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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 822 Documents
 79   80   81   82   83 
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.
Thromboelastography Profile of Covid-19 Patients Before and After Convalescent Plasma Therapy Administration Fatonah, Siti; Xaveria, Xaveria; Hartanti, Khoirunisah Dwi; Purnamasari, Putri; Ningtyas, Denina Setya; Ramadhani, Saskia
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.2024.033.02.11

Abstract

In Covid-19 patients, coagulopathy disorder is commonly characterized as hypercoagulable, although hemorrhagic complications can arise. However, thromboelastography (TEG) is an examination tool with the ability to assess the complete hemostasis process, including primary, secondary, and fibrinolysis stages, closely resembling the in vivo coagulation process. Therefore, this study provides a descriptive analysis of the hemostatic state of Covid-19 patients before and after administration of convalescent plasma therapy using TEG. In this study, the blood sample was collected from 21 Covid-19 patients at RSSA Malang from June to November 2020, followed by a TEG examination, which was performed on the first day of admission and after convalescent plasma therapy administration. The results were analyzed descriptively. Before convalescent plasma therapy, coagulation index (CI) analysis of TEG results in 21 patients showed that 62% exhibited normocoagulability, 23.8% were hypercoagulable, and 14.2% used hypercoagulability. While TEG results after convalescent plasma therapy showed that 71.4% were normocoagulable, 4.7% hypocoagulable, and 23.9% hypercoagulable. Based on TEG parameters, R, K, and MA, before administration of convalescent plasma therapy showed decreased platelet function by 38%, primary fibrinolysis by 5%, secondary fibrinolysis by 10%, platelet hypercoagulability 5%, and 43% was normal. Coagulopathy profile after convalescent plasma therapy showed decreased platelet function by 24%, secondary fibrinolysis by 10%, platelet hypercoagulability by 10%, enzymatic hypercoagulability by 5%, enzymatic and platelet hypercoagulability by 5%, and 48% was normal. TEG in Covid-19 patients showed a hypercoagulable state before and after administration of convalescent plasma therapy
Congenital Orbital Teratoma of the Newborn: A Rare Case Report Yuliawati, Putu; Wetarini, Krisnhaliani; Sutyawan, I Wayan Eka; Surasmiati, Ni Made Ayu; Utari, Ni Made Laksmi; Sunariasih, Ni Nyoman
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.2024.033.02.19

Abstract

Congenital orbital teratoma is a rare and complex congenital anomaly due to abnormal tissue growth within the orbit. This case report aims to highlight the significance of early prenatal screening in identifying congenital orbital teratoma and its potential complications. A 6-day-old male newborn presented with macrocephaly and a unilateral massive protrusion of the left eye. Prenatal ultrasonography performed at 36 weeks gestation showed a suspicion of fetal craniofacial mass. Further brain CT scan revealed an orbital heterogeneous mass, with calcified components dominantly in the anterior and middle cranial fossa into the left orbit, which was subsequently diagnosed as congenital orbital teratoma associated with non-communicating hydrocephalus. This finding prompted an urgent ventriculoperitoneal (VP) shunt. Unfortunately, despite prompt intervention, the patient passed away after the procedure. Pathological examination was compatible with an immature teratoma. Multidisciplinary management is warranted to improve diagnostic screening and refine management strategies for better outcomes in such cases.
Identification of Gram Negative Bacteria in the Urine of Catheterized Patients at Referral Hospital in Ternate Waraningsih, Septiana; Do Toka, Wahyunita; Dahlan, Muhammad; Rachman, Ismail
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.2024.033.02.5

Abstract

Infections can occur anywhere and often occur usually sourced from hospitals. Nosocomial infection is an infection caused by various microorganisms, one of which is bacteria originating from the hospital environment. Gram-negative bacteria, especially the Enterobacteriaceae family, are the main bacteria that cause nosocomial infections. One of the common infectious diseases in health care is urinary tract infection and some UTIs are caused by catheter insertion. This research aimed to identify gram-negative bacteria in the urine of catheterized patients at RSUD Dr. H. Chasan Boesoirie, a referral hospital in Ternate. The research method is descriptive observational with a cross sectional approach using a total sampling technique obtained 83 samples from November 14, 2023 to December 17, 2023. The results showed that 7 samples (8.4%) were identified as positive for gram-negative bacteria with 7 types of bacterial species and the highest percentage of bacteria was Escherichia coli (33.4%). The use of urinary catheters was mostly female (55.4%) with the highest age in the age group 56-65 years (34.9%) and the duration of urinary catheter use was mostly in samples with a duration of <72 hours (90.4%). In conclusion, gram-negative bacteria were identified in the urine of catheterized patients.
Left Lobe Hepatocellular Carcinoma in Non-Alcoholic Fatty Liver Disease Patient: A Case Report Inayah, Ninda Nurul; Astariyani, Thaibah; Batubara, Raya Henri; Nikita, Ester Grace; Irwan, Khair El Nisa; Putri, Kirei Aulia; Handayani, Lisa; Palambang, Sira Sappa
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.2024.033.02.20

Abstract

Hepatocellular Carcinoma (HCC) is the second most common cause of death from cancer worldwide, affecting more men than women with a ratio of 2:1. Approximately 70–90% of HCC patients have risk factors such as chronic liver disease and liver cirrhosis. Another significant risk factor is non-alcoholic fatty liver disease (NAFLD). We report a case of left lobe hepatocellular carcinoma in a 54-year-old woman who presented with heartburn and shortness of breath, with a history of hypertension but no alcohol consumption. Chest X-ray revealed cardiomegaly without pulmonary congestion. A whole abdominal CT scan identified a left lobe hepatic tumor measuring ± 11x12x13 cm. Pathology examination revealed an epithelial mass with infiltrative, trabecular, acinar, and solid arrays, indicative of a malignant liver tumor.

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