Universa Medicina

Journal Information
ISSN / EISSN : 1907-3062 / 2407-2230
Current Publisher: Universa Medicina (10.18051)
Total articles ≅ 196
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Latest articles in this journal

, Fajar Lamhot Gultom
Published: 2 January 2021
Universa Medicina, Volume 40, pp 52-56; doi:10.18051/univmed.2021.v40.52-56

Abstract:
BackgroundTumors of the skull usually affect adult patients and less than twenty percent of pediatric patients. As the tumors grow, the surrounding bone may undergo destruction and erosion. When the tumors are located in the fontanel, the timely closure of the fontanel may be inhibited. Epidermoid cysts are benign tumors that are intracranially located and very rarely in the midline of the cranium. Meanwhile about 32% of stratified-squamous epithelial epidermoid cysts affect the head and neck region and only 6.7% occur in the scalp. We report an unusual epidermoid cyst located and growing in the anterior fontanel of a pediatric patient and inhibiting fontanel closure.Case Description A 21-month-old boy and his parents visited our polyclinic because there was a lump on his anterior fontanel since four months before they came to the hospital. The lump was initially the size of a peanut and had grown to become as large as a quail’s egg. The physical examination was normal and the brain CT-scan showed bone destruction without any intracranial lesion. The tumor was excised on the preoperative diagnosis of dermoid cyst. Histopathology examination showed the characteristics of an epidermoid cyst. The cyst had a wall and was full of keratin flakes without hair follicles or sebaceous glands. Follow-up one year after complete excision did not reveal any recurrence. ConclusionEpidermoid cysts in the skull of pediatric patients must be completely excised as soon as possible because their growth can damage the bone and inhibit the closure of the sutures.
Maruni Wiwin Diarti, Khoviya Yuwina Selinada Harmi, Dwi Nur Ahsani
Published: 2 January 2021
Universa Medicina, Volume 40, pp 36-44; doi:10.18051/univmed.2021.v40.36-44

Abstract:
BACKGROUND A high-fat diet can lead to hyperlipidemia which will end up as liver damage (steatohepatitis). Ethanolic Feronia elephantum Correa fruit extract (EFEC) has an antioxidant activity which is expected to overcome hyperlipidemia in the liver. The objective of this study was to determine the effects of EFEC on liver function and morphological changes in rats.METHODSThis was an experimental study with a post-test only group design. A total of 20 male Wistar rats aged 2-4 months were randomized into 5 groups, A= negative control, B= positive control (high fat diet + 10 mg/kgBW simvastatin), C = high fat diet + 500 mg/kgBW EFEC fruit extract, D = high fat diet + 600 mg/kgBW EFEC, and E = high fat diet + 700 mg/kgBW EFEC). High-fat diet was given for 4 weeks (quail egg yolks, 10ml/200gBW). EFEC was administered for 4 weeks after induction of hypercholesterolemia. Examination of liver serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) was performed on rat blood serum and histopathological examination was carried out using steatohepatitis grading. One way ANOVA test and Post-Hoc Tamhane’s test were used to analyze the data. RESULTSAdministration of EFEC at 700 mg/kgBW improved the liver enzymes (p=0.00 for SGPT and SGOT) and steatohepatitis grading in high-fat diet induced rats (mild condition, E = 75% vs A = 100% mild)CONCLUSIONEthanolic Feronia elephantum Correa fruit extract at 700 mg/kgBW was able to improve steatohepatitis in high-fat diet induced rats.
Winda Mulyamin, , Endy Adnan, Yuyun Widaningsih, Irfan Idris, Arif Santoso, Ika Yustisia
Published: 2 January 2021
Universa Medicina, Volume 40, pp 22-28; doi:10.18051/univmed.2021.v40.22-28

Abstract:
BACKGROUNDHigh-sensitivity C-reactive protein (hsCRP) has been widely accepted as a predictor of future cardiovascular risk that reflects a microinflammatory state. Obesity linked to microinflammation increases the prevalence of metabolic disorders and cardiovascular diseases. This study aimed to determine the association between several obesity indices namely body mass index (BMI), waist circumference (WC), body fat percentage (fat), and visceral fat (VF) with hsCRP in non-diabetic adults. METHODSThis was a cross-sectional study performed on 80 non-diabetic adults with ages ranging from 20-40 years. The obesity indices BMI, WC, body fat percentage, and VF were measured. We then measured the hsCRP levels using an immunoturbidimetric method. Simple and multiple linear regression tests were used to analyze the association between obesity indices and hsCRP levels. RESULTSMean of log BMI, log WC, and log VF was 1.41 ± 0.08 kg/m2, 1.93 ± 0.06 cm, and 0.95 ± 0.27 units, respectively. Simple linear regression tests showed that log BMI (â=3.506; p<0.001), log WC (â=3.672; p<0.001), log VF (â=0.833; p<0.001), and log systolic blood pressure (â=3.739; p=0.024) had a significant positive correlation with log hsCRP levels. Further multiple linear regression test showed that log BMI (â=3.772; Beta=0.674; p<0.001) had the greater effect on log hsCRP levels compared to other indices. CONCLUSIONS BMI had a greater influence on hsCRP levels compared to other obesity indices in non-diabetic adults. Body mass index can be used as a better index in predicting hsCRP levels compared to other indices.
Ira Aini Dania, Nanda Novziransyah
Published: 2 January 2021
Universa Medicina, Volume 40, pp 69-76; doi:10.18051/univmed.2021.v40.69-76

Abstract:
The current coronavirus disease-19 (COVID-19) pandemic has changed the order of social life; the efforts made to tackle this pandemic have sometimes raised various obstacles related to norms, ethics and culture. An increased risk of COVID-19-associated mental disorders is found in many communities, causing excessive emotional reactions such as feelings of pressure, leading to unhealthy behavior. This situation confirms that health care providers have a key role in dealing with emotional disturbances that occur as a form of pandemic response. Public health emergencies can affect the health, safety and well-being of every individual as well as the social stigma in connection with the COVID-19 pandemic. Various mental health studies related to disasters have determined that emotional distress is widespread and can also be found in populations related to COVID-19. There are various kinds of risk factors that have an impact on health workers during the COVID-19 pandemic, including social isolation, lack of support, and concerns about safety of family members. We included published, observational and experimental studies that reported the mental health effects on health workers during the COVID-19 pandemic. Efforts made by policy holders, especially in the health sector, have greatly contributed to the response to the pandemic, but not all of them can run smoothly, several steps and policies in the health sector must involve many stakeholders in order to realize the expected efforts. The main purpose of this review paper was to not only focus on health workers, but include the communities in overcoming the COVID-19 pandemic.
Augustine Chinedu Ihim, Samuel Chukwuemeka Meludu, Charles Chinedum Onyenekwe, Arthur Ebelenna Anyabolu, Comfort N Akujiobi
Published: 2 January 2021
Universa Medicina, Volume 40, pp 45-51; doi:10.18051/univmed.2021.v40.45-51

Abstract:
BackgroundThe burden of tuberculosis (TB) and cardiovascular disease (CVD) is enormous worldwide. Public health programs have been challenged with the overlapping of TB and CVD epidemics.Mycobacterium tuberculosis (MTB) is also a main driver of atherogenesis, suggesting a potential pathogenic role of tuberculosis in cardiovascular disease. The objective of this study was to compare the serum levels of apolipoprotein B (apo B), apolipoprotein B48 (apo B48) and apolipoprotein B100 (apo B100) between patients with tuberculosis and healthy subjects. Methods A cross-sectional study was conducted involving 251 subjects consisting of 120 treatment naïve active TB patients [26 HIV co infected (TB+HIV+) and 82 TB+), 12 malaria parasite co-infected (TB+MP+)], 26 latent TB infected (LTB) and 105 healthy controls. Their body mass index (BMI) was calculated. Mycobacterium tuberculosis infection was determined by Ziehl-Nelseen (ZN) sputum smear microscopy and confirmed positive using GeneXpert. Latent TB was determined by Mantoux test, MP was evaluated by microscopy while HIV by immunochromatographic techniques using serial algorithm. Apolipoproteins were determined using spectrophotometry. A one-way ANOVA test and LSD’s post hoc multiple comparisons were used for statistical analyses. ResultsSignificantly lower mean levels of BMI were observed in LTB, TB+, TB+HIV+ and TB+MP+ compared with the controls (p<0.005). The mean serum levels of apo B, apo B48 and B100 were significantly higher in LTB, TB+, HIV+TB+ and TB+MP+ compared with apparently healthy controls (p<0.05). Conclusion Elevated levels of apolipoproteins among infected TB individuals might predispose them to cardiovascular disease.
Nur Anna C Sa’Dyah, , Bayu Tirta Dirja, Nurul Hidayah, Salma Yasmine Azzahara, Risky Candra Satria Irawan
Published: 2 January 2021
Universa Medicina, Volume 40, pp 29-35; doi:10.18051/univmed.2021.v40.29-35

Abstract:
IntroductionLiver fibrosis (LF) results from the unregulated chronic wound healing process in liver tissue. Transforming growth factor-beta (TGF-β) is the major contributing cytokine of LF promotion through activation of quiescent hepatic stellate cells (HSCs) into myofibroblasts (MFs) and increased extracellular matrix (ECM) deposition such as collagen leading to scar tissue development. Mesenchymal stem cells (MSCs) have an immunomodulatory capability that could be used as a new treatment for repairing and regenerating LF through suppression of TGF-β. This study aimed to examine the role of MSCs in liver fibrosis animal models through suppression of TGF-β levels without scar formation particularly in the proliferation phase.MethodsIn this study, a completely randomized design was used with sample size of 24. Male Sprague Dawley rats were injected intraperitoneally (IP) with carbon tetrachloride (CCl4), twice weekly, for eight weeks to induce LF. Rats were randomly assigned to four groups: negative control, CCl4 group, and CCL4 + MSC-treated groups T1 and T2, at doses of 1 x 106 and 2x106 cells, respectively. TGF-β levels were analyzed by enzyme-linked immunosorbent assay (ELISA). One-way ANOVA and a least significant difference (LSD) was used to analyse the data. ResultsThe TGF levels of LF rat models decreased on day 7 after MSC administration. The levels of TGF-β in both MSC groups T1 and T2 decreased significantly compared with the control group (p<0.05). The TGF-β suppression capability of T2 was optimal and more significant than that of T1.ConclusionMSCs can suppress TGF levels in liver fibrosis induced rats.
Dewi Kristanti, Ekowati Rahajeng, Eva Sulistiowati, Nunik Kusumawardani, Frans Dany
Published: 2 January 2021
Universa Medicina, Volume 40, pp 3-13; doi:10.18051/univmed.2021.v40.3-13

Abstract:
BackgroundType 2 diabetes mellitus (DM) is a non-communicable disease that constitutes a huge health burden, with the presence of comorbidities of DM adding to it. This study aimed to obtain the main determinants of the combined incidence of DM and its main comorbidities in adults.MethodsThis was a further analysis of the Non-Communicable Disease Risk Factor Cohort Study 2011 – 2018 involving 3730 subjects. Data of diabetes-free respondents at baseline were followed up every 2 years for 6 years. Data collection was carried out through interviews and health examinations. All subjects were assayed for blood glucose and lipid parameters. Chi-square test and Cox regression were implemented for data analysis.ResultsDuring 6 years of follow-up, DM incidence occurred in 567 (15.2%) subjects. The most common comorbidities were increased low density lipoprotein (LDL), central obesity, increased total cholesterol, obesity and hypertension. Most of the comorbidities occurred before the diagnosis of DM incidence. The determinants of the combined DM incidence–increased LDL are obesity, hypertension, and a family history of DM. The determinants of the combined DM incidence–central obesity are increased triglycerides, hypertension, male gender, and family history of DM. While the determinants of the combined DM incidence–hypertension are obesity and increased triglycerides.CONCLUSIONThis study demonstrated a high burden of diabetes incidence with comorbidities among adults. Knowledge of the magnitude of the diabetescomorbidity determinants emphasizes the role of non pharmacological intervention such as weight reduction and dietary modification.
Thania Vinsalia, Yvonne Suzy Handajani
Published: 2 January 2021
Universa Medicina, Volume 40, pp 14-21; doi:10.18051/univmed.2021.v40.14-22

Abstract:
BackgroundQuality of life tends to decrease as age increases. This study aimed to determine the most significant risk factors (family support, spirituality, and life satisfaction) for the elderly’s quality of life. MethodsThis was a cross-sectional study of 101 subjects aged ³60 years in West Jakarta. The variables were assessed using the World Health Organization Quality of Life–BREF (WHOQOL–BREF), Family Support, Daily Spiritual Experience Scale (DSES), and the Satisfaction with Life Scale (SWLS) instruments. Multivariate logistic regression was used to analyze the association between quality of life and its determinant factors.ResultsBased on sociodemographic characteristics, the respondents were mostly women (66.3%), had more than nine years of education (79.2%), and were married (56.4%). The analysis showed that life satisfaction was significantly associated with overall quality of life (OR=9.71; 95% CI:2.04–46.26; p=0.004) and general health (OR=7.52; 95% CI:1.70–33.25; p=0.008). Life satisfaction was also a risk factor for the environmental domain (OR=36.02; 95% CI:5.07–255.82; p<0.001). Furthermore, spirituality was found to be a risk factor for the physical health domain (OR=4.18; 95% CI:1.51–11.59; p=0.006), psychological domain (OR=6.67; 95% CI:2.4–17.86; p<0.001), and environmental domain (OR=11.46; 95% CI:3.10–42.37; p<0.001).ConclusionLife satisfaction plays a significant role in increasing the environmental domain of quality of life, the overall quality of life, and general health among the elderly. Awareness of these factors can assist providers in identifying people at risk and guide new intervention programs to improve care for these invaluable elderly of our communities.
Published: 2 January 2021
Universa Medicina, Volume 40, pp 1-2; doi:10.18051/univmed.2021.v40.1-2

Abstract:
According to the World Health Organization (WHO), primary health care (PHC) can be defined as a whole-of-society approach to health and well-being, centered on the needs and preferences of individuals, families and communities. In the last five years, several major events occurred that emphasize the importance of and the need for PHC. First, the publication of the United Nations Sustainable Development Goals (SDGs) in 2015. One of the SDGs is to achieve universal health care (UHC). UHC means that all people can get access to health service without it resulting in financial hardship, and the WHO believes that PHC is fundamental to achieving UHC. Second, a new international declaration on PHC has been released in Astana, Kazakhstan, in 2018. This is a new declaration and global commitment on PHC, four decennia after the first declaration on PHC in Alma-Ata, in the former Soviet Union
Yenny Yenny, , Raditya Wratsangka
Published: 2 January 2021
Universa Medicina, Volume 40, pp 57-68; doi:10.18051/univmed.2021.v40.57-68

Abstract:
Since the outbreak in Wuhan City, China, in late December 2019, the Coronavirus Disease 2019 (COVID-19) has spread to nearly the whole world, so that it was declared a pandemic by the Word Health Organization. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative organism of COVID-19, is extremely infectious and can adhere to droplet nuclei of < 5 mm diameter and become airborne (aerosol). Since COVID-19 was declared a pandemic, there has been controversy on the use of cloth masks by the public, because of the still inconclusive evidence of the efficacy of cloth masks in protecting against COVID-19 transmission. Universal masking as a healthcare intervention in the community is currently made mandatory by local governments of most countries, since they follow the recent recommendation by the World Health Organization. The issuing of the WHO recommendation on the public use of masks was based on a study demonstrating that COVID-19 transmission does not occur only through droplets but also through aerosols. In addition, there was a study showing that COVID-19 transmission does not only occur from patients with clinical symptoms but also through asymptomatic and pre-symptomatic subjects, so that universal masking is of benefit in providing protection when used by healthy people and as source control to prevent cross-transmission to other people. This review article aims to discuss the mechanism of COVID-19 transmission, the evidence related to the efficacy of cloth masks, and the guidelines related to the selection and use of masks by the general population.
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