Folia Medica Indonesiana

Therapeutic Response in Children with Immune Thrombocytopenia Purpura

Mia Ratwita Andarsini — 2024-12-11

Immune Thrombocytopenia Purpura (ITP) is an autoimmune disorder triggered by antiplatelet autoantibodies. Without prompt treatment and close monitoring, the condition could worsen, potentially resulting in fatal consequences. Clinically, ITP is classified into three phases including Newly-Diagnosed ITP, Persistent ITP, and Chronic ITP, each with distinct durations and therapy implications. In ITP patients, platelet counts decrease, accompanied by abnormal shifts in platelet indices, including Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Platelet Large Cell Ratio (P-LCR), and Plateletcrit (PCT). Thus, therapeutic response in ITP patients can be evaluated through increased platelet counts and normalization of platelet indices. This study aimed to assess the therapeutic response of platelet counts and platelet indices in pediatric ITP patients by comparing pre- and post- therapy levels. This retrospective study included ITP patients under 18 years old at Dr. Soetomo General Academic Hospital, Surabaya, conducted from September 2023 to March 2024. Platelet count and platelet indices pre- and post-therapy levels were analyzed using the Paired T-test for normally distributed data and the Wilcoxon test for non-normally distributed data, with significance set at p < 0.05. In summary, there were notable changes in the pre- and post-therapy levels of platelet, MPV, PDW, P-LCR, and PCT in each ITP category and for all therapies. Platelet count and PCT increased, while MPV, PDW, and P-LCR decreased. Patients treated with prednisone exhibited the best therapeutic response. Among the categories, Newly Diagnosed ITP demonstrated the most optimal therapeutic response. Overall, ITP therapy led to significant differences between pre- and post-therapy levels, marked by an increase in platelet counts and normalization of platelet indices.

Unveiling The Tubarial Gland: Key Anatomical Features and Clinical Significance

Dwi Martha Nur Aditya — 2024-12-11

Medical technological advancements have revealed previously unknown anatomical features in the nasal cavity known as tubarial glands. However, many questions remain unanswered concerning these glands. The authors intend to give analysis of the tubarial glands, including their major discovery (MD), anatomical and histological features (AHF), and clinical significance (CS), through this systematic review. Articles were identified using the PRISMA methods, with data collected from SCOPUS, ScienceDirect, SpringerLink, and PubMed until September 2024. Medical Subject Headings (MeSH) were utilized using various terminology: "tubarial gland*", "tubarial salivary gland*", and "radiotherapy”. Inclusion criteria were: (1) type of study was original research report, case report, case studies, letter to editor, brief communication, commentary, editorial, and news (2) articles with full-text access only, and (3) The article provides information on the tubarial glands. Exclusion criteria were: (1) type of study systematic review, meta-analysis, or bibliometry and (2) article is not in english. The identification yielded a total of 37 articles worldwide. The distribution of the types of studies includes original research (19; 51.3%), case report (3; 8.1%), letter to editor (6; 16.2%), brief communication (2; 5.4%), commentary (7; 18.9%), editorial (1; 2.7%), news (1; 2.7%). Based on research subjects and their total number includes healthy patients (1; 2.7%) with a total of 26 subjects, prostate cancer (12; 32.4%) with a total of 612 subjects, head and neck cancer (3; 8.1%) with a total of 38 subjects, nasopharyngeal carcinoma (1; 2.7%) with a total of 240 subjects, Sjorgren's syndrome (1; 2.7%) with a total of 29 subjects, oncocytic papillary cystadenoma (1; 2.7%) with a total of one subject, and others (20; 54.0%). This newly discovered gland has similar morphological, histological, and physiological properties to salivary glands and may have a function in upper airway lubrication and maintenance.

Efficacy and Safety of Ozoralizumab versus Moxibustion for Rheumatoid Arthritis

Luthfiana Rofhani Susanti — 2024-12-11

Rheumatoid arthritis (RA) is a chronic inflammatory disease that symmetrically damages the synovial membrane, affecting approximately thirteen percent of the global population. Systemic complications and substantial declines in quality of life may ensue from untreated RA. This study investigates the safety and efficacy of moxibustion and ozoralizumab in reducing disease activity scores in RA patients. Between July and November 2023, we performed an extensive search across four online databases (PubMed, Cochrane, Scopus, and ProQuest) utilizing keywords, reference searches, and other methodologies in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The obtained randomized controlled trials (RCTs) have been assessed using the Cochrane Risk of Bias 2 Risk of Bias Tools (ROB2). MetaInsight version 5.2.1 was employed to conduct this indirect network meta-analysis, which employed mean difference (MD) as summary statistics. This study demonstrated that ozoralizumab had a more significant effect on rheumatoid arthritis than placebo, as measured by DAS28 (MD=-1.88; 95% CI -2.24-(-1.52)) and moxibustion (MD=-0.69; 95% CI=-1.07-0.31). Ozoralizumab exhibited mild, moderate, and severe side effects, whereas moxibustion exhibited modest side effects compared to the placebo. In summary, ozoralizumab and moxibustion decreased DAS28 scores in rheumatoid arthritis patients, with ozoralizumab being the more effective treatment. Nevertheless, the adverse effects of ozoralizumab were more diverse than those of moxibustion.

Urine Periostin Level and Renal Function in Malignancy Patients Treated with High-Dose Cisplatine

Harry Yusuf — 2024-12-11

Cisplatin has been used extensively as a cancer treatment. Nephrotoxicity, which is assessed by blood urea levels, blood creatinine, and estimated glomerular filtration rate (eGFR), is caused by cisplatin metabolites that build up in the kidneys. Because of these indicators' numerous flaws, optimal biological markers are required. One of the key mediators of inflammatory processes, such as kidney fibrosis and inflammation, is periostin. In cancer patients undergoing high-dose cisplatin therapy, the purpose of this study is to ascertain how urine periostin changes and how it relates to kidney function. This cross-sectional study was carried out at the National Center General Hospital of Cipto Mangunkusumo's medical hematology-oncology outer clinic and medical hematology-oncology ward on the eighth floor starting in November 2019 and ending when the minimum sample was obtained through consecutive sampling. Data was analyzed by IBM SPSS Statistics for Windows version 23.0 based on the research objective. Of the 37 responders, 70.3% were men, 29.7% were between the ages of 41 and 50, 78.4% were married, 59.5% had completed high school, 37.8% were employed, 59.5% had NPC, and 64.9% had a Karnofsky score of 80. Between before and one week following chemotherapy II, the respondents' blood creatinine and urea levels rose. The eGFR value has also decreased. Periostin levels, on the other hand, tended to rise one week following treatment III after declining during chemotherapy I and II (p value>0.05). Urine periostin levels and other kidney function indicators did not significantly correlate (p>0.05), according to the correlation test, and several domains had negative directions. The correlation coefficient values were modest (r = 0.017-0.254). There is a changing of urine periostin level of malignant patients receiving high dose cisplatin therapy which increase after the third chemotherapy. No significant correlation was found between periostin levels and kidney function in malignant patients with high-dose cisplatin therapy.

Hypnopressure Innovation: A Non-Invasive Method For Anxiety And Pain Management In Primigravida Women During Active Labor

Yeni Fitrianingsih — 2024-12-11

Psychological factors, fear, and anxiety are often responsible for prolonged delivery length, with 58% of primigravida women experiencing anxiety and 2-4% feeling pain scored between 30 – 40 out of 50 Hypnopressure (HP) is a combination of hypnotherapy and acupressure on the san yin jiao point (Sp6) and hegu point (Li4) 20 times in 3-5 seconds during the first stage of labor contractions.. Therefore, this study aimed to determine the effect of HP on Hegu (Li4) and Sanyinjiao (Sp6) points in reducing anxiety level and pain degree during the active phase of the first delivery stage among primigravida women The design used was a double-blind randomized pre-test and post-test controlled trial, which included 80 subjects. To compare the effects of different interventions and determine which particular intervention is more effective, they were divided into groups. Hypnopressure (HP), hypnotherapy (HA), acupressure (AK), and control (K), each consisting of 20 individuals.The treatment interventions were conducted in the active phase of the first delivery stage, followed by Wilcoxon and Kruskal Wallis statistical tests. The treatment groups of HP (p=0.000), HA (p=0.000), and AK (p=0.002) experienced decreasing anxiety levels. Kruskal Wallis post-test results (after treatment) showed a significant difference (p = 0.000), where HA had the lowest decrease in anxiety compared to the other three groups. Additionally, the degree of delivery pain (p=0.000) was lower in the HP group (4.00±1.496) than in the other three groups. There was a significant difference between the four treatment groups (p=0.000), with HP subjects experiencing lower pain than HA (p=0.000), AK (0.000), and K (p=0.000), suggesting that HP treatment could decrease the level of anxiety and delivery pain degree.