Hang Tuah Medical Journal

Heavy Metals Excessive Intake in Humans: Implications for Brain Cognition and Selected Dietary Essential Micronutrients

YUSUF SARKINGOBIR, AMINU UMAR IMAM — Thu, 28 Nov 2024 00:00:00 +0000

The objective of this article is to deliver a conceptual review of implications of heavy metals intake for brains and certain dietary nutrients such as copper, zinc, etc. Heavy metals are metallic or relative elements that are described bases on certain characteristics such as higher density, toxicity, and likes. They are present ideally in the natural environment, therefore, have to be expunged through human activities which are currently excessive in nature. Humans take in heavy metals because of excessiveness of human activities and thereby causing detrimental effects on the body, brain, development, and nutritional growth. On the brain, heavy metals improvised ways to circumvent the wall of the bilayer and exert harm on certain areas of the brain. This lead to poor functioning of the brain, as well as the body. Similarly, the heavy metals utilized efforts such as molecular mimicry or chelation to outcompete or impede the functions of essential micronutrients required for body functioning. Cd2+ impede Cu2+, Ca2+, and Zn2+; Pb2+ also has the ability to impede essential elements. Other heavy metals such as chromium, arsenic, exert similar approaches. This review elucidated the following themes: Meaning of heavy metals, dietary sources of heavy metals, non-dietary sources of heavy metals, dietary nutrients for learning/cognition, implications of heavy metals to the Brian or quasi, effects of heavy metals on micronutrients. Food materials, and water should be safeguarded from heavy metals through disparate methods. Curative methods for heavy metals removal (remediation) should be made accessible to all.

Model Penampungan Air Berbasis Morfometrik Terhadap Keberadaan Vektor Demam Berdarah: Pilot Project di Candi, Sidoarjo

Thu, 28 Nov 2024 00:00:00 +0000

Background: The Aedes aegypti mosquito is a vector of many diseases that transmit diseases such as yellow fever, filariasis, chikungunya, zika, and Dengue Haemorrhagic Fever (DHF). The eradication of DBD mosquito is carried out mainly in places that have potential to become mosquito habitats, like containers or water reservoirs. Community action against the eradication of mosquito nests (PSN) rated 3M PLUS is still less, especially in draining the bathtub regularly. This paper aims to collect information on the characteristics of the container and its effect on the presence of aedes aegypti mosquito larvae so that a model of a mosquito larva-free bathtub can be created based on the morphometric study.
Method: This paper is a narrative review of literature that analysed 21 research journals from 2015 to 2019, consisting of 17 Indonesian journals, four English journals, two books, and four articles Indonesian Ministry of Health.
Result: The study found bathtubs that aren’t at risk as breeding places for larvae, are made of cement, are textured, brightly coloured, such as yellow, orange, or light green, have a cover, volume less than 50 litres, and a height of 80 cm.
Conclusion: Bathtub’s becomes the most potential breeding place for Aedes aegypti. Based on the literature study, the characteristics of the bathtub can influence the presence of mosquito larvae, so to achieve a larvae-free bathtub, the bathtub can be modified according to the characteristics that have already been found.

The Need For Marine Medicine Specialists for An Integrated Service Network Towards Advanced Indonesia 2045

Thu, 28 Nov 2024 00:00:00 +0000

Need for Marine Medicine Specialist Doctors: I. Hospital-Based Study Program, starting to run in 8 study programs, July 2024. II. Service Needs: 1) Regulations, 2) Development of Remote and Coastal Areas, 3) The existence of a Sea Highway, 4) The existence of marine tourism, 5) Fisheries, 6) Defense, 7) The existence of a New National Capital. III. Service Network: 1) Marine Medicine Service Center in the National Capital, 2) Frontline Areas, 3) Coastal Areas, 4) Hospital Ships. IV. Integrated Systems Network: 1) Defense System, 2) Transportation System, 3) Tourism System, 4) Fisheries System, 5) Telemedicine System, 6) Coastal Area Development, 7) Education, Research, Community Service and Innovation Systems. On August 25, 2023, the Marine Medicine Study Program was approved for a SCOR of 0.001/1,000 population, including efforts to accelerate the achievement of meeting needs. Calculation of Minimum Needs: calculated as 50% of the optimal value, 50% x 319 = 159.5 Rounded to 160, UNRAM and UHT Production Three more years: 3 +5 = 8, then it will only be achieved 20 to 40 years later. Proposed Solutions: 1) PRODI at UNRAM and UHT; There are 2 PRODIs with 3 classes: Regular, Parallel, and Scholarship, projected graduates 9+15 =24; 2) Immediately establish 10 Hospital Based PRODIs, this will meet the increasing needs, so produce 10 PRODIs, projected graduates 10 x 10 = 100; 3) Immediately form a Service Network and System Network, spread throughout Indonesia. 9 types, so there are 9 PRODI. Projection of graduates 9 x 10 = 90. Total projection: 24 + 100 + 90 = 214 per semester.

Keywords: need for specialist doctors, study program, student class, graduate projections.

Efek Sinergis Vitamin C Dalam Meningkatkan Kinerja Antijamur Madu Apis dorsata Terhadap Biofilm Candida albicans Untuk Terapi Kandidiasis

MASFUFATUN, FATIMATUZ ZAHRA, DWI PUTRI AGUSTIN ANGRAENI, FIRDAUSI NUZULA — Thu, 28 Nov 2024 00:00:00 +0000

Honey is a natural ingredient produced by bees from flower nectar that has antimicrobial, antioxidant, anti-inflammatory, good wound healing effects, and bacteriostatic. This study aims to determine the synergistic effect of vitamin C in improving the antifungal performance of Apis dorsata honey against Candida albicans biofilm for candidiasis therapy. This research design is true experimental with a post-test only control group design approach using the microtiter plate assay method to measure the Optical Density (OD) value of the biofilm matrix. The test of the synergistic effect of Vitamin C on Honey was carried out by adding vitamin C to honey concentrations of 5%, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, and 50%. Furthermore, the MBIC₅₀ value between honey and the combination of honey and vitamin C was compared. The results showed that both honey and the combination of honey and vitamin C were each able to decrease the growth of C. albicans biofilm matrix against A. dorsata honey at various concentrations. The results of the Minimum Biofilm Inhibitory Concentration 50% (MBIC₅₀) value in A. dorsata honey and the combination of A. dorsata honey and vitamin C were 84.27% and 63.56% respectively. Based on this study, it can be concluded that vitamin C can increase the antifungal performance of A. dorsata by lowering the MBIC₅₀ value. Thus, the combination of vitamin C and honey can be used as an alternative therapy for candidiasis.

Karakteristik Pasien Penderita Apendisitis Akut di RSUD Sanjwiani, Gianyar

SRI MASYENI, MIRACLE NYOMAN SANJAYA LIE, INDRA WIJAYA — Thu, 28 Nov 2024 00:00:00 +0000

Acute appendicitis is one of the most common emergency surgical cases of lower right abdominal pain, a small proportion of cases in emergency units in the world which are often experienced by children and adults. This study aims to identify the characteristics of acute appendicitis in patients at Sanjiwani Hospital, Gianyar. This research is a descriptive study with a retrospective cross-sectional approach method that uses secondary data in the form of medical records of acute appendicitis patients who underwent examinations at Sanjiwani Regional Hospital, Gianyar in the period 1 January 2020–31 December 2022. The results showed that the highest number of acute appendicitis sufferers were aged 10–19 years (34.3%), with the highest incidence in males (60.6%), and the most symptoms found, namely lower right abdominal pain (100%), with the most positive examination of the Mc Burney Sign (89.9%) and increased white blood cells with an average of 12.8 x 10^3/uL.

Profil Pasien Kanker Payudara Yang Menjalani Kemoterapi Di Rspal Dr. Ramelan Surabaya Periode Januari – Desember 2021

SEKAR KURNIA CAHYA, ANANG MUFTI SUMARSONO, PRAWESTY DIAH UTAMI — Thu, 28 Nov 2024 00:00:00 +0000

Background : Breast cancer is the most frequent cancer that occurs in Indonesia and becomes the main cause of mortality. Progression of breast cancer is affected by various factors, such as age, occupational status, menopause, estrogens, and lifestyle with high-fat dietary and alcohol consumption. Breast cancer progressivity may be stopped by surgery, chemotherapy, radiation, and hormonal therapy. Chemotherapy is an anticancer treatment management with the aim of killing cancer cells in the body and preventing recurrence and metastasis by administering cytotoxic agents. Chemotherapy may be performed previous to surgery (neoadjuvant) to achieve the decreased size of the tumor and facilitate the resection surgery. It may be performed as well after the surgery (adjuvant) to destroy any residual tumor cells. This study aimed to describe the profile of breast cancer patients who underwent chemotherapy from January to December 2021 at RSPAL Dr. Ramelan Surabaya.

Methods: This study was descriptive with a retrospective design. Data collected from secondary sources of medical records patients with breast cancer in RSPAL Dr. Ramelan Surabaya from January to December 2021.

Results: From the 79 samples, the most frequent age group in this study was a group of pre-elderly (45-59 years old). Most breast cancer patients are housewife. Breast cancer was commonly found in stage III. The most frequent chemotherapy management implemented for the breast cancer patient was adjuvant chemotherapy.

Conclusion: women aged 45-59 years, not working, stage III, receiving adjuvant chemotherapy.

Keywords : breast cancer, age, occupation, staging, chemotherapy

Hubungan Dukungan Manajemen Rumah Sakit dan Sikap Kepala Ruangan dengan Kepatuhan Perawat

JESSIKA PRAMUDYA Wardani, GUNTUR A. GAMA MUHAMMAD, DIANSANTO PRAYOGA — Thu, 28 Nov 2024 00:00:00 +0000

The importance of implementing safety measures and improving service quality in hospitals is supported by nurses' compliance in preventing patient fall risks. The factors of management support and inpatient chief support are also considered to influence nurses' compliance in following SOP to prevent patient fall risks at RSUD Blambangan. This study is to determine the correlation between hospital management support and inpatient chief support with nurses' compliance in implementing the SPO for preventing patient fall risks at RSUD Blambangan. This research is a quantitative study. The sample of this research are 103 nurses. The results of that correlation between inpatient chief attitude and nurses' compliance showed no significant correlation, with p-value of 0.126. Meanwhile, the relationship between hospital management support and nurses' compliance in implementation of patient fall risk prevention in the inpatient ward showed a significant relationship, with p-value of 0.007. The analysis of correlation test results indicates that the inpatient chief attitude variable is not related. On the other hand, the hospital management support variable has a significant correlation with nurses' compliance in implementing SPO for preventing patient fall risks in the inpatient ward of RSUD Blambangan.

Profilaksis Ekstrak Brokoli terhadap Kadar Gula Darah pada Tikus putih yang Diinduksi Deksametason

Thu, 28 Nov 2024 00:00:00 +0000

Diabetes mellitus is a chronic metabolic disease with chronic hyperglycemia. The increasing consumption of dexamethasone, especially during the COVID-19 pandemic, results in an increase in patients with hyperglycemia and even increases the risk of developing type 2 diabetes mellitus (T2DM). Glucocorticoids, including dexamethasone, often cause drug-induced hyperglycemia and drug-induced diabetes. Prophylactic therapy with natural ingredients, such as broccoli, which contains antidiabetic, antihyperglycemic, antioxidant and anti-inflammatory agents from its flavonoid compounds is needed to prevent or reduce hyperglycemia and the risk of T2DM. This study aims to determine the effect of prophylactic administration of broccoli extract (Brassica oleracea var. italica) as an inhibition against the increase in fasting blood glucose levels in rats caused by dexamethasone induction. 24 Wistar male white rats (Rattus norvegicus) were divided into 3 different groups; K(-) = no treatment, K(+) = subcutaneous dexamethasone induction 10 mg/KgBB/day for 10 days, KP = prophylaxis of broccoli extract 1000 mg/KgBB/day for 7 days and broccoli extract was continued along with subcutaneous dexamethasone induction 10 mg/KgBB/day for 10 days. The study lasted for 24 days and on the 25th day blood samples were taken for fasting blood glucose measurement.

The mean fasting blood glucose of K(-) = 173.62; K(+) = 304.89; KP = 180.50. One Way Anova parametric test results obtained significance p = 0.001 (p < 0.05). Post Hoc LSD results; K(+) and KP have a significance of p = 0.001 (p < 0.05).

Prophylactic administration of broccoli extract 1000 mg/KgBB can inhibit the increase (decrease) fasting blood glucose levels of Wistar male white rats induced by dexamethasone 10 mg/KgBB/day for 10 days.

Perbandingan Efektivitas Platelet Rich Plasma VS Hypertonic Dextrose Prolotherapy terhadap Perbaikan Klinis Pasien Osteoartritis Genu

Thu, 28 Nov 2024 00:00:00 +0000

ABSTRACT

Background:

Knee osteoarthritis (OA) affects mainly older individuals, causing joint degeneration and decreased mobility. While current treatments include medications and surgery, regenerative therapies like Platelet Rich Plasma (PRP) and Hypertonic Dextrose Prolotherapy (HDP) offer promising alternatives. This study aims to compare the effectiveness of PRP and HDP injections in knee OA patients, providing insights into optimal treatment choices.

Methods:

This experimental analytical study involved two groups of participants. Group 1 (N=20) received PRP injections three times into both knees with four-week intervals. Group 2 (N=20) received HDP injections with 20% concentration into both knees with the same intervals. Numeric Rating Scale (NRS) and Western Ontario and McMaster University Arthritis Index (WOMAC) scores were assessed before and after injections to evaluate changes in pain, stiffness, and functional limitation.

Results:

Both PRP and HDP injections significantly reduced NRS scores, pain, stiffness, functional limitation, and total WOMAC scores. The reduction in pain, functional limitation, and total WOMAC scores was higher with HDP, while PRP was more effective in reducing stiffness. Mild pain during injection and knee swelling were reported by some participants, but no systemic complaints were noted, and all side effects resolved within a week.

Conclusion:

Both PRP and HDP injections are equally effective in reducing pain and stiffness and improving function in knee OA patients. These procedures offer promising, cost-effective, and easily administered therapies for knee OA, with HDP being a more cost-efficient option compared to PRP.

Keywords: Osteoarthritis, regenerative therapy, comparison

Peran Uvula bifida terhadap pertumbuhan dan perkembangan bicara anak

ERNY, OKKY PRASETYO, AYLI SOEKANTO — Thu, 28 Nov 2024 00:00:00 +0000

Background: uvula bifida is a congenital abnormality of the oral cavity that has the potential to cause disturbances in the swallowing process and speech disorders.

Case: a 4-year-old boy weighing 11kg came with the main complaints of difficulty gaining weight since the age of 1 year and unclear speech. History of frequent choking and difficulty finishing his food portions. Frequent illnesses such as cough and cold. Evaluation of possible tuberculosis and UTI was done and the results were negative. Physical examination found uvula bifida degree 1 and other examinations within normal limits. Conservative management in the form of education on how to feed little but often, chew slowly, liquid food consistency and avoid spicy foods. Avoid talking while eating and supplementation of Fe, Zinc and multivitamins. Parents are expected to always correct unclear speech, regulate breathing when talking and eliminate habits that make children afraid, such as loud voices, scolding. At the next visit, there was a significant improvement in the child's weight and speech.

Conclusion: in cases of malnutrition, it is necessary to look for problems with food intake and expenditure, one of which is often overlooked is oral cavity abnormalities such as uvula bifida. Conservative therapy is performed on grade 1 uvula bifida.

Peran Terapi Penyekat Beta Pada Takikardia Persisten Yang Disebabkan Oleh Sepsis: Tinjauan Sistematis dan Meta-Analisis

KETUT ANGGA ADITYA PUTRA PRAMANA, BASUKI RAHMAT, YUSRA PINTANINGRUM — Thu, 28 Nov 2024 00:00:00 +0000

Terdapat peningkatan minat dalam penggunaan penyekat beta untuk mengobati takikardia pada sepsis, namun umumnya penyekat beta relatif dikontraindikasikan untuk sepsis karena dapat menyebabkan penurunan aktivitas jantung. Tujuan dari penelitian ini adalah untuk mengetahui peran pengobatan penyekat beta pada pasien dengan takikardia persisten yang disebabkan oleh sepsis. Pencarian jurnal elektronik dilakukan di PubMed, ScienceDirect, dan Cochrane dari Januari 2013 hingga Mei 2023 untuk mengidentifikasi uji coba kontrol acak yang menilai peran pengobatan penyekat beta pada pasien dengan takikardia persisten yang disebabkan oleh sepsis. Penyekat beta yang dipilih pada penelitian ini adalah penyekat beta kerja pendek esmolol. Penggunaan penyekat beta pada pasien dengan takikardia persisten dan sepsis secara signifikan dikaitkan dengan rendahnya risiko semua penyebab kematian (P<0,0001; OR 0,42; 95%CI 0,27 - 0,65). Terdapat juga penurunan denyut jantung yang signifikan (P<0.00001; MD -18.34; 95%CI -25.62 - -11.06) dan peningkatan signifikan pada indeks volume sekuncup (P 0.01; MD 2.61; 95%CI 0.62 - 4.59) pada kelompok kelompok penyekat beta dibandingkan dengan kontrol. Beberapa penelitian lainnya melaporkan bahwa penurunan denyut jantung dengan esmolol secara efektif meningkatkan efisiensi kardiovaskular dengan menurunkan elastansi arteri statis dan meningkatkan volume sekuncup.