ISSN / EISSN : 1907-3062 / 2407-2230
Published by: Universa Medicina (10.18051)
Total articles ≅ 220
Latest articles in this journal
Universa Medicina, Volume 40, pp 163-172; https://doi.org/10.18051/univmed.2021.v40.166-175
Chronic limb ischemia (CLI) is a type of peripheral arterial disease (PAD) that is still underdiagnosed and undertreated despite the increasing incidence, thus becoming a global health burden. And CLI reflects the local manifestations of a lethal systemic disease — atherosclerosis. If left untreated, chronic limb ischemia can result in major limb loss. In this pandemic era, limb ischemia has become one of several clinical manifestations that occur in patients with COVID-19 infection. Systemic inflammation in COVID-19 infection, direct viral infection, hypercoagulable state, and hyperinflammatory response are responsible for damage to the arterial system, causing endothelial dysfunction. Diagnosing PAD has become a challenge especially in the early stage and in the asymptomatic phase. The untreated condition could lead to the development of CLI. The primary physicians in the primary health facilities hold an important role in the early diagnosis and management of patients with CLI symptoms or with risk factors of CLI, especially in patients who have experienced COVID-19 infection. Due to the limitation of diagnostic testing modalities at primary health facilities, the physician can assess the ankle-brachial index (ABI) to determine the presence of CLI. Management of the disease is different for every patient and is customized based on the other comorbidities. Risk factors should be controlled in order to achieve a better outcome. A good management strategy will improve the quality of life of the patient. This review will discuss the occurrence of CLI in COVID-19 infection.
Universa Medicina, Volume 40, pp 87-95; https://doi.org/10.18051/univmed.2021.v40.90-98
BACKGROUNDSensory stimulation activates the gate control mechanism, raises the level of beta endorphins, and the secretion of beta endorphins increases the pain threshold, reducing or eliminating the feeling of pain. It has been reported that skin-to-skin contact or sensual stimulation reduces stress, pain and crying time in newborns. The present study aimed to examine the effect of the mother’s hand tool (MHT) - developed by the researchers for three purposes: touch, positioning and vibration - on pain levels in newborns. METHODSA quasi-experimental study was conducted involving 52 newborns aged 0-15 days who were being treated in the neonatal intensive care unit. The MHT was applied to support the newborn and was applied 8 times in 24 hours for 3 minutes in total. Demographic data collection form (DDCF), neonatal evaluation form (NEF) to assess the respiratory rate, pulse rate, SPO2 and CO2 level, and neonatal infant pain scale (NIPS) were used to collect data. The Wilcoxon signed rank test was applied to analyse the data. A p value of <0.05 was considered to be statistically significant. RESULTSAfter the MHT application, it was revealed that there was a significant difference in pulse rate (p=0.000), SPO2 level (p=0.029), CO2 level (p=0.000) and NIPS pain scores (hour 6,9,12,15,18, and 24) and total NIPS (p=0.000) pain scores, before and after MHT practice. CONCLUSIONThis study demonstrated that MHT application to the newborns had a decreasing effect on pain level, heart rate, CO2 level, and an increasing effect on SPO2 level.
Universa Medicina, Volume 40, pp 130-137; https://doi.org/10.18051/univmed.2021.v40.133-140
BackgroundLung cancer is still the main cause of cancer deaths. The high lung cancer mortality rate is caused by a diagnosis factor or therapy selection. The cell block cytology technique using fine needle aspiration (FNA) samples can provide immunocytochemical material that plays an important role in the differential diagnosis of lung cancer subtypes and in determining immunotherapy administration. This study aimed to determine the sensitivity and specificity of transthoracic FNA (TTFNA) cell block cytology in comparison with bronchial washing smears and TTFNA smears in diagnosing lung cancer. MethodsThis was a cross-sectional diagnostic study involving 26 subjects. All subjects had undergone bronchial washing and CT scan-guided fine needle aspiration followed by cell block preparation. Both direct FNA smears and cell blocks are useful in the diagnostic work-up of patients. Comparative statistical analysis of TTFNA cell block versus bronchial washing smear and TTFNA smear cytology was carried out using the McNemar test. ResultsLung cancer was found in 15 patients (57.7%) using the TTFNA cell block technique. The sensitivity and specificity of the TTFNA cell block technique were 85.7% and 75%, respectively. There was no difference in the positivity value between TTFNA cell block technique of bronchial wash smear technique, and TTFNA smear on lung cancer diagnosis (p>0.05). ConclusionsTransthoracic fine-needle aspiration in combination with the cell block technique has good sensitivity and specificity. The TTFNA can be used for immunocytochemical examinations in lung cancer diagnosis and therapy. This approach is valuable for providing individualized treatment and prognostic evaluations.
Universa Medicina, Volume 40, pp 173-185; https://doi.org/10.18051/univmed.2021.v40.176-188
COVID-19 has emerged as a dreadful pandemic caused by the virus SARS-CoV-2. Though the number of patients recovering from infection is encouraging, sturdy cure is still being researched upon and the effective vaccines are yet to be rigidly resolute. COVID-19 has so far instigated a massive loss of lives globally and even the countries with the most advanced healthcare systems have come under its grasp. Health experts suggest in such case “Prevention is better than cure” which includes an appropriate daily lifestyle and a rugged immune system that could help mankind surmount this peril. This review highlights the importance of influential herbs and their medicinal significance. Biomedical articles were explored from PubMed, Google Scholar, Web of Science for the period of 2010-2021. Guidelines from the Ministry of Ayush (India) were also considered. The Ayurveda does not mention any cure for the novel coronavirus; however, it emphasizes the means of boosting one’s immunity. Accordingly, this article highlights some of the role of prevalent Ayurvedic herbs in promoting immunity for combating the novel coronavirus. The herbs in combination with drugs could be utilized for the sake of curtailing the side effects as well as the malefic repercussions of strong synthetic drugs used for treating COVID-19 patients, which would be a paramount leap in the field of Ayurveda as well as western-style medicine. However, the beneficial effects of these traditional medicines and their clinical trials remained to be known. We reviewed the latest updates on traditional medicines proposed for promoting immunity towards COVID-19.
Universa Medicina, Volume 40, pp 118-129; https://doi.org/10.18051/univmed.2021.v40.121-132
BackgroundPain from knee and hip osteoarthritis (OA) can have a significant impact on the physical function and quality of life of affected individuals worldwide. The objective of this study was to evaluate the effect of extracorporeal shockwave therapy (ESWT) on pain, flexibility, function, and medial collateral ligament (MCL) thickness in knee osteoarthritis (KOA). MethodsA study of quasi experimental design was performed involving 15 subjects aged 50 – 70 years with Kellgren-Lawrence grade 2-3 KOA. All subjects were evaluated regarding baseline -pain using visual analogue scale (VAS), range of motion (ROM), functional outcome using Western Ontario and McMaster Universities Arthritis Index (WOMAC), and MCL size. Extracorporeal shock wave therapy was given 3 times, at baseline, and 4 and 8 weeks after intervention. All subjects were given 4000 shocks at intensities of 1.5 – 4 Bar (raised gradually) per session. The shocks were given in the supine position, knee flexed 90o, without topical anesthetic. Statistical analyses were conducted using a dependent t-test. ResultsAfter 8 weeks of intervention, ESWT significantly improved pain score (p<0.01), WOMAC (p<0.01) and MCL thickness (p0.05). ConclusionThe use of ESWT for treatment of knee OA had a beneficial effect on pain relief, function outcome and MCL thickness. However, there remains a lack of clarity regarding the frequency and dosage levels of ESWT required to achieve maximum improvement.
Universa Medicina, Volume 40, pp 138-147; https://doi.org/10.18051/univmed.2021.v40.141-150
BACKGROUNDMeningiomas are the most common primary extra-axial non-glial intracranial tumors. The severe grade of meningioma, according to WHO, has the highest recurrence rate accompanied by high morbidity and mortality rates. Therefore, it is imperative to perform pre-operative assessments so the clinician can give prompt treatment to gain a better prognosis. It is a novel alternative way of predicting meningioma’s malignancy by calculating the tumor’s apparent diffusion coefficient (ADC) value. The objective of the study was to determine the value of ADC for differentiating benign and malignant meningiomas. METHODSThis cross-sectional study involved 32 subjects with clinically diagnosed or histologically verified meningioma (21 benign and 11 malignant). They underwent a head-magnetic resonance imaging (MRI) examination and biopsy. We calculated the ADC value by creating regions of interest (ROIs) on the solid part of the tumor, guided by contrast and fluid-attenuated inversion recovery (FLAIR) sequence. We analyzed the ADC value with independent t-test and Bland-Altman graphs, calculated the average difference, CI 95%, limit of agreement between observers, and ROC. RESULTSMean ADC of malignant meningiomas (0.877 ± 0.167 x 10-3 mm2/s) was significantly lower than that of benign meningiomas (0.990 ± 0.105 x 10-3 mm2/s) (p<0.05). The ADC threshold is 0.886 x 10-3 mm2/s with sensitivity 63.6%, specificity 85.7%, positive predictive value 70% and negative predictive value 81.8%. CONCLUSIONThe ADC value measurement provides a discriminative feature to differentiate between benign and malignant meningiomas. However, the clinical applicability still needs to be elucidated, as histopathological confirmation remains the mainstay of definitive diagnosis.
Universa Medicina, Volume 40, pp 148-156; https://doi.org/10.18051/univmed.2021.v40.151-159
BackgroundRadical cystectomy (RC) is the gold standard treatment for muscle-invasive bladder carcinoma. A predictive factor is needed for the aggressive approach as it could lead to overtreatment. Elevated blood cell count (BCC) markers are reported to have a significant association with poor outcomes in several types of malignancy. Neutrophil-to-lymphocyte-ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are well-known inexpensive and effective representative markers of inflammatory conditions. This study aimed to determine the BCC as a predictive factor of overall survival (OS) in patients with bladder carcinoma (BC) after RC. MethodsA retrospective cohort study was conducted involving 26 patients who had undergone RC. The demographic characteristics and BCC markers such as hemoglobin (Hb). NLR, PLR and lymphocyte/monocyte ratio (LMR) were collected. The patients were categorized based on the BCC marker value (³ median and < median). Kaplan–Meier survival analysis was done to determine overall survival (OS) on BCC markers. The association between patient demographics and one-year survival was also determined using Mantel-Cox (Log-rank) method. ResultsAmong the 26 patients, the mean age was 55.6 ± 12.9 years. On univariate analysis, none of the demographic characteristics was found to be a significant predictor of one-year and overall survival (p>0.05). Hemoglobin, NLR, PLR and LMR were not significant predictors of one-year survival and OS (p>0.05). ConclusionsThe BCC was not a significant predictive factor of survival in patients with bladder cancer after radical cystectomy.
Universa Medicina, Volume 40, pp 96-106; https://doi.org/10.18051/univmed.2021.v40.99-109
BackgroundThe pandemic has placed health-care workers (HCW) under an unprecedented strain where surgeries are being delayed and health care workers’ deaths because of COVID-19 are prominent and causing staff shortages. An effective, fast, and concise approach to preoperative screening is very much needed. Hospitals are suggested to develop their own algorithm to minimize delays and complications. The objective of this study was to optimize HCW safety by developing a working system based on the hospital’s service capability in treating orthopedic surgeries. Methods A retrospective study was conducted involving 305 HCW. Data were collected on the application of a novel elective and emergency orthopedic surgery clinical pathway and scoring method based on questionnaires, and laboratory and radiographic chest examinations for several months to ensure the safety of HCW. HCW COVID-19 status was routinely checked as the indicator of HCW’s safety. Results Mean age of all patients was 47.0 ± 22.41 years. The screening process was done in a series of questionnaires and laboratory examinations, with the majority of patients (82 or 35.9%) having a score of 0. Patients with a score of 3 or more and testing positive for COVID-19 were immediately referred to a hospital having adequate facilities to prevent delays. There were 51 patients (16.7%) with positive rapid test results, and 21 patients (6.8%) with positive PCR tests. There were 4 (1.3%) COVID-19 positive HCW. Conclusions Despite COVID-19 being a new threat, we have shown that developing an effective perioperative clinical pathway could eventually optimize healthcare worker safety.
Universa Medicina, Volume 40, pp 107-117; https://doi.org/10.18051/univmed.2021.v40.110-120
BACKGROUND Basic knowledge of sexual and reproductive health is important to be introduced during the premarital period, to reduce high-risk sexual behavior among adolescents, as well as to increase the correct attitude in their future marriage. This study explored the knowledge of HIV/AIDS, sexually transmitted diseases (STDs) and anemia among unmarried adolescents. METHODS This was a cross-sectional analytical study on secondary data from the Indonesian Demographic and Health Population Survey 2017, initially conducted by the National Population and Family Planning Board (BKKBN). Knowledge of HIV/AIDS, STDs and anemia among unmarried adolescents aged 15-24 years in West Java Province and Jakarta, the capital city of Indonesia, was compared and analyzed using the chi-square test. RESULTS In total, 5,389 weighted data were retrieved. In general, adolescents in Jakarta had better knowledge of all diseases compared to those in West Java (p<0.001). Knowledge of anemia and STDs was poor compared to that of HIV/AIDS which was moderate to good (p90%) had their own mobile phone with almost daily internet access, however most of their information sources on health education were from their school period. CONCLUSION Premarital education in schools is imperative to enhance the knowledge of STDs and anemia. Moreover, poor knowledge of anemia is a challenge for introducing the topic of thalassemia major, an inherited autosomal recessive type of anemia due to hemoglobinopathy. Since Indonesia is harboring 6-10% of thalassemia carriers, integrative premarital education is needed for better family planning.
Universa Medicina, Volume 40, pp 79-86; https://doi.org/10.18051/univmed.2021.v40.79-89
Background Health literacy (HL) is the ability to access, understand, appraise, and apply health information, making it crucial for navigating coronavirus and COVID-19 information environments. The objective of this study was to determine the health literacy of international students who could not return to their countries after announcement of the coronavirus disease (COVID-19) pandemic and their perspective and behavior about COVID-19.MethodsA cross-sectional study was conducted involving 399 international students. A 73-item questionnaire consisting of health literacy (23 items), knowledge, attitude and practice about Covid-19 (37 items), and sociodemographic characteristics (13 items) was answered by the students. The relationship between the HL score and various variables was determined using univariate and multiple binary logistic regression. Results Of the 399 international students, 322 (80.7%) participated. The HL of the international students was found to be poor (78.0%) and good (22.0%). Participants’ COVID-19-related behaviors: 8.4% of the participants’ knowledge level was good, and 38.5% had high COVID-19 related practice. Multivariate models showed that HL was independently and significantly associated with COVID-19 related practice (OR= 6.27; 95% CI: 2.45 - 15.79; p=0.000). ConclusionThis study revealed that international students’ HL was poor and that low COVID-19 related practice increased the risk of low HL in international students. According to the findings, further efforts should be made to enhance levels of HL and COVID-19-related behavior of international students.