Pub Date : 2022-11-09DOI: 10.21776/ub.jkb.2022.032.02.9
R. Husein, B. Daryanto, P. Satyagraha, Pradana Nurhadi
Congenital adrenal hyperplasia (CAH) is the most common cause (60%) of Disorder of Sex Development (DSD), which causes three problems: symptoms and conditions arising due to adrenal endocrine disorders, long-term treatment, and quality of life due to genital ambiguity. An 18-year-old female patient was diagnosed with simple virilizing CAH and had genital ambiguity from birth. The patient was raised as a male. Overall, the examination results indicated a female. Physical examination before surgery showed virilization, such as external genital pigmentation, precocious pubic hair, and bilateral impalpable testis. The karyotype genetic examination confirmed female: 46, XX. Eventually, the patient decided as a female and underwent surgical management consisting of clitoroplasty, labioplasty, and vaginoplasty, followed by long-term corticosteroid therapy. Observations were made for three years after surgery to see the progress of the patient's condition. After undergoing glucocorticoid therapy and surgery, the patient had not experienced menstruation. Her breasts did not enlarge, and mustache and beard were still growing on her face. The patient was concerned about her condition, especially about the risk of infertility and inappropriate physical changes. The management of virilization in CAH with genital ambiguity should be seen from psychological and surgical perspectives. Understanding the disease, the goals of surgery, long-term treatment, and social adaptation help improve quality of life and reduce negative stigma.
{"title":"46 XX Congenital Adrenal Hyperplasia (CAH) after Clitoroplasty, Labioplasty, and Vaginoplasty","authors":"R. Husein, B. Daryanto, P. Satyagraha, Pradana Nurhadi","doi":"10.21776/ub.jkb.2022.032.02.9","DOIUrl":"https://doi.org/10.21776/ub.jkb.2022.032.02.9","url":null,"abstract":"Congenital adrenal hyperplasia (CAH) is the most common cause (60%) of Disorder of Sex Development (DSD), which causes three problems: symptoms and conditions arising due to adrenal endocrine disorders, long-term treatment, and quality of life due to genital ambiguity. An 18-year-old female patient was diagnosed with simple virilizing CAH and had genital ambiguity from birth. The patient was raised as a male. Overall, the examination results indicated a female. Physical examination before surgery showed virilization, such as external genital pigmentation, precocious pubic hair, and bilateral impalpable testis. The karyotype genetic examination confirmed female: 46, XX. Eventually, the patient decided as a female and underwent surgical management consisting of clitoroplasty, labioplasty, and vaginoplasty, followed by long-term corticosteroid therapy. Observations were made for three years after surgery to see the progress of the patient's condition. After undergoing glucocorticoid therapy and surgery, the patient had not experienced menstruation. Her breasts did not enlarge, and mustache and beard were still growing on her face. The patient was concerned about her condition, especially about the risk of infertility and inappropriate physical changes. The management of virilization in CAH with genital ambiguity should be seen from psychological and surgical perspectives. Understanding the disease, the goals of surgery, long-term treatment, and social adaptation help improve quality of life and reduce negative stigma.","PeriodicalId":17705,"journal":{"name":"Jurnal Kedokteran Brawijaya","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80161977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-09DOI: 10.21776/ub.jkb.2022.032.02.6
H. Naim, B. Daryanto, Pradana Nurhadi
Pediatric hydronephrosis is often hideous, and its severity highly correlates with a significantly increased incidence of pathological condition and outcome. The management of this disease is based on the severity level by identifying the clinical manifestation, so performing an early detection is crucial to prevent the disease progression. This research aimed to determine the predictor factors for the severity degree of pediatric hydronephrosis to give better treatments for patients. This study retrospectively reported 51 data of hydronephrosis cases that were collected from January 2012 to August 2019. Severity degree was evaluated using SFU (Society of Fetal Urology) scoring system and divided into two groups, mild-moderate (first and second degree) and moderate-severe (third and fourth degree). Data including age, gender, number of kidneys affected, etiology, and antenatal care were collected and statistically analyzed using Pearson's Chi-square and Fischer Exact test. The research result from 51 pediatric patients, 72.55% were categorized as moderate-severe hydronephrosis while the remaining 27.45% were categorized ad mild-moderate hydronephrosis. Ureteropelvic junction (UPJ) stenosis (37.25%) is the most common cause of pediatric hydronephrosis. Significant correlations are noted among severity degree and gender, the number of kidneys affected, etiology, and chosen antenatal care between obstetrician-gynecologist and midwife (p<0.05). In short, gender, number of kidneys affected, etiology, patient's choice on antenatal care can be the predictor factors for pediatric hydronephrosis. Thus, these findings are essential for urologists in pediatric hydronephrosis management.
儿童肾积水通常是可怕的，其严重程度与病理状况和预后的发生率显著增加高度相关。该病的管理是基于临床表现的严重程度，因此早期发现对预防疾病进展至关重要。本研究旨在确定儿童肾积水严重程度的预测因素，为患者提供更好的治疗。本研究回顾性报告了2012年1月至2019年8月收集的51例肾积水病例资料。严重程度采用SFU (Society of Fetal Urology)评分系统进行评分，分为轻度-中度(一、二度)和中度-重度(三、四度)两组。收集年龄、性别、受影响肾脏数量、病因、产前护理等资料，采用Pearson’s卡方检验和Fischer精确检验进行统计学分析。研究结果51例患儿中，72.55%为中重度肾积水，其余27.45%为轻中度肾积水。肾盂输尿管连接处(UPJ)狭窄(37.25%)是儿童肾积水最常见的原因。严重程度与性别、受影响肾脏数量、病因、选择的产前护理在妇产科医生和助产士之间存在显著相关性(p<0.05)。总之，性别、受影响的肾脏数量、病因、患者对产前护理的选择可能是儿童肾积水的预测因素。因此，这些发现对泌尿科医生在小儿肾积水处理中至关重要。
{"title":"Predictor Factor for Severity Degree of Pediatric Hydronephrosis in Tertiary Hospital","authors":"H. Naim, B. Daryanto, Pradana Nurhadi","doi":"10.21776/ub.jkb.2022.032.02.6","DOIUrl":"https://doi.org/10.21776/ub.jkb.2022.032.02.6","url":null,"abstract":"Pediatric hydronephrosis is often hideous, and its severity highly correlates with a significantly increased incidence of pathological condition and outcome. The management of this disease is based on the severity level by identifying the clinical manifestation, so performing an early detection is crucial to prevent the disease progression. This research aimed to determine the predictor factors for the severity degree of pediatric hydronephrosis to give better treatments for patients. This study retrospectively reported 51 data of hydronephrosis cases that were collected from January 2012 to August 2019. Severity degree was evaluated using SFU (Society of Fetal Urology) scoring system and divided into two groups, mild-moderate (first and second degree) and moderate-severe (third and fourth degree). Data including age, gender, number of kidneys affected, etiology, and antenatal care were collected and statistically analyzed using Pearson's Chi-square and Fischer Exact test. The research result from 51 pediatric patients, 72.55% were categorized as moderate-severe hydronephrosis while the remaining 27.45% were categorized ad mild-moderate hydronephrosis. Ureteropelvic junction (UPJ) stenosis (37.25%) is the most common cause of pediatric hydronephrosis. Significant correlations are noted among severity degree and gender, the number of kidneys affected, etiology, and chosen antenatal care between obstetrician-gynecologist and midwife (p<0.05). In short, gender, number of kidneys affected, etiology, patient's choice on antenatal care can be the predictor factors for pediatric hydronephrosis. Thus, these findings are essential for urologists in pediatric hydronephrosis management.","PeriodicalId":17705,"journal":{"name":"Jurnal Kedokteran Brawijaya","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85651044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-04DOI: 10.21776/ub.jkb.2022.032.02.11
Mangkubumi Putra Wijaya, Kurnia Penta Seputra, B. Daryanto, Taufiq Nur Budaya
Migration of the intrauterine device (IUD) into the bladder has been a rare case. There were reported 31 cases of IUD migration into the bladder until 2006. Although IUD migration is asymptomatic, it should be removed to prevent complications such as pelvic abscess, bladder or intestinal rupture, and adhesion. A 52-year-old woman came to the urology clinic with pyuria since the previous 3 months. She had a history of IUD insertion in 1982; and two months later, she got pregnant. Since 2015, she has suffered from dysuria but has never been treated and has worsened in the past 3 months. On physical examination, tenderness was found in the suprapubic region. The results of urinalysis showed pyuria and hematuria. The ultrasonography findings, there were large bladder stones. An abdominal x-ray revealed the presence of a bladder stone with the IUD tail. Vesicolithotomy was performed and the IUD was found attached to an 11x7 cm bladder stone. The patient had a good postoperative condition without any special complications. The IUD in the bladder is a medium for forming secondary bladder stones. Most cases of IUD migration are caused by a lack of evaluation after the installation procedure. This case suggested that the physician should be more careful in carrying out the installation procedure. It is necessary to evaluate the location of the IUD after installation to prevent further patient complications.
{"title":"Calculus Formation in Bladder from Migrated Intrauterine Devices","authors":"Mangkubumi Putra Wijaya, Kurnia Penta Seputra, B. Daryanto, Taufiq Nur Budaya","doi":"10.21776/ub.jkb.2022.032.02.11","DOIUrl":"https://doi.org/10.21776/ub.jkb.2022.032.02.11","url":null,"abstract":"Migration of the intrauterine device (IUD) into the bladder has been a rare case. There were reported 31 cases of IUD migration into the bladder until 2006. Although IUD migration is asymptomatic, it should be removed to prevent complications such as pelvic abscess, bladder or intestinal rupture, and adhesion. A 52-year-old woman came to the urology clinic with pyuria since the previous 3 months. She had a history of IUD insertion in 1982; and two months later, she got pregnant. Since 2015, she has suffered from dysuria but has never been treated and has worsened in the past 3 months. On physical examination, tenderness was found in the suprapubic region. The results of urinalysis showed pyuria and hematuria. The ultrasonography findings, there were large bladder stones. An abdominal x-ray revealed the presence of a bladder stone with the IUD tail. Vesicolithotomy was performed and the IUD was found attached to an 11x7 cm bladder stone. The patient had a good postoperative condition without any special complications. The IUD in the bladder is a medium for forming secondary bladder stones. Most cases of IUD migration are caused by a lack of evaluation after the installation procedure. This case suggested that the physician should be more careful in carrying out the installation procedure. It is necessary to evaluate the location of the IUD after installation to prevent further patient complications.","PeriodicalId":17705,"journal":{"name":"Jurnal Kedokteran Brawijaya","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88095225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-04DOI: 10.21776/ub.jkb.2022.032.02.3
W. Widowati, T. Wargasetia, Meganita Marthania, Tazkia Salma Hanifa, Teddy Marcus Zakaria, Michael Sebastian Gunadi, Natanael Halim, Sheryl Santiadi
Herbal teas was are widely consumed by people around the world have high antioxidant activities. The flavor and color combination of specific teas enriches the aroma and appearance of the tea, producing a tea with fresh color and tastier flavor. This study determines the antioxidant activity of telang flower tea (Clitoria ternatea), pineapple tea (Ananas comosus), and the formula of the combination of telang flower tea and pineapple tea called TeNan. The antioxidant activities of herbal teas were measured by 2,2 Diphenyl-1-picrylhydrazyl (DPPH), Hydrogen Peroxide (H2O2), 2,2′-Azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) (ABTS), Ferric Reducing Antioxidant Power (FRAP) assay. The total phenol measurement used Gallic Acid Equivalent (GAE), while the flavonoid content measurement used Quercetin Equivalent (QE). The DPPH scavenging activities of telang flower tea, pineapple tea, and TeNan tea (IC50: 17.07%, 11.81%, and 22.22%), H2O2 scavenging activities (IC50: 26.62%, 41.81%, and 96.22%), ABTS-reducing activities (IC50: 2.51%, 3.39%, and 1.02%), and FRAP activities (IC50: 5.56%, 18.67%, and 7.48%). The total phenolic and flavonoid contents of TeNan tea were lower (9.44 μg GAE/100%; 3.46 μg QAE/100% sample concentration) than those of telang flower tea (16.20 μg GAE/100%; 4.88 μg QAE/100% sample concentration) but higher than those of pineapple tea (0.82 μg GAE/100%; 0.17 μg QAE/100% sample concentration). TeNan tea has the higher in ABTS and FRAP activities but lower in H2O2 and DPPH scavenging activities compared to telang flower tea and pineapple tea. In summary, telang tea has stronger antioxidant activity compared to pineapple and TeNan tea in FRAP and H2O2 assays.
{"title":"Antioxidant Properties of TeNan Herbal Tea Formulation “Telang (Clitoria ternatea) and Pineapple (Ananas comosus)”","authors":"W. Widowati, T. Wargasetia, Meganita Marthania, Tazkia Salma Hanifa, Teddy Marcus Zakaria, Michael Sebastian Gunadi, Natanael Halim, Sheryl Santiadi","doi":"10.21776/ub.jkb.2022.032.02.3","DOIUrl":"https://doi.org/10.21776/ub.jkb.2022.032.02.3","url":null,"abstract":"Herbal teas was are widely consumed by people around the world have high antioxidant activities. The flavor and color combination of specific teas enriches the aroma and appearance of the tea, producing a tea with fresh color and tastier flavor. This study determines the antioxidant activity of telang flower tea (Clitoria ternatea), pineapple tea (Ananas comosus), and the formula of the combination of telang flower tea and pineapple tea called TeNan. The antioxidant activities of herbal teas were measured by 2,2 Diphenyl-1-picrylhydrazyl (DPPH), Hydrogen Peroxide (H2O2), 2,2′-Azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) (ABTS), Ferric Reducing Antioxidant Power (FRAP) assay. The total phenol measurement used Gallic Acid Equivalent (GAE), while the flavonoid content measurement used Quercetin Equivalent (QE). The DPPH scavenging activities of telang flower tea, pineapple tea, and TeNan tea (IC50: 17.07%, 11.81%, and 22.22%), H2O2 scavenging activities (IC50: 26.62%, 41.81%, and 96.22%), ABTS-reducing activities (IC50: 2.51%, 3.39%, and 1.02%), and FRAP activities (IC50: 5.56%, 18.67%, and 7.48%). The total phenolic and flavonoid contents of TeNan tea were lower (9.44 μg GAE/100%; 3.46 μg QAE/100% sample concentration) than those of telang flower tea (16.20 μg GAE/100%; 4.88 μg QAE/100% sample concentration) but higher than those of pineapple tea (0.82 μg GAE/100%; 0.17 μg QAE/100% sample concentration). TeNan tea has the higher in ABTS and FRAP activities but lower in H2O2 and DPPH scavenging activities compared to telang flower tea and pineapple tea. In summary, telang tea has stronger antioxidant activity compared to pineapple and TeNan tea in FRAP and H2O2 assays.","PeriodicalId":17705,"journal":{"name":"Jurnal Kedokteran Brawijaya","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84717754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-04DOI: 10.21776/ub.jkb.2022.032.02.7
Alfansuri Kadri, Eko Yandra
Cerebral toxoplasmosis is one of the frequent opportunistic infections of the central nervous system of Human Immunodeficiency Virus (HIV) patients in the presence of Toxoplasma Gondii infection. In Indonesia, the incidence of HIV patients with cerebral toxoplasmosis is 45%. This study was done to determine the demographic, clinical, and laboratory characteristics of HIV patients with cerebral toxoplasmosis at Haji Adam Malik Hospital, Medan, based on medical record data in 2022. The total sample was 23 patients with time periods from January to March 2022. Demographically, the data showed that most of the HIV patients with cerebral toxoplasmosis were male (91.3%), a mean age of 36.48 ± 5.74 years, married (87%), high school graduates (69.6%), and working (91.3%). The most common clinical characteristics were headache (69.6%) and cognitive impairment (56.5%). Laboratory characteristics found were (56.5%) non-reactive (<0.8 COI) and (43.5%) reactive (≥1 COI) anti toxoplasma IgM, while reactive anti-toxoplasma IgG (≥3 IU/ml) was obtained in all research samples (100%).
脑弓形虫病是人类免疫缺陷病毒(HIV)患者在弓形虫感染的情况下，中枢神经系统常见的机会性感染之一。在印度尼西亚，艾滋病毒患者伴脑弓形体病的发病率为45%。本研究旨在根据2022年棉兰Haji Adam Malik医院的医疗记录数据，确定脑弓形虫病HIV患者的人口学、临床和实验室特征。总样本为23例，时间为2022年1月至3月。人口统计学上，HIV脑弓形虫病患者以男性(91.3%)为主，平均年龄36.48±5.74岁，已婚(87%)，高中毕业(69.6%)，有工作(91.3%)。最常见的临床特征是头痛(69.6%)和认知障碍(56.5%)。实验室特征为无反应性(<0.8 COI)的占56.5%，抗弓形虫IgM反应性(≥1 COI)的占43.5%，而抗弓形虫IgG反应性(≥3 IU/ml)的占100%。
{"title":"Demographic, Clinical, and Laboratory Characteristics of HIV Patients with Cerebral Toxoplasmosis at Haji Adam Malik General Hospital Medan","authors":"Alfansuri Kadri, Eko Yandra","doi":"10.21776/ub.jkb.2022.032.02.7","DOIUrl":"https://doi.org/10.21776/ub.jkb.2022.032.02.7","url":null,"abstract":"Cerebral toxoplasmosis is one of the frequent opportunistic infections of the central nervous system of Human Immunodeficiency Virus (HIV) patients in the presence of Toxoplasma Gondii infection. In Indonesia, the incidence of HIV patients with cerebral toxoplasmosis is 45%. This study was done to determine the demographic, clinical, and laboratory characteristics of HIV patients with cerebral toxoplasmosis at Haji Adam Malik Hospital, Medan, based on medical record data in 2022. The total sample was 23 patients with time periods from January to March 2022. Demographically, the data showed that most of the HIV patients with cerebral toxoplasmosis were male (91.3%), a mean age of 36.48 ± 5.74 years, married (87%), high school graduates (69.6%), and working (91.3%). The most common clinical characteristics were headache (69.6%) and cognitive impairment (56.5%). Laboratory characteristics found were (56.5%) non-reactive (<0.8 COI) and (43.5%) reactive (≥1 COI) anti toxoplasma IgM, while reactive anti-toxoplasma IgG (≥3 IU/ml) was obtained in all research samples (100%).","PeriodicalId":17705,"journal":{"name":"Jurnal Kedokteran Brawijaya","volume":"401 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76625854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-04DOI: 10.21776/ub.jkb.2022.032.02.10
Rizal Trianto, Pradana Nurhadi, B. Daryanto
Diphallia is a rare urogenital defect and varies from a small accessory penis or duplication of the glans to complete penile duplication. Its incidence is 1 in 5.5 million live births. Only 100 cases were reported from 1609 until 2021. A two-year-old boy with diphallia and multiple congenital anomalies had an uncircumcised penis with two glans penis and two complete urethral orifices, accompanied by scrotum bifidum, asymmetric right buttock, with normal anorectal position. Spina bifida with lipomyelocele, tethered cord at the level of vertebra lumbar 3-4, scrotum bifidum, and left mild hydronephrosis were observed using Magnetic Resonance Imaging (MRI). Urethrocystoscopy of both complete urethra revealed meatal stenosis and bulbar urethral stricture, normal posterior urethral, and no verumontanum in the right urethral orifice and did dilatation. Whereas normal urethral orifice, anterior urethra, posterior urethra and verumontanum were found in the left side. Management for diphallia must consider associated anomalies and the goal of patient satisfaction. In this case, conservative treatment is the best choice.
{"title":"A Two-Year-Old Boy with Diphallia and Multiple Congenital Anomalies","authors":"Rizal Trianto, Pradana Nurhadi, B. Daryanto","doi":"10.21776/ub.jkb.2022.032.02.10","DOIUrl":"https://doi.org/10.21776/ub.jkb.2022.032.02.10","url":null,"abstract":"Diphallia is a rare urogenital defect and varies from a small accessory penis or duplication of the glans to complete penile duplication. Its incidence is 1 in 5.5 million live births. Only 100 cases were reported from 1609 until 2021. A two-year-old boy with diphallia and multiple congenital anomalies had an uncircumcised penis with two glans penis and two complete urethral orifices, accompanied by scrotum bifidum, asymmetric right buttock, with normal anorectal position. Spina bifida with lipomyelocele, tethered cord at the level of vertebra lumbar 3-4, scrotum bifidum, and left mild hydronephrosis were observed using Magnetic Resonance Imaging (MRI). Urethrocystoscopy of both complete urethra revealed meatal stenosis and bulbar urethral stricture, normal posterior urethral, and no verumontanum in the right urethral orifice and did dilatation. Whereas normal urethral orifice, anterior urethra, posterior urethra and verumontanum were found in the left side. Management for diphallia must consider associated anomalies and the goal of patient satisfaction. In this case, conservative treatment is the best choice.","PeriodicalId":17705,"journal":{"name":"Jurnal Kedokteran Brawijaya","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75627364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-04DOI: 10.21776/ub.jkb.2022.032.02.1
Muhamad Nur Syukriani Yusuf, Abdi Dzul Ikram Hasanuddin, Zuhriana K. Yusuf, Trinny Tuna, N. Ibrahim, Marshanda Tiara Posumah, Ridho Tianggara
In the urogenital system, simvastatin is associated with interstitial cystitis adverse effects, but the exact mechanism is not yet clearly defined. This study aims to determine the effect of simvastatin on eosinophilic inflammation of bladder tissue in vivo. Laboratory experimental research design with the post-test only control group using 24 female Wistar rats aged 8-10 weeks were randomly divided into simvastatin 50mg/kg BW (n=12) or placebo carboxymethylcellulose 0.5% (n=12). All groups received treatment through oral gavage for thirty days. After that, each group was divided equally into three subgroups: control rat, day 0 Interstitial Cystitis (IC) rat (IC0), and day 3 IC rat (IC3). Control or IC0 rats each received intravesical instillation of buffered saline or protamine sulfate (PS), respectively, and were terminated immediately less than 3 hours after instillation. The IC3 rats received intravesical PS instillation and were terminated three days post-instillation. The bladder tissue was made in Hematoxylin-Eosin histology preparations. As in previous studies, the results showed successful desquamation of the urothelium after PS instillation. Tissue eosinophil counts were significantly higher in the simvastatin group than in the placebo group in the IC3 model (15.50±5.92 vs. 4.00±2.83, p=0.013). It can be concluded that the mechanism of the adverse effect of simvastatin on bladder tissue is through increased tissue inflammation mediated by eosinophils along with urothelial layer destruction by the protamine sulfate.
{"title":"Effect of Simvastatin on Eosinophilic Inflammation of Bladder Tissue in Interstitial Cystitis Rat Model","authors":"Muhamad Nur Syukriani Yusuf, Abdi Dzul Ikram Hasanuddin, Zuhriana K. Yusuf, Trinny Tuna, N. Ibrahim, Marshanda Tiara Posumah, Ridho Tianggara","doi":"10.21776/ub.jkb.2022.032.02.1","DOIUrl":"https://doi.org/10.21776/ub.jkb.2022.032.02.1","url":null,"abstract":"In the urogenital system, simvastatin is associated with interstitial cystitis adverse effects, but the exact mechanism is not yet clearly defined. This study aims to determine the effect of simvastatin on eosinophilic inflammation of bladder tissue in vivo. Laboratory experimental research design with the post-test only control group using 24 female Wistar rats aged 8-10 weeks were randomly divided into simvastatin 50mg/kg BW (n=12) or placebo carboxymethylcellulose 0.5% (n=12). All groups received treatment through oral gavage for thirty days. After that, each group was divided equally into three subgroups: control rat, day 0 Interstitial Cystitis (IC) rat (IC0), and day 3 IC rat (IC3). Control or IC0 rats each received intravesical instillation of buffered saline or protamine sulfate (PS), respectively, and were terminated immediately less than 3 hours after instillation. The IC3 rats received intravesical PS instillation and were terminated three days post-instillation. The bladder tissue was made in Hematoxylin-Eosin histology preparations. As in previous studies, the results showed successful desquamation of the urothelium after PS instillation. Tissue eosinophil counts were significantly higher in the simvastatin group than in the placebo group in the IC3 model (15.50±5.92 vs. 4.00±2.83, p=0.013). It can be concluded that the mechanism of the adverse effect of simvastatin on bladder tissue is through increased tissue inflammation mediated by eosinophils along with urothelial layer destruction by the protamine sulfate.","PeriodicalId":17705,"journal":{"name":"Jurnal Kedokteran Brawijaya","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80867065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-05DOI: 10.21776/ub.jkb.2021.031.02.6s
Wahyu Febrianto, Wiwin Indriani, A. Dewanto, H. Holipah
The Covid-19 pandemic has brought negative consequences on hospital finances, the mental health of health care workers (HCWs), and even resulted in the deaths of several health workers at Hasta Brata Hospital (HBH). This study aimed to explore the experiences of HBH's staff in dealing with the pandemic in the hospital. This research is qualitative research with a phenomenological approach. Data were collected using in-depth interviews with two of HBH's staff and then followed by the theme analysis. Hospital staff experienced job demands including emotional and physical stress at work, fear of infection, repeated conflicts with patient visitors, different mindsets among staff, increased workload, and feelings of frustration towards people who do not comply with prevention protocols. Fortunately, they had adequate job resources, ranging from the provision of personal protective equipment, nutrition improvement, and regular Covid-19 screening; update knowledge and methods of handling Covid-19; to motivational and spiritual support from HBH leaders. The staff also had strong personal resources so that they could cope with stressful work situations, feel optimistic that they could win against Covid-19, and hoped that the pandemic would end. Spiritual support embodies tawakal, an Islamic concept that gives complete surrender to God after employing maximum effort. The presence of strong job and personal resources has moderated job demands and resulted in work engagement. Tawakal is an added value for personal resources staff who finally realize that Covid-19 cannot be avoided and must be fought before surrendering entirely to God.
{"title":"How Do Hospital Staff Cope with Covid-19 at Work? A Phenomenological Study","authors":"Wahyu Febrianto, Wiwin Indriani, A. Dewanto, H. Holipah","doi":"10.21776/ub.jkb.2021.031.02.6s","DOIUrl":"https://doi.org/10.21776/ub.jkb.2021.031.02.6s","url":null,"abstract":"The Covid-19 pandemic has brought negative consequences on hospital finances, the mental health of health care workers (HCWs), and even resulted in the deaths of several health workers at Hasta Brata Hospital (HBH). This study aimed to explore the experiences of HBH's staff in dealing with the pandemic in the hospital. This research is qualitative research with a phenomenological approach. Data were collected using in-depth interviews with two of HBH's staff and then followed by the theme analysis. Hospital staff experienced job demands including emotional and physical stress at work, fear of infection, repeated conflicts with patient visitors, different mindsets among staff, increased workload, and feelings of frustration towards people who do not comply with prevention protocols. Fortunately, they had adequate job resources, ranging from the provision of personal protective equipment, nutrition improvement, and regular Covid-19 screening; update knowledge and methods of handling Covid-19; to motivational and spiritual support from HBH leaders. The staff also had strong personal resources so that they could cope with stressful work situations, feel optimistic that they could win against Covid-19, and hoped that the pandemic would end. Spiritual support embodies tawakal, an Islamic concept that gives complete surrender to God after employing maximum effort. The presence of strong job and personal resources has moderated job demands and resulted in work engagement. Tawakal is an added value for personal resources staff who finally realize that Covid-19 cannot be avoided and must be fought before surrendering entirely to God.","PeriodicalId":17705,"journal":{"name":"Jurnal Kedokteran Brawijaya","volume":"24 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91496134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-15DOI: 10.21776/ub.jkb.2021.031.02.7s
I. Sastrawan, V. Wardhani
Although clinical pathway (CP) is aimed to ensure quality and cost, the development of CP at hospitals is primarily for administrative purposes as it is required by accreditation standards, thus causing high variations in its implementation. This study aimed to develop a clinical pathway for caesarean section and explore the problem during development and implementation test. The selection of caesarean section was based on high volume, risk, and cost. Using participatory action research, the researcher started the program by performing an implementation evaluation, literature review, and regulatory development. The evaluation identified implementation discrepancies and prolonged length of stay. Based on the evaluation and literature review results, the Professional Care Provider (PCP) in the hospital conducted discussions and made suggestions by considering available resources, current practices, and behavior. The main differences of the new clinical pathway are: 1) it is developed based on literature and current practice, and 2) it should be added with notification, explanation, inclusion and exclusion criteria, and references. Before the implementation test, the hospital provide resources, develops a standard operational procedure followed by monitoring and evaluation. Differences in the type of medication and documentation method were found, which then further discussed with all involved PCP to define the agreed solutions. Professional engagement and openness culture that embraces along the process are the main key lesson learned in addition to the understanding that CP development and implementation is a continuous learning process.
{"title":"Development of Caesarean Section Clinical Pathway: A Lesson Learned","authors":"I. Sastrawan, V. Wardhani","doi":"10.21776/ub.jkb.2021.031.02.7s","DOIUrl":"https://doi.org/10.21776/ub.jkb.2021.031.02.7s","url":null,"abstract":"Although clinical pathway (CP) is aimed to ensure quality and cost, the development of CP at hospitals is primarily for administrative purposes as it is required by accreditation standards, thus causing high variations in its implementation. This study aimed to develop a clinical pathway for caesarean section and explore the problem during development and implementation test. The selection of caesarean section was based on high volume, risk, and cost. Using participatory action research, the researcher started the program by performing an implementation evaluation, literature review, and regulatory development. The evaluation identified implementation discrepancies and prolonged length of stay. Based on the evaluation and literature review results, the Professional Care Provider (PCP) in the hospital conducted discussions and made suggestions by considering available resources, current practices, and behavior. The main differences of the new clinical pathway are: 1) it is developed based on literature and current practice, and 2) it should be added with notification, explanation, inclusion and exclusion criteria, and references. Before the implementation test, the hospital provide resources, develops a standard operational procedure followed by monitoring and evaluation. Differences in the type of medication and documentation method were found, which then further discussed with all involved PCP to define the agreed solutions. Professional engagement and openness culture that embraces along the process are the main key lesson learned in addition to the understanding that CP development and implementation is a continuous learning process.","PeriodicalId":17705,"journal":{"name":"Jurnal Kedokteran Brawijaya","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72938446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-15DOI: 10.21776/ub.jkb.2021.031.02.10s
Menis Rahmawati, V. Wardhani
Waiting time in the outpatient pharmacy is still a problem in hospitals. This study aimed to identify the root causes and implement solutions to reduce the waiting time at a type C hospital. This study applied a descriptive approach. The potential causes were identified using HFMEA (Healthcare Failure Mode Effect and Analysis) confirmed through an online survey on 15 staff involved in pharmacy services. Scoring and Focus Group Discussion were used to identify the priority problems and solutions. The study results revealed six causing factors of the lengthy waiting time at the outpatient pharmacy, which were doctor's schedule, absence of specific time target for each drug preparation stage, changes of the drug storage, drug stock different from the planning, incomplete standard operating procedures, and one counter for prescription collection and drug dispensing. Three solutions were implemented in six days: checking drug stock in every shift, developing an SOP, and separating the counters for prescription collection and drug dispensing. The implementation results showed a significant increase in the waiting time percentage of compounded drugs, which met the standard (≤60 minutes) from 26% to 43%. This increase was even higher for non-compounded drug waiting time (<20), from 27% to 48%. Drug stock checking, procedure standardization, and separation of service counters are the keys to reducing outpatient pharmacy waiting time.
{"title":"Key Strategies to Reduce Waiting Time in Outpatient Pharmacy","authors":"Menis Rahmawati, V. Wardhani","doi":"10.21776/ub.jkb.2021.031.02.10s","DOIUrl":"https://doi.org/10.21776/ub.jkb.2021.031.02.10s","url":null,"abstract":"Waiting time in the outpatient pharmacy is still a problem in hospitals. This study aimed to identify the root causes and implement solutions to reduce the waiting time at a type C hospital. This study applied a descriptive approach. The potential causes were identified using HFMEA (Healthcare Failure Mode Effect and Analysis) confirmed through an online survey on 15 staff involved in pharmacy services. Scoring and Focus Group Discussion were used to identify the priority problems and solutions. The study results revealed six causing factors of the lengthy waiting time at the outpatient pharmacy, which were doctor's schedule, absence of specific time target for each drug preparation stage, changes of the drug storage, drug stock different from the planning, incomplete standard operating procedures, and one counter for prescription collection and drug dispensing. Three solutions were implemented in six days: checking drug stock in every shift, developing an SOP, and separating the counters for prescription collection and drug dispensing. The implementation results showed a significant increase in the waiting time percentage of compounded drugs, which met the standard (≤60 minutes) from 26% to 43%. This increase was even higher for non-compounded drug waiting time (<20), from 27% to 48%. Drug stock checking, procedure standardization, and separation of service counters are the keys to reducing outpatient pharmacy waiting time.","PeriodicalId":17705,"journal":{"name":"Jurnal Kedokteran Brawijaya","volume":"121 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75020685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：