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Smart Medical Journal
Published by Universitas Sebelas Maret
ISSN : 26211408     EISSN : 26210916     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology Public Health
Smart Medical Journal (SmedJour) is published by Faculty of Medicine Universitas Sebelas Maret. SMedJour publishes original research articles or article review in the basic medical sciences, clinic medical sciences, medical education and public health.
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Articles 100 Documents
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Potensi Padina australis sebagai Marine Drug untuk Aterosklerosis I Gusti Ayu Stiti Sadvika; Ni Wayan Ari Wulansari; Ni Putu Elsinthia Suryaningsih; Agung Nova Mahendra
Smart Medical Journal Vol 5, No 1 (2022): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v5i1.55479

Abstract

Atherosclerosis is characterized by endothelial dysfunction, altered lipid accumulation, inflammation, and foam cells deposition. Fucoxanthin and fucoidan that are contained in Padina australis are known to have potential anti-atherosclerotic effects. This review aims to see the activity and potential of Padina australis as an anti-atherosclerotic marine drug. This literature review article was obtained through a online-based scientific database using terms or phrases relevant to the topic. Fucoxanthin reduces ROS and inhibits production of NO, PGE2, TNF-α, IL-6, and IL-1β. Meanwhile, fucoidan can regulate the development of atherosclerosis by preventing SMC from forming foam cells, LOX-1 expression, and proinflammatory molecules significantly. A decrease in total cholesterol, triglycerides, LDL, and increased HDL-c also shown to be one of the effects of fucoidan in modulating lipid metabolism. Fucoxanthin can increase thermogenesis by increasing PRDM16, UCP-1, and UCP-3 in BAT and decreasing adipocyte size, leptin, and increasing adiponectin in WAT. Fucoidan can lower the cholesterol index, triglycerides, LDL, and increase the expression of PPARγ which can increase lipid metabolism and inhibit hyperlipidemia. In conclusion, Padina australis is potential anti-atherosclerosis agent due to its fucoxanthin and  fucoidan exhibiting antioxidant, anti-inflammatory effects, and modulation of lipid metabolism.Keywords: Padina australis, fucoxanthin, fucoidan, atherosclerosis, marine drug
Comparison between SIRS and qSOFA Score for Predicting Mortality and Length of Stay Sepsis Patients in ICU of Dr Moewardi Hospital Surakarta Rahma Pramatama Tameru; Rth Supraptomo; Eko Setijanto
Smart Medical Journal Vol 5, No 1 (2022): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v5i1.40216

Abstract

Introduction: Sepsis is still one of the causes of morbidity and mortality in patients who are hospitalized. Early recognition and therapy is needed to prevent deterioration of the disease and predict outcomes. The Third International Consensus Definitions for Sepsis and Septic Shock in 2016 issued the latest definition for sepsis and recommended qSOFA score to replace the previous assessment system, SIRS criteria. This study was conducted with the aim of knowing the accuracy of the SIRS criteria, the accuracy of the qSOFA score, and the comparison between the two for predicting the mortality rate and length of stay of sepsis patients at the ICU of Dr Moewardi Hospital SurakartaMethods: This research was an observational analytic study with cross sectional approach, conducted in Dr Moewardi Hospital on September-November 2018. The samples were 106 sepsis patients. The data were collected by reading the medical record of sepsis patients who were hospitalized in ICU during of period July 2017 until June 2018 and analyzed statistically by and ROC curve analysis, chi square analysis test, and zero-truncated regression poisson testResult: qSOFA Score Pre-ICU (Sens 67.9%, Spe 50%, p=0.120, OR=2.111), qSOFA Score ICU (Sens 63.1%, Spe 77.3%, p=0.001, OR=5.813), SIRS Criteria Pre-ICU (Sens 88.1%, Spe 18.2%, p=0.439, OR=1.644), and SIRS Criteria ICU (Sens 84.5%, Spe 40.9%, p=0.009, OR=3.781). AuROC in predict mortality for qSOFA Pre-ICU, SIRS Pre-ICU, qSOFA ICU, and SIRS ICU were 0.625, 0.503, 0.754, and 0.644 consecutively. AuROC in predict length of stay in ICU > 3 days for qSOFA Pre-ICU, SIRS Pre-ICU, qSOFA ICU, and SIRS ICU were 0.580, 0.566, 0.681 and 0.639 consecutively. Conclusion: The qSOFA score has poor sensitivity and moderate specificity, while the SIRS criteria has high sensitivity but low specificity. But, qSOFA is superior to SIRS for predicting mortality and length of stay in ICU > 3 days. Keyword : Sepsis, ICU, SIRS, qSOFA,mortality
Clinical Profile of Children Hospitalized with COVID-19 in Indonesia’s District Hospital : A First Year Pandemic Wave Single Centre Study Dina Luthfiyah; Muhammad Ali Shodikin
Smart Medical Journal Vol 5, No 2 (2022): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v5i2.57406

Abstract

Background: Children are known to be less infected by Coronavirus disease 2019 (COVID-19) rather than adults. However, children are still a vulnerable group and the incidence of patients admitted to hospital continues to increase. As Indonesia’s district has limited resources during pandemic wave, the data on pandemic cases was still underreported especially cases of children.Methods: This retrospective observational study collected data on pediatric case aged 0 – 18 years old, who were hospitalized at dr. Soebandi Hospital, Jember, Indonesia and confirmed to have COVID-19, from March 2020 to the end of March 2021.Results: 40 children were hospitalized and confirmed COVID-19 during the study period, the majority aged 15 – 18 years (40%), male (65%), and had a history of contact (67.5%). The most common symptoms were cough (85%), fever (67.5%), and shortness of breath (40%). Laboratory results showed that the majority had decreased neutrophils and increased lymphocytes, while most of the patient had normal chest X-rays (52.5%). From 5 pediatric patients who had multimorbidity, 4 patients died. All four had common underweight clinical morbidity, while acute respiratory distress syndrome was dominated the cause of death. The mortality rate in this study reached 10%.Conclusion: The majority of pediatric patients were found to have mild to moderate symptoms with good outcomes. Case mortality rate in this study was lower than national data. Meanwhile, the underweight comorbid in children with COVID-19 was worsening the outcome in this study.
Meta-Analysis of Enteral Lactoferrin Supplementation for Reducing the Risk of Preterm Infants Sepsis Yehuda Tri Nugroho Supranoto; Dini Cynthia Dewi Tanuwijaya
Smart Medical Journal Vol 5, No 2 (2022): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v5i2.57007

Abstract

Introduction: Severe COVID-19 in pregnancy is strongly associated with preterm infant late-onset sepsis (LOS), which is a major cause of morbidity and mortality in infants. Recently, Lactoferrin, an iron-binding protein significantly discovered in human colostrum, shows potential effect on reducing the risk of preterm infant LOS and mortality by its immunomodulatory properties. Therefore, this study aimed to evaluate the effect of Lactoferrin on reducing the risk of preterm LOS, necrotizing enterocolitis (NEC), and mortality in preterm infants. Methods: This study followed the guidelines provided by PRISMA. A literature search was conducted with PubMed, Cochrane Library, Google Scholar, and ScienceDirect. The combined effect of LOS, NEC and mortality incidence were presented as risk ratios (RR) with a 95% confidence interval (CI) using a random-effects model (REM) or fixed-effects model (FEM) forest plot. Furthermore, the heterogeneity level was checked by I2 and the p-value of the chi2 test. Results: The incidence of LOS was significantly higher in the control than lactoferrin supplementation group [RR=0.65, 95% CI (0.56,0.77), p
The Association Between Age Groups with Clinicopathologic and Molecular Subtypes of Breast Cancer Patients Tejo Jayadi; Brenda Miriane Rustam; Puji Kristi; Ngesti Chintia Dewi; Wiwiek Probowati; Hariatmoko Hariatmoko; Jonathan Willy Siagian
Smart Medical Journal Vol 5, No 2 (2022): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v5i2.59179

Abstract

 Introduction: The increase in incidence proportion of breast cancer disease among young patients < 40 years old is exceeding that of older patients. The purpose of the research is to know the differences between clinicopathologic and molecular subtypes between patients < 40 years old and ≥ 40 years old.Methods: The conducting research on Medical Records (MR) was an observational analytic method with a cross-sectional design. The independent variable was age. Dependent variables were histopathological type, stage of disease, grade of tumor, and molecular subtype of cancer. Univariate analyses to describe the samples. The differences between those variables according to age groups were analyzed by a bivariate statistic and the odds ratio with a confident interval (CI) of 95% of each variable would be displayed by binary logistic regression statistic. Results: The most prevalent age of breast cancer patients was in the range of 50-59 years (47%), the mean age of 53.66 ± 0.977 years, in the range of 29 years old to 86 years old, and patients aged < 40 years was 12%. Ductal carcinoma type (89.7%), stage III tumor (40.2%), poor differentiation grade III (60.7%), and luminal A subtype (42.7%) were the most prevalent clinicopathologic and molecular subtypes. There weren’t differences between histopathologic type, stage of disease, and molecular subtype with age. The histopathologic grade was different from the age variable (p=0.015). Old age had worse histopathologic differentiation than young age (OR 2.166; 95% CI 0.973-4.823).Conclusions: There weren’t significant differences between stage and molecular subtypes of breast cancer between age groups. There was poorer histopathologic differentiation in patients ≥ 40 years.  
Pemphigus Vulgaris Management in Elderly Patient: A Case Report Prayogi Miura Susanto; Wisyanti Mian Uli Siahaan
Smart Medical Journal Vol 5, No 2 (2022): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v5i2.61240

Abstract

Pemphigus vulgaris is an autoimmune disease characterized by mucocutaneous involvement in the form of loose bullae on the skin and mucous membranes. This disorder is typically associated with the poor general condition and can be life-threatening. Furthermore, it has a rare incidence among elders. Pemphigus vulgaris was reported in a 73-year-old female patient. The diagnosis was performed clinically according to the history of the disease course and its typical lesions with a predilection for location. The patient's clinical condition improved after receiving systemic corticosteroids and additional supportivetherapy.
Relationship between RALE Score, Age, Gender, D-Dimer, Diabetes Mellitus and Hypertension with Mortality Rate of COVID-19 Patients in the Intensive Care Unit Ivan Ferdion; Widiastuti Widiastuti; Yusup Subagio; Hari Wujoso
Smart Medical Journal Vol 5, No 2 (2022): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v5i2.61512

Abstract

Introduction: The evaluation of changes in RALE scores on chest radiography and increased D-Dimer values of COVID-19 patients can be prognosticators of severity in the progressive phase and risk of ARDS. This study aims to determine the relationship between Rale scores and mortality of COVID-19 patients in the Intensive Care Unit (ICU) at RSUD Dr. Moewardi.Methods: This research is an analytical observational study with a cross sectional approach was conducted on COVID-19 patients who had undergone a chest radiography and a D-Dimer examination at RSUD Dr. Moewardi in the period May 2021 to July 2021.Results: This research included of 126 patients with 109 (87%) have died and 17 (13%) lived. Increased RALE and D-Dimer scores were associated with mortality of COVID-19 patients in the ICU while gender (p=0.416), age (p=0.336), diabetes mellitus (DM) (p=0.852), and hypertension (p=0.464) did not have a significant relationship with the outcome of COVID-19 patients admitted to the ICU with p>0.05. The RALE score has an OR = 7.566 (95% CI = 2.117-27.043) which means that the increase in the RALE score is 7.566 times greater for the death outcome than the RALE score which remains or decreases. The D-Dimer got an OR value of 3,679 (95% CI=1.169-11,576) which means that D-Dimer >2000 has a 3.655 times greater risk of death than D-Dimer <2000 in COVID-19 patients treated in the ICU.Conclusion: There is a relationship between changes in RALE and D-Dimer scores with the mortality rate of COVID-19 patients in the ICU of RSUD Dr. Moewardi. Future research is expected to analyze other factors that have the potential to bias the results of the study such as changes in D-Dimer values, sociodemographic factors, clinical conditions and medical history in research subjects.
A 21-Year-Old Woman with Suspecting Gitelman Syndrome Berty Denny; Nurhasan Agung Prabowo; Desy Puspa Putri; Risalina Myrtha; Hendrastutik Apriningsih
Smart Medical Journal Vol 5, No 2 (2022): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v5i2.61735

Abstract

Introduction: Gitelman syndrome (GS), is a hereditary condition marked by a specific kidney function impairment. GS symptoms do not normally manifest until beyond the age of six years. We present a rare case of a 21-year-old woman with a background in generalized weakness muscle cramps with tetany, fever, and dyspnea.  The goal of this study is to give a case report of Gitelman syndrome suspicion.Result: Gitelman syndrome is identified through clinical indicators and lab testing, such as low potassium and magnesium levels in the blood, metabolic alkalosis, and low calcium levels in the urine. We do a variety of physical and laboratory tests to determine the disease and rule out other possibilities. Molecular proof is difficult to get due to a lack of resources and the high expense of genetic testing, which has become one of our case report's flaws. This patient was diagnosed as suspecting Gitelman syndrome and treated for electrolyte imbalances. The patients were given replacement therapy, which comprised intravenous potassium, sodium, and chloride therapy, as well as calcium therapy. In addition, we also provided some symptomatic therapy. She was discharged five days later in fine condition.Conclusion : This is one of the few reports of a 21-year-old lady being suspected of having Gitelman syndrome (GS). We conduct a battery of physical and laboratory tests to diagnose the disease and rule out other possibilities. We provide the appropriate therapies in accordance with the guidelines, and the outcomes are favorable.
Preservation of Goat Kidneys Using Low Concentration Formalin for Human Anatomy Learning Sindhu Wisesa; Khusnul Muflikhah; Mustofa Mustofa; Fitranto Arjadi
Smart Medical Journal Vol 5, No 2 (2022): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v5i2.62820

Abstract

Background: Exposure to formaldehyde from a preserved cadaver can cause several health problems in students, lecturers, and laboratory technicians working in medical anatomy laboratories. These conditions include respiratory tract irritation and cancer due to acute and chronic exposure, respectively. Lowering the frequency of contact with formaldehyde from preserved organs helps to ensure the safety of students, lecturers, and laboratory technicians. Therefore, this study aims to determine the effectiveness of low concentration formalin as a preservative solution for goat kidneys. The organ was selected due to its anatomical structure similarity to humans.Method: Goat kidneys with 50-60 ml of volume were collected, washed, immersed in preservative solution, and stored for two months. The samples were then divided into four groups, which were preserved with different formalin concentrations, namely 30%, 20%, 10%, and 5%. The preservation parameters, namely organ structure and integrity, color, springiness, odor, and mold growth were qualitatively described, while the kidney volume was quantitatively measured.Results: After the samples were preserved for two months, they were observed, and all groups showed similar characteristics. The kidneys preserved with 5% or 10% formalin showed equal volume before and after two months of preservation.Conclusion: Low concentration formalin has the same effectiveness in preserving goat kidneys as the high concentration. It also has the potential to be applied in human anatomy learning.
Effect of Diet Program on Upper Arm Circumference Istiqomah Istiqomah; Rino Arianto Marswita; Istiqomah Syarifah Nabila
Smart Medical Journal Vol 5, No 3 (2022): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v5i3.51135

Abstract

Introduction: As time goes by, lifestyle is changing. The imbalance of energy intake and energy expenditure will result in underfeeding or overfeeding. Police officers at Polresta Depok are obese about 34,6 %. This research is the first research to investigate the effect of the diet program with Mid-Upper Arm Circumference on Policemen at Bhayangkara Prof. Dr. Awaloedin Djamin hospital in Semarang City. Methods: The design of this study is one group pre-test and post-test design with inclusion criteria that are Policemen with BMI >30 and willing to take part in this study. The exclusion criteria are having a history of medullary thyroid carcinoma. The data collected in this study used consecutive sampling. The statistical analysis used a nonparametric Wilcoxon test.Results: Mid-Upper Arm Circumference mean before and after intervention were 36,8 ± 5,72 and 38,9 ± 3,22 with Asymp. Sig. (2 - tailed) p= <0,001. (p<0,05). Thus, the effect of a diet program with Mid-Upper Arm Circumference is significant.Conclusion: A diet program, consisting of liraglutide injection, diet food, and exercise, has a significant effect on Mid-Upper Arm Circumference.

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