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Folia Medica Indonesiana The Unit of Journal Consortium and Folia Medica Indonesiana Faculty of Medicine, Universitas Airlangga Jl. Prof. Dr. Moestopo No.47, Pacar Kembang, Kec. Tambaksari, Surabaya, Jawa Timur 60132, Indonesia
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Folia Medica Indonesiana
Published by Universitas Airlangga
ISSN : 23558398     EISSN : 2599056X     DOI : https://doi.org/10.65346/2958-4515.2401
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience
Folia Medica Indonesiana, as indicated by its name, focuses on publishing good quality articles about research and education on health science and medicine in Indonesia. However, due to the fast growth of science and knowledge in these fields, we also welcome submitted articles from around the world, especially the ones that contain related matters from lower-middle income countries. Folia Medica Indonesiana is an open-access, peer-reviewed journal that is published online at least four times a year. The scope covers various aspects of basic medical sciences includes anatomy, physiology, pathology, microbiology, pharmacology, and molecular medicine) and clinical medicine (covers specialties like internal medicine, surgery, pediatrics, oncology, psychiatry, etc). We highlight the pathology and potential treatment of metabolic syndromes and infectious diseases. Folia Medica Indonesiana also encourages the publication of articles about health education. The scope includes, but is not limited to, articles that emphasize on preventive education on certain diseases in a community, also research report of various materials and/or methods to develop medical education. We recognize the importance of this type of articles to be published alongside the assigned topic in each of our yearly issues, to provide our readers with updated information in medical sciences’ research and education simultaneously.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 571 Documents
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Effect of Short-Term Extra Maltodextrin during a Diet Break on the Resistance Training Performance of Rattus norvegicus Indiarto, Muhammad Irfan; Irwadi, Irfiansyah; Lukitasari, Lina; , Atika
Folia Medica Indonesiana Vol. 59, No. 4
Publisher : Folia Medica Indonesiana

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Abstract

Highlights: 1. The ongoing advancement of dietary research has significant importance in the exploration of strategies to optimize the impact of nutrition on performance during resistance training. 2. This study provides a prompt for future research to explore the effectiveness of incorporating an additional dietary strategy that may enhance resistance training performance. Abstract: Poor diet with a purpose to lose a certain body weight or body fat can impair muscle protein synthesis. This results in muscle loss and poor performance in physical training, particularly resistance training. This study aimed to determine the short-term effect of extra carbohydrates, specifically in the form of maltodextrin, during a diet break on the resistance training performanced by rats. This study was an experimental laboratory study with a randomized posttest-only control group design. Twenty-seven male rats, aged 3 months with a weight range of 140–165 g, were randomly and equally assigned into three groups: KN (standard diet), KP (75% calorie intake), and K1 (65% calorie intake with a diet break and extra maltodextrin every week). These diets were administered for four weeks, during which the rats had ad libitum feeding. Additionally, the rats underwent ladder-climbing training three times a week. The body weight was measured pre- and post-treatment, while the performance in resistance training was evaluated post-intervention using a ladder climbing platform. There was no significant difference in the weight before and after treatment, with p>0.05 for the increments (∆) among KN (14.00±9.89 g), KP (13±9.5 g), and K1 (20.89±14.77 g). According to the posttest assessment results, only 17 out of 27 rats succeeded in the maximum weightlifting test. This study showed that a short-term high-carbohydrate diet break does not improve the resistance training performance of rats. Further research is necessary to ascertain the outcomes of the treatment implemented over an extended period of time.
Bacterial Profiles and Antibiotic Resistance in Chronic Obstructive Pulmonary Disease Patients with Exacerbation and Type 2 Respiratory Failure at Adam Malik General Hospital Annisa, Lia Mutia; Syarani, Fajrinur; Pradana, Andika; Mutiara, Erna
Folia Medica Indonesiana Vol. 60, No. 3
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Highlights: 1. This study provides a comprehensive analysis of various factors such as age, sex, education, occupation, BMI, and comorbidities, and their relationship with bacterial infections in COPD patients experiencing exacerbation and type 2 respiratory failure. 2. While the COPD patients experiencing exacerbation did not exhibit resistance to linezolid and vancomycin, they demonstrated specific antibiotic resistance patterns characterized by high resistance rates to commonly used antibiotics such as meropenem and amikacin. 3. The findings enhance the understanding of the complex interplay of factors influencing infection patterns in this patient population. Abstract Chronic obstructive pulmonary disease (COPD) is a prevalent condition characterized by persistent respiratory symptoms and airflow limitation. Bacterial infections may trigger COPD exacerbations, leading to more severe symptoms as well as increased morbidity and mortality rates. This study aimed to investigate the bacterial profiles and antibiotic resistance in COPD patients who had experienced exacerbation and type 2 respiratory failure at Adam Malik Central General Hospital, Medan, Indonesia. This retrospective study utilized medical records spanning from January 1, 2020, to December 1, 2022. The sample included patients aged 40–90 years who had experienced COPD exacerbation and type 2 respiratory failure. The exclusion criteria were patients who had received antibiotic therapy within 48 hours before admission, were severely immunocompromised, and had severe malignancy. The analysis results were presented in the form of means, standard deviations, and frequency distributions. Additionally, an analysis of the relationship between the categorical variables was performed using the Chi-squared test (p<0.05). The study analyzed 25 subjects with an average age of 63.6 years, primarily consisting of men (84%). It was shown that severe exacerbations were prevalent (92%), accompanied by the presence of common comorbidities including pneumonia (52%), diabetes mellitus (32%), and other non-communicable diseases (44%). Bacterial growth was observed in 76% of the subjects, predominantly involving Gram-negative bacteria (89.4%). Klebsiella pneumoniae (26.3%) and Pseudomonas aeruginosa (21.1%) were the most frequently isolated species. The antibiotic resistance patterns indicated that meropenem and amikacin had the highest resistance rates (100%). Cefepime, ertapenem, and gentamicin exhibited notable resistance rates of 66.7%, 66.7%, and 75.0%, respectively. This study highlights the high prevalence of Gram-negative bacteria and significant antibiotic resistance in COPD patients who exhibit exacerbation and type 2 respiratory failure.
Prognostic Nutritional Index with Wound Complication After Laparotomy in Colorectal Cancer Patients at Dr. Zainoel Abidin General Hospital Banda Aceh Hadi, Amirul; Yusuf, Muhammad; Naufal, Iflan; Hidayat, Imam
Folia Medica Indonesiana Vol. 60, No. 4
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Abstract

Colorectal cancer patients generally undergo laparotomy as part of the management. The earliest complications of laparotomy are bleeding, surgical wound infection, and anastomotic dehiscence. Albumin-lymphocytes are indicators of nutritional status and inflammation combined in the Prognostic Nutritional Index (PNI). Evaluation of PNI related to the degree of post-laparotomy wounds in colorectal cancer has not been widely explained. Objective: to find out the correlation of PNI for laparotomy wound complications in colorectal cancer patients at Dr. Zainoel Abidin General Hospital Banda Aceh. Method: A cross-sectional study will assess the correlation of PNI to the degree of post-operative wounds with the South Hampton Wound Scale. PNI values were determined by albumin and lymphocytes. The subjects were colorectal cancer patients, aged 18 years and underwent laparotomy. The assessment was carried out on the 7th day after laparotomy. The Spearman test was performed to determine the correlation. Results: 30 colorectal cancer patients as samples, with an average age of 49.43 years old (±11.06), male (56.7%), moderately differentiated adenocarcinoma (46.7%), average albumin 3.08 (±0.47) and lymphocytes 13.93 (±8.22). After evaluation, we found that patients with normal PNI values had South Hampton grade 1 (23.3%), while mild malnutrition was in grade 1 (6.7%) and 2 (6.7%), moderate malnutrition was in grade 3 (23.3%) and grade 4 (16.7%) and severe malnutrition were in grade 4 (16.7%) and grade 5 (13.3%). Conclusion: There was a very strong correlation between PNI and postoperative wound complications in colorectal cancer.
Centella asiatica Nanoparticles as Potential Acetylcholinesterase Inhibitor for Cognitive Decline Therapy using Ellman's Method: An in Vitro Study Nathania, Nathania; Kusumaningrum, Selvina Cindy; I'tishom, Reny; Kumalasari, Feranita; Margiana, Ria
Folia Medica Indonesiana Vol. 60, No. 4
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Highlights: 1. This research contributes novel data to current studies by combining the potential of Centella asiatica extract with PEG-400 to develop a therapeutic agent aimed at improving cognitive function through an effective drug delivery system capable of penetrating the blood-brain barrier. 2. The findings of this study revealed that the combination of Centella asiatica extract and PEG-400 at an adequate ratio exhibits great potential as an acetylcholinesterase inhibitor. Abstract Cognitive impairment, caused by neurocognitive changes and neuroinflammation, affects 65.6 million elderly people worldwide and can interfere with their quality of life. Centella asiatica is recognized for its neuroprotective potential due to its active compounds. This study aimed to investigate the acetylcholinesterase inhibitory properties of Centella asiatica as potential therapeutic agents for cognitive decline. Polyethylene glycol 400 (PEG-400) was used to achieve an effective drug delivery system of Centella asiatica extract, facilitating the inhibition of the apoptosis signaling pathway and allowing neuroprotective agents to cross the blood-brain barrier (BBB). This research involved several testing stages, including gas chromatography-mass spectrometry (GC-MS) to identify active compounds (e.g., tryptamine, γ-sitosterol, and β-sitosterol) that contribute to cognitive function improvement. Particle size analysis (PSA) tests were conducted on three formulations of the extract and PEG-400, with ratios of 1:100, 100:1, and 1:1, to determine the optimal formulation for subsequent testing. Scanning electron microscopy (SEM) was utilized to observe the morphology and surface structure of the samples, while Ellman's method was employed to test the ability of acetylcholine (ACh) in improving cognitive abilities. The results subsequently underwent descriptive analysis, particle distribution analysis, analysis of variance (ANOVA), nonparametric tests, image analysis, regression tests, multivariate analysis, and correlation tests. The synthesis demonstrated that the 1:100 formulation produced ideal-sized nanoparticles (5–7 nm), optimal for penetrating the BBB. The PSA and SEM analyses supported this finding by demonstrating homogeneous particle morphology and consistent chemical composition. The in vitro Ellman's assay revealed a high inhibitory rate of 97.63% for the 100:1 formulation. The 1:1 and 1:100 formulations demonstrated a very high effectiveness as acetylcholinesterase inhibitors. The combination of PEG-400 and Centella asiatica extract has great potential as an innovative pharmacological therapy for cognitive decline. However, further research is required to ensure the right dosage and development of the research findings.
The Use of Comics as a Tuberculosis Learning Medium for Junior High School Students Utomo, Budi; Fatmaningrum, Widati; , Sulistiawati; Fauziyah, Shifa; Sucipto, Teguh Hari; Khuen, Chan Chow
Folia Medica Indonesiana Vol. 60, No. 1
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Highlights: 1. Comics centered around tuberculosis offer a novel method tailored for specific audiences, specifically children or those of school age, to learn about the disease. 2. The tuberculosis comics feature the etiology, prevention, and treatment of tuberculosis conveyed through their unique design. 3. Comics can be an innovative promotional method to support the preventive campaign against tuberculosis. Abstract As a tropical country, Indonesia continues to grapple with the prevalence of tuberculosis. This study conducted by the Department of Public Health and Preventive Medicine at Universitas Airlangga, Surabaya, Indonesia, presented a novel approach to prevent tuberculosis through measures tailored to the socio-cultural context of the population. Specifically, this study assessed how effective the use of tuberculosis comics is as an educational tool to inform junior high school students about tuberculosis. This research was quasi-experimental, with a one-group pre-test-post-test design. Seventy junior high school students in Dukun District, Gresik, Indonesia participated in this study. Each participant received a questionnaire consisting of ten questions about tuberculosis. Afterward, tuberculosis education was shared through comics. The post-test was carried out using the same questions as the pre-test. The data were analyzed using the R Program for Windows, version 4.1.3 (Auckland University, New Zealand). The analysis revealed a significant difference between the pre-test and post-test results (p < 0.0001). As indicated by the data, comics proved to be an effective method of educating people about infectious diseases, specifically tuberculosis. Here, we introduce an educational tool designed to revitalize the educational method for disseminating knowledge about infectious diseases. Ultimately, comics can increase students' interest in learning about tuberculosis, including its etiology, prevention, and treatment strategies.
Front Matter Vol.58 No.3 September 2022 , FMI
Folia Medica Indonesiana Vol. 58, No. 3
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front matter
Surgical Site Infection caused by Non-Hemolytic Staphylococcus aureus Following a Total Knee Arthroplasty at a Class C Hospital in Indonesia , Satiyo; Rosa, Elsye Maria
Folia Medica Indonesiana Vol. 59, No. 1
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Highlights: • A patient with grade IV osteoarthritis underwent an arthroplasty and developed a surgical site infection caused by Staphylococcus aureus. • The treatment for the surgical site infection included antibiotic medications and revision surgery for the previous total knee arthroplasty. Abstract: This article presents a case report of a knee arthroplasty surgical site infection caused by non-hemolytic Staphylococcus aureus. A 56-year-old woman came to the Orthopedic Outpatient Clinic, with the chief complaint of pain in the left knee for the last three years. After being diagnosed with grade IV osteoarthritis, the patient underwent a total knee arthroplasty. The patient had routine post-operative follow-ups at the Orthopedic Outpatient Clinic. However, the patient complained of swelling, pain, and discharge at the surgical site after three months. The patient underwent a second surgery for debridement, implant removal, and interspacer placement. A broad-spectrum antibiotic (gentamicin) was administered while waiting for the culture and antibiotic sensitivity test results. The culture results showed non-hemolytic Staphylococcus aureus presence. The antibiotics were then changed and administered for two weeks according to the culture and antibiotic sensitivity test results. As the results were good, the patient was scheduled for revision surgery for her previous total knee arthroplasty.
Combination Therapy for Cryptosporidiosis in Immunocompromised Patients: A Systematic Review Utami, Wiwien Sugih; Rozaq, M.S. Irham; Indreswari, Laksmi; Abrori, Cholis; Hermansyah, Bagus
Folia Medica Indonesiana Vol. 60, No. 4
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Cryptosporidium sp. is a gastroenteritis-causing pathogen that may increase mortality and morbidity in immunocompromised patients. Diarrhea is a common problem among acquired immunodeficiency syndrome (AIDS) patients, with 30–60% of patients in developed countries and 90% in developing countries affected. The prevalence of cryptosporidiosis is 3–5% of the global population, with 14.42% of those affected being immunocompromised. There is currently no vaccine available to prevent cryptosporidiosis, while nitazoxanide monotherapy is ineffective in eradicating the organism in immunocompromised hosts and malnourished children. This study aimed to determine the most effective combination therapy for cryptosporidiosis in immunocompromised patients. This study used a systematic review design and implemented eligibility criteria for the literature search across PubMed, ScienceDirect, Epistemonikos, Google Scholar, Nature, Springer, and John Wiley databases. The search utilized specific keywords and Boolean operators, i.e., “Cryptosporidium,” OR “cryptosporidiosis,” AND “combination therapy,” OR “combination treatment,” AND “immunocompromised.” Two cohort studies and two case reports were selected, three of which used a nitazoxanide and azithromycin combination as the intervention, whereas only one cohort study used a nitazoxanide and fluoroquinolone combination. The studies comprised 54 samples from post-kidney transplantation patients and one sample from an acute lymphoblastic leukemia (ALL) patient. The nitazoxanide and fluoroquinolone combination showed superior outcomes than the nitazoxanide and azithromycin combination. The stool clearance was significantly lower with nitazoxanide monotherapy than the nitazoxanide and fluoroquinolone combination (OR=0.65, 95% CI=0.34–0.92, p=0.01). However, it was non-significantly lower with the nitazoxanide and azithromycin combination compared to monotherapy (OR=0.27, 95% CI=0.01–5.77, p=0.24). Nitazoxanide monotherapy exerted a significantly lower effect than the nitazoxanide and fluoroquinolone combination in stopping diarrhea symptoms (OR=0.45, 95% CI=0.21–0.81, p=0.004). In conclusion, a combination therapy using nitazoxanide and fluoroquinolone for cryptosporidiosis in immunocompromised patients offers more favorable outcomes compared to monotherapy, particularly in stopping diarrhea and enhancing stool clearance.
Effect of L-Citrulline on Creatine Kinase MM (CK-MM) Isoenzymes in Mice: An In Vivo Study Focusing on Immunohistochemistry Analysis Ghozali, Dhoni Akbar; Rahma, Annisa Aghnia; Hanifa, Shafira Nur; Ilyas, Muhana Fawwazy
Folia Medica Indonesiana Vol. 60, No. 3
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Highlights: 1. This study elucidates the effect of L-citrulline supplementation on creatine kinase MM (CK-MM) expression post-eccentric exercise, offering novel insights into its potential role in mitigating muscle damage. 2. The findings demonstrate that L-citrulline administration significantly reduces CK-MM expression levels in skeletal muscle tissue, suggesting its therapeutic potential in enhancing muscle recovery and performance following exercise-induced damage. 3. This study contributes valuable insights into the multifaceted benefits of L-citrulline supplementation for supporting overall muscle health and performance by identifying its protective effects under different mechanisms, including improved blood flow, antioxidant activity, enhanced mitochondrial function, and promotion of muscle protein synthesis.   Abstract Eccentric exercise often induces muscle injuries in athletes, resulting in impaired performance and prolonged recovery time. Creatine kinase MM (CK-MM) is a biomarker for assessing muscle damage, with elevated levels indicating injury. L-citrulline, an amino acid, has shown promise in enhancing performance and reducing recovery time. However, its specific effect on CK-MM remains unclear. This study utilized immunohistochemistry analysis to investigate the effect of L-citrulline supplementation on CK-MM expression post-eccentric exercise in male BALB/c mice. This in vivo study was conducted with a post-test-only design. A total of 25 mice were divided into two control groups (normal/C1 and negative/C2) and three treatment groups (T1, T2, and T3), each containing five mice. The T1, T2, and T3 groups were daily administered 250, 500, and 1,000 mg/kg bw of L-citrulline for seven days, respectively. All mice, except the C1 group, performed a downhill running procedure. The CK-MM expression in skeletal muscle tissue post-eccentric exercise was assessed using immunohistochemistry analysis. The statistical analysis included the Shapiro-Wilk test for data distribution and the Kruskal-Wallis and Mann-Whitney post-hoc tests for significant differences (p<0.05). The results showed that CK-MM expression in the C2 group (91.00±2.24%) was significantly higher (p=0.008) than that of the C1 group (70.00±10.0%). Subsequently, the T1 (68.00±9.08%, p=0.008), T2 (72.00±7.58%, p=0.008), and T3 (67.00±9.75%, p=0.008) groups exhibited significantly lower expressions than the C2 group. These results were consistent with the role of CK-MM as a marker for muscle damage, and they indicated that L-citrulline might have a protective effect against muscle damage post-eccentric exercise. However, no significant differences were observed among the C1, T1, T2, and T3 groups. In conclusion, L-citrulline supplementation demonstrates promise in attenuating muscle damage following eccentric exercise, as evidenced by reduced CK-MM expression levels. These findings highlight the potential therapeutic role of L-citrulline in enhancing muscle recovery and performance.
Clinical Profiles and Il-6 Level Analysis of Critical Covid-19 Patients Receiving Lopinavir-Ritonavir Triyono, Erwin Astha; Rehatta, Nancy Margarita; , Nabilah; Tan, Feriawan
Folia Medica Indonesiana Vol. 59, No. 2
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Highlights: 1. Lymphocyte, procalcitonin, D-dimer and high IL-6 levels in COVID-19 patients are associated with a poor prognosis. 2. IL-6 serial measurement for COVID-19 patients may be a potential indicator for evaluating the severity and patient outcome. Abstract The COVID-19 pandemic has affected over 760 million individuals worldwide, resulting in more than 6.8 million reported deaths. Early detection of patient deterioration can assist in predicting outcomes and prioritizing healthcare services based on evidence-based indicators. Interleukin-6 (IL-6) is a cytokine that plays a role in the inflammatory process, making it a potential parameter for assessing a patient's inflammatory state. This study aimed to analyze the characteristics, laboratory profiles, and IL-6 levels of COVID-19 patients. This study used a retrospective cohort study design with medical record data. The characteristics (n=68) and IL-6 levels (n=52) of the patients on the first, third, and sixth days of treatment were recorded consecutively. The mean age of the patients was 49 years, with the majority being male (72%) and the most prevalent comorbidity being hypertension (29%). The average duration of hospitalization was 10.94 days. Shortness of breath was the most commonly reported symptom (45.6%). The medians of neutrophil-lymphocyte ratio, C-reactive protein, procalcitonin, ferritin, and D-dimer were above normal. Significant differences were observed in lymphocytes (p=0.046), procalcitonin (p=0.023), and D-dimer (p=0.000) between survivor and non-survivor patients. Significant dynamic changes in IL-6 levels were observed from the first day to the sixth day (p=0.014) and from the third day to the sixth day (p=0.041). In conclusion, risk stratification, laboratory profiles, and IL-6 levels play a role in assessing the severity and outcomes of COVID-19 patients.

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