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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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Outcomes of ureteral stent placement for hydronephrosis in patients with ureteral stone Widyokirono, Dyah Ratih; Kloping, Yudhistira Pradnyan; Rahman, Zakaria Aulia; Hakim, Lukman
Universa Medicina Vol. 40 No. 3 (2021)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2021.v40.226-233

Abstract

BackgroundRoutine ureteral stent placement after ureteroscopy (URS) for ureteral stone treatment is arguable due to the possible stent-related symptoms. Several studies claimed that its use is necessary, while others reported that its use is excessive. Hydronephrosis occurs when urine cannot drain out from the kidney to the bladder due to blockage or obstruction. We aimed to evaluate the role of ureteral stents in hydronephrosis resolution in ureteral stone patients following URS lithotripsy. MethodsThis was a prospective observational study using secondary data involving 130 ureteral stone patients undergoing URS lithotripsy [99 patients (76.2%) with stent placement and 31 patients (23.8%) without stent]. Data consisting of baseline characteristics, pre-operative status, intraoperative characteristics, and postoperative complications were collected from the medical record database and presented descriptively. The patients were divided into two groups based on stent placement. Comparison of hydronephrosis resolution between the groups was analyzed with Chi-square. ResultsUreteral lesions were the most common indication of ureteral stent placement following URS lithotripsy (28.3%). The most bothersome symptoms were dysuria in 18 patients (18.2%); followed by frequency in eight patients (8.1%) and low back pain in six patients (6.1%). All symptoms were successfully treated with oral medications. There were 41 patients (91.1%) with pre-operative hydronephrosis significantly resolved after stent placement compared to 5 (62.5%) patients without stent placement (p=0.027). ConclusionUreteral stenting significantly resolves pre-operative hydronephrosis after URS lithotripsy in patients with ureteral stone. Ureteral stent placement is the preferred method for the treatment of pre-operative hydronephrosis.
Obesity is the most influential risk factor of cardiopulmonary endurance in older women Khairani, Rita; Adriani, Donna; Amani, Patwa
Universa Medicina Vol. 40 No. 3 (2021)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2021.v40.254-262

Abstract

BackgroundPulmonary function decreases with age. Similarly, physical exercise capacity measured by maximal oxygen uptake, which is one indicator to measure the level of cardiac and pulmonary vascular resistance, decreases by >1% per year. This results in many respiratory diseases that occur in older persons, especially in obese older persons. Pulmonary function is a basic component of cardiopulmonary endurance, besides other factors such as age, hemodynamics, metabolism, and lifestyle. The objective of this study was to determine whether body mass index (BMI) and pulmonary function have a significant association with cardiopulmonary endurance in older women. MethodsThe study used a cross-sectional design involving 66 subjects aged 60 years and older in South Jakarta. Data was collected by measuring body mass index (BMI), pulmonary function (FEV1, FVC, FEV1/FVC) and maximal oxygen uptake (VO2 max) for cardiopulmonary endurance. Data analysis used simple and multiple linear regression tests in SPSS v.25, with p<0.05. ResultsOf the 66 older persons, 57.6% was obese. Pulmonary function of subjects showed restriction (33.3%), obstruction (6.1%) and a combination of restriction and obstruction (1.5%). Furthermore, mean VO2 max was 12.2 mL/kg/min. Multiple linear regression analysis showed a significant association of BMI and FEV1/FVC with VO2 max (â =-0.56; 95% CI=-0.81 - (-) 0.31; p=0.000; â =0.09; 95% CI=0.01-0.18; p=0.028). BMI was the most influential risk factor of VO2 max (Beta = -0.46). ConclusionsThere was a significant association of BMI and FEV1/FVC with VO2 max, BMI being the most influential risk factor of cardiopulmonary endurance in older women.
Morning hypertension for stroke and cardiovascular: clinical pearls for primary care Rasyid, Al; Wiyarta, Elvan
Universa Medicina Vol. 40 No. 3 (2021)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2021.v40.270-278

Abstract

Hypertension is the world’s leading cause of mortality and morbidity. One of the phenomena that commonly occur in hypertensive as well as normotensive patients, is morning hypertension. Blood pressure (BP) follows a diurnal rhythm, reaching its highest level during the morning hours and dropping to the lowest level at midnight. Transient increases in BP in morning hypertension plus persistent stressors within 24 hours are thought to increase target organ damage and trigger cardiovascular events. Therefore, ambulatory BP monitoring or morning home BP monitoring is recommended as a strong predictor of cardiovascular events. There are two types of morning hypertension according to its underlying mechanisms; the first one is called nocturnal hypertensive morning hypertension, and the other one is morning-surge hypertension. Numerous studies have proved that this phenomenon often leads to several acute cardiovascular events, such as stroke, coronary artery disease, and peripheral artery disease. To prevent these complications, cost-effective management is needed, especially for identifying accurate diagnostic tools, as well as creating specific regimens. Therefore, to achieve appropriate management of hypertension, including morning hypertension, long-acting antihypertensive drugs should be used, at full doses and in the form of combination therapy. The clinical usefulness of antihypertensive drugs with specific mechanisms for morning BP or split or timed dosing of long-acting drugs in controlling morning BP remains under investigation. More studies are needed, especially looking for other clinical evidence of the benefits of lowering BP in the morning. Home BP monitoring is recommended as a good choice for BP measurements, especially in the primary care setting.
Barriers to breast cancer screening in Iranian females: a review article Masoudi, Nazanin; Dastgiri , Saeed; Sanaat, Zohreh; Abbasi, Zhila; Dolatkhah, Roya
Universa Medicina Vol. 41 No. 1 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.79-89

Abstract

Breast cancer is one of the most common malignancies among females in Iran. Screening and detection in the early stages can increase the likelihood of breast cancer treatment and prognosis, thereby decreasing the mortality rate and promoting patient survival. However, mass screening programs for breast cancer are still confronted by predominant barriers in Iran. We tried to review and recognize the barriers to breast cancer screening and early detection in Iranian females as the main research question. We searched all available databases, and screened manuscripts for eligibility according to our inclusion/exclusion criteria. The search strategy was based on the following keywords: Breast, Malignancy, Cancer, Screening, Early Detection, Mammography, Iran, and Barrier. Responsible authors performed a literature review and compiled the results into a report. Various perceived barriers at different levels (individual, intrapersonal, health systems, and community) play influential and pivotal roles in women’s decisions to participate in breast cancer screening programs to facilitate early detection. Lack of awareness, neglect, procrastination, embarrassment, religious beliefs, and lack of primary health workers awareness and recommendation were cited as perceived barriers in screening procedures in Iran. There are still barriers in performing mammography at population levels in five major dimensions including availability, accessibility, cost, fears, and acceptability. However, the rate of regular mammography utilization in Iran is low compared with other countries and needs increasing through informing women. Many perceived barriers can affect women’s willingness and self-efficacy in screening procedures and one of the most effective ways of overcoming these barriers is to increase women’s awareness.
Interleukin-22-induced β‑defensin-2 expression by intranasal immunization with Streptococcus pneumoniae RrgB epitopes Mufida, Diana Chusna; Saputra, Antonius Dwi; Hermansyah, Bagus; Agustina, Dini; Shodikin, Muhammad Ali; Armiyanti, Yunita
Universa Medicina Vol. 41 No. 1 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.37-46

Abstract

BackgroundStreptococcus pneumoniae causes pneumococcal disease, which is responsible for millions of deaths worldwide. Various pneumococcal vaccine candidates have been developed to prevent S. pneumoniae infection, one of which is an epitope-based vaccine. This study aimed to prove that intranasal immunization with each of the five S. pneumoniae RrgB epitopes can induce a mucosal immune response by increasing the β-defensin-2 concentration through upregulation of interleukin (IL)-22 expression. MethodsAn experimental laboratory study was conducted using 28 male Wistar rats aged 3-4 months, that were randomly divided into 7 groups containing four rats each. Group 1 was given 40 mL of phosphate-buffered saline (PBS) only (control group). Group 2 was the adjuvant group that received 40 mL PBS containing 2 ìg cholera toxin B (CTB), and groups 3-7 were immunized with 40 mL PBS containing a combination of adjuvant and one of the five different S. pneumoniae RrgB epitopes. The concentrations of IL-22 and β-defensin-2 from nasal rinse examination were measured by means of ELISA. The Kruskal-Wallis test, followed by the Mann-Whitney post-hoc test were used for statistical analysis. ResultsRats immunized with the adjuvant-epitope combination had significantly higher β-defensin-2 and IL-22 levels than the control group (p=0.030; p=0.018, respectively), according to the Kruskal-Wallis test. And the Mann-Whitney statistical test, showed there was a significant increase in β-defensin-2 and IL-22 levels. ConclusionsIntranasal immunization with epitope 1 of the S. pneumoniae RrgB can increase β-defensin-2 expression significantly and has a greater potential to be developed into a pneumococcal vaccine.
Increased oxidative stress in adult women with iron deficiency anemia KARABULUT, Alpaslan; ALP AVCI, Gulcin; AVCI, Emre
Universa Medicina Vol. 41 No. 1 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.29-36

Abstract

BackgroundIron deficiency anemia (IDA), a type of anemia with an increasing global frequency, is more common in women than men in the population. In IDA, the sensitivity of erythrocytes to oxidants is increased and their lifespan is shortened. Oxidative stress is an imbalance between free radicals and antioxidant molecules which is one of the potential biochemical mechanisms involved in the pathogenesis of IDA. In our study, we aimed to determine the levels of oxidant and antioxidant markers by assessing the levels of total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), paraoxonase-1 (PON-1), and myeloperoxidase (MPO) in women with IDA. MethodsThis was a cross-sectional study involving 47 women with IDA aged ³40 years and 47 women volunteers. The levels of TAS, TOS, OSI, PON-1, and MPO were determined spectrophotometrically using appropriate kits. Non-parametric Mann Whitney-U tests were used to analyze the data. ResultsThe levels of antioxidants TAS (1.42 mmol Trolox equiv./L) and MPO (54.00 U/L) in the IDA group were significantly lower than in the control group [TAS (1.67 mmol Trolox equiv./L) and MPO (89.00 U/L)] (p=0.000 and p= 0.019, respectively). However, TOS (6.25 ìmol H2O2 equiv./L) level in the IDA group was significantly higher than in the control group (4.13 ìmol H2O2 equiv./L) (p=0.000), but PON-1 was not significantly different between the two groups (p=0.375). ConclusionIn women with IDA, the oxidant-antioxidant balance is impaired, resulting in oxidative stress. Therefore, IDA in adult women must receive adequate attention in clinical practice.
Tale of the double pandemics, COVID-19 and obesity: a never ending story Hamid, Roslida Abdul
Universa Medicina Vol. 41 No. 1 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.1-3

Abstract

Parasite immunomodulatory role in reducing the prevalence of COVID-19 in endemic regions Hermansyah, Bagus; Agustina, Dini; Zulaikha, Siti; Habibi, Ali
Universa Medicina Vol. 41 No. 1 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.90-99

Abstract

Nearly 35 million cases and one million deaths over the nine months of the COVID-19 pandemic have been reported worldwide. Africa and some countries with endemic parasitic infections had a low incidence of COVID-19. By contrast, the United States and several European countries, having a non-endemicity of parasitic infections, recorded a high incidence of COVID-19. Some parasites have an immunomodulatory mechanism that can induce an immune tolerance state in the infected persons by balancing pro-inflammatory and anti-inflammatory responses. Emerging reports also stated that COVID-19 and helminth co-infections may have more hidden outcomes than predictable ones. Hence, the aim of this literature review is to show and identify that an increase in the number of regulatory immune cells due to the immunomodulatory role of a pre-existing parasitic infection could reduce the risk of COVID-19. This study explored the existing literature to determine the role of parasitic infections in modulating the immune response and possibly reduce the risk of COVID-19 infection in endemic countries. The mechanism of immunomodulation by parasites is the increased numbers of Treg cells, M2 macrophages, eosinophils, the Th2 cytokines IL-4 and IL-5, and the pro-inflammatory downregulation of IFN λ, TNF α, and IL-6, which play an essential role in inducing cytokine storms in COVID-19 infection. This condition will probably occur in an individual with parasitic infection in a community with limited facilities and infrastructure to treat parasitic infections, particularly in developing countries. To conclude, in endemic areas, the immunomodulatory effect of parasitic infection to reduce the risk of COVID-19 cases/deaths is a possibility if the host is immunocompetent. Herein, the current knowledge on the immunomodulatory role of COVID-19 and helminth co-infections will be discussed.
High glycosylated hemoglobin level as a risk factor of latent tuberculosis infection in patients with uncomplicated type 2 diabetes mellitus Arliny, Yunita; Yanifitri, Dewi Behtri; Mursalin, Diennisa
Universa Medicina Vol. 41 No. 1 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.47-55

Abstract

Background Diabetes mellitus (DM) is known to increase the risk of infection including tuberculosis (TB). Some studies also showed that 2-15% of latent TB infection (LTBI) will progress to active TB. This study aimed to obtain the prevalence of LTBI and to determine the risk factors of LTBI in patients with type 2 diabetes mellitus (T2DM). Methods This was a cross-sectional study on 242 adult T2DM patients. For LTBI screening we performed the interferon gamma release assay (IGRA) (Quantiferon TB Gold Plus test) and for confirmation of active TB (pulmonary TB) we performed GeneXpert MTB/Rif sputum examination and chest X-ray. Glycosylated hemoglobin (HbA1c) levels, smoking history and BCG scar were collected. Multivariate logistic regression was used to analyze the data. Results Positive IGRA results were found in 99 of 242 uncomplicated T2DM patients while LTBI was found in 82 patients (33.8%). There were significant differences between T2DM patients with latent TB and T2DM patients without infection in HbA1c and specific IFN-ã levels (TB1 minus nil and TB2 minus nil), i.e. 8.5% and 7.6%, 2.5 IU/mL and 0.06 IU/mL, and 2.6 IU/mL and 0.08 IU/mL, respectively. Multivariate analysis showed that the risk factors for LTBI in T2DM patients were smoking history, HbA1c >7%, and no BCG scar. Conclusions Because LTBI is prevalent in T2DM, it is important to screen for it in T2DM patients due to the risk of developing severe active TB. Absence of a BCG scar and high HbA1c levels are strong predictors of LTBI in T2DM patients.
Microscopic examination using negative staining for rapid diagnosis of syphilis Rosana, Yeva; Effendi, Ida; Indriatmi, Wresti; Yasmon, Andi
Universa Medicina Vol. 41 No. 1 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.64-70

Abstract

BACKGROUNDSyphilis is a global health problem, especially in developing countries including Indonesia. Treponema pallidum, the etiologic agent of syphilis, cannot be cultured in vitro. Syphilis has several clinical manifestations, making laboratory testing a very important aspect of diagnosis. Microscopic examination may support the diagnosis but is rarely used in Indonesia. The aim of this study was to evaluate negative staining using the light microscope to detect T. pallidum in syphilitic lesions. METHODSA cross-sectional study was conducted involving 27 subjects who came to several dermato-venereology clinics in Jakarta. Exudates were collected from genital ulcers, condylomata lata, and dry mucocutaneous rash on palms and soles of syphilis patients. Negative staining using one drop of Indian ink was used to examine for treponemas under the light microscope at 10x100 magnification. RESULTSMicroscopic examination using negative staining showed a few clusters of small and spiral shaped bacteria. Of the 39 specimens from 27 subjects, microscopic examinations were successfully done on 10 specimens. Observations could only be conducted on 5 specimens, 3 (60.0%) of which showed the morphology of spirochetes. This examination is the easiest method for detecting the bacteria. Moreover, the bacteria that were isolated from painless genital ulcers could be observed more clearly than those from erythematous maculopapular lesions. CONCLUSIONTreponema pallidum was successfully detected by microscopic examination in all moist lesions, but was difficult to detect in dry lesions. Negative staining under the light microscope appears to be simple, affordable, and available in most microbiology laboratories in Indonesia.

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