{"title":"Current condition of social security administrator for health (BPJS Kesehatan) in Indonesia: contextual factors that affected the national health insurance","authors":"A. Mukti, C. Jaya, Rizki Lestari Suhardi","doi":"10.13181/mji.com.226296","DOIUrl":"https://doi.org/10.13181/mji.com.226296","url":null,"abstract":"[No abstract available]","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45635574","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}
BACKGROUND Coagulopathy is a serious COVID-19 complication that requires rapid diagnosis and anticoagulation. This study aimed to determine the role of coagulation examination using thromboelastography (TEG) on the decision-making time of anticoagulant therapy in COVID-19 patients and its clinical outcomes. METHODS A prospective observational study was conducted in Cipto Mangunkusumo Hospital, Indonesia, from October 2020 to March 2021. We consecutively recruited moderate and severe COVID-19 patients in the high and intensive care units. Turnaround time, time to anticoagulant therapy decision, and clinical outcomes (length of stay and 30-day mortality) were compared between those who had a TEG examination in addition to the standard coagulation profile examination (thrombocyte count, PT, APTT, D-dimer, and fibrinogen) and those who had only a standard coagulation profile laboratory examination. RESULTS Among 100 moderate to severe COVID-19 patients recruited, 50 patients had a TEG examination. The turnaround time of TEG was 45 (15–102) min versus 82 (19–164) min in the standard examination (p<0.001). The time to decision was significantly faster in the TEG group than the standard group (75 [42–133] min versus 184 [92–353] min, p<0.001). The turnaround time was positively correlated with time to decision (r = 0.760, p<0.001). However, TEG did not improve clinical outcomes such as length of stay (10.5 [3–20] versus 9 [2–39] days) and 30-day mortality (66% versus 64%). CONCLUSIONS The TEG method significantly enables quicker decision-making time for moderate to severe coagulation disorder in COVID-19 patients.
{"title":"Thromboelastographic method for early decision on anticoagulant therapy in moderate to severe COVID-19 patients","authors":"K. Ferdiana, A. Ramlan, R. Soenarto, Anas Alatas","doi":"10.13181/mji.oa.225890","DOIUrl":"https://doi.org/10.13181/mji.oa.225890","url":null,"abstract":"BACKGROUND Coagulopathy is a serious COVID-19 complication that requires rapid diagnosis and anticoagulation. This study aimed to determine the role of coagulation examination using thromboelastography (TEG) on the decision-making time of anticoagulant therapy in COVID-19 patients and its clinical outcomes. \u0000METHODS A prospective observational study was conducted in Cipto Mangunkusumo Hospital, Indonesia, from October 2020 to March 2021. We consecutively recruited moderate and severe COVID-19 patients in the high and intensive care units. Turnaround time, time to anticoagulant therapy decision, and clinical outcomes (length of stay and 30-day mortality) were compared between those who had a TEG examination in addition to the standard coagulation profile examination (thrombocyte count, PT, APTT, D-dimer, and fibrinogen) and those who had only a standard coagulation profile laboratory examination. \u0000RESULTS Among 100 moderate to severe COVID-19 patients recruited, 50 patients had a TEG examination. The turnaround time of TEG was 45 (15–102) min versus 82 (19–164) min in the standard examination (p<0.001). The time to decision was significantly faster in the TEG group than the standard group (75 [42–133] min versus 184 [92–353] min, p<0.001). The turnaround time was positively correlated with time to decision (r = 0.760, p<0.001). However, TEG did not improve clinical outcomes such as length of stay (10.5 [3–20] versus 9 [2–39] days) and 30-day mortality (66% versus 64%). \u0000CONCLUSIONS The TEG method significantly enables quicker decision-making time for moderate to severe coagulation disorder in COVID-19 patients.","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42721511","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}
BACKGROUND Blacksoap® is recognized as adjuvant therapy for scabies, but there has been no significant study on its effectiveness. This study aimed to compare the efficacy and safety between Blacksoap® and placebo on standard treatment for pruritus visual analog scale (VAS) and transepidermal water loss (TEWL) scores before and after receiving therapy. METHODS This single-blind randomized controlled trial was held in a boarding school in West Java in 2018. Subjects were recruited consecutively by random cluster sampling. Both groups received standard permethrin 5% cream therapy. The intervention group (n = 37) obtained Blacksoap®, while the control (n = 41) received baby soap. During the initial assessment, pruritus VAS and TEWL scores were taken. The cure rate, scores of pruritus VAS and TEWL, as well as side effects were assessed and compared during the first and fourth weeks. Data were analyzed using SPSS software version 20 (IBM Corp., USA) by a third party, mostly using non-parametric tests. RESULTS The cure rate of the intervention group was lower than the control in the first week with 75% versus 81% but higher in the fourth week with 97% versus 92%. There was no significant difference in the scores of pruritus VAS and TEWL, as well as side effects between the two groups. CONCLUSIONS The efficacy and safety of scabies treatment were similar between Blacksoap® and placebo adjunctive to standard treatment. Blacksoap®, on top of standard scabies treatment, might benefit patients by providing a higher cure rate in 4 weeks without any considerable adverse effects.
{"title":"Efficacy and side effects of Blacksoap® as adjuvant therapy of scabies: a randomized control trial","authors":"Lidwina Anissa, Wresti Indriatmi, Larisa Paramitha Wibawa, Sandra Widaty","doi":"10.13181/mji.oa.225965","DOIUrl":"https://doi.org/10.13181/mji.oa.225965","url":null,"abstract":"BACKGROUND Blacksoap® is recognized as adjuvant therapy for scabies, but there has been no significant study on its effectiveness. This study aimed to compare the efficacy and safety between Blacksoap® and placebo on standard treatment for pruritus visual analog scale (VAS) and transepidermal water loss (TEWL) scores before and after receiving therapy. \u0000METHODS This single-blind randomized controlled trial was held in a boarding school in West Java in 2018. Subjects were recruited consecutively by random cluster sampling. Both groups received standard permethrin 5% cream therapy. The intervention group (n = 37) obtained Blacksoap®, while the control (n = 41) received baby soap. During the initial assessment, pruritus VAS and TEWL scores were taken. The cure rate, scores of pruritus VAS and TEWL, as well as side effects were assessed and compared during the first and fourth weeks. Data were analyzed using SPSS software version 20 (IBM Corp., USA) by a third party, mostly using non-parametric tests. \u0000RESULTS The cure rate of the intervention group was lower than the control in the first week with 75% versus 81% but higher in the fourth week with 97% versus 92%. There was no significant difference in the scores of pruritus VAS and TEWL, as well as side effects between the two groups. \u0000CONCLUSIONS The efficacy and safety of scabies treatment were similar between Blacksoap® and placebo adjunctive to standard treatment. Blacksoap®, on top of standard scabies treatment, might benefit patients by providing a higher cure rate in 4 weeks without any considerable adverse effects.","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48333447","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}
BACKGROUND Shivering is a frequent event during neuraxial anesthesia due to impaired central and peripheral thermoregulation control. Meperidine and MgSO4 are effective in lowering the shivering threshold. Hence, this study aimed to compare the efficacy of MgSO4 and meperidine to prevent shivering in patients undergoing spinal anesthesia. METHODS This was a double-blind randomized clinical trial of 100 patients divided into 2 groups. One group had MgSO4 30 mg/kg, and the other group had meperidine 0.5 mg/kg intravenously in 100 ml of 0.9% NaCl before undergoing spinal anesthesia. Participants were non-pregnant patients aged 18–65 years and had physical status I or II (based on the American Society of Anesthesiologist). Shivering was considered significant if it occurred in grade 3 or 4. Patient characteristics, shivering degree, tympanic membrane temperature, and side effects were recorded. RESULTS Shivering occurred 10% in the MgSO4 group and 19% in the meperidine group, with p = 0.23. Both groups had similar side effects of nausea, vomiting, and hypotension. CONCLUSIONS MgSO4 30 mg/kg was not superior to meperidine 0.5 mg/kg intravenously in preventing shivering in patients undergoing spinal anesthesia.
背景由于中枢和外周温度调节控制受损，在轴索麻醉过程中，颤抖是一种常见的事件。甲基哌啶和硫酸镁能有效降低颤抖阈值。因此，本研究旨在比较硫酸镁和哌替啶预防脊柱麻醉患者颤抖的疗效。方法对100例患者进行双盲随机临床试验，分为2组。一组在接受脊髓麻醉前，用MgSO4 30 mg/kg，另一组在100 ml 0.9%NaCl中静脉注射美哌啶0.5 mg/kg。参与者是18-65岁的非孕妇，身体状况为I或II（根据美国麻醉师协会）。如果发生在3或4年级，颤抖被认为是显著的。记录患者特征、颤抖程度、鼓膜温度和副作用。结果硫酸镁组和美哌替啶组分别有10%和19%的颤抖发生，p＝0.23。两组患者的恶心、呕吐和低血压副作用相似。结论在预防脊麻患者颤抖方面，30 mg/kg硫酸镁的静脉注射效果并不优于0.5 mg/kg美哌替啶。
{"title":"Intravenous magnesium sulfate versus intravenous meperidine to prevent shivering during spinal anesthesia","authors":"Pryambodho, S. Manggala, Magdalena Sihombing","doi":"10.13181/mji.oa.225886","DOIUrl":"https://doi.org/10.13181/mji.oa.225886","url":null,"abstract":"BACKGROUND Shivering is a frequent event during neuraxial anesthesia due to impaired central and peripheral thermoregulation control. Meperidine and MgSO4 are effective in lowering the shivering threshold. Hence, this study aimed to compare the efficacy of MgSO4 and meperidine to prevent shivering in patients undergoing spinal anesthesia. \u0000METHODS This was a double-blind randomized clinical trial of 100 patients divided into 2 groups. One group had MgSO4 30 mg/kg, and the other group had meperidine 0.5 mg/kg intravenously in 100 ml of 0.9% NaCl before undergoing spinal anesthesia. Participants were non-pregnant patients aged 18–65 years and had physical status I or II (based on the American Society of Anesthesiologist). Shivering was considered significant if it occurred in grade 3 or 4. Patient characteristics, shivering degree, tympanic membrane temperature, and side effects were recorded. \u0000RESULTS Shivering occurred 10% in the MgSO4 group and 19% in the meperidine group, with p = 0.23. Both groups had similar side effects of nausea, vomiting, and hypotension. \u0000CONCLUSIONS MgSO4 30 mg/kg was not superior to meperidine 0.5 mg/kg intravenously in preventing shivering in patients undergoing spinal anesthesia.","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49252187","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}
M. Jaya, Arif Sejati, Hariadi Hadibrata, L. Suciadi
Constrictive pericarditis is a rare type of pericardial disease that can be caused by various factors. Tuberculosis (TB) is one of the most common causes of this abnormality in Indonesia. Interestingly, tuberculous constrictive pericarditis can occur in the absence of acute pericarditis, pulmonary, or extrapulmonary TB. This case described a male adolescent with refractory right-sided heart failure symptoms who developed a rapidly progressive tuberculous constrictive pericarditis. Various imaging modalities, such as echocardiography, chest computed tomography (CT) scan, cardiac magnetic resonance imaging, and incidental PET/CT scan, were used to diagnose the pericardial abnormality. Histopathological findings in pericardial tissues confirmed the diagnosis. Complete surgical pericardiectomy, in conjunction with anti-TB drugs, diuretics, and colchicine, resulted in a significant clinical improvement.
{"title":"A case report of tuberculous constrictive pericarditis as a sole manifestation of tuberculosis in a male adolescent","authors":"M. Jaya, Arif Sejati, Hariadi Hadibrata, L. Suciadi","doi":"10.13181/mji.cr.225822","DOIUrl":"https://doi.org/10.13181/mji.cr.225822","url":null,"abstract":"Constrictive pericarditis is a rare type of pericardial disease that can be caused by various factors. Tuberculosis (TB) is one of the most common causes of this abnormality in Indonesia. Interestingly, tuberculous constrictive pericarditis can occur in the absence of acute pericarditis, pulmonary, or extrapulmonary TB. This case described a male adolescent with refractory right-sided heart failure symptoms who developed a rapidly progressive tuberculous constrictive pericarditis. Various imaging modalities, such as echocardiography, chest computed tomography (CT) scan, cardiac magnetic resonance imaging, and incidental PET/CT scan, were used to diagnose the pericardial abnormality. Histopathological findings in pericardial tissues confirmed the diagnosis. Complete surgical pericardiectomy, in conjunction with anti-TB drugs, diuretics, and colchicine, resulted in a significant clinical improvement.","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42891271","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}
A. Putranto, F. Suyatna, V. Soetikno, Y. Moenadjat
BACKGROUND The pathogenesis of intestinal fibrosis after strangulation in abdominal surgery is not fully understood. Developing an experimental and reliable method is needed to overcome this problem. This study aimed to develop an effective method for intestinal strangulation leading to fibrosis, which might induce intestinal obstruction. METHODS This study was conducted from 2018 to 2019 at the Department of Pharmacology, Faculty of Medicine, Universitas Indonesia. A total of 24 Sprague Dawley rats were used in this study. Artificial intestinal strangulation using cable ties made of durable plastic, which is generally used to ligate objects, was applied, and rats were further classified into control, 6-hour, and 24-hour strangulation groups. At the end of the study, the rats were sacrificed, intestinal tissues were collected, and histomorphological changes were observed using hematoxylin and eosin stain. Moreover, Masson’s trichome staining was used to assess collagen density. RESULTS Median collagen density score of the 24-hour strangulation group was higher than the control. A significant difference in collagen density was found between the submucosal layer of the 24-hour strangulation group and the control (45.4 [11.4] versus 32.4 [14.0], p<0.001) and between the mucosa of the 6- and 24-hour strangulation groups and the control (26.9 [17] versus 6.46 [4.3], p = 0.01 and 24.9 [8] versus 6.46 [4.3], p = 0.004, respectively). CONCLUSIONS The simple use of cable ties adequately promotes intestinal strangulation.
{"title":"Novel and simple method using cable ties to induce intestinal strangulation in a rat model","authors":"A. Putranto, F. Suyatna, V. Soetikno, Y. Moenadjat","doi":"10.13181/mji.oa.225799","DOIUrl":"https://doi.org/10.13181/mji.oa.225799","url":null,"abstract":"BACKGROUND The pathogenesis of intestinal fibrosis after strangulation in abdominal surgery is not fully understood. Developing an experimental and reliable method is needed to overcome this problem. This study aimed to develop an effective method for intestinal strangulation leading to fibrosis, which might induce intestinal obstruction. \u0000METHODS This study was conducted from 2018 to 2019 at the Department of Pharmacology, Faculty of Medicine, Universitas Indonesia. A total of 24 Sprague Dawley rats were used in this study. Artificial intestinal strangulation using cable ties made of durable plastic, which is generally used to ligate objects, was applied, and rats were further classified into control, 6-hour, and 24-hour strangulation groups. At the end of the study, the rats were sacrificed, intestinal tissues were collected, and histomorphological changes were observed using hematoxylin and eosin stain. Moreover, Masson’s trichome staining was used to assess collagen density. \u0000RESULTS Median collagen density score of the 24-hour strangulation group was higher than the control. A significant difference in collagen density was found between the submucosal layer of the 24-hour strangulation group and the control (45.4 [11.4] versus 32.4 [14.0], p<0.001) and between the mucosa of the 6- and 24-hour strangulation groups and the control (26.9 [17] versus 6.46 [4.3], p = 0.01 and 24.9 [8] versus 6.46 [4.3], p = 0.004, respectively). \u0000CONCLUSIONS The simple use of cable ties adequately promotes intestinal strangulation.","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48376708","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}
N. Jaafar, Idayu Badilla Idris, Norfazilah Ahmad, R. Hod, Baidi Baddiri, R. Hod
BACKGROUND Internet addiction (IA) is prone to be experienced by students and has become a major health concern. However, data on IA among allied health students are limited. This study aimed to describe the prevalence of IA and the association between mental health problems and IA among allied health students in Malaysia. METHODS A cross-sectional study was conducted from July to December 2021 in three government-funded allied health training institutes in Malaysia. A total of 265 allied health students undertaking a diploma in nursing, medical assistant training, physiotherapy, occupational therapy, and diagnostic imaging were recruited using stratified random sampling. The Malay version of the IA test was used to measure IA, while depression, anxiety and stress scale-21 items were used to assess their mental health problems. A general linear model was used to analyze the association between IA scores and mental health problems. RESULTS The prevalence of IA among allied health students was more than 80%, with 16.2% and 2.3% of them reporting moderate and severe IA, respectively. Higher depression (p<0.001), anxiety (p<0.001), and stress scores (p = 0.002) were associated with higher IA scores. CONCLUSIONS There were significant associations between mental health problems and IA scores among allied health students. Future studies with rigorous scientific methods are necessary to explore mental health effects on IA. Early intervention is also needed to prevent mental health problems among allied health students to overcome the problem of IA.
{"title":"Internet addiction and its association with depression, anxiety, and stress symptoms among allied health students in Malaysia","authors":"N. Jaafar, Idayu Badilla Idris, Norfazilah Ahmad, R. Hod, Baidi Baddiri, R. Hod","doi":"10.13181/mji.oa.225820","DOIUrl":"https://doi.org/10.13181/mji.oa.225820","url":null,"abstract":"BACKGROUND Internet addiction (IA) is prone to be experienced by students and has become a major health concern. However, data on IA among allied health students are limited. This study aimed to describe the prevalence of IA and the association between mental health problems and IA among allied health students in Malaysia. \u0000METHODS A cross-sectional study was conducted from July to December 2021 in three government-funded allied health training institutes in Malaysia. A total of 265 allied health students undertaking a diploma in nursing, medical assistant training, physiotherapy, occupational therapy, and diagnostic imaging were recruited using stratified random sampling. The Malay version of the IA test was used to measure IA, while depression, anxiety and stress scale-21 items were used to assess their mental health problems. A general linear model was used to analyze the association between IA scores and mental health problems. \u0000RESULTS The prevalence of IA among allied health students was more than 80%, with 16.2% and 2.3% of them reporting moderate and severe IA, respectively. Higher depression (p<0.001), anxiety (p<0.001), and stress scores (p = 0.002) were associated with higher IA scores. \u0000CONCLUSIONS There were significant associations between mental health problems and IA scores among allied health students. Future studies with rigorous scientific methods are necessary to explore mental health effects on IA. Early intervention is also needed to prevent mental health problems among allied health students to overcome the problem of IA.","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42894570","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}
S. Patrick, Huwaina Abdul Satar, Wan-Hazabbah Wan Hitam
This was a rare case of preseptal cellulitis with an unexpected complication by cerebral venous sinus thrombosis. A 73-year-old woman with poorly controlled diabetes mellitus presented with a week history of swelling and redness on the left upper eyelid and right forehead, associated with poor oral intake, lethargy, and fever. She was generally lethargic with poor verbal response. She had cellulitis of the left upper eyelid and right forehead with the left upper eyelid necrosis. Computed tomography venography of the brain revealed thrombosis of the right transverse sinus, right sigmoid sinus, and right internal jugular vein. She later developed left upper eyelid and right forehead abscesses. Incision, drainage, and wound debridement were performed. She was treated with intravenous antibiotics and anticoagulant. After 1 week of treatment, the preseptal and forehead cellulitis had resolved. However, she passed away due to aspiration pneumonia with respiratory failure on day-13 of hospitalization.
{"title":"Preseptal cellulitis and cerebral venous sinus thrombosis complication in a patient with diabetes mellitus","authors":"S. Patrick, Huwaina Abdul Satar, Wan-Hazabbah Wan Hitam","doi":"10.13181/mji.cr.225568","DOIUrl":"https://doi.org/10.13181/mji.cr.225568","url":null,"abstract":"This was a rare case of preseptal cellulitis with an unexpected complication by cerebral venous sinus thrombosis. A 73-year-old woman with poorly controlled diabetes mellitus presented with a week history of swelling and redness on the left upper eyelid and right forehead, associated with poor oral intake, lethargy, and fever. She was generally lethargic with poor verbal response. She had cellulitis of the left upper eyelid and right forehead with the left upper eyelid necrosis. Computed tomography venography of the brain revealed thrombosis of the right transverse sinus, right sigmoid sinus, and right internal jugular vein. She later developed left upper eyelid and right forehead abscesses. Incision, drainage, and wound debridement were performed. She was treated with intravenous antibiotics and anticoagulant. After 1 week of treatment, the preseptal and forehead cellulitis had resolved. However, she passed away due to aspiration pneumonia with respiratory failure on day-13 of hospitalization.","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44994470","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}
BACKGROUND Neoadjuvant chemotherapy (NACT) has been shown to improve the overall survival of locally advanced breast cancer (LABC) patients with pathological complete response. However, the efficacy may be reduced due to chemoresistance mediated by P-glycoprotein (Pgp). This study aimed to explore the association between Pgp expression and patients’ response to NACT. METHODS A prospective cohort study was carried out from May 2018 to October 2019 at Cipto Mangunkusumo Hospital and Koja Hospital. Treatment-naïve LABC patients were consecutively enrolled in the study. Immunohistochemistry analysis of the biopsy samples was done to semi-quantitatively measure Pgp expression. The clinical response was evaluated after 3 cycles of NACT, while the pathological response was evaluated for subjects who underwent surgery post-NACT. RESULTS Mean age of the subjects was 46.2 (9.6) years old, and most of the cases were invasive ductal (78%) and luminal B subtype (61%). Pgp was strongly expressed in 21/27 subjects (78%). There were no differences between Pgp-positive and -negative subjects for clinical response (relative risk [RR] 1.1, 95% confidence interval [CI] 0.33–4.01, p = 0.61) and pathological response (RR 1.3, 95% CI 0.8–1.9, p = 0.22). Other clinicopathologic variables were not associated with either clinical or pathological responses. CONCLUSIONS These results showed that Pgp is expressed in most LABC patients, but its role as a predictive factor could not be established. However, due to the limited subjects and a lack of standardized Pgp measurement, careful consideration must be done when interpreting these results.
{"title":"Association of P-glycoprotein expression and response to anthracycline-based neoadjuvant chemotherapy in locally advanced breast cancer","authors":"E. D. Yulian, Filipus Dasawala, N. Siregar","doi":"10.13181/mji.oa.225863","DOIUrl":"https://doi.org/10.13181/mji.oa.225863","url":null,"abstract":"BACKGROUND Neoadjuvant chemotherapy (NACT) has been shown to improve the overall survival of locally advanced breast cancer (LABC) patients with pathological complete response. However, the efficacy may be reduced due to chemoresistance mediated by P-glycoprotein (Pgp). This study aimed to explore the association between Pgp expression and patients’ response to NACT. \u0000METHODS A prospective cohort study was carried out from May 2018 to October 2019 at Cipto Mangunkusumo Hospital and Koja Hospital. Treatment-naïve LABC patients were consecutively enrolled in the study. Immunohistochemistry analysis of the biopsy samples was done to semi-quantitatively measure Pgp expression. The clinical response was evaluated after 3 cycles of NACT, while the pathological response was evaluated for subjects who underwent surgery post-NACT. \u0000RESULTS Mean age of the subjects was 46.2 (9.6) years old, and most of the cases were invasive ductal (78%) and luminal B subtype (61%). Pgp was strongly expressed in 21/27 subjects (78%). There were no differences between Pgp-positive and -negative subjects for clinical response (relative risk [RR] 1.1, 95% confidence interval [CI] 0.33–4.01, p = 0.61) and pathological response (RR 1.3, 95% CI 0.8–1.9, p = 0.22). Other clinicopathologic variables were not associated with either clinical or pathological responses. \u0000CONCLUSIONS These results showed that Pgp is expressed in most LABC patients, but its role as a predictive factor could not be established. However, due to the limited subjects and a lack of standardized Pgp measurement, careful consideration must be done when interpreting these results.","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49183294","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}
BACKGROUND Sepsis is a leading cause of mortality and morbidity globally. Gram-negative bacteremia was reported to have a high risk of septic shock and poor prognosis. This study aimed to evaluate the role of procalcitonin in predicting mortality in patients with sepsis due to Gram-negative bacteria. METHODS This was a retrospective cohort study performed based on medical records and sepsis registry of Tropical and Infectious Disease Division, Department of Internal Medicine, Cipto Mangunkusumo Hospital. The inclusion criteria were patients aged ≥18 years diagnosed with sepsis due to Gram-negative bacteria based on blood culture on admission and hospitalized between March 2017 and October 2020. Data taken from medical records included subjects’ characteristics, laboratory parameters, and 28-day mortality outcomes during hospitalization. Receiver operating characteristic was used to determine the area under the curve (AUC) of procalcitonin and its accuracy. RESULTS A total of 128 patients were eligible. The cumulative survival of patients with Gram-negative bacteremia was 48.4% (standard error 0.96%). The AUC of procalcitonin to predict mortality was 0.45 (95% confidence interval 0.36–0.54). Escherichia coli was the predominant microorganism in blood culture (n = 38, 29.7%). CONCLUSIONS Procalcitonin has a poor performance in predicting mortality of patients with sepsis due to Gram-negative bacteria.
{"title":"Procalcitonin prognostic value in predicting mortality among adult patients with sepsis due to Gram-negative bacteria","authors":"Bonita Effendi, C. Pitoyo, R. Sinto, S. Suwarto","doi":"10.13181/mji.oa.225864","DOIUrl":"https://doi.org/10.13181/mji.oa.225864","url":null,"abstract":"BACKGROUND Sepsis is a leading cause of mortality and morbidity globally. Gram-negative bacteremia was reported to have a high risk of septic shock and poor prognosis. This study aimed to evaluate the role of procalcitonin in predicting mortality in patients with sepsis due to Gram-negative bacteria. \u0000METHODS This was a retrospective cohort study performed based on medical records and sepsis registry of Tropical and Infectious Disease Division, Department of Internal Medicine, Cipto Mangunkusumo Hospital. The inclusion criteria were patients aged ≥18 years diagnosed with sepsis due to Gram-negative bacteria based on blood culture on admission and hospitalized between March 2017 and October 2020. Data taken from medical records included subjects’ characteristics, laboratory parameters, and 28-day mortality outcomes during hospitalization. Receiver operating characteristic was used to determine the area under the curve (AUC) of procalcitonin and its accuracy. \u0000RESULTS A total of 128 patients were eligible. The cumulative survival of patients with Gram-negative bacteremia was 48.4% (standard error 0.96%). The AUC of procalcitonin to predict mortality was 0.45 (95% confidence interval 0.36–0.54). Escherichia coli was the predominant microorganism in blood culture (n = 38, 29.7%). \u0000CONCLUSIONS Procalcitonin has a poor performance in predicting mortality of patients with sepsis due to Gram-negative bacteria.","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48383598","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}
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