Search

The emerging renal complications in beta-thalassemia patients have raised the global exchange of views. Despite better survival due to blood transfusion and iron chelation therapy, the previously unrecognized renal complication remain a burden of disease affecting this population -the primary concern on how iron overload and chelation therapy correlated with renal impairment is still controversial. Early detection and diagnosis is crucial in preventing further kidney damage. Therefore, a systematic review was performed to identify markers of kidney complications in beta thalassemia patients with iron overload receiving chelation therapy.Searches of PubMed, Scopus, Science Direct, and Web of Science were conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to identify studies of literature reporting renal outcome in β-TM patients with iron overload and receiving chelation therapy. The eligible 17 studies were obtained.uNGAL/NGAL, uNAG/NAG, uKIM-1 are markers that can be used as predictor of renal tubular damage in early renal complications, while Cystatin C and uβ2MG showed further damage at the glomerular level.The renal complication in beta-thalassemia patients with iron overload receiving chelating agent therapy may progress to kidney disease. Early detection using accurate biological markers is a substantial issue that deserves further evaluation to determine prevention and management.

introduction: A cataract is a condition of the eye lens experiencing turbidity. It is the highest cause of blindness in the world. Smoking is one of the risk factors for cataracts. According to the Brinkman index, the degree of smoking is a multiplication between smoking time and the number of cigarettes consumed in a day. This study aims to analyze the influence of smoking degree on cataracts.

Tuberculosis (TB) is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. The incidence of tuberculosis in Indonesia is high because the success rate of tuberculosis treatment has decreased which causes the chain of transmission continues to occur. The main government programs to decrese the incidence and increasing the success treatment with the Directly Observed Treatment (DOTS) program. One important indicator of the DOTS program to assessing the success of tuberculosis treatment is the conversion of positive AFB sputum to negative at the end of the intensive phase of treatment. AFB sputum conversion to negative at the end of the intensive phase of treatment is influenced by several internal factors such as level of education and income, gender, adherence, patient's nutritional status, and comorbidities. Then external factors can also influence the AFB sputum conversion in anti-tuberculosis treatment such as environmental conditions, smear positivity, drug taking supervisors (PMO), and availability of drugs in health facilities.

Background: To date, coronavirus diseases 2019 (COVID-19) has no definitive treatment. Thrombosis and hypercoagulation may occur in the advanced stage. Further study on how to use anticoagulants is still required to promote the best prognosis. Methods: A cross-sectional study of 110 moderate, 140 severe, and 81 critical patients receiving unfractioned heparin (UFH), low-molecular-weight heparin (LMWH), and fondaparinux was conducted. Data were collected from March 15th to August 31st 2020 at Universitas Airlangga and Husada Utama Hospital. A comparative study of white blood cell (WBC), neutrophils, lymphocytes, neutrophil-lymphocyte ratio (NLR), c-reactive protein (CRP), procalcitonin (PCT), D-dimer, all-cause mortality rate, length of stay, and days of death among three severities of COVID-19 was done. Univariate and multivariate analysis were used to determine the correlation between inflammatory state after anti-coagulant with patients’ mortality. Results: Two deaths occurred in moderate cases, 36 deaths in severe cases, and 70 deaths in critical cases on ventilators. On day 13, moderate and severe groups showed decreased WBC, neutrophils, NLR, CRP, and D-dimer (p < 0.05). NLR, CRP, and D-dimer (p Conclusions: Anticoagulants in COVID-19 patients lower inflammation markers. Evaluating inflammatory status is essential to predict the mortality. Inflammatory markers on day 13, based on the severity of COVID-19 and comorbidities, were associated with mortality in moderate and critical cases.

Pradana Zaky Romadhon,1– 3 Ami Ashariati Prayoga,1– 3 Siprianus Ugroseno Yudho Bintoro,1– 3 Muhammad Noor Diansyah,1– 3 Putu Niken Ayu Amrita,1– 3 Merlyna Savitri,1– 3 Satriyo Dwi Suryantoro,1,2 Kartika Prahasanti,4 Andi Yasmin Wijaya,5 Winona May Hendrata,5 Choirina Windradi,2 Bagus Aulia Mahdi,1 Krisnina Nurul Widiyastuti,1 Esthiningrum Dewi Agustin1 1Department of Internal Medicine, Faculty of Medicine, Airlangga University, Surabaya, Indonesia; 2Department of Internal Medicine, Universitas Airlangga Hospital, Surabaya, Indonesia; 3Hematology and Oncology Division, Department of Internal Medicine, Dr. Soetomo General Teaching Hospital, Surabaya, Indonesia; 4Department of Physiology, Faculty of Medicine, Muhammadiyah Surabaya University, Surabaya, Indonesia; 5Faculty of Medicine, Airlangga University, Surabaya, IndonesiaCorrespondence: Pradana Zaky Romadhon, Department of Internal Medicine, Faculty of Medicine, Airlangga University, Jl. Mayjen Prof. Dr. Moestopo No. 47, Pacar Kembang, Kec. Tambaksari, Kota SBY, Surabaya, Jawa Timur, 60132, Indonesia, Email zaky.romadhon@fk.unair.ac.idBackground: miRNA-21, one of breast cancer (BC) predictive markers, is now gaining cardinal attention from researchers worldwide to evaluate BC patients’ survival rate. However, cancer staging, hormonal status, and other BC markers still have to be discussed. We aim to determine the relationship between miRNA-21 and associating factors such as BC staging, other tumor markers, and hormonal status to predict the 2-year survival rate of BC patients.Methods: We conducted a prospective cohort study on 49 BC patients (26 early stage, 23 advanced stage). Apart from cancer staging, we also examined CEA, Ca15-3, and hormonal status (ER, PR, Her2) and correlated them with miRNA-21 to predict 2-year survival rate. We did bivariate, multivariate, and survival analyses to determine the link between miRNA-21 and those factors to prognosticate on 2-year survival rate.Results: There are significances between advanced and loco-regional stage (p < 0.001); high and low miRNA-21 (p = 0.002) and CA 15– 3 (p = 0.001), and low survival rate in patients with ER/PR-Her2- status (p=0.0015). Cox proportional hazard showed miRNA-21 (Adjusted HR 1.41; 95% CI = 1.205– 1.632), cancer stage (Adjusted HR 9.5; 95% CI = 1.378– 20.683), and CA15-3 (Adjusted HR 4.64; 95% CI = 1.548– 13.931) affected patients’ mortality within 2 years.Conclusion: Low two-year survival rate depends on miRNA-21, cancer stage, CA15-3, and ER/PR-Her2-. Cancer stage is robustly associated with miRNA-21 in predicting 2-year survival rate.Keywords: breast cancer, miRNA-21, survival, stage, health

Extranodal non-Hodgkin lymphoma still seems to be a rare case and an issue to discuss a lot. Clinical evidence and guidelines on treatment have not yet been widely published and accessible. We present a case of a forty-five-year-old male with the chief complaint of a bulky and huge right mass in the testis with an ulcer on it. The patient underwent an orchiectomy, and the biopsy showed a malignant round cell tumor, suspected as non-Hodgkin lymphoma. The patient then received the following treatment: chemotherapy with R-CHOP regiment every three weeks, consisting of 6 cycles showing shrinkage size of the testis by day 7 and final complete response after 4th cycle with ADE grade 0 no sexual activity disorder after chemotherapy. This raises hope in developing treatment modalities that the right choice on chemotherapy regimen with complete control on the drug effects may improve clinical outcome and patient’s quality of life.

Introduction: Various medical education institutions around the world have different methods and criteria in selecting the ideal candidate. This study aims to determine the most appropriate admission criteria for predicting student academic performance in a newly established medical faculty in Indonesia.

Background: To date, coronavirus diseases 2019 (COVID-19) has no definitive treatment. Thrombosis and hypercoagulation may occur in the advanced stage. Further study on how to use anticoagulants is still required to promote the best prognosis. Methods: A cross-sectional study of 110 moderate, 140 severe, and 81 critical patients receiving unfractioned heparin (UFH), low-molecular-weight heparin (LMWH), and fondaparinux was conducted. Data were collected from March 15th to August 31st 2020 at Universitas Airlangga and Husada Utama Hospital. A comparative study of white blood cell (WBC), neutrophils, lymphocytes, neutrophil-lymphocyte ratio (NLR), c-reactive protein (CRP), procalcitonin (PCT), D-dimer, all-cause mortality rate, length of stay, and days of death among three severities of COVID-19 was done. Univariate and multivariate analysis were used to determine the correlation between inflammatory state after anti-coagulant with patients’ mortality. Results: Two deaths occurred in moderate cases, 36 deaths in severe cases, and 70 deaths in critical cases on ventilators. On day 13, moderate and severe groups showed decreased WBC, neutrophils, NLR, CRP, and D-dimer (p < 0.05). NLR, CRP, and D-dimer (p Conclusions: Anticoagulants in COVID-19 patients lower inflammation markers. Evaluating inflammatory status is essential to predict the mortality. Inflammatory markers on day 13, based on the severity of COVID-19 and comorbidities, were associated with mortality in moderate and critical cases.

Background: To date, coronavirus diseases 2019 (COVID-19) has no definitive treatment. Thrombosis and hypercoagulation may occur in the advanced stage. Further study on how to use anticoagulants is still required to promote the best prognosis. Methods: A cross-sectional study of 110 moderate, 140 severe, and 81 critical patients receiving unfractioned heparin (UFH), low-molecular-weight heparin (LMWH), and fondaparinux was conducted. Data were collected from March 15th to August 31st 2020 at Universitas Airlangga and Husada Utama Hospital. A comparative study of white blood cell (WBC), neutrophils, lymphocytes, neutrophil-lymphocyte ratio (NLR), c-reactive protein (CRP), procalcitonin (PCT), D-dimer, all-cause mortality rate, length of stay, and days of death among three severities of COVID-19 was done. Univariate and multivariate analysis were used to determine the correlation between inflammatory state after anti-coagulant with patients’ mortality. Results: Two deaths occurred in moderate cases, 36 deaths in severe cases, and 70 deaths in critical cases on ventilators. On day 13, moderate and severe groups showed decreased WBC, neutrophils, NLR, CRP, and D-dimer (p < 0.05). NLR, CRP, and D-dimer (p Conclusions: Anticoagulants in COVID-19 patients lower inflammation markers. Evaluating inflammatory status is essential to predict the mortality. Inflammatory markers on day 13, based on the severity of COVID-19 and comorbidities, were associated with mortality in moderate and critical cases.

Preeclampsia is one of the most common complications in pregnancy that can lead to various complications such assevere illness, long-term disability, andmaternal, fetal, and neonatal mortality. The prevalence of preeclampsia, 30%-40% can cause maternal mortality, and 30%-50% can lead to perinatal mortality. Maternal age is one of the riskfactors for late-onset preeclampsia. Maternal age is grouped into two categories; extreme age ( 35 years)and reproductive age (21-35 years). This studyaims to determine the relationship between maternal age and late-onsetpreeclampsia at PKU Muhammadiyah Surabaya Hospital from January to June 2020. The research method used isobservational analytic with case control design. The samples involved were pregnant women visiting PKUMuhammadiyah Surabaya Hospital from January to June 2020. The data were analyzed using a statistical test ofcontingency coefficient correlation. The results showed that respondents who experienced late-onset preeclampsia inthe extreme age group ( 35 years) were 37 respondents (100%) and in reproductive age (21-35 years)were 28 respondents (80%), the respondent who did not experience late-onset preeclampsia in extreme ages ( 35 years) was 0 respondents(0%) and in reproductive age (21-35 years) were 7 respondents (20%). The resultsof the statistical test for the contingency coefficient correlation showed a p-value of 0.004 below (≤0.05). All thingsconsidered, there was a significant relationship between maternal age and late-onset preeclampsia at the PKUMuhammadiyah Surabaya Hospital from January to June 2020.

Penyakit COVID-19 telah menjadi pandemi global sejak Desember 2019. Menurut WHO, hingga 28 September 2020, sudah ada 33.137.748 kasus yang dikonfirmasi di seluruh dunia, 3,01% di antaranya meninggal dunia (998.372). Dengan Case Fatality sebesar 3,17% WHO menetapkan Wabah COVID-19 ini di tingkat pandemi. Dari 2,5 juta kematian akibat Covid-19 yang dilaporkan pada akhir Februari 2021, 2,2 juta lebih dari setengah populasinya diklasifikasikan sebagai kelebihan berat badan. Obesitas menjadi salah komorbid yang dikaitkan dengan keparahan gejala COVID-19 dikarenakan Obesitas sendiri dapat menyebabkan gejala seperti gangguan cardiovaskular, gangguan respirasi, gangguan imun, dan juga inflamasi kronis. Tujuan penelitian ini untuk mengetahui pengaruh peningkatan jaringan adiposa pada pasien obesitas terhadap tingkat keparahan pasien COVID-19.

Dunia saat ini dikejutkan dengan wabah virus baru COVID-19 yang bermulai dari Wuhan, Provinsi Hubei yang menyebar dengan cepat hingga berbagai negara. Menanggapi masalah ini WHO menetapkan COVID-19 sebagai pandemi global. Virus ini dapat ditularkan dari manusia ke manusia dan telah menyebar secara luas di China dan lebih dari 190 negara dan teritori lainnya. Sampai tanggal 29 Maret 2020, terdapat 634.835 kasus dan 33.106 jumlah kematian di seluruh dunia. Sementara di Indonesia dilaporkan ditemukan sejumlah 2 kasus pada tanggal 2 Maret 2020 dan merupakan tingkat kematian tertinggi di Asia Tenggara. Kematian akibat COVID-19 dapat terjadi pada bayi hingga lanjut usia. Lanjut usia tetap menjadi faktor risiko kematian utama dibandingkan dengan usia yang lain dikarenakan beberapa faktor seperti gangguan kognitif, gangguan perilaku, dan sebagainya. Lanjut usia juga sering dikaitkan dengan penyakit komorbid seperti hipertensi dan diabetes. Tujuan penulisan ini untuk mengetahui gambaran faktor risiko lanjut usia terhadap kematian pasien dengan COVID-19 .

Transient Receptor Potential Vanilloid type 1(TRPV1) adalah saluran kation nonselektif yang diaktifkan oleh berbagai rangsangan penghasil rasa sakit seperti capsaicin, perubahan pH dan panas. Diketahui kemungkinan bahwa TRPV1 berperan penting dalam terjadinya pruritus dan induksi inflamasi pada dermatitis atopik, sehingga Antagonis TRPV1 PAC-14028 dapat menjadi pilihan terapi potensial untuk pasien dermatitis atopik. Tujuan ditulisnya artikel ini untuk mengetahui potensi penggunaan antagonis TRPV1 krim PAC-14028 sebagai terapi pada dermatitis atopik. Artikel ini dibuat dengan meninjau jurnal penelitian dan artikel – artikel ilmiah berdasarkan pencarian menggunakan PubMed, PMC, Google Scholar. Hasil penelitian menunjukkan Antagonis TRPV1 krim PAC-14028 dapat menekan gejala mirip dermatitis atopik dengan mempercepat pemulihan penghalang kulit. Sehingga dapat disimpulkan bahwa Krim PAC-14028 mempunyai potensi sebagai pengobatan pada dermatitis atopik.

Exercise with HICT methods is not the only effort to prevent cardiovascular disease. The development of science and technology of sports has resulted in the latest innovations and discoveries such as High Intensity Interval Training (HIIT) method that can improve cardiovascular abilities. HIIT is more flexible to do than High Intensity Continous Training (HICT) method. The purpose of this study is to compare exercise with HIIT and HICT method. It is an experimental quasy using 32 swimming athletes who were divided into two groups and given different training to measure VO2max, heart rate recovery, and resting heart rate. Subjects did training for five weeks with a frequency of exercise five times a week. The results show an increase in VO2Max in the HIIT group (22.83%) compared to the continuous group (9.36%) with p

Background: Exclusive breastfeeding is giving breast milk exclusively from newborns to 6 months of age without giving any food. Exclusive breastfeeding is essential for optimal baby growth and development, contains various essential nutrients for babies. In 2018 the coverage of exclusive breastfeeding in Indonesia still reached 65.16%, and the coverage of breastfeeding in East Java itself was still below the target of 76.98%. The low level of exclusive breastfeeding is still a problem because it can cause the baby's immune system to become lower, indigestion and illness risk in the baby is more generous to target.Objective: To determine the relationship between mothers' level of knowledge about breastfeeding and exclusive breastfeeding at Kenjeran Primary Health Center.Methods: This observational analytic study with a cross-sectional study design. The sampling technique was using the purposive sampling technique. Respondents in this study were mothers who had babies 6-24 months. The data collection process was directly asked through a questionnaire and analyzed using the contingency coefficient test.Results: This study involved 51 mothers who gave exclusive breastfeeding and 51 mothers who did not. The results showed that most of the respondents who breastfed and did not have the right knowledge level. Based on the contingency coefficient test results, it was found that there was no relationship between the level of mother's knowledge about breast milk to give exclusive breastfeeding at the Kenjeran Primary Health Center (the value of p = 0.251).Conclusion: There is no relationship between mothers' level of knowledge about breastfeeding and exclusive breastfeeding at the Kenjeran Primary Health Center.Background: Exclusive breastfeeding is giving breast milk exclusively from newborns to 6 months of age without giving any food. Exclusive breastfeeding is essential for optimal baby growth and development, contains various essential nutrients for babies. In 2018 the coverage of exclusive breastfeeding in Indonesia still reached 65.16%, and the coverage of breastfeeding in East Java itself was still below the target of 76.98%. The low level of exclusive breastfeeding is still a problem because it can cause the baby's immune system to become lower, indigestion and illness risk in the baby is more generous to target.Objective: To determine the relationship between mothers' level of knowledge about breastfeeding and exclusive breastfeeding at Kenjeran Primary Health Center.Methods: This observational analytic study with a cross-sectional study design. The sampling technique was using the purposive sampling technique. Respondents in this study were mothers who had babies 6-24 months. The data collection process was directly asked through a questionnaire and analyzed using the contingency coefficient test.Results: This study involved 51 mothers who gave exclusive breastfeeding and 51 mothers who did not. The results showed that most of the respondents who breastfed and did not have the right knowledge level. Based on the contingency coefficient test results, it was found that there was no relationship between the level of mother's knowledge about breast milk to give exclusive breastfeeding at the Kenjeran Primary Health Center (the value of p = 0.251).Conclusion: There is no relationship between mothers' level of knowledge about breastfeeding and exclusive breastfeeding at the Kenjeran Primary Health Center.

Latar Belakang: Menurut data WHO tahun 2012, stroke merupakan penyakit yang menyebabkan kematian terbesar ketiga di seluruh dunia setelah kanker dan penyakit jantung koroner serta terdapat 6,2 juta kematian disebabkan oleh stroke. Pada kondisi stroke akut sering kali mengalami hipertensi, hiperglikemia,dan leukositosis. Kenaikan kadar gula darah pada pasien stroke yang tidak memiliki riwayat diabetes sebelumnya disebut dengan hiperglikemia reaktif. Hal ini dapat mempengaruhi mortalitas dan morbiditas dari penderita stroke. Dimana kelainan ini kemungkinan disebabkan oleh peningkatan drastis sekresi kortisol sebagai respon terhadap segala jenis situasi stress yang diperantarai oleh susunan sistem saraf pusat melalui peningkatan aktivitas sistem aksis hipotalamus-pituitari-adrenal. penelitian ini dilakukan untuk melihat outcome atau hasil keluaran dari pasien stroke akut yang mengalami hiperglikemia dan akan dievaluasi dengan Indeks Barthel. Tujuan: Untuk mengetahui adanya hubungan antara hiperglikemia reaktif pada stroke fase akut dengan keluaran pasien stroke berdasarkan Indeks Barthel di Rumah Sakit Siti Khodijah Sepanjang Metode: Menggunakan desain cross sectional dengan teknik pengambilan sampel sampling from consecutive admission yaitu menurut kasus yang datang berturut-turut sampai jumlah sampel terpenuhi. Penelitian ini dimulai dengan mengambil daftar pasien yang mengalami stroke iskemik di Instalasi Gawat Darurat, kemudian mengambil data pasien di ruangan rawat inap dengan melihat berkas rekam medis pasien untuk melihat nilai gula darah acak pasien pada fase akut serangan stroke, setelah itu melakukan penilaian Indeks Barthel pada hari kelima pasien dirawat. Hasil: Hasil uji statistik menggunakan Koefisien Kontingensi didapatkan nilai signifikan p: 0.039 (p

COVID 19 saat ini merupakan salah satu masalah yang ramai diperbincangkan oleh seluruh masyarakat di dunia. Penyebaran virus ini sangat cepat bahkan hampir seluruh negara di dunia merasakan dampak dari virus ini. Virus ini sangat berbahaya apabila menginfeksi orang yang memiliki daya tahan tubuh yang rendah dan dipengaruhi usai, jenis kelamin laki-laki, perokok aktif. dan beberapa penyakit komorbid diantaranya adalah hipertensi dan diabetes mellitus. Pada pasien hipertensi, diabetes melitus, dan perokok, diduga adanya peningkatan ekspresi reseptor ACE2. Hipertensi dapat mejadi faktor risiko dari COVID 19, hal ini dikaitkan dengan penggunaan obat anti hipertensi seperti obat angiotensin mengkonversi enzim inhibitor (ACEI) dan angiotensin reseptor blockers (ARBs), karena penggunaan obat ini bisa saja meregulasi reseptor ACE2 bahkan memperparah COVID 19, namun hal ini belum terbukti secara jelas, karena beberapa penelitian juga menjelaskan bahwa penggunaan obat ini tidak mempengaruhi tingkat keparahan COVID 19.