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Majalah Kedokteran Bandung
Published by Universitas Padjadjaran
ISSN : 0126074X     EISSN : 23386223     DOI : 10.15395/mkb
Core Subject : Health,
Medicine & Pharmacology
Majalah Kedokteran Bandung (MKB)/Bandung Medical Journal publishes peer-reviewed original articles and case reports in basic medical research, clinical research, and applied medical science. This journal is published quarterly (March, June, September, and December) by Faculty of Medicine Universitas Padjadjaran. Articles are original research that needs to be disseminated and written in English. All submitted manuscripts will go through the double-blind peer review and editorial review before being granted with acceptance for publication.
Arjuna Subject : -
Articles 651 Documents
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Impact of Covid-19 Pandemics on Urology Practices and Residency Training in an Indonesian Tertiary Hospital Kusumajaya, Christopher; Tjahjodjati, Tjahjodjati
Majalah Kedokteran Bandung Vol 56, No 1 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.2657

Abstract

The World Health Organization (WHO) declared Covid-19 as a global pandemic on March 11, 2020. Alterations in health service provisions must be applied to maintain prime services and decrease the number of healthcare workers exposure to Covid-19 by reducing the number of patients and workload, as well as cancelling elective surgeries. This study aimed to describe the urological services and residency training program during a Covid-19 year at Dr. Hasan Sadikin General Hospital, Bandung, which is a tertiary health center and teaching hospital in Indonesia. This was a comparative retrospective study conducted from January 2019 to December 2020 that compared the number of patients in inpatient and outpatient settings and emergency department, as well as surgical procedures performed before and during Covid-19 pandemic. Data were obtained from the administration department of the hospital, showing a reduction of 40,94%, 7.39%, 32.3%, and 53.89% of total inpatients, outpatients, emergency cases, and surgical procedures, respectively, in the urology department of the hospital when compared to the previous year. The number of surgeries that could be performed by residents was reduced by 30-60%. This current study showed the decreased number of patients and urological operative procedures during COVID-19 pandemic. This is assumed to give negative impacts to the urological residency training due to the limited exposure to variety of cases and surgical skill procedures.
Front Cover, Editorial Team, Table of Contents, and Back Cover Back, Front
Majalah Kedokteran Bandung Vol 55, No 3 (2023)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Effect of Hypervirulent Strains, Antibiotic Resistance, and Host Characteristics on Mortality of Klebsiella pneumoniae Bacteremia Patients at a Tertiary Referral Hospital in Denpasar, Indonesia Adhy Candra, I Kadek Bayu; Suranadi, I Wayan; Darwinata, Agus Eka; Tarini, Ni Made Adi; Dharmika, Ida Ayu Gde Wahyudevi; Fatmawati, Ni Nengah Dwi
Majalah Kedokteran Bandung Vol 55, No 4 (2023)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v55n4.3297

Abstract

Klebsiella pneumoniae bacteremia is one of the leading causes of sepsis that has a high mortality rate. The effect of multidrug resistance and different virulence of Klebsiella pneumoniae on mortality is still controversial. This study aimed to determine the impact of hypervirulent K. pneumoniae (hvKp), MDR, and clinical characteristics on mortality of K. pneumoniae bacteremia patients. A retrospective cross-sectional study was conducted on  K.  pneumoniae bacteremia cases of patients hospitalized at Professor dr. I.G.N.G Ngoerah General Hospital from December 1, 2020, to May 31, 2021. A positive PCR of rmpA, iucA genes, and/or a positive string test was identified as hvKp. The mortality rate of 51 K. pneumoniae bacteremia patients samples (aged 0-74 years) was 72.5%, in which 9.8% (5/51) of them were hvKp and 51% of the isolates (26/51) produced the Extended Spectrum Beta Lactamase (ESBL). Furthermore, 9.8% (5/51) of the cases were carbapenem-resistant. Thus, hvKp, MDR, gender characteristics, and comorbidities do not significantly affect the mortality of K. pneumoniae bacteremia patients. Multivariate logistic regression analysis showed that sepsis (odds ratio (OR) 4.29; p=0.038) and adult age group (mean 50 years) (OR 3.75; p=0.039) are independent predictors with a significant effect on mortality of  K. pneumoniae bacteremia patients. Careful and integrated management of K. pneumoniae bacteremia patients is essential for better outcomes, especially in sepsis and elderly patients. Although hvKp prevalence is low, emerging MDR-hvKp in health facilities is a severe concern for further actions and research.
Histopathological Aspects as Predictor of Recurrency of Locally Advanced Breast Cancer Rizki, Kiki Akhmad; Djajakusumah, Teguh Marfen; Agustina, Hasrayati; Hidayat, Peri
Majalah Kedokteran Bandung Vol 56, No 2 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.3193

Abstract

The histopathological aspect of breast cancer has been established as one of the important prognostic factors of recurrence. This study aimed to determine whether histopathological examination can be used as a predictor of the incidence of recurrence in locally advanced breast cancer patients. This was a cohort retrospective observational study with a correlative analytical approach. Subjects of this study were breast cancer patients who have undergone mastectomy and/or received additional therapy at Dr. Hasan Sadikin General Hospital Bandung, Indonesia, between January 2017 and September 2019. Data were collected through medical records and anatomical histopathology data. Subjects were divided based on their recurrency status. A total of 62 breast cancer patients were included in the study with 31 recurrent patients and 31 non-recurrent patients. A total of 29 patients in the recurrent group (93.5%) had lymphovascular invasion. Histopathology grading showed a difference in both groups, in which recurrent group patients were mostly (74.2%) in the high histopathological grade while 51.6% of samples in non-recurrent group were categorized as moderate histopathological grade. Complete histopathological margins were found in both recurrent and non-recurrent groups for 54.8% and 87.1% respectively. There is a correlation between histopathologic grading, lymphovascular invasion, and incision margin with the recurrence of a locally advanced stage breast cancer. It can be concluded that some histopathological aspects can be used as a predictor of recurrence in locally advanced breast cancer.
Predictive Factors of Amputation for Post-Bypass Surgery on Vascular Trauma Patients Kusworo, Afila Reza; Soebroto, Heroe; Suroto, Heri
Majalah Kedokteran Bandung Vol 56, No 1 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.3107

Abstract

n Indonesia, most vascular trauma is linked to traffic collisions. According to the Statistics Indonesia (Badan Pusat Statistik, BPS), there were 116,411 accidents in 2019. Limb salvages become important in  vascular trauma, which is performed through, among others, vascular bypass surgery. However, secondary amputation still occurs after vascular bypass. This study aimed to determine the predictors of secondary amputation after vascular bypass due to vascular trauma. This study used descriptive analysis of medical records and univariate analysis. Medical records of patients with vascular trauma underwent vascular bypass in Dr Soetomo Regional Hospital, Indonesia, from January 2018 to December 2020 were collected. Independent variables were age, MESS, time interval between the incident of trauma to the first incision of bypass surgery, penetrating and blunt injury, injured arterial segment, multiple injuries, and obesity. The dependent variable was secondary amputation. Fisher Exact Test was used to analyze the correlation between dependent and independent variables. Results showed a significant difference between patients with a MESS score of >7 and those with a MESS score of  ≤7 (p=0.044), where more patients with a MESS score of >7 experienced secondary amputation. Other variables showed no significant difference (p>0.05). This study concluded that MESS could be used as a predictor of secondary amputation in vascular trauma after vascular bypass. Further studies using multivariate analysis and a larger sample need to be conducted to get further insights on this phenomenon.
Accuracy of Kampala Trauma Score as a Predictor in Assessing the Prognostic Value of Multiple Trauma Usman, Nurhayat; Ruchimat, Tommy; Rahmawan, Andhika
Majalah Kedokteran Bandung Vol 55, No 4 (2023)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v55n4.3080

Abstract

Determining a trauma scoring system appropriate for certain conditions will help in predicting mortality and morbidity, and can determine the need for treatment in patients. Kampala Trauma Score (KTS) is a trauma scoring system that uses a decent number of assessment variables and can be used in all general groups. This study was a retrospective prognostic test conducted in Dr. Hasan Sadikin Hospital Bandung, Indonesia, from December 2021 to July 2022. Data obtained was processed using Microsoft Excel and SPSS spreadsheets. The respondents were 66 people with multiple trauma. Results showed that this study was dominated by patients with blunt trauma  (n=63, 95.45%). The mean KTS score in this study was 13.08±1.03. In 49 (74.24%) patients who survived, the mean KTS score was 13.41±0.89 and in 17 (25.76%) patients who died, the mean KTS score was 12.12±0.79. The greatest mortality accuracy was at the cutoff point of the KTS score >12 (81.82% accuracy; 70.59% sensitivity; 85.71% specificity). The accuracy value of the KTS score is in line with the ROC where the optimal KTS score is >12 (85.77%). In conclusion, the Kampala trauma score can be used as a predictor in assessing the prognostic value of multiple trauma patients with the obtained cut-point value as it has high accuracy, sensitivity, and specificity values.
Effects of Yacon Leaf Extract on MCP-1 and IL-10 Expressions and Macrophage Phenotypes in CKD Mouse Model Sofyana, Meida; Wasityastuti, Widya; Ihsana, Nuni; Purwono, Setyo; Arfian, Nur
Majalah Kedokteran Bandung Vol 56, No 2 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.3605

Abstract

Macrophages are essential in tissue homeostasis and immunity, but also contribute to disease development and progression. Chronic kidney disease (CKD) is characterized by interstitial infiltration of macrophages, the density of which correlates inversely with kidney survival. Studies have shown that yacon (Smallanthus sonchifolius) has beneficial effects on CKD. Therefore, this study aimed to investigate the effects of yacon leaf extract on mice with subtotal nephrectomy by evaluating the M1 and M2 macrophage counts and mRNA expressions of monocyte chemoattractant protein-1 (MCP-1 and IL-10. The mice were randomly divided into five groups: SO (negative control: underwent sham operation), SN (positive control: underwent subtotal nephrectomy), and yacon-treated groups: YK1, YK2, and YK3 (underwent subtotal nephrectomy, given peroral yacon leaf extract for 14 days with doses of 24,5 mg/kgBW/day, 49 mg/kgBW/day, and 98 mg/kgBW/day, respectively). The macrophage subtypes were assessed using immunohistochemistry anti-CD68 for M1 and anti-Arginase I for M2. MCP-1 and IL-10 mRNA expressions were analyzed using semi-quantitative PCR. Results showed that yacon leaf extract could significantly lower the M2 macrophage count (p<0.001) and the mRNA expressions of MCP-1 and IL-10 in all yacon-treated groups when compared to the SN group. However, the M1 macrophage count was only lower in the YK2 group (p=0.009). In conclusion, the administration of yacon leaf extract could attenuate kidney injury by lowering the macrophage count and the expression of MCP-1 and IL-10.
Lactic Acid Level as A Predictor of Severity in Patients with Acute Appendicitis Aditya, Raka; Rudiman, Reno; Hapsari, Putie
Majalah Kedokteran Bandung Vol 56, No 1 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.3086

Abstract

Perforated appendicitis is the leading cause of morbidity and mortality of all appendicitis cases in adults and children, with delayed preoperative diagnosis as the main reason. In previous studies, diagnostic modalities such as radiological examination and the current scoring system have been demonstrated as unable to predict the onset of perforated appendicitis. Serological biomarkers of lactic acid are associated with intestinal obstruction and ischemia. The serological value of lactic acid in identifying perforated appendicitis compared to acute one was shown to increase significantly by 0.25 mmol/L (p<0.05) in a previous study. This study aimed to determine the correlation between lactic acid and the severity of appendicitis. This was a cross-sectional prospective analytic observational study in patients treated in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Subjects were adult patients diagnosed with appendicitis during the period of 2021 in the Emergency Room of the hospital. Data were analyzed using the bivariate analysis and correlation test of difference. This study involved 54 subjects, divided into the complicated appendicitis (study) and control groups, with a mean of lactic acid level of 2,5093 mmol/L (0.9 mmol/L–11.8 mmol/L). In the complicated appendicitis group, 20 subjects (37%) demonstrated an increase in lactic acid level (OR 1.07; 95% CI: -0.03–0.22; p=0.14). The correlation analysis resulted in a negative correlation. This study concluded that there is no significant correlation between lactic acid levels and the severity of appendicitis in these patients.
Front Cover, Editorial Team, Table of Contents, and Back Cover Back, Front
Majalah Kedokteran Bandung Vol 55, No 4 (2023)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Etiology and Antifungal Sensitivity Test in Otomycosis Caused by Candida Sp Darmawan, Anton Budhi; Krisniawati, Nia; Widhi, Anriani Puspita Karunia Ning; Hestiyani, Rani Afifah Nur; Kurniawan, Dhadhang Wahyu; Darmayan, Bella Jovita
Majalah Kedokteran Bandung Vol 55, No 4 (2023)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v55n4.3337

Abstract

Otomycosis is a common fungal infection of the external auditory meatus frequently diagnosed in otolaryngology outpatient clinics. Resistance to antifungals is currently a significant concern, with intrinsic and acquired resistance increasing among isolates that cause fungal infections. The purpose of this research was to identify Candida species causing otomycosis and determine the pattern of antifungal susceptibility among these Candida species. A prospective study was conducted in the Margono Soekarjo General Hospital and Department of Microbiology, Faculty of Medicine, Universitas Jenderal Soedirman Purwokerto, Indonesia, from April – September 2022. Forty-seven (47) clinical samples of otomycosis were collected from 41 patients and then isolated bedside on fungal culture media and was prepared on an object glass for direct microscopic examination of the specimens. Fungal identification was performed using 10% potassium hydroxide (KOH) to observe fungal elements. Samples were cultured on Saboraud dextrose agar (SDA) media with chloramphenicol and Czapek dox agar. The Germ Tube Test was used to identify Candida while yeast-specific identification and antifungal susceptibility assay using a rapid commercial kit was applied for specific identification of the fungus. Antifungal susceptibility patterns were obtained using the Integral System Yeast Plus (ISYP) media pack. Candida parapsilosis was the most prevalent Candida species discovered in this study, accounting for approximately 41.66%, which was followed by Candida tropicalis (25%) and Candida krusei (12.5%), whereas Candida albicans only accounted for 4.1% of the specimens. All Candida species were sensitive to flucitosine and ketoconazole, whereas the voriconazole sensitivity rate reached 96%.  This study concludes that Candida parapsilosis is the most prevalent species of Candida in otomycosis, and that all Candida species are sensitive to Flucitosine, ketoconazole, and voriconazole.

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