40.151-159

Abstract

BackgroundRadical cystectomy (RC) is the gold standard treatment for muscle-invasive bladder carcinoma. A predictive factor is needed for the aggressive approach as it could lead to overtreatment. Elevated blood cell count (BCC) markers are reported to have a significant association with poor outcomes in several types of malignancy. Neutrophil-to-lymphocyte-ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are well-known inexpensive and effective representative markers of inflammatory conditions. This study aimed to determine the BCC as a predictive factor of overall survival (OS) in patients with bladder carcinoma (BC) after RC. MethodsA retrospective cohort study was conducted involving 26 patients who had undergone RC. The demographic characteristics and BCC markers such as hemoglobin (Hb). NLR, PLR and lymphocyte/monocyte ratio (LMR) were collected. The patients were categorized based on the BCC marker value (³ median and < median). Kaplan–Meier survival analysis was done to determine overall survival (OS) on BCC markers. The association between patient demographics and one-year survival was also determined using Mantel-Cox (Log-rank) method. ResultsAmong the 26 patients, the mean age was 55.6 ± 12.9 years. On univariate analysis, none of the demographic characteristics was found to be a significant predictor of one-year and overall survival (p>0.05). Hemoglobin, NLR, PLR and LMR were not significant predictors of one-year survival and OS (p>0.05). ConclusionsThe BCC was not a significant predictive factor of survival in patients with bladder cancer after radical cystectomy.

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