Universa Medicina

Journal Information
ISSN / EISSN : 1907-3062 / 2407-2230
Current Publisher: Universa Medicina (10.18051)
Total articles ≅ 176
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Surilena Hasan, Christopher Yovan Junardi
Published: 19 August 2020
Universa Medicina, Volume 39, pp 128-134; doi:10.18051/univmed.2020.v39.128-134

Abstract:
BackgroundPatients with bipolar disorder commonly experience sleeping problems. On the other hand, sleep disturbances have been suggested as one of the symptoms that indicate the development of bipolar disorder. Considering the detrimental effect of bipolar disorder, especially in young people, this study aimed to determine the relationship between sleep quality and risk of bipolar disorder in senior high school students. MethodsA cross-sectional study was conducted involving 725 senior high school students. The instruments used were a demographic questionnaire, Young Mania Rating Scale (YMRS), MINI International Neuropsychiatric Interview (MINI ICD-10), Hypomania/Mania Symptom Checklist (HCL-32), and Pittsburgh Sleep Quality Index (PSQI). Univariate and bivariate (simple logistic regression) analyses were performed to evaluate the relation between sleep quality and the risk of bipolar disorder.ResultsAround 28% of subjects were at risk of bipolar disorder, of which 96.6% were prone to type I, and the rest were type II. Most of the participants with bipolar disorder (64%) had poor sleep quality. The percentage of participants with type I bipolar disorder that had poor sleep quality was higher than that of type II (65.3% and 28.6%, respectively). There was a significant relationship between bipolar disorder and sleep quality (OR = 2.2; 95% CI=1.581-3.087; p=0.000). ConclusionsOur study demonstrated that in senior high school students, bipolar disorder increased the risk of poor sleep quality. Assessment of sleep disturbances routinely in psychiatric interviews may improve sleep quality. Keywords: Bipolar disorder, sleep quality, senior high school student
Mirna Widiyanti, Moch Irfan Hadi, Mei Lina Fitri Kumalasari, Evi Iriani Natalia, Dedi Ananta Purba, Setyo Adiningsih
Published: 13 August 2020
Universa Medicina, Volume 39, pp 121-127; doi:10.18051/univmed.2020.v39.121-127

Abstract:
BackgroundThe body mass index (BMI) may contribute somewhat to drug metabolism, thus affecting the efficacy of antiretroviral therapy (ART). CD4+ counts in people infected with HIV are essential in determining the stage of the disease, initiation of antiretroviral therapy, opportunistic infections and evaluating treatment outcomes. The aim of this study was to determine the association of BMI and clinical stage with CD4+ counts in HIV patients seeking treatment using first-line antiretroviral therapy (ART).MethodsAn analytic study with a cross-sectional approach was conducted involving 251 HIV/AIDS patients who had received first-line antiretrovirals over six months. BMI, clinical staging according to WHO and CD4 + were collected. Multiple linear regression was used to evaluate the relationship between BMI, clinical stage and CD4+.ResultsAmong the enrolled patients, the median age was 36 years, 135 (55%) of the patients was female, 102 (40.6%) was overweight/obese, 161 (64.1%) was in stage 3 of the disease, and the median CD4+ count was 389 cells/mm3. Multiple linear regression test showed two variables with a significant effect on CD4+ count, namely BMI (B=69.247; 95 % CI : 42.886-95.608) and clinical stage (B=61.590; 28.910-94.270). BMI was the most influencing factor for CD4+ count (β=0.307) compared to clinical stage (β=0.216). ConclusionsBody mass index was the most influencing factor for CD4 + counts of HIV/AIDS patients. Regular ART can increase CD4+ counts and maintain the health of HIV/AIDS patients.
Shaban Mehrvarz, Seyed Masoud Khatami, Shahram Manoochehry, Hossien Khedmat, Mahdi Arefinia, Hamid Reza Rasouli
Published: 11 August 2020
Universa Medicina, Volume 39, pp 113-120; doi:10.18051/univmed.2020.v39.113-120

Abstract:
BackgroundSpecialist surgeons are at high risk of exposure to hepatitis viruses through occupational exposure to blood or body fluids. Protective measures against occupational exposure to the hepatitis B virus (HBV) and hepatitis C virus (HCV) must be taken in order to prevent infection in surgeons. We aimed to determine the needlestick injuries, and markers HBV and HCV in Iranian surgeons.MethodsThis study was cross-sectional research, performed in Baqyatallah, Shohada, Rasoul Akram, Sina, Taleghani, and Emam Hossein hospitals (all university hospitals) of Tehran, Iran. Overall 318 eligible surgeons were included. Anonymous questionnaires were used containing data about demographic characteristics, self-reported blood and needlestick contacts, occasional exposures, risk behaviors and vaccination. Also, the blood samples were taken and tested for hepatitis B surface antigen (HBsAg), antibody against Hepatitis B surface antigen (antiHBs) and HCV antibody (HCVAb). Fisher exact test and Kruskal Wallis test were used to analyze the data.ResultsThe mean age of the surgeons was 47.76 ± 8.95 years and 177 of them (55.66%) were male. The average number of needle–sticks was 28.28 ± 16.58 during the surgeons’ working life. Among them, 5 cases (1.59%) were positive for HBsAg and 2 cases (0.66%) were positive for HCVAb. ConclusionIn spite of the high needlestick rate in Iranian surgeons, prevalence of hepatitis B and C is not very high among them. A high degree of vigilance and a careful surgical technique is the only means available to prevent the transmission of the viruses.
Nefise Kandemir, Murat Gultekin, Mehmet Kara, Arslan Bayram, Nazife Tascioglu, Meral Mirza, Munis Dundar
Published: 23 July 2020
Universa Medicina, Volume 39, pp 105-112; doi:10.18051/univmed.2020.v39.105-112

Abstract:
BackgroundEssential tremor (ET) is the most common disease among movement disorders. Genes such as essential tremor 1-4 (ETM 1-4), HS1-binding protein-3 (HS1BP3), dopamine receptor D3 (DRD3), leucine-rich repeat and Ig domain containing 1 (LINGO1), glial high affinity glutamate transporter member 2 (SLC1A2), FUS, high temperature requirement A2 (HTRA2) and TENM4 had been shown to be responsible for the genetic inheritance of the disease. The aim of the present study was to investigate the effect of propranolol on the expression of DRD3, SLC1A2, and HTRA2 genes in patients with ET.MethodsA study of non-randomized experimental design was conducted involving 76 subjects. They were divided into two groups: 38 patients with ET in the patient group (Group 1) and 38 healthy people in the control group (Group 2). DRD3, SLC1A2 and HTRA2 gene expressions were assessed before and after 8 weeks of propranolol treatment. Fahn-Tolosa-Marin tremor scale results were compared before and after propranolol administration. Kruskal Wallis test was used to determine differences in gene expressions between the groups.ResultsD3 dopamine receptor and SLC1A2 gene expression in the patient group appeared to be lower than in the control group (p<0.001). However, the HTRA2 gene expression level was significantly higher in the patient group (p<0.001). Conclusion D3 dopamine receptor and SLC1A2 gene expressions were decreased in ET patients which at first glance can be explained in relation to etiology, but after treatment it was not increased as expected but decreased even more.
Raditya Wratsangka, Rully Ayu Nirmalasari Haryadi Putri
Published: 21 July 2020
Universa Medicina, Volume 39, pp 135-149; doi:10.18051/univmed.2020.v39.135-149

Abstract:
Anemia is a global health problem with an extremely high prevalence and occurring in nearly 25% of the world population, particularly in the elderly group. Currently Indonesia is facing a rapid growth of the elderly population, with around 21 million elderly (8.2% of the total population), that is projected to increase to 33.7 million (11.8%) in the year 2025. Anemia in the elderly is frequently neglected, although the facts show that low hemoglobin concentration is an important marker of physiological decline and functional limitations. Although the factor of intrinsic aging may cause low hemoglobin concentration, anemia in the elderly is known to have a wide range w88ith regard to etiology, underlying disorders, and possible mechanisms, such that it should be clinically followed up. Whatever its causes or underlying pathophysiological, anemia in the elderly has been proven to play a role in their morbidity and mortality, and may decrease their quality of life, that comprises all aspects of physical, mental, and social health, known as health-related quality of life (HRQoL). The impact of anemia on HRQoL has been studied in various populations, and most studies report the presence of an association between HRQoL and anemia in elderly individuals, which on the subscale level is particularly associated with physical health. Early diagnosis of anemia is important to prevent aggravation of the condition, to retard the progress of the disease, and to improve the health-related quality of life (HRQoL) of the patient. Prior to determining the treatment plan, the primary diagnosis and the comorbidities, especially treatable disorders, had better be identified first. The available data show that the overall prognosis will improve for anemia in patients with well-managed and corrected chronic disorders.
Setyo Trisnadi, Adi Muradi Muhar, Agung Putra, Azizah Retno Kustiyah
Published: 9 July 2020
Universa Medicina, Volume 39, pp 97-104; doi:10.18051/univmed.2020.v39.97-104

Abstract:
BackgroundPeritoneal adhesions (PAs) are generally described as fibrous bands between intra-abdominal organs following an abdominal surgical operation. The definitive treatments of PAs are currently ineffective yet. Hypoxia-mesenchymal stem cells (H-MSCs) have a higher capability to survive at the site of injury than normoxia-MSCs (N-MSCs) to repair injured tissue without fibrosis. This study aimed to analyze the effect of H-MSCs in controlling formation of PAs by reducing TGF-β level in a rat model. Methods A study of post-test only control group design was conducted, involving eighteen PA rat models weighing 250 ± 25 g that were randomly assigned into 3 groups, comprising control group (C), and groups T1 and T2 receiving H-MSC treatment at doses of 3 x 106 and 1.5 x 106, respectively. To induce H-MSCs, MSCs were incubated in hypoxic conditions at 5% O2 and 37oC for 24 hours. Expression level of TGF-β was analyzed by enzyme-linked immunosorbent assay (ELISA) at 450 nm and adhesion formation was described macroscopically. The Kruskal-Wallis variance analysis was used to analyze significant differences among the groups.ResultsThe results of this study showed that H-MSCs in group T1 inhibited TGF-β expression significantly on day 8 (p<0.001) and day 14 (p<0.05). Moreover, there was almost no adhesion apparent following H-MSC administration in group T1. ConclusionsBased on this study, we conclude that H-MSCs may attenuate PA formation following inhibition of TGF-β expression in the PA rat model.
Nutria Widya Purna Anggraini, Sri Sulistyowati
Published: 7 July 2020
Universa Medicina, Volume 39, pp 88-96; doi:10.18051/univmed.2020.v39.88-96

Abstract:
BACKGROUNDCoronavirus Infection 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an emergency condition for global public health. Early detection of COVID-19 in pregnant women is needed. The neutrophil-to-lymphocyte ratio (NLR), as a marker of viral inflammatory response, is used to determine the presence of a viral or bacterial infection, both acute and chronic. The objective of this study was to determine the relationship between NLR and the polymerase chain reaction (PCR) swab test results in pregnant women with suspected coronavirus disease 2019.METHODSA cross-sectional study was conducted on 9 pregnant women with suspected COVID-19. The subjects were inpatients at Moewardi Hospital Surakarta from 19 April-19 May 2020, who had rapid tests, complete blood examinations, and PCR swab tests. The NLR was categorized based on early warning scores according to research developed at Zhejiang University, with cut-off point 5.8. Diagnosis of COVID-19 was confirmed by PCR swab tests. Relation between NLR and PCR swab results was analyzed by the prevalence ratio.RESULTSTwo patients (22.2%) had NLR >5.8, with positive swab results in both (100%). Seven patients with NLR <5.8 had positive swabs in only one (33.3%). The relationship between NLR and PCR swab test results showed a prevalence ratio of 0.143 (95% CI 0.023-0.877).CONCLUSIONPregnant women with NLR < 5.8 had a decreased risk of COVID-19. Routine blood examination is more suitable for finding pregnant women with suspected COVID-19.
Monica Dwi Hartanti
Published: 17 June 2020
Universa Medicina, Volume 39, pp 71-73; doi:10.18051/univmed.2020.v39.71-73

Abstract:
Since it was first reported in Wuhan, China in December 2019, coronavirus disease 2019 (COVID-19) has been considered as a pandemic. It is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a member of the Coronavirus family. In Indonesia, this disease first detected in the middle of March 2020 and it was spreading all over Indonesia. The Indonesian Government has implemented several strategies in order to detain the spreading of COVID-19, including improving diagnostic management. Until now, the most reliable method of detecting COVID-19 is real time-PCR.
Uki Retno Budihastuti, Sri Sulistyowati, Eriana Melinawati, Yohan Pamuji Marbun
Published: 20 May 2020
Universa Medicina, Volume 39, pp 74-80; doi:10.18051/univmed.2020.v39.74-80

Abstract:
BackgroundThe polycystic ovary syndrome (PCOS) is caused by endocrine system dysfunction in women. MUCIN-1 (MUC-1) expression is found in endometrial tissues, which leads to implantation process dysfunction because of imbalance of trophoblast adhesion process. This study was conducted to compare endometrial MUC-1 expression between PCOS and normal women considering all existing external variables.MethodsThis cross-sectional study was conducted in General Hospital Dr. Moewardi Surakarta. Endometrial samples were obtained from 30 infertile PCOS women based on Rotterdam criteria, and 30 normal women. Life style and reproductive data such as age, menstrual problems, menstrual cycle, age at menarche, and BMI were collected. Subjects underwent endometrial biopsy in luteinizing hormone (LH) secretion phase LH + 5 days to LH + 10 days for immunohistochemistry (IHC) of MUC-1 expression. An independent-t and multiple linear regression test were used to analyze the data at significance level of p<0.05. ResultsMean MUC-1 expression in the PCOS endometrium (49.66 ± 47.79) was significantly higher than in normal women (7.66 ± 14.55) (p=0.03). Multivariate linear regression model of life style and reproductive variables with MUC-1 showed that PCOS (b=29.54; 95% CI 9.57-49.49; p=0.004) and BMI (b= 29.99; 95% CI 5.91-54.07; p=0.001) significantly increase MUC-1 expression. PCOS (Beta=0.37) was more important than BMI (Beta=0.30) in increasing the MUC-1 expression. ConclusionExpression of MUC-1 levels in the PCOS endometrium was higher than in normal women. This suggests that MUC-1 contributes to the unexplained reproductive failure in PCOS.
Yudhi Wibowo, Nendyah Roestijawati, Dyah Krisnansari, Agoes Y Purnomo
Published: 10 April 2020
Universa Medicina, Volume 39, pp 55-62; doi:10.18051/univmed.2020.v39.55-62

Abstract:
BACKGROUND Scabies is a World Health Organization neglected tropical disease common in children in low-and middle-income countries. The prevalence of scabies, especially in tropical countries, is still quite high at more than 200 million cases per year. Transmission of scabies is predominantly via skin-to-skin contact. The purpose of the study was to determine the epidemiology of clinical scabies among schoolchildren and spatial modeling using geographic information systems (GIS).METHODSA study of unmatched case-control design with a ratio of 1: 1 was performed to identify specific risk factors of scabies. Cases were patients with clinical scabies and controls were healthy people in the area. A total of 100 students were involved in the study. Simple and multiple logistic regression was used to test any association between the variables. Geographical Information Systems (GIS) modeling was used to determine the spatial distribution of clinical scabies based on 69 cases.RESULTThere was a significant association between the level of environmental sanitation and the prevalence of clinical scabies (OR = 2.53;95% C.I. 1.11-5.74). Multivariate analysis showed that the level of environmental sanitation was significant (AOR = 3.05;95% C.I. 1.19-7.81). Risk factors for developing clinical scabies increased to 3 times after considering other risk factors, namely gender, age group and respondent education level. Analysis of average nearest neighbor distance showed that the spatial distribution of clinical scabies was clustered. CONCLUSIONSThe distribution of clinical scabies was spatial clustering, and prediction of transmission in a clockwise direction with Southeast and Northwest ellipses.
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