Jurnal Biomedika dan Kesehatan

Estradiol Towards Sepsis

2023-11-08T13:33:41+07:00

Sepsis is an emergency condition as a result of host dysregulation systemic immune response to infection that is related to the end stage of organ dysfunction. Both sepsis and septic shock conditions are the main problems in ICU especially, those that affect millions of people in the whole world every year. Studies in line with immune-neuroendocrine related to sepsis get high attention about factors that play roles in sepsis pathogenesis and prognosis, like correlation to gender, hormones, and other factors. In this case, lots of experimental studies and clinical studies showed that sepsis has significant sexual dysmorphic. The female gender has proven protective against sepsis, meanwhile, males could have worse sepsis because of decreasing immunologic response that mediates cell and cardiovascular function. Estrogen is a hormone in women that plays important roles in not only reproductive function but also non-reproductive function. Physiological estrogen in women is divided into three forms: estrone (E1), estradiol (E2 or 17β- estradiol), and estriol (E3). Several experimental studies in animals showed that estradiol has a protective response when infection occurs. Estrogen generally stimulates cytokine release, induction of HO-1, and restoration of organ function due to sepsis. Potential pathogenesis for this condition is a specific expression of cytokine pro and anti-inflammation. This pathological inflammatory condition is related to gender that is found in surgical patients at the molecular level.

Review: an Overview of Neurodegenerative Diseases: Huntington, Alzheimer, and Parkinson

2023-12-25T15:28:25+07:00

Neurodegenerative diseases occur due to dysfunction of the nervous system, which is accompanied by memory and movement disorders. Neurodegenerative diseases can be viewed from an etiological and pathological perspective (pathophysiological and histopathological). The most common neurodegenerative diseases are Huntington's, Alzheimer's, and Parkinson's. This review article will review the etiology and pathology of Huntington's, Alzheimer's, and Parkinson's diseases. The method used in this writing uses journals and books from Google Scholar, PubMed, ResearchGate, and the Web. The keywords used are etiology, pathology, pathophysiology, histopathology, neurodegenerative disease, Huntington's, Alzheimer's, and Parkinson's. The author limited the last 10 years of literature used. Based on a literature review, it is known that the etiology of Huntington's disease is caused by mutations in the huntingtin gene on chromosome four. The pathology of Huntington's disease is caused by unstable expansion of trinucleotide-encoded polyglutamine (CAG) repeats. One of the histopathological features of Huntington's disease can be identified from increased iron levels in the striata of the brain. The etiology of Alzheimer's disease involves interactions between genetic factors, lifestyle, environment, and the aging process. The pathology of Alzheimer's disease occurs due to the presence of apolipoprotein and its relationship to 3 mutated genes. The histopathology of Alzheimer's disease is identified by the presence of neuronal cell death, which is characterized by the shrinking of the nuclei of brain neuronal cells and the cytoplasm has a more eosinophilic color. The etiology of Parkinson's disease is progressive nerve damage to certain areas of the brain. The pathophysiology of Parkinson's disease is thought to involve a reduction in striatal dopamine, which causes an increase in inhibitory output from the globus pallidus pars interna/substantia nigra pars reticulata (Gpi/SNr), resulting in movement suppression. Histopathologically, Parkinson's disease is characterized by degeneration of neurons and neurophagia. This review concludes that Huntington's, Alzheimer's, and Parkinson's diseases can be caused by aging and genetic factors. The pathology of the disease is due to mutations, increased levels of iron, apolipoprotein, neuronal cell death, increased inhibitory output, and neuronal degeneration. The symptoms caused can be motoric, cognitive, and psychiatric.

Role Of Exercise Intensity in Skeletal Muscle Hypertrophy

2024-03-13T09:45:15+07:00

Endurance training, a form of physical activity that relies on continuous aerobic exercise and repetitive muscle contractions, is widely acknowledged for its positive effects on overall physical fitness. Aerobic exercise, an essential component of endurance training, has numerous benefits including improved cardiovascular and respiratory health, increased muscle endurance, and enhanced resistance against fatigue. It has also been found to contribute to skeletal muscles, potentially by stimulating the synthesis of proteins involved in muscle fiber formation. Although resistance exercise has been favored for promoting muscle growth, some suggests that aerobic exercise can also produce skeletal muscle hypertrophy comparable to that of resistance exercise if performed correctly. The duration, intensity, and specific type of aerobic exercise play important roles in determining skeletal muscle mass. The mammalian target of rapamycin (mTOR) known as a key regulator of muscle protein synthesis that associated with exercise activity. Several signaling pathways, such as Akt/mTOR and MAPK, are involved in controlling muscle protein synthesis during exercise. This review aimed to understand the impact of aerobic exercise intensity and other training parameters on skeletal muscle, to provide valuable insights for optimizing exercise programs and fostering muscle hypertrophy. In this review, we had systematically searched PubMed and Google Scholar from January 2013 to May 2023. Our result indicated that aerobic exercise can be expected to promote skeletal muscle hypertrophy and improve muscle mass and function. The regulation of skeletal muscle mass is complex, involving various signaling pathways such as mTOR, as well as the influence of hormones and growth factors.

Painless Placental Abruption with 80% Retroplacental Bleeding: Case Report

2024-02-24T12:07:14+07:00

The maternal mortality rate in Indonesia is still high. According to the Indonesian Household Health Survey (SKRT) in 2001 found that bleeding in pregnancy contributes as the main cause of maternal mortality. Antepartum hemorrhage can be caused by placental abruption (PA) and placenta previa. This bleeding condition is an emergency case because it threatens the lives of both mother and fetus (mother-fetal dyad). Placental abruption is usually accompanied by pain due to continuous uterine contractions. In this case, although concealed hematoma exists in almost 80% of PA cases, the mother shows no sign or symptom even though the fetus is severely at risk. This condition can cause delayed management that leads to mother and fetal mortality, known as asymptomatic placental abruption.

The Challenges in Treating Obesity Patients with Major Depressive Disorder (MDD) Treatment: a Case Report

2024-02-28T12:03:33+07:00

Depression and obesity are two disorders that profoundly impact worldwide health. This is primarily because of their high occurrence, which is linked to both illness and death. Obesity increases the likelihood of developing depression and vice versa. The susceptibility to depression in individuals with obesity implies the existence of linked mechanisms between both conditions, although the molecular processes involved are not well comprehended. We describe a 28-year-old man who sought help from a dietitian or nutrition specialist to address weight gain that occurred after he began taking medication for his major depressive disorder (MDD) three years ago. This case study aims to address the challenges of treating obesity in patients with major depressive disorder (MDD) treatment.

CD68 Expression on Macrophages as Anti-Inflammatory Effect of Tamarillo (Solanum betaceum Cav.) Fruit Peel Ethanol Extract (Study on Carrageenan-Induced Buccal Mucosa of Rats)

2024-02-05T10:01:06+07:00

Background

Inflammation is one problem in the oral cavity that patients often complain about. Anti-inflammatory drugs are generally used to treat inflammation but these drugs have side effects therefore currently many anti-inflammatory drugs are developed from natural ingredients, one of which is Tamarillo. The flavonoid of Tamarillo fruit peel can inhibit inflammation. Carrageenan is an irritant that is often used as an indicator of inflammation because it has many advantages. Macrophages are innate immune cells that are important in inflammation. Macrophage cluster of differentiation 68 or CD68 expression can be used to detect inflammation activity. The objective of this study is to detect CD68 expression on macrophages as the anti-inflammatory effect of Tamarillo fruit peel (Solanum betaceum Cav.) ethanol extract.

Methods

This study used biological specimens of in vivo experimental research by observing immunohistochemical preparations of 5 sample groups, diclofenac sodium as a positive control, NaCl as a negative control, and Tamarillo fruit peel extract groups at doses of 70, 140, and 280 mg/kg.BW. Statistical analysis was performed using the one-way ANOVA test.

Results

There were significant differences (p< 0.05) in CD68 expression between each treatment group on the 24, 48, and 72 hours with the lowest number of expressions on the 72 hours of 280 mg/kg.BW group.

Conclusions

Ethanol extract of Tamarillo (Solanum betaceum Cav.) fruit peel has an effect on CD68 expression of macrophage cells in the buccal mucosa of carrageenan-induced rats with the most optimal dose of 280 mg/kg.BW on 72 hours.

Relationship Between Blood Lead (Pb) Levels and Hypertension in Motorcycle Taxi Drivers

2023-11-27T10:12:36+07:00

Background

Hypertension is a disease that is a major health problem in developed and developing countries and is the number one cause of death in the world every year. The causes of hypertension can be divided into genetic and environmental factors. One of the causes of hypertension from environmental causes is exposure to lead. This study aims to determine the relationship between blood lead levels and hypertension.

Methods

The design of this research is descriptive research with laboratory analysis using a cross-sectional approach. Sample selection using a purposive sampling method. The research sample was online motorcycle taxi drivers aged >35 years, with a minimum of 1 year as an online motorcycle taxi driver. Research samples were taken at the Faculty of Medicine, Trisakti University in September 2022. Laboratory examinations were carried out at the Prodia clinical laboratory, in Jakarta.

Results

Of the 133 samples examined, high lead levels were found in 20 respondents (15%) and low lead levels in 113 respondents (85%). High lead levels were found in 7 respondents who had hypertension and 13 respondents with normal blood pressure. The chi-square statistical test value shows a p-value = 0.260.

Conclusions

Blood lead levels do not have a significant relationship with blood pressure in motorbike taxi drivers.

The association between Stress Levels and Social Support in Mothers Regarding Exclusive Breastfeeding in Samarinda

2023-11-08T14:34:03+07:00

Background

The COVID-19 pandemic is causing stress in all aspects of life, including nursing mothers. This situation may affect exclusive breastfeeding coverage, which was only 66% in 2020. Factors contributing to low breastfeeding rates include maternal stress and social support. The aim of this study was to determine the association between maternal stress levels and social support for exclusive breastfeeding during the COVID-19 pandemic in Wonorejo Health Center, East Kalimantan.

Methods

The study design was cross-sectional with a sample of 165 mothers with children aged 6-24 months. Data collection was conducted online via a questionnaire on a Google Form link provided to subjects through their WhatsApp contacts. Data were analyzed using the chi-square test and the Kolmogorov-Smirnov test.

Results

55.8% of mothers had high levels of social support supporting exclusive breastfeeding, and 81.2% of mothers experienced moderate stress. Data analysis using the chi-square test and Kolmogorov-Smirnov test showed no relationship between social support (p=0.056) and stress level (p=0.969) during exclusive breastfeeding.

Conclusions

There was no significant association between stress levels and social support among mothers of exclusively breastfed children aged 6 to 24 months during the COVID-19 pandemic at the Wonorejo Health Center in Samarinda, East Kalimantan. Wonorejo Health Center is encouraged to continuously improve its breastfeeding promotion programs for mothers and families.

The Effect of Sleep Patterns to Incident of Hypertension: A Case-Control Study of Fishermen on the Puger Coast, Jember District

2023-12-19T09:16:08+07:00

Background

Hypertension prevalence in coastal areas is higher (53.3%) than in mountainous areas (6.8%). The high prevalence of hypertension in coastal areas is caused by lifestyle, one of which is poor sleep patterns. The research purpose was to determine the effect of sleep patterns on hypertension incidence in Puger fishermen.

Methods

This research used a Case-Control design. This research was conducted in February-March 2023. The research sample was calculated using a formula Lemeshow and there were 31 respondents in each group for a total of 62 respondents. The sampling technique used simple random sampling and the data taken included the variables hypertension and sleep patterns which consist of quality, duration, latency, efficiency, sleep disturbances, use of sleeping pills, and concentration problems during the day. Analysis data used frequency distribution for univariate analysis and tests Chi-Square and Fisher for bivariate analysis.

Results

The results showed that both groups had short sleep duration, it’s <7 or 8 hours. The results showed that 93.5% of fishermen in the case group experienced poor sleep patterns (score>5), while as many as 45.2% of fishermen in the control group experienced poor sleep patterns. Obtained (p-value <0.001; OR 17.6; CI 95%: 3.6-87.0), which means that the influence between sleep patterns and hypertension is the incidence in Puger fishermen and the OR value is 17.6 indicates that fishermen who have a poor sleep pattern have a 17.6 times risk attacked of hypertension than fishermen who have a good sleep pattern.

Conclusions

Sleep pattern is a risk factor for hypertension in Puger fishermen, so it’s recommended that respondents implement sleep patterns by optimizing sleeping hours as well and for The Puger Community Health Center to encourage respondents to utilize the facilities so they can monitor symptoms of hypertension.

Patient Characteristics Correlation with Cost of Hospitalisation in Ischemic Stroke Geriatric Patient

2024-03-10T09:50:58+07:00

Background

Ischemic stroke is a degenerative condition that primarily affects the elderly and has high treatment expenses. There is no data on how much it costs to treat stroke patients in Indonesia, and there are many factors that influence the cost of ischemic stroke treatment, particularly in geriatric patients.

Methods

This study was conducted from October to December 2018 using a cross-sectional technique. In this study, 53 patients who met the exclusion and inclusion criteria were employed as samples. The patient's characteristics, such as age, gender, length of stay, number of comorbidities, and drug quantities, are the independent variables in this study. The cost of treatment is the dependent variable. Data was acquired utilizing data collecting sheets from hospital information systems and medical records. The Spearman test and the eta test were conducted with 95 percent confidence to determine the correlation between patient characteristics and treatment costs, and the value of R was used to determine the strength of the correlation between variables.

Results

According to the findings, the average cost of treatment for geriatric ischemic stroke patients was Rp 5,144,083 Rp 4,423,794. The length of stay (p-value 0.05; R=0.756), the number of comorbidities (p-value 0.05; R=0.44), and the number of drugs (p-value 0.05; R=0.60) all had a significant correlation with the cost of treatment.

Conclusions

The factors that significantly affect the cost of hospitalisation for geriatric ischemic stroke patients are the length of stay, number of comorbidities, and number of drugs.

The Relationship of Flat Foot to Agility in Children Aged 7-10 Years

2024-03-08T09:39:19+07:00

Background

Lower extremity deformity could cause changes in the anatomical structure of the body, one of which was a flat foot. It was stated that 90% of the clinic visits for foot problems were related to flat foot. Studies still showed controversy regarding the relationship between flat foot and agility especially in children. This study aims to see the relationship between the incidence of flat foot and the level of agility in children aged 7 to 10 years.

Methods

A cross-sectional study was conducted on children aged 7-10 years who attend primary school in Jakarta. Sampling used simple random sampling with inclusion criteria for research subjects who had a normal BMI, were cooperative, and were willing to take part in the study. Exclusion criteria included children with special needs, children with pain or a history of lower extremity injuries, those having a cavus foot, and children in unhealthy conditions. The research was carried out from February to April 2023. Assessment of flat feet used the wet footprint test and shuttle run test was being used to measure the children’s agility. Bivariate data analysis used the Chi-square test with a significance level of p <0.05.

Results

As 168 respondents were studied, it was found that 58.3% had flat feet. Measurement of agility with the shuttle run test results in 51.8% of respondents who have below-average agility. The results of the Chi-Square test showed that there was a significant relationship between flat feet and agility (p<0.05).

Conclusions

There is a relationship between flat foot and agility in children aged 7-10 years.

The Correlation between Laboratory Metabolic Profile and Blood Pressure

2024-03-08T09:54:05+07:00

Background

High blood glucose and cholesterol are risk factors for hypertension. This study aims to determine the correlation between blood glucose and cholesterol levels with blood pressure in the normal blood pressure (NBP), controlled hypertension (CHT), and uncontrolled hypertension groups (UHT).

Methods

The study used a cross-sectional design with analytic observations on subjects aged 36 years or older. Ninety-five subjects were divided into three groups: NBP, CHT, and UHT. Subjects were men and women, without chronic heart failure or chronic renal failure. Samples were taken by consecutive random sampling. Blood pressure, body mass index, random BG, and lipid profile (triglycerides, HDL, LDL, total cholesterol) were measured. Statistical test using Spearman correlation test with p-value <0.05 significantly.

Results

There were 95 subjects with a range age of 36-81 years old. There were 30 NBP subjects, 34 CHT subjects, and 31 UHT subjects. There was a weak positive correlation between HDL level and diastolic BP in the NBP group (r=0.391;p=0.032). There was no correlation between blood glucose and other lipid profiles with BP in the three groups.

Conclusions

The increase in HDL is accompanied by an increase in diastolic blood pressure in NT but not with random blood sugar and other lipid profiles in all three blood pressure groups.

Relationship Between Pterygium and Dry Eye Syndrome Among Delivery Motorbike Drivers

2024-03-08T14:08:37+07:00

Background

Dry eye syndrome (DES) is an eye disease caused by many factors involving the ocular surface, with characteristic damage to tear layer homeostasis accompanied by ocular symptoms due to tear layer instability, hyperosmolarity, damage and inflammation of the ocular surface, and neurosensory abnormalities. Delivery motorbike drivers are often on the streets where the role of environmental factors will be able to pose a risk of experiencing DES. This study aims to assess risk factors associated with the incidence of dry eye syndrome in delivery motorbike drivers. The benefit of this research is to improve public health, especially in preventive behavior against factors associated with dry eye syndrome.

Methods

This study used observational analytical methods with a cross-sectional research design. The selection of samples by consequential non-random sampling amounted to 124 with the criteria of inclusion of delivery motorbike drivers, exclusion of not using artificial tears eye drops, and not use of contact lenses. Data were collected by filling out a DES risk factor questionnaire and a Tear Break Up Time (TBUT) examination to assess DES. The research data were analyzed using the Chi-Square test.

Results

This study's results show that subjects with dry eye syndrome are dominated by adults aged 19–44 and male sex. Subjects who experienced DES 76.6%, adult age 78.2%, male 80.6%, no pterygium 66.1%, working period 2-5 years 62.9%, length of work ≥8 hours 94.4%, always using a closed helmet 83.9%, not using protective glasses 39.5%, coffee consumption 71.8%, active smokers 66.1%, using gadgets >6 hours 91.9%. There is no significant relationship between subjects' characteristics and DES (p>0.05). The incidence of DES in pterygium showed significant results (p= 0.001).

Conclusions

There is a significant relationship between the incidence of pterygium and DES.

Relationship between Blood Magnesium Level, Physical Fitness and Stress Level in Online Driver

2024-03-08T14:02:44+07:00

Background

Most countries around the world suffered from the high-level transmission COVID-19. Thus, the government enforced a policy for the citizens to work from home. These restrictions impact the mental health of the citizens, and the prevalence of stress increases. Some of the factors that affect stress are magnesium intake and physical fitness. The study found that magnesium levels and fitness are correlated with stress levels. But some studies got different results. Thus, learning more about the relationship between magnesium level, fitness, and stress level is necessary.

Methods

This is a cross-sectional design study with consecutive non-random sampling methods. This study involving online drivers was held in Kampus B, Fakultas Kedokteran Universitas Trisakti, in September 2022. The inclusion criteria are aged 15-64 years, willing to sign the informed consent, can communicate well, while the exclusion criteria are in the therapy of anti-depressant or anti-anxiety drugs, and has a history of heart attack within one month.

Results

Based on the data, it can be concluded that most respondents are male, from the middle-aged group, and suffer from obesity, and about 50% of the respondents suffer from high blood pressure. Most respondents have normal blood-magnesium levels and medium levels of stress, while all the respondents have poor or very poor physical fitness. On the Chi-square test between age, sex, body mass index, blood pressure, physical fitness and stress level, the level of significance consecutively are 0.645; 0.208; 0.364; 0.451 and 1.000. While on the Fisher test, the significance level between blood magnesium level and stress level is 0.099.

Conclusions

Based on the bivariate test, it can be concluded that there is no significant relationship between age, sex, body mass index, blood pressure, physical fitness and blood magnesium level with the stress level.

Screening T4 and TSH in Early Detection of Congenital Hypothyroidism in Newborns: What’s the Dilemma?

2024-03-17T10:47:41+07:00

Untreated congenital hypothyroidism (CH) leads to intellectual disability. Newborn screening (NBS) for CH should be done on all infants. Prompt diagnosis by NBS leads to early and adequate treatment outcomes in very normal neurocognitive outcomes in adulthood. Newborn screening (NBS) for congenital hypothyroidism (CH) is one of the major achievements in preventive medicine. Most neonates born with CH have a normal appearance and no detectable physical signs. Blood spot thyroid stimulating hormone (TSH), thyroxine (T4), or both can be used for CH screening. The latter is more sensitive but not cost-effective, so screening by TSH or T4 is used in various programs worldwide. TSH screening is more specific in the diagnosis of CH. T4 screening is more sensitive in detecting newborns with rare hypothalamic-pituitary-hypothyroidism, but it’s less specific with a high frequency of false positives especially in low birth weight and premature infants. NBS alone is not sufficient to prevent adverse outcomes from CH in a pediatric population. In addition to NBS, the management of CH requires timely confirmation of the diagnosis and accurate interpretation of thyroid function testing, effective treatment, and consistent follow-up. Doctors need to consider hypothyroidism in the face of clinical symptoms, even if NBS thyroid test results are normal. When clinical symptoms and signs of hypothyroidism appear (such as large posterior fontanelles, large tongue, umbilical hernia, prolonged jaundice, constipation, lethargy, and/or hypothermia), measurement of serum thyroid hormone and free thyroxine is indicated, regardless of NBS results. So all these babies should be treated as having CH during the first 3 years of life, taking into account the risk of mental retardation. Re-evaluation after 3 years is required in such patients.