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INDONESIA
Jurnal Kedokteran Brawijaya
Published by Universitas Brawijaya
ISSN : 02169347     EISSN : 23380772     DOI : http://dx.doi.org/10.21776/ub.jkb
Core Subject : Health,
Medicine & Pharmacology
JKB contains articles from research that focus on basic medicine, clinical medicine, epidemiology, and preventive medicine (social medicine).
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 782 Documents
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Case Series: Two Cases of Critical Pulmonary Artery Stenosis Focusing on the Timing of Diagnosis and Management Koentartiwi, Dyahris; Ramadhanti, Ardhanis; Damayani Susilo, Monica
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.17

Abstract

Critical stenosis of the pulmonary valve in neonates is related to ductus-dependent pulmonary circulation. Percutaneous transcatheter balloon valvuloplasty (PTBV) is the treatment of choice for critical pulmonary stenosis. Unfortunately, many children in developing countries are usually diagnosed late and seldom get immediate care, which leads to delayed growth and development and, ultimately, higher morbidity and mortality. We present two cases of critical pulmonary artery stenosis in a 17-year-old boy and a 4-day-old girl who received PTBV procedures, but had different outcomes. We underline the importance of early diagnosis and intervention in critical pulmonary stenosis for the patient’s prognosis.
Review of Determinants of Nonmedical Caesarean Section in Indonesia: A Systematic Review Nurfianto, Sigit; Suhanda, Rachmad; Yuarta, Ferina Agustia; Refani, Priska; Sembiring, Thyrister Nina Asarya; Mellazulfa, Dhea Sofiana; Laurentina, Yoriko; Yeni, Yeni
Jurnal Kedokteran Brawijaya Vol. 33 No. 1 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.01.9

Abstract

Caesarean section (C-section) delivery has increased worldwide. The number of deliveries using the C-section procedure at the age of 10–54 years in Indonesia reached up to 17.6% of the total number of deliveries, due to the presence of medical and nonmedical indications. This study aims to analyze about nonmedical indications of C-section. This study uses a systematic review method. The inclusion criteria for the investigated studies were articles published in 2011–2021, written in English or Bahasa Indonesia, observational studies with case control or cohort as the design, and available to be downloaded in full text. In total, 12 articles were included in this systematic review. The nonmedical factors that influence the C-section procedure are antenatal care, the mother's level of education, residency, health insurance, socio-economics, occupation, previous birth histories, the mother's demand, the family's support and decision-making, and doctor's referral. The government, through the help of health practitioners, needs to increase the education to pregnant women and their families regarding the advantages and disadvantages of their preferred delivery methods.
Correlation between De Ritis Ratio with Severity of Covid-19 Patients Severity Rostini, Tiene; Khairunnissa, Khairunnissa; Turbawaty, Dewi Kartika
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.14

Abstract

SARS COV-2 is the causative agent of the infectious disease Corona Virus Illness-19 (Covid-19). Covid-19 can cause damage to multiple organs, including the liver. The de Ritis ratio is a ratio between AST and ALT in blood serum, which may be a useful indicator for assessing liver damage in Covid-19 patients. The aim of this study is to determine the association between the severity of liver injury and an increase in the de Ritis ratio in Covid-19. The study population included patients with acute Covid-19 disease whose infection was validated using real-time PCR. A retrospective cross-sectional study was conducted.  There were 1.983 subjects included, and 1.123 belonged to the moderate, 673 severe, and 181 to the critical groups. Calculations using Spearman rank revealed a strong significant association between De Ritis ratio and Covid-19 grade severity (rs=0.624, p<0.001). The more severe Covid-19, the higher de Ritis ratio values. The ROC curve of de Ritis ratio with Covid-19 severity shows AUC of 0.771 (P<0.001), sensitivity of 63.5%, specificity of 90.6%, PPV of 98.5% and an NPV of 20.02%. In conclusion, the severity of Covid-19 symptoms increases proportionally with the de Ritis ratio.
C-Reactive Protein (CRP) Value and Platelet Counts in Pediatric Dengue Patients at RSUP Dr. Hasan Sadikin Bandung Irawati, Indri; Tristina, Nina; Andriyoko, Basti
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.8

Abstract

Plasma leakage, thrombocytopenia, and cytokines play roles in pathogenesis of dengue infection. Thrombocytopenia correlates with severity of the disease. Dengue virus infection produces cytokines that stimulate C-Reactive Protein (CRP). This study aims to describe the results of CRP and platelet counts with severity of dengue infection in paediatric inpatient at Hasan Sadikin Hospital Bandung. This is a descriptive observational study with retrospective, cross-sectional data collection in January 1-December 31, 2021 at Hasan Sadikin Hospital. From 32 total subjects, there were 24(75%) non-severe dengue infections compared to severe dengue 8(25%). Non-severe dengue 19(79.2%), had the most platelet counts of 50,000-150,000/L, while platelets count 20,000-50,000/µL was mostly in severe dengue 4/8(50%). CRP value was mostly normal (<0.3mg/dl) as many as 18/24(75%) in mild dengue, whereas in severe dengue CRP was mostly high as many as 6/8(75%). CRP examination is mostly done in critical phase, both in severe and non-severe dengue. Severe dengue infection was found mostly in platelet counts of 50,000-150,000/µL and normal CRP level as many as 14(58.3%). In severe dengue infection, platelet counts was found mostly in 20,000-50,000/µL and high CRP (≥0.3mg/dl) as many as 3(37.5%). Most cases of dengue fever infections in children at Hasan Sadikin General Hospital in 2021 were of mild severity, with platelet counts ranging from 50,000 to 150,000/µL and normal CRP levels. Examinations were typically carried out during the critical phase.
Risk Factors Analysis for Rapid In-Hospital Mortality among Covid-19 Patients in a Tertiary Care Hospital in Indonesia Febriawati, Juwita; Putra, Ngakan Putu Parsama; Listyoko, Aditya Sri; Djajalaksana, Susanthy
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.15

Abstract

Systemic inflammation plays an important role in pathogenesis of Covid-19, especially in development of ARDS which is characterized by decrease of PaO2/FiO2 ratio. CRP and procalcitonin are inflammatory markers that are closely associated with severity and mortality of Covid-19. Although several studies have addressed benefit of CRP and procalcitonin as markers on Covid-19 severity, the benefit of these inflammatory markers for in-hospital mortality remain inadequately understood. The aim of this study was to analyze PaO2/FiO2 ratio,comorbidity,CRP,and procalcitonin as risk factors that affect time of in-hospital mortality Covid-19 patient. This was a retrospective observational cohort study of 250 Covid-19 patients who died during hospitalization and data was retrieved from medical record. Laboratory data was collected from three different times, including at time of admission,third day of hospital care,and before patient’s death. Data were analyzed using Chi square test,Mann Whitney test,Wilcoxon test, Friedman test, and binary logistic regresion. There were significant differences between CRP and procalcitonin at admission and time of in-hospital mortality (p<0.001; p=0.007). Binary logistic regression  analysis revealed significant relationship between CRP and time of in-hospital mortality with p=0.007. ROC curve showed optimal threshold of 11.75mg/L with sensitivity 72.3%; specificity 59.6%, RR 3.24(95% CI: 1.84-5.70). Significant changes were observed regarding PaO2/FiO2 ratio,CRP,and procalcitonin at admission as compared to before patient’s death with p<0.001;p=0.017;p<0.001 respectively. This study showed significant decrease of PaO2/FiO2 ratio, elevated CRP and procalcitonin at admission as compared to before patient’s death. The increase of CRP could serve as predictor for time of in-hospital mortality for Covid-19 patient.
Examining the Relationship between Infection Control Practices and ESBL Bacterial Carriage in Healthcare Workers Ayunisih, Lintang Sekar; Krisniawati, Nia; Wicaksono, Madya Ardi; Hestiyani, Rani Afifah Nur; Widhi, Anriani Puspita Karunia Ning
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.9

Abstract

The Enterobacteriaceae family widely produces Extended Spectrum Beta-Lactamase (ESBL), and infection by ESBL-producing bacteria can significantly increase morbidity, complicate therapeutic difficulties, escalating healthcare costs, and increase mortality rates. Transmission of these bacteria within the hospital environment may lead to the prevalence of ESBL-producing bacterial carriers among healthcare workers. Health workers' infection prevention and control (IPC) behavior plays a role in transmitting these pathogenic bacteria. This study aimed to determine the relationship between IPC behavior and the incidence of ESBL-producing bacterial carriers in health workers at Banjarnegara Islamic Hospital. This research used an observational analytic approach with a cross-sectional method. The sampling technique involved purposive sampling, resulting in a total sample of 61 people. Data were obtained by completing an IPC behavior questionnaire and collecting rectal swab samples cultured on CHROM ESBL Agar media. Statistical analysis was done using the Mann-Whitney test. The research identified a prevalence of 13.1% (8/61) ESBL-producing bacterial carriers among health workers at Banjarnegara Islamic Hospital. However, based on statistical analysis, the p-value was 0.664, leading to the rejection of the hypothesis (accepted if p-value <0.05). In conclusion, there is no significant relationship between IPC behavior and the incidence of ESBL-producing bacterial carriers in health workers at Banjarnegara Islamic Hospital.
The Effect of Lipopolysaccharide Challenge in RAW 264.7 Cells on Nitric Oxide Release and Cell Viability Suprapto, Ratih Paramita; Kusumastuty, Inggita; Rizal, Ardian; Adi Nugroho, Dwi
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.2

Abstract

Lipopolysaccharide (LPS) is a major component of a gram-negative bacterial wall that is widely used and well-established to induce inflammation in vitro. In addition, the in vitro model using RAW 264.7 cells is the most commonly applied in screening the anti-inflammatory and elucidating the pathophysiology of inflammation-based disease, as well.  However, there is still limited data on the efficacy of different doses of LPS in inducing inflammation in RAW 264.7 cells. This study aimed to evaluate the effect and safety of LPS at various doses in RAW 264.7 cells. RAW 264.7 cells were exposed to LPS at different dose ranges (10ng/mL-10µg/mL) for 24 hours. The nitric oxide (NO) release as inflammatory responses and viability test were evaluated using Griess assay and CCK-8 assays, respectively. The result showed that NO production was increased at different doses of LPS compared to the control although not significant. Whereas, All LPS-treated RAW 264.7 cells tended to increase but not significantly compared to the control groups. This study showed that the LPS treatment effectively induced inflammation in RAW 264.7 cells as shown by NO production and was considerably safe as the viability was comparable between LPS and control group for RAW cells 264.7 at least up to 10µg/mL for 24 hours.
Effectiveness of Earthworm Extract on the Lipid Profile of Diabetic Wistar Rats Suandy, Suandy; Chiuman, Linda; Halim, Angel Jonathane
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.3

Abstract

Various metabolic diseases, such as diabetes mellitus, are characterized by hyperglycemia, stemming from decreased insulin action, secretion, or both. The use of chemical medicines for diabetes mellitus, especially acarbose, involves regulating the digestion and absorption of complex carbohydrates. However, acarbose may disrupt liver function, prompting exploration into alternative sources for treatment, such as earthworm extract. The purpose of this study was to identify the effectiveness of ethanol extract and coelomic fluid from earthworms (E. eugeniae) on the lipid profile of male diabetic wistar rats (R. norvegicus) in vivo. The research hypothesis is that earthworm extracts could effectively lower the lipid profile of diabetic Wistar rats. This research is experimental research with pre-test and post-test control study group design, using an in vivo method. The results of the one-way ANOVA test of HDL were p=0.441; p=0.441; p=0.000; for LDL were p=0.691; p=0.101; p=0.049; for total cholesterol were p=0.107; p=0.347; p=0.486; and for triglycerides were p=0.028; p=0.926; p=0.553 on days 0, 7, and 14, respectively. Based on the research data, both ethanol extract and a combination of ethanol extract and coelomic fluid were able to reduce lipid profile levels on the 7th and 14th days. Earthworm extract has the potential to promote repair of β cells and is anti-inflammatory which can be used to reduce lipid profile levels.
Correlation of Wellness Program Against Degenerative Indicators Through Experimental Pre-Posttest Suandy, Suandy; Susianto, Susianto; Handoko, Erwin; Luwis, Kevin; Sanoesi, Vindelin
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.4

Abstract

The incidence of degenerative diseases, such as hyperuricemia, hypercholesterolemia, obesity, hypertension, and diabetes mellitus, is increasing, primarily due to unhealthy lifestyles. Holistic treatment, involving pharmacology and lifestyle modification, is recommended. The Wellness program, covering diet, exercise, and relaxation techniques like meditation and yoga offers a holistic approach to reduce the incidence of degenerative diseases. Adopting a Wellness program could have positive outcomes, including cost-effectiveness, nutritional balance, and improvements in both physical (through yoga) and mental (through meditation) well-being, but the potential downsides include lack of control groups, inadequate consideration of age and gender, insufficient sample sizes, limited observation days, and an excessive number of measured parameters. This study aims to see the effectiveness and influence of the Wellness program on reducing uric acid levels, cholesterol, blood sugar levels, systolic and diastolic blodd pressure. The intervention is designed for women aged 30-60 who experience rage. However, individuals who are consuming medications or supplements, pregnant, breastfeeding, or not following a prescribed diet are excluded. This study used the quasi-experimental pre-posttest design to see the Wellness program’s effectiveness on uric acid, blood pressure, blood sugar levels, and total cholesterol. Sample size calculation was performed using G*Power version 3.1.9.7, and data analysis utilized the T-paired sampled test. The findings from a 3-day study involving 47 participants revealed significant differences post-implementation of the Wellness program, indicating a reduction in uric acid levels and an increase in blood sugar levels with a p-value<0.05.
The Study of Congestive Heart Failure as a Risk Factor of Cardiac Arrest in ICU Pramono, Ardi; Hernawan, Andhika Rajendra
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.7

Abstract

Cardiovascular disease, especially congestive heart failure, is the second most common cause of death after stroke In Indonesia, current data on cardiac arrest in the ICU, especially those related to CHF, are still limited. This study aimed to determine the relationship between congestive heart failure and cardiac arrest in Intensive Care Unit (ICU) inpatients. The study used an analytic observational method with a cross-sectional research design. To find the relationship between the two variables, a regression test was performed on subjects with congestive heart failure and cardiac arrest in the ICU. Data was collected from 316 subjects, including 111 Congestive Heart Failure (CHF) subjects and 205 without CHF. Of the 111 CHF subjects, 51 subjects (45.9%) experienced cardiac arrest, and 60 subjects (54.1%) did not experience cardiac arrest. In comparison, the 205 subjects without CHF comprised 125 subjects (61.0%) who experienced cardiac arrest, and 80 subjects (39.0%) did not experience cardiac arrest. There is a relationship between congestive heart failure (CHF) and cardiac arrest, but CHF is not the only risk factor for cardiac arrest (p<0.05; OR 0.75). Congestive heart failure is associated with cardiac arrest in ICU patients with a relative risk of 0.75 times compared to subjects without congestive heart failure. Future research is needed to find the cause of congestive heart failure leading to cardiac arrest.

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