Folia Medica Indonesiana

Efficacy, Safety, and Clinical Outcomes of Splenorenal Shunt Surgery as a Therapeutic Intervention for Portal Hypertension Patients

Yan Efrata Sembiring — 2023-09-10

Highlights:

1. This study systematically reviewed the efficacy, clinical outcomes, and safety of the splenorenal shunt procedure with a comprehensive and meticulous approach.
2. The splenorenal shunt procedure is an innovative surgical intervention that offers a viable option for the management of portal hypertension.

Abstract

Portal hypertension is the second most common gastrointestinal bleeding in cirrhosis and non-cirrhosis patients. The splenorenal shunt surgery is a potential intervention that may be considered for portal hypertension patients with clinical symptoms such as upper gastrointestinal bleeding caused by the rupture of gastro-esophageal varices. In this study, the researchers aimed to analyze the efficacy, clinical outcomes, and safety of splenorenal shunt surgery in portal hypertension patients. The sources were obtained from electronic search databases, including PubMed, Google Scholar, and ScienceDirect, using the keywords "Efficacy," "Safety," and "Clinical Outcomes." in relation to splenorenal shunt surgery in portal hypertension patients. The researchers set specific criteria for inclusion and exclusion to select the articles. This systematic review revealed the efficacy of the splenorenal shunt procedure with favorable outcomes. The success rate of splenorenal shunt surgery in reducing the clinical symptoms of portal hypertension varied between 66% and 100%. The prevailing complications observed in this study were shunt thrombosis, rebleeding, and thrombocytopenia. However, notable improvements could be achieved with general treatment. In terms of short- and long-term clinical outcomes, the splenorenal shunt procedure demonstrated favorable results. It can be concluded that splenorenal shunt surgery provides excellent clinical outcomes and should be considered a viable treatment option for patients with both cirrhotic and non-cirrhotic portal hypertension.

Traumatic Brain Injury Patients in the Emergency Unit of a Tertiary Hospital

Ramdinal Aviesena Zairinal — 2023-09-10

Highlights:

1. The main focus of this study was to underscore the importance of exploring the characteristics of traumatic brain injury (TBI) patients, which have not been extensively investigated, to help establish effective clinical procedures and decisions.
2. Three out of every four trauma patients in the emergency unit had mild TBIs, and those who did not survive showed a significant trend of rapid deterioration.
3. It is crucial to consistently conduct a thorough and comprehensive head-to-toe examination for all trauma patients.

Abstract

Traumatic brain injury (TBI) is a prevalent neurological condition in emergency units. TBI cases are frequently diagnosed with severe conditions. Underdiagnosis is common in mild TBI cases. As a result, physicians have an uncomprehensive understanding of the patients' characteristics in their daily practice. This study aimed to discuss the characteristics of trauma patients who were diagnosed with TBIs in an emergency unit. We conducted a retrospective cohort observational study to examine the adult population of TBI patients from April 2022 to March 2023. This study collected several data points, including demographics, clinical characteristics, surgical procedures, and disposition distribution. All variables were compiled and summarized using descriptive statistics and analyzed by calculating frequencies and percentages. During the period of this study, 483 trauma patients were admitted to the emergency unit. A total of 361 (74.7%) of these cases were identified as TBIs. Most of the traumatic brain injuries occurred in men (75.6%), with the predominant age range being 18–22 years (22.4%). Mild TBI cases (74.5%) were the most prevalent, followed by moderate (20.2%) and severe (5.3%) TBI cases. The average score from the Glasgow Coma Scale assessment was 15. Most patients (80.9%) had no hypotension, while a greater number of patients (98.1%) did not exhibit hypoxia as a comorbidity. The Injury Severity Score revealed that the highest percentage of TBIs was categorized as minor (62.3%). It was found that 53.5% of the patients were discharged, while 36% of the patients were hospitalized. However, 7 patients (1.9%) passed in the emergency unit, and 30 patients (8.3%) opted to be discharged against medical advice. Only 21 patients (5.8%) received neurosurgical management. As the most prevalent trauma, TBI necessitates careful management to handle the implications of clinical decision-making. It is crucial to investigate the underlying risk of mortality in TBI cases because the majority of patients do not require neurosurgical intervention.

Development of Formulae to Determine Living Stature using Handprint Anthropometry of Tagalog People in the Philippines

Tharmar Nataraja Moorthy — 2023-09-10

Highlights:

1. This is the first-ever anthropological study on Tagalog people in the Philippines that has established formulae for determining stature using handprint length measurements.
2. This study has generated formulae that are applicable for personal identification purposes within real crime scenes.

Abstract

Forensic science plays a crucial role in the pursuit of justice, particularly through the identification of physical evidence found at crime scenes, such as human fingerprints and handprints. This study aimed to develop formulae for determining living stature using the handprint anthropometry of Tagalog people, an indigenous ethnic group in the Philippines. A total of 360 Tagalog volunteers, comprising 180 men and 180 women, were recruited. This study excluded subjects who had finger and hand-related diseases, injuries, or were under the age of 18. The materials used were a stadiometer for height measurement, a digital vernier caliper for handprint measurements, and a handprint kit to collect handprints. Five length measurements were collected for each handprint. The length measurement spanned the distance from the middle wrist crease to the tips of each of the five fingers. The data were analyzed statistically using regression analysis (p<0.05) in IBM SPSS Statistics for Windows, version 26.0 (IBM Corp., Armonk, N.Y., USA). The analysis results produced equations for determining stature using all the length measurements of the handprints. The study involved the calculation of correlation coefficients (r values) and standard deviations using the stature and handprint lengths of individuals of both genders. The results are presented in the form of tables and figures. The study concluded with the development of regression equations that may be utilized for determining stature based on various handprint length measurements of the Tagalog people. This study represents the first-ever anthropological study conducted on the Philippine Tagalog population within the scope of this research subject matter. The formulae can be applied to actual crime scenes for the purpose of personal identification.

Physical Activity Levels and Total Food Intake among Preclinical Students at a School of Medicine and Health Sciences

Lydia Esterlita Halim — 2023-09-10

Highlights:

1. This is the first cross-sectional study in Indonesia that was conducted specifically to find a correlation between physical activity levels and food intake.
2. As lower physical activity was found to be associated with higher food intake, this study suggests that physical activity might be taken into consideration to manipulate one’s food consumption

Abstract

One of the most crucial things a person can do to enhance the well-being of their body is to engage in regular physical activity. However, currently, there are still many people who have low physical activity levels. It is stated that habitual physical activity can affect the sensitivity of food intake regulation. This study aimed to determine the correlation between the total food intake and physical activity of preclinical students. This study was conducted using the cross-sectional method among preclinical students (n=238) in the classes of 2017, 2018, and 2019 at the School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia. Subjects with appetite-manipulating supplements, a diet program, a history of metabolic disease, a history of eating disorders, stress, or trauma were excluded from this study. The physical activity level was evaluated using the Baecke Physical Activity Questionnaire (BPAQ), while the total food intake was evaluated using the three-day food record method. The statistical test applied in this study was the Spearman test, with a significance of p<0.05. There were 22.3% of respondents with a low physical activity level, and there were 9.7% of respondents with a total food intake higher than recommended. The statistical analysis showed a significant negative correlation between physical activity levels and total food intake (p=0.008). In conclusion, there is an association between students’ physical activity levels and their total food intake.

Metformin Effectiveness in Reducing Mortality among Covid-19 Patients with Type 2 Diabetes Mellitus at a Tertiary Hospital in Indonesia

Yudivaniel Zihono — 2023-09-10

Highlights:

1. As there is a scarcity of publications on the use of metformin for COVID-19 in Indonesia, the findings of this present study may contribute more insight to the existing body of research and provide data specific to the Southeast Asian population.
2. This study revealed a decreased mortality rate associated with metformin use in diabetic patients with mild to moderate COVID-19 infection.
3. This study suggests that diabetic patients may continue metformin treatment during a COVID-19 infection as the medication has sustained therapeutic effects.

Abstract

COVID-19 patients with comorbidities, such as type 2 diabetes (T2DM), have a higher mortality rate compared to those without any comorbidities. T2DM patients usually receive metformin as their first-line treatment. However, the effectiveness of metformin in reducing mortality rates still requires further analysis. The objective of this study was to analyze the effectiveness of metformin in reducing mortality rates among COVID-19 patients with T2DM. An analytic observational design with a retrospective cohort approach was used in this study. Samples were acquired from hospitalized COVID-19 patients with T2DM medical records at Fatmawati Central General Hospital, Jakarta, Indonesia, throughout 2020–2021. The samples were collected using a purposive sampling technique and analyzed using Chi-square test (p<0.05; RR<1). This study comprised 137 samples, with 56 samples receiving metformin and 81 not receiving metformin. The mortality rate in the sample group that received metformin was lower (19.6%) compared to the group that was not given the medication (38.3%). The Chi-square test results indicated a statistically significant relationship between metformin treatment and a lower mortality rate among COVID-19-contracted individuals with T2DM (p=0.020; RR=0.513). Therefore, this study concludes that the administration of metformin treatment reduces mortality among COVID-19 patients with T2DM.