JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga

Front Matter Vol 15 No 2, 2024

Front Matter — 2024-08-10

Back Matter Vol 15 No 2, 2024

Back Matter — 2024-08-10

Arterial Blood Gas Parameters to Evaluate Oxygenation and Acid-Base Disorders in Corticosteroid-Receiving Severe and Critical COVID-19 Patients

Bintang Temenggung — 2024-08-10

Highlights:

Both severe and critical COVID-19 patients primarily presented with hypoxemia.
Severe and critical COVID-19 patients differed through their tendencies towards respiratory alkalosis/metabolic acidosis and respiratory acidosis, respectively.

Abstract

Introduction: Increased inflammation and immune dysregulation in severe and critical COVID-19 trigger oxygen and acid-base disorders, possibly mitigated by corticosteroids. Variations in arterial blood gas (ABG) parameters and the influence of corticosteroid administration have become a concern for clinicians. This study aimed to uncover significant differences in temporal arterial blood gas parameters between severe and critical COVID-19 cases undergoing corticosteroid treatment.

Methods: This case-control study, which adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, analyzed severe (n=27) and critical (n=41) COVID-19 patients treated in the high care unit (HCU) and the intensive care unit (ICU) of Universitas Airlangga Hospital, Surabaya, from May to July 2021. Arterial blood gas results were categorized into three evaluations (E1-E3) based on collection days. The International Business Machines Corporation (IBM) Statistical Package for the Social Sciences (SPSS) for Macintosh version 27.0 was used for statistical analysis, with a p<0.05 considered statistically significant.

Results: Hypoxemia through PaO₂ and P/F ratios was prominent in both groups throughout E1-E3, with differences only in E1 P/F ratios (p=0.003). While SaO₂ stayed normal in severe cases, critical cases were low, with differences in E1 (p=0.012) and E3 (p=0.004). Severe cases maintained normal pH, while critical cases tended towards acidemia, notably differing in E1-E3. Both groups had low HCO₃ levels, differing only in E2 (p<0.001). Severe and critical groups exhibited low and high PaCO₂ trends, respectively, with distinctions in E2 (p<0.001) and E3 (p=0.003).

Conclusion: Hypoxemia was prevalent in both groups. Compensated respiratory alkalosis or metabolic acidosis was common in the severe group, while the critical presented with respiratory acidosis.

Effects of Clove Leaf Essential Oil (Syzygium aromaticum) in Inhibiting Biofilm Formation on Candida albicans Isolate

Achmad Rifai — 2024-08-10

Highlights:

Candida albicans is capable of forming biofilm, which can lead to resistance to antifungal treatments.
Clove leaf essential oil, which can inhibit biofilm formation, making it a potential anti-biofilm agent.

Abstract

Introduction: Candida albicans (C. albicans) has a virulence factor, like biofilm formation. Biofilm is a three-dimensional structure that plays a role in antimicrobial resistance, thus requiring antibiofilm agents to address this problem. One of them is Clove leaf (S. aromaticum). S. aromaticum has active phytochemicals (eugenol, β-caryophyllene, and others) that can inhibit biofilm formation in microorganisms, including fungi. This study aimed to prove the effect and to find a concentration of Clove leaf essential oil that affects the biofilm formation of C. albicans isolate.

Methods: This study used a microtiter plate with a two-fold dilution technique. The tested concentrations were 6.25%, 3.125%, and 1.5625%. The positive control was 200 µL of C. albicans biofilm suspension, and the negative control was 200 µL of tryptic soy broth media, and all were repeated four times. The biofilm was observed using crystal violet and evaluated using optical density. The data was analyzed statistically using the International Business Machines Corporation (IBM) Statistical Package for the Social Sciences (SPSS) version 26, with a p<0.05 considered statistically significant.

Results: The Optical density (O.D.) of the isolate was 2.039, while the negative control was 0.349, indicating that the isolate was a strong biofilm former. The concentrations of 6.25%, 3.125%, and 1.5625% showed inhibition percentages of 8.533%, 17.214%, and 8.484%, respectively. The Optical density was found to be normally distributed but not homogeneous p>0.05, The Kruskal-Wallis’s test was significant, and the Mann-Whitney test was not significant between test groups and positive control.

Conclusion: Clove leaf essential oil has inhibitory effects on C. albicans biofilm isolates. However, statistically, there was no significant difference between the test groups and the positive control.

Prevalence and Risk Factors of Latent Tuberculosis Infection (LTBI) at Madura Boarding School as a High-Risk Congregate Setting

Muhammad Arif Ananto — 2024-08-10

Highlights:

Boarding school is a high-risk location for tuberculosis transmission. Therefore, stricter early prevention measures are required.
Gender and knowledge level were significantly related to latent tuberculosis infection, but there was no significant relationship between age and nutritional status.
Low level of knowledge was the highest risk factor compared to other factors, with a five times greater risk of contracting latent tuberculosis infection.

Abstract

Introduction: Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), is a highly contagious airborne disease. High-risk environments with frequent close interactions contribute to the spread of TB. This study examined latent TB infection (LTBI) epidemiology in such settings to inform public health interventions and strategies to curb TB transmission in similar environments.

Methods: This cross-sectional observational study, conducted from January to August 2022 at two boarding schools in Bangkalan, involved 100 adolescents aged 10-18 years old tested for latent tuberculosis infection using interferon-gamma (IFN-γ) release assay (IGRA). Data were collected via questionnaires. Bivariate analysis was used to determine the correlation between latent tuberculosis infection prevalence and each research variable using Pearson Correlation and odds ratio (OR) to find risk factors for each variable. A p<0.05 was considered statistically significant.

Results: This study found that 30% of 100 adolescents in boarding schools had latent tuberculosis infection. Risk analysis showed a significant association between gender and LTBI (p=0.000), with males having a higher risk with an odds ratio (OR) of 1.02 times. Additionally, lower education levels were significantly associated with a higher risk of LTBI (p=0.021) with an odds ratio of 5.2 times.

Conclusion: Boarding schools pose a tuberculosis transmission risk. Early latent tuberculosis infection screening is essential for tuberculosis eradication in Indonesia, and these findings emphasize the need to improve latent tuberculosis infection detection and prophylaxis therapy as a preventive measure against tuberculosis outbreaks.

Nasal Symptoms of Chronic Rhinosinusitis were Related to Its Nasoendoscopic Findings: A Retrospective Cohort Study at Dr. Soetomo General Academic Hospital, Surabaya

Christopher Marcellino Chandra — 2024-08-10

Highlights:

Nasal congestion was the most common symptom presented in CRS patients.
Nasal symptoms of CRS were positively associated with nasoendoscopic findings (Polyp, Edema, Secretions).

Abstract

Introduction: Chronic rhinosinusitis (CRS) is often encountered in Indonesia. Nasal endoscopy, or nasendoscopy, is considered the gold standard for assessing the severity of CRS. However, as nasendoscopy is unavailable in Indonesia, only symptom assessments can be conducted at primary healthcare facilities. This study aimed to elucidate the relationship between nasoendoscopic findings based on the Lund-Kennedy score (LKS) and symptoms in CRS patients based on the visual analogue scale (VAS) score.

Methods: This retrospective analytic study evaluated CRS cases identified in the Ear, Nose, and Throat (ENT) Outpatient Clinic of Dr. Soetomo General Academic Hospital, Surabaya, from July 2021 to July 2022. Statistical analysis was conducted using Spearman’s rank correlation test to identify the correlation (r) between LKS and the VAS score. Statistical significance was achieved if p<0.05. All statistical tests were conducted using the International Business Machines Corporation (IBM) Statistical Package for the Social Sciences (SPSS) version 26.0 for Windows.

Results: A total of 57 CRS patients were included in this study, mostly females (64.9%) and those aged 50–59 years old (26.9%). Nasal congestion was the dominant nasal symptom (80.7%), with mostly moderate symptom severity (VAS 4-7) reported. Across both nasal cavities, the most frequent nasoendoscopic finding among CRS patients was nasal edema (82.4% and 93%). A positive and weak correlation existed between the total VAS score of all symptoms and the total LKS of both nasal cavities (r=0.387, p=0.003).

Conclusion: The nasal symptoms of CRS patients were significantly associated with its nasoendoscopic findings (Polyp, Edema, Secretions).

Antibacterial Effects of Basil (Ocimum sanctum) Leaf Extract in Combination with Meropenem against Extended Spectrum Beta-Lactamase (ESBL) Producing Klebsiella pneumoniae

Billy Yanssen Lifindra — 2024-08-10

Highlights:

Ocimum sanctum leaf extract does not significantly increase its antibacterial effects when combined with meropenem against ESBL-producing K. pneumoniae.
Ocimum sanctum leaf extract has different antibacterial effects depending on geological and environmental factors.

Abstract

Introduction: Antibiotic usage for bacterial infections causes antibiotic resistance in bacteria. One is extended-spectrum beta-lactamase (ESBL), which produces Klebsiella pneumoniae, a pathogen responsible for increased antibiotic resistance. Basil (Ocimum sanctum) is a candidate for combination therapy. It has been proven to have antibacterial effects. However, its combination with antibiotics is rarely researched. This study evaluated the antibacterial effects of O. sanctum leaf extract and meropenem combination against ESBL-producing K. pneumoniae.

Methods: This study used the disk diffusion method. The extract was tested for each experiment at 6%, 4%, 2%, 1%, and 0.5% concentration. The research was divided into two experiments to evaluate the antibacterial effects of O. sanctum leaf extract (n=18) and its combination with meropenem against ESBL-producing K. pneumoniae (n=18). The data was analyzed using the International Business Machines Corporation (IBM) Statistical Package for the Social Sciences (SPSS) version 26.0 for Windows. A probability p<0.050 was considered significant.

Results: The first experiment showed that the extract had the largest antibacterial effect at 0.5% concentration (n=18, p=0.007). Meanwhile, the second experiment showed that the combination of the extract and meropenem did not have significant antibacterial effects (n=18, p=0.597).

Conclusion: Ocimum sanctum leaf extract has viable antibacterial effects, but its combination with Meropenem does not significantly improve its antibacterial effects against Extended Spectrum Beta-Lactamase (ESBL) producing K. pneumoniae.

Effect of Ajwa Date Fruit (Phoenix dactylifera) Methanol Extract on Blood Glucose Levels in Mice with Diabetes Mellitus

Anggita Annisa Wahyu Dewanti — 2024-08-10

Highlights:

The widespread incidence of DM leads to costly treatments and often results in undesirable side effects.
The widespread incidence of DM leads to costly treatments and often results in undesirable side effects.
Methanol extract of Ajwa date fruit can effectively lower blood glucose levels in diabetic mice at specific optimal doses.

Abstract

Introduction: High diabetes mellitus (DM) cases result in costly medical expenses. Ajwa date fruit contains triterpenoids, carbohydrates, and flavonoids believed to lower blood glucose, which requires research validation using methanol extract on streptozotocin (STZ)-induced mice. This study aimed to determine the effect of methanol extract of Ajwa dates with several dose levels, namely 3 g/WB, 5 g/WB, and 7 g/WB, given orally to mice induced by STZ.

Methods: This study utilized a randomized pre- and post-test control group design to assess Ajwa date fruit methanol extract effects on blood glucose in Swiss-Webster mice (Mus musculus). The mice were divided into four groups: Group K (6 mice without date extract intervention), P1 (6 mice with 3 g/WB/day oral dose date extract intervention), P2 (7 mice with 5 g/WB/day oral dose date extract intervention), and P3 (7 mice with 7 g/WB/day oral dose date extract intervention) and were induced with 100 mg/WB streptozotocin. Administered daily for three weeks, Ajwa dates fruit extract showed varying impacts. Weekly blood glucose measurements and analysis of variance (ANOVA) in the International Business Machines Corporation (IBM) Statistical Package for the Social Sciences (SPSS) version 27.0 disclosed significant group differences, with a p<0.05 considered statistically significant.

Results: Post-test blood glucose measurements in the third week showed a significant difference (p=0.017), with an optimal reduction in P3 (7 mice with 7 g/WB/day oral dose date extract intervention).

Conclusion: In the third week, Ajwa dates fruit extract, at an optimal 7 g/WB dose, effectively reduced blood glucose levels via flavonoid hypoglycemic mechanisms.

Knowledge Level and Frequency of Swimming to the Incidence of Otitis Externa in Swimming Athletes in Medan

Fahmi Romadhani — 2024-08-10

Highlights:

Respondents who had otitis externa and frequently engaged in swimming activities had an adequate level of awareness of the condition.
Frequent swimming can cause a person to experience otitis externa.

Abstract

Introduction: Otitis externa, also called swimmer's ear, is a common disease in swimmers and poses a significant public health problem. Frequent exposure to water for long periods is very susceptible to infection. This study aimed to ascertain the level of knowledge regarding the connection between otitis externa and swimming and investigate whether there was a correlation between the frequency of swimming and the occurrence of otitis externa.

Methods: Using a questionnaire, the sample comprised 74 Tirta Prima Medan Swimming Association members in 2022. Apart from evaluating descriptive comparisons of pretest and post-test knowledge levels, this study also conducted a Spearman rank correlation test to determine the correlation between knowledge level and frequency of swimming with the incidence of otitis externa. The chosen significance level (p) was 0.05. Variables were considered related if the p<0.05 and not considered related if the p>0.05. The International Business Machines Corporation (IBM) Statistical Package for the Social Sciences (SPSS) version 26.0 for Windows was used for statistical analysis.

Results: Of the 74 study participants, pretest knowledge was categorized as follows: good level of knowledge (6.8%) of respondents, sufficient (58.1%), and (35%) poor. In the post-test assessment, respondents showed good (75.7%), sufficient (21.6%), and poor (2.7%) knowledge. The results of the Spearman analysis test showed a significant correlation (p=0.042) between swimming frequency and the incidence of otitis externa. Meanwhile, there was no significant correlation between the level of knowledge about otitis externa and the incidence of otitis externa, with a p-value of 0.785.

Conclusion: The level of knowledge for the pretest was sufficient. For the same respondents, the post-test results showed good knowledge. There was a correlation between swimming frequency and the incidence of otitis externa. However, there was no significant correlation between the level of expertise and the incidence of otitis externa at the Tirta Prima Medan Swimming Association.

Risk Factors and Complications in Herpes Zoster Patients at Dr. Soetomo General Academic Hospital, Surabaya

Shafa Karin Nadiva — 2024-08-10

Highlights:

The highest distribution of herpes zoster patients’ age and gender was between 46-55 years old and females.
The highest distribution of herpes zoster patients’ complications was post-herpetic neuralgia.

Abstract

Introduction: Herpes zoster (HZ) is a painful rash confined to a dermatome resulting from the reactivation of the varicella-zoster virus (VZV). Factors that increase the risk of HZ include age, sex, prior varicella infection, immunocompromised conditions, SARS-CoV-2 infection, and varicella vaccination. Potential complications of Herpes zoster may encompass post-herpetic neuralgia (PHN), Ramsay Hunt syndrome, meningoencephalitis, vasculopathy, and varicella pneumonia. This study aimed to identify risk factors and complications associated with Herpes zoster and to enhance preventive measures to decrease the incidence of Herpes zoster at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

Methods: This descriptive, retrospective analysis utilized secondary data from the medical records of Herpes zoster patients at the Dermatology Clinic of Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, from 2019 to 2021. Data analysis used the International Business Machines Corporation (IBM) Statistical Package for the Social Sciences (SPSS) version 25.0.

Results: Out of 105 cases, Herpes zoster was more frequently observed in females (61 patients, 58.1%), with the highest occurrence found in the 46–55 years old age group (33 patients, 31.04%). The thoracic nerve was the most frequently involved (58 patients, 55.2%). Hypertension emerged as the most prevalent risk factor (26 patients, 24.7%), followed by diabetes mellitus/DM (15 patients, 14.3%) and autoimmune disorders (7 patients, 6.7%). Most patients had no comorbidities (33 patients, 31.4%). Post-herpetic neuralgia was the most frequent complication (19 patients, 18.1%), while 78 patients (74.3%) reported no complications.

Conclusion: Herpes zoster was more prevalent among females, with hypertension being the most significant risk factor and post-herpetic neuralgia the most common complication.

Flat Foot based on Clarke's Angle Method and Overweight among Medical Students of Universitas Airlangga

Nelsya Safira Aulia Putri — 2024-08-10

Highlights:

Being overweight can be one of the causes of flat foot.
A person with flat feet may experience pain in the medial malleolus area and discomfort when tiptoeing.

Abstract

Introduction: A flat foot is an arch deformity, and being overweight is one of the risk factors. It can cause problems such as fatigue, pain in the ankle and back, foot pain (especially during long walks or sports), and disturbances in balance and walking patterns. This study examined the relationship between flat feet (measured using Clarke's angle) and overweight students at the Faculty of Medicine, Universitas Airlangga.

Methods: This study used an observational analytic design with a cross-sectional method, gathering primary data directly from the research sample. The data were analyzed using the International Business Machines Corporation (IBM) Statistical Package for the Social Sciences (SPSS) version 26 with a p<0.05 considered statistically significant.

Results: Of the 56 samples meeting inclusion criteria, most flat foot cases occurred in males. A total of 36 research subjects were overweight or obese, evenly split between females and males. Among the 112 samples, 19 had flat feet, and 93 did not. Chi-square test analysis indicated a highly significant (p=0.001), suggesting a significant relationship between flat feet and overweight.

Conclusion: Flat feet (measured using Clarke's angle) had a significant relationship with overweight. Most subjects in this study were overweight based on body mass index (BMI), and most had a non-flat foot arch type. All cases of flat foot were found in subjects with overweight BMI.

Histopathological Grading based on Tumor Margin according to BI-RADS Mammography in Breast Cancer

Shabrinna Ayasha — 2024-08-10

Highlights:

The highest distribution of breast cancer patients’ age based on the 5-year age interval was 45- 49 years old.
There was no significant difference between tumor margin and age of breast cancer patients.
There was no significant difference between tumor margin and histopathological grade.

Abstract

Introduction: Mammography is an X-ray technique used to take images of the breast. It is the primary diagnostic method for breast tumors. Breast imaging reporting and data system (BI-RADS) classification is needed to determine benign or malignant masses by accessing the mass's shape, margin, density, and other features. However, the tumor margin is the most helpful one. This study aimed to know the difference in the distribution of tumor margin types in each histopathological grading in breast cancer patients.

Methods: This was an observational analytic study with a comparative approach using secondary data from medical records of patients with breast cancer at the radio diagnostic and anatomical pathology installation of Dr. Soetomo General Academic Hospital, Surabaya, from January 2017 to December 2021. All statistical data were performed using the International Business Machines Corporation (IBM) Statistical Package for Social Sciences (SPSS) version 27, with a p<0.05 considered statistically significant.

Results: Out of 235 cases, the highest distribution of breast cancer patients’ age interval was 45-49 years old (20.9%), the primary tumor margin type was spiculated (64.3%), and the highest distribution of histopathological grading was grade 3 (53.2%). There was no significant difference between tumor margin and age of breast cancer patients (p=0.815), with spiculated tumor margin as the most common type in all age intervals. There was no significant difference (p=0.163) in the distribution of tumor margin types in each histopathological grading, with spiculated tumor margin as the most common type in every grade.

Conclusion: There was no significant difference between tumor margin and age of breast cancer patients, and there was no significant difference between tumor margin and histopathological grading.