E-Jurnal Medika Udayana is a peer-reviewed scientific journal dedicated to publish good quality of research work in all areas of medical sciences. Scope of the journal includes: medicine, dentistry, nursing and allied health sciences, pharmacy, pathology, anatomy, pharmacology, toxicology, surgery and physiology.
QUALITY-OF-LIFE OF ELDERLY NATIONAL HEALTH INSURANCE PARTICIPANTS WITH HYPERTENSION AND TYPE 2 DIABETES MELLITUS IN DENPASAR
Elderly individuals are at a high risk of suffering from chronic diseases, especially hypertension and type 2 diabetes mellitus (DM type 2). Chronic diseases were often accompanied by multimorbidity and require long-term treatment. This led to a decline in the quality - of -l ife among the elderly. This research aimed to understand the quality-of-life among elderly individuals with hypertension and DM type 2 who are participants of BPJS Kesehatan and reside in the city of Denpasar. The study used a cross-sectional descriptive design, conducted from January to August 2023. A total of 49 elderly individuals (age ≥60 years) from 4 community health centers in Denpasar were selected as respondents using consecutive sampling. Data were collected through interviews using a questionnaire. The collected data include d respondent characteristics and the level of quality-of-life based on the SF-36 questionnaire. Based on the data analysis, the majority of respondents suffer red from hypertension (51.0%) for a duration of 2-5 years (44.9%), with one accompanying disease (48.9%), mainly heart disease (48.9%). In terms of physical and mental aspects, elderly individuals with hypertension and/or DM type 2 had good quality-of-life . Individuals with hypertension/DM had better physical functional abilities compared to mental functional abilities, with poor social functioning. Conversely, elderly individuals with more than one chronic disease generally had a lower quality-of-life , with better mental functional abilities compared to physical functional abilities. Therefore, policymakers were encouraged to maintain efforts to improve the quality-of-life , such as through exercise or health promotion programs (Prolanis), and develop health programs focused on mitigating the impact of multimorbidity at both individual and community levels. Keywords :
quality-of-life, hypertension, diabetes mellitus.
THE INCIDENCE OF INFECTIOUS DISEASES IN CHILDREN IN TRUNYAN TOURISM VILLAGE
Background: Infectious diseases are the leading cause of death and morbidity among children. Children with these illnesses are frequently seen in primary healthcare settings. Epidemiological surveillance is essential to monitor and review the incidence of infections. Such surveillance activities provide valuable information about infection rates and emerging patterns. This study aims to determine the incidence of infectious diseases among children in Trunyan Village. Methods: This study is an analytical observational study using a cross-sectional design. Data were collected from electronic medical records of children aged 0 to 18 years who visited the health center in Trunyan Village between January 2024 and October 2024. All data were processed and statistically analyzed using SPSS version 26. Descriptive statistics, including proportions (percentages), counts, averages (standard deviations), and ranges (minimum–maximum), were calculated. The relationship between dependent and independent variables was assessed using Chi-square analysis, with a significance threshold of p<0.05. Results: A total of 79 study subjects met the inclusion and exclusion criteria, and 10 infectious diseases were identified. The three most prevalent conditions were upper respiratory tract infections (URTI), pneumonia, and diarrhea. Most patients were male (54.4%). The youngest patient was 1 year old, and the oldest was 17.3 years, with children in the age category of 6–12 years comprising the largest group (38%). Based on anthropometric data, the average body mass index (BMI) was 17.3, with a minimum of 11.1 and a maximum of 29.0. Most children were fully immunized (81%) and had received exclusive breastfeeding (68.4%). Regarding hospitalization history, 27.8% of children had been hospitalized due to conditions such as pneumonia, typhoid, diarrhea, and dengue fever. Conclusion: Ten common infectious diseases lead children to seek treatment, with four requiring hospital admission (Pneumonia, typhoid fever, diarrhoea, and dengue fever). The incidence of infections is influenced by factors such as exclusive breastfeeding and immunization status.
infectious diseases, pediatric infections, risk factors, tourism village
MULTIDRUG-RESISTANT KLEBSIELLA PNEUMONIAE DAN ESCHERICHIA COLI DI RUMAH SAKIT TERSIER PASCA PANDEMI COVID-19: PREVALENSI, KARAKTERISTIK, DAN POLA KEPEKAAN
Klebsiella pneumoniae dan Escherichia coli adalah bakteri Gram negatif dari famili Enterobacteriaceae yang banyak terisolasi di rumah sakit sebagai penyebab infeksi, baik hospital-acquired infections (HAIs) maupun community-acquired infections. Prevalensi resistensi bakteri tersebut semakin meningkat, termasuk resistensi terhadap antibiotik golongan karbapenem dan sefalosporin spektrum luas. Penelitian ini bertujuan untuk mengetahui pola kepekaan K. pneumoniae dan E. coli penghasil extended spectrum β-lactamase (ESBL) dan resisten karbapenem terhadap antibiotik yang diisolasi dari pasien rawat inap serta distribusinya berdasarkan usia, jenis kelamin, diagnosis, ruang rawat, lama rawat, status rujukan, dan jenis spesimen. Penelitian ini adalah penelitian deskriptif observasional dengan desain cross-sectional menggunakan data laboratorium dan data rekam medis di Instalasi Laboratorium Sentral dan Instalasi Rekam Medis RSUP Dr. Mohammad Hoesin Palembang periode Juli 2022-Juni 2023. Terdapat 587 isolat K. pneumoniae dan 506 isolat E. coli penghasil ESBL atau resisten karbapenem. Distribusi K. pneumoniae dan E. coli berdasarkan profil resistensinya di RSUP Dr. Mohammad Hosein Palembang, antara lain ESBL-K. pneumoniae (53,6%), ESBL-E. coli (72,1%), CR-K. pneumoniae (8%), CR-E. coli (1,8%), ESBL-CR-K. pneumoniae (2%), dan ESBL-CR-E. coli (1%). Berdasarkan pola kepekaan, isolat penghasil ESBL sensitif terhadap antibiotik piperasilin/tazobaktam, golongan karbapenem, amikasin, nitrofurantoin, dan tigesiklin. Isolat CRE sensitif terhadap amikasin, nitrofurantoin, dan tigesiklin. Isolat Enterobacteriaceae multidrug-resistant (MDR) yang paling banyak di RSUP Dr. Mohammad Hoesin Palembang selama periode penelitian adalah ESBL-E. coli (72,1%), dengan sensitivitasnya yang masih cukup tinggi terhadap piperasilin/tazobaktam, karbapenem, amikasin, nitrofurantoin, dan tigesiklin. ABSTRACT Hospital-acquired infections (HAIs) and community-acquired infections are frequently caused by two Gram-negative bacteria from the Enterobacteriaceae family: Escherichia coli and Klebsiella pneumoniae. These bacteria are frequently identified in hospitals. Resistance in bacteria, especially resistance to broad-spectrum cephalosporins and carbapenems, is becoming more common. This study aims to determine the antibiotics sensitivity pattern of ESBL-producing and carbapenem-resistant K. pneumoniae and E. coli isolated from hospitalized patients and its distribution based on age, gender, diagnosis, ward, length of stay, referral status, and specimen type. This research is a descriptive observational study with a cross-sectional design using laboratory and medical record. In this investigation, 587 K. pneumoniae isolates and 506 E. coli isolates that produced ESBL, or carbapenem-resistant, were detected. At Dr. Mohammad Hosein General Academic Hospital Palembang, the distribution of K. pneumoniae and E. coli is determined by their resistance profiles, which include ESBL-K. pneumoniae (53.6%), ESBL-E. coli (72.1%), CR-K. pneumoniae (8%), CR-E. coli (1.8%), ESBL-CR-K. pneumoniae (2%), and ESBL-CR-E. coli (1%). The susceptibility pattern showed that ESBL-producing isolates were sensitive to piperacillin/tazobactam, carbapenems, amikacin, nitrofurantoin, and tigecycline. The CRE isolate was sensitive to tigecycline, nitrofurantoin, and amikacin. ESBL-E. coli was the most prevalent multidrug-resistant Enterobacteriaceae in this investigation, with a significant degree of sensitivity to tigecycline, amikacin, carbapenems, nitrofurantoin, and piperacillin/tazobactam.
Klebsiella pneumoniae, Escherichia coli, ESBL, CRE
ASSOCIATION BETWEEN PARENTAL FEEDING STYLES AND FEEDING DIFFICULTIES AMONG PRESCHOOL CHILDREN IN DENPASAR, INDONESIA
Background: Nutrition during the preschool period is crucial for growth and cognitive development. Feeding difficulties are common and can lead to malnutrition. Parental feeding style—authoritarian, democratic, or permissive—plays a major role in children’s eating behaviour. This study aimed to determine the association between parental feeding style and feeding difficulties among preschoolers in Denpasar, Indonesia. Methods: A descriptive-analytic cross-sectional study was conducted between April and June 2025 in five kindergartens selected by cluster random sampling. A total of 196 children were recruited systematically. Data were collected using validated questionnaires on feeding style and feeding difficulty behaviour and analysed with SPSS 26 using univariate, bivariate, and multivariate statistics. Results: Feeding style was significantly associated with feeding difficulties (p < 0.001). Children of authoritarian parents showed the highest prevalence of feeding problems (95.0%, PR = 5.2, 95% CI 3.76–7.26), followed by permissive (52.5%, PR = 3.6, 95% CI 2.24–5.78), whereas democratic parenting showed the lowest rate (0.9%). Multivariate logistic regression confirmed feeding style (B = 0.499, p < 0.001) as a key determinant of feeding difficulty. Conclusion: Parental feeding style is significantly associated with feeding difficulties among preschool children in Denpasar. Authoritarian and permissive styles increase risk, while democratic style is protective.
Preschool children, feeding difficulty, parental feeding style
Hak Cipta (c) 2025 E-Jurnal Medika Udayana
ASSOCIATION BETWEEN PROGRAMMED DEATH-LIGANT 1 (PD-L1) EXPRESSION WITH MENINGIOMA GRADE AT PROF. DR. I.G.N.G. NGOERAH DENPASAR HOSPITAL
Background: Meningioma is the most common primary intracranial tumor, mostly benign, yet higher-grade tumors tend to recur and behave more aggressively. The expression of Programmed Death-Ligand 1 (PD-L1) contributes to tumor immune evasion and may serve as a prognostic biomarker as well as a potential target for immune checkpoint inhibitor therapy. Objective: To analyze the association between PD-L1 expression and meningioma grade at Prof. dr. I.G.N.G. Ngoerah General Hospital. Methods: This analytical observational study used a cross-sectional design. Samples were selected using a purposive sampling method from paraffin-embedded meningioma tissues diagnosed at the Department of Anatomical Pathology, Prof. dr. I.G.N.G. Ngoerah General Hospital. Immunohistochemistry was performed using a polyclonal anti–PD-L1 antibody (Genetex, GTX104763). PD-L1 expression was evaluated using the Tumor Proportion Score (TPS) and Combined Positive Score (CPS). Statistical analysis was conducted using the chi-square test with a significance level of p<0.05. Results: A total of 41 meningioma cases were included, consisting of 20 (48.8%) grade 1, 15 (36.6%) grade 2, and 6 (14.6%) grade 3. PD-L1 expression showed an increasing trend with higher meningioma grades in both TPS and CPS evaluations. A significant correlation was observed between PD-L1 expression and tumor grade (p<0.05). Conclusion: Higher PD-L1 expression was associated with higher meningioma grades, suggesting its potential role as a prognostic biomarker and as a rationale for considering immune checkpoint inhibitor therapy in high-grade or recurrent meningiomas.
Meningioma, PD-L1, Immunohistochemistry, Tumor Proportion Score, Combined Positive Score, Grade
Hubungan Asimetrik Facet Joint dengan Herniasi Diskus Intervertebralis Lumbalis Pada Pasien LBP dengan Menggunakan Magnetic Resonance Imaging
ANASTASIA MARCELLA. Hubungan Asimetrik Facet Joint dengan Herniasi Diskus Intervertebralis Lumbalis Pada Pasien LBP dengan Menggunakan Magnetic Resonance Imaging (disupervisi oleh Junus Baan, Mirna Muis, dan Andi Alfian Zainuddin) Facet joint asimetrik dapat membuat distribusi tegangan asimetris pada jaringan zygapophysial dan diskus intervertebralis serta dapat meningkatkan risiko herniasi diskus lumbar. Pemeriksaan Magnetic Resonance Imaging (MRI) ditujukan untuk memvisualisasikan struktur non-osseous dari facet joint termasuk kartilago articular serta menilai herniasi dari nukleus pulposus dengan baik. Penelitian ini bersifat observasional analitik dengan pendekatan cross sectional di RSUP Dr. Wahidin Sudirohusodo Makassar untuk menilai hubungan asimetrik facet joint dengan herniasi diskus intervertebralis lumbalis dengan menggunakan MRI lumbosakral. Sampel penelitian diambil dari bulan Januari 2020 hingga Januari 2023, dan didapatkan sebanyak 92 orang. Program SPSS versi 26.0 digunakan untuk analisis data. Uji bivariat menggunakan uji Chi Square. Terdapat hubungan yang bermakna antara derajat herniasi diskus intervertebralis lumbal dengan derajat asimetrik facet joint pada level spinal L3-L4, L4-L5 dan L5-S1 (p < 0,001). Kata kunci: MRI lumbosakral, asimetrik facet joint, herniasi diskus intervertebralis.
MRI lumbosakral, asimetrik facet joint, herniasi diskus intervertebralis
EFFECTS OF PLANT-BASED VERSUS ANIMAL-BASED COMPLEMENTARY FEEDING ON GROWTH AND NUTRITIONAL OUTCOMES IN HEALTHY INFANTS: A META-ANALYSIS
In recent years, there has been growing interest among parents in plant-based diets, including vegetarian and vegan feeding patterns for infants. Plant-based complementary feeding (CF) may fall short in delivering sufficient amounts of bioavailable iron, zinc, calcium, vitamin B12, and high-quality protein, all of which are essential for proper growth and neurodevelopment for infants. Method: This study employs statistical modeling to combine the results of multiple studies using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed qualitatively based on study design, sample size, and outcome reporting. Result: In the initial stage of search, total of 350 articles were identified but total of 5 primary studies met all the inclusion criteria and were included in the final study using Review Manager (RevMan) version 5.4. The pooled analysis revealed that infants who received animal-based CF experienced significantly better growth outcomes compared to those who received plant-based CF. Discussion: The findings of this meta-analysis are consistent with prior literature indicating that animal-source foods contribute significantly to optimal growth in early childhood due to their high nutrient density and bioavailability of key micronutrients. Compared to plant-based foods, animal-based complementary feeding provides heme iron, complete proteins, vitamin B12, and zinc in forms that are more efficiently absorbed by the body, potentially explaining the superior growth outcomes observed in the included studies. Conclusion: This meta-analysis demonstrates that animal-based CF is significantly more effective in supporting the growth of infants aged 6–24 months compared to plant-based CF.
THE CORRELATION BETWEEN p16 AND p53 PROTEIN EXPRESSION WITH PATHOLOGICAL T STAGE (pT) AND LYMPH NODE METASTASIS IN PENILE SQUAMOUS CELL CARCINOMA AT PROF. DR. I.G.N.G. NGOERAH HOSPITAL
Background: Penile carcinoma is a rare cancer worldwide. Approximately 95% of penile cancers are classified as penile squamous cell carcinoma (PSCC). Bali province has the highest incidence of PSCC in Indonesia. The prognosis of PSCC causes psychological trauma and becomes worse when the disease is diagnosed at advanced stages, making treatment more complex. The pathological stage and lymph node metastasis status are significant prognostic factors. The expression of p16 and p53 proteins plays a role in the classification and prognosis of PSCC. Various studies have shown that PSCC with positive p16 expression has a better prognosis compared to PSCC with abnormal p53 expression. Although the relationship between p16 and p53 expression and prognostic factors has been widely studied, research combining both p16 and p53 expressions remains limited. This study aims to evaluate the relationship between the expression of p16 and p53 proteins with pathological T stage and lymph node metastasis status in PSCC patients, as prognostic markers. Methods: This study is an observational analytical research with a cross-sectional design. The sample consists of PSCC patients whose specimens were examined at the Anatomical Pathology Laboratory of Prof. Dr. I.G.N.G. Ngoerah Hospital from January 1, 2019, to June 30, 2025, according to the inclusion and exclusion criteria set by the researchers, with a sample size of 43 patients. Immunohistochemistry was performed using p16INK4A clone JC2 and p53 clone DO-7. The research results were analysed using Chi-square analysis to assess the relationship between p16 and p53 protein expression with pathological T stage and lymph node metastasis, with a significance level of p<0.05. Results: The study found that the patients' age ranged from 32 to 97 years, with a mean age of 60.09±14.046 years. The most cases were at advanced stages (26 cases), and most patients showed no lymph node metastasis (31 cases). Immunohistochemical examination revealed that most cases had negative p16 expression (30 cases) and abnormal p53 expression (36 cases). Regarding the combination of p16 and p53 expressions, 26 cases showed negative p16 and abnormal p53, 10 cases showed positive p16 and abnormal p53, 4 cases showed negative p16 and normal p53, and 3 cases showed positive p16 and normal p53. However, based on Chi-square analysis, there was no statistically significant relationship between p16 and p53 protein expression and pathological T stage (p = 0.493) or lymph node metastasis (p = 0.506). Conclusion: There is no significant relationship between p16 and p53 protein expression and pathological T stage or lymph node metastasis in SCCP.
Penile squamous cell carcinoma, p16 expression, p53 expression
Hak Cipta (c) 2026 E-Jurnal Medika Udayana
CHARACTERISTICS OF IMMUNOHISTOCHEMISTRY EXAMINATION OF BREAST CANCER IN MANGUSADA HOSPITAL PERIOD 2022-2024
ABSTRACT Background: Breast cancer ranks first in the number of cancer cases as well as being the largest cause of cancer deaths in the world each year. In Indonesia, breast cancer is an urgent public health issue, yet it is clear that the burden of breast disease in Indonesia is considerable, influenced by several factors such as socioeconomic disparities, cultural beliefs, and limited access to healthcare, especially in Bali which is a popular tourist destination, which faces unique challenges in terms of breast health due to the large number of visitors and the potential for delayed diagnosis or inadequate follow-up. Immunohistochemical profiling examination has been widely used as a basis in classifying breast cancer molecularly. Therefore, a comprehensive analysis of the geographical distribution of breast cancer cases as well as immunohistochemical profiling is essential for further prevention and treatment, especially in Bali. Methods: This retrospective study aimed to analyze the distribution of breast cancer from 2022 to 2024. Data was extracted from the hospital's medical record based on age, breast cancer diagnosis as well as immunohistochemistry results during the specified period. Statistical analysis was performed using SPSS 26.0 software. Results: This study identified 182 samples, of which the most common age range was >50 years, 111 cases (60.98%) with the most common diagnosis being Invasive Carcinoma of no special type, 149 cases (81.86%). Most of the cases were grade II, namely 108 (59.34%). Based on subtypes, luminal B and HER-2 positive/ HER-2 Enriched were the dominant subtypes with 82 cases (45.05%) and 38 cases (20.87%) respectively, followed by triple negative/basal-like with 32 cases (17.58%) and luminal A with 28 cases (15.38%). Conclusion: This study showed a wide variety of samples based on age, diagnosis, grade and immunohistochemical profile of breast cancer patients. Age showed a significant association between age and breast cancer prevalence and a variety of histologic types of breast cancer, with Invasive carcinoma of no special type being the most common subtype and grade II is the most common. By subtype, luminal B was the predominant case. Keywords: breast cancer, immunohistochemical examination, Bali ABSTRAK Latar Belakang: Kanker payudara menempati urutan pertama jumlah kasus kanker sekaligus menjadi penyebab kematian terbesar akibat kanker di dunia setiap tahunnya. Di Indonesia, kanker payudara merupakan masalah kesehatan masyarakat yang mendesak, dipengaruhi beberapa faktor seperti kesenjangan sosial ekonomi, kepercayaan budaya, dan akses kesehatan yang terbatas, terutama di Bali yang merupakan tujuan wisata populer, yang menghadapi tantangan unik dalam hal kesehatan payudara karena banyaknya pengunjung dan potensi keterlambatan diagnosis atau tindak lanjut yang tidak memadai. Pemeriksaan profil imunohistokimia telah digunakan secara luas sebagai dasar dalam mengklasifikasikan kanker payudara secara molekuler. Oleh karena itu, analisis komprehensif tentang distribusi geografis kasus kanker payudara serta profil imunohistokimia sangat penting untuk pencegahan dan pengobatan lebih lanjut, terutama di Bali. Metode : Studi retrospektif ini bertujuan untuk menganalisis distribusi kanker payudara dari tahun 2022 hingga 2024. Data diambil dari rekam medis rumah sakit berdasarkan usia, diagnosis, serta hasil imunohistokimia selama periode yang ditentukan. Analisis statistik dilakukan dengan menggunakan perangkat lunak SPSS 26.0. Hasil: Studi ini mengidentifikasi 182 sampel, di mana rentang usia paling banyak >50 tahun sebanyak 111 kasus (60,98%) dengan diagnosis paling umum adalah Invasive Carcinoma of no special type yaitu sebanyak 149 kasus (81.86%). Sebagian besar kasus adalah grade II yaitu sebanyak 108 (59,34%). Berdasarkan subtipenya luminal B dan HER-2 positif/ HER-2 Enriched merupakan subtipe dominan dengan masing-masing 82 kasus (45,05%) dan 38 kasus (20,87%), diikuti dengan triple negative/basal-like sebanyak 32 kasus (17,58%) dan luminal A sebanyak 28 kasus (15,38%). Kesimpulan: Studi ini menunjukkan berbagai variasi sampel berdasarkan usia, diagnosis, grade dan profil imunohistokimia pasien kanker payudara. Berdasarkan usia menunjukkan hubungan yang signifikan antara usia dan prevalensi kanker payudara serta beragam jenis histologis kanker payudara, dengan Invasive carcinoma of no special type yang merupakan subtipe yang paling umum dan grade II paling banyak ditemukan. Berdasarkan subtipe, luminal B merupakan kasus dominan. Kata kunci: kanker payudara, pemeriksaan imunohistokimia, Bali
THE PREVALENCE AND CHARACTERISTICS OF FLUOR ALBUS AT DERMATOLOGY AND VENEREOLOGY POLYCLINIC OF PROF. DR. I.G.N.G. NGOERAH GENERAL HOSPITAL,DENPASAR, 2021-2023
Fluor albus, also known as leukorrhea, is defined as the appearance of abnormal vaginal discharge, assessed based on the amount, odor, color, and whether it is accompanied by complaints such as lower abdominal pain. Based on its type, leukorrhea consists of physiological and pathological leukorrhea. The causes of pathological vaginal discharge can be transmitted with or without sexual contact. Pathological vaginal discharge transmitted through sexual contact is referred to as a sexually transmitted infection (STI). Sexually transmitted infections remain a significant issue in both developing and developed countries. This study was conducted to determine the prevalence rate and characteristics of fluor albus cases, particularly at the Dermatology and Venereology Polyclinic of Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, from 2021 to 2023. This study is a retrospective descriptive research with a cross-sectional design. The sample for this study consists of 85 individuals, obtained using a total sampling method. The prevalence of fluor albus at the Dermatology and Venereology Polyclinic of Prof. dr. I.G.N.G. Ngoerah General Hospital, Denpasar, from 2021 to 2023 was found to be 32.06%. Physiological vaginal discharge was found in 7.1%, while pathological discharge accounted for 92.9%, with the most common cause being bacterial vaginosis. The incidence of fluor albus based on the sample characteristics predominantly occurred in the reproductive age group (94.1%), with students accounting for 21.2%, those with a high school education level making up 30.6%, and unmarried individuals constituting 35.3%.
Association Between Hemoglobin Levels and Severity of Diabetic Foot Ulcers in Type 2 Diabetes Mellitus Patients at RSUP Prof. dr. I.G.N.G Ngoerah Denpasar
Diabetic Foot Ulcer (DFU) is a condition characterized by loss of skin integrity in the distal foot, involving at least the epidermis and part of the dermis in individuals with a history of Diabetes Mellitus (DM). Anemia which is defined by low hemoglobin levels, may exacerbate DM-related complications. However, the connection between hemoglobin levels and the severity of DFU remains poorly understood. This study aimed to describe the prevalence of anemia and investigate the association between hemoglobin levels and DFU severity among type 2 DM patients at Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar. An analytical observational study with a cross-sectional design was conducted on type 2 DM patients presenting with DFU, who were registered at the hospital from 2022-2023. Consecutive sampling was used to select subjects and secondary data were sourced from medical records. Data analysis included univariate and bivariate Chi-Square tests. A total of 74 patients aged 38-77 years were included in the study. Anemia was identified in 64 patients (86.5%) with 15 (20.3%) experiencing mild anemia, 37 (50%) moderate anemia, and 12 (16.2%) severe anemia, while 10 patients had normal hemoglobin levels. A total of 41 patients (55.4%) had severe DFU and 33 patients (44.6%) had mild to moderate DFU. Bivariate Chi-Square analysis revealed no significant association between hemoglobin levels and DFU severity (p = 0.635).
DIFFERENCE IN PERCEIVED QUALITY OF SERVICE AND PATIENT SATISFACTION BETWEEN GOVERNMENT AND PRIVATE HOSPITALS IN MEDAN, INDONESIA
Since the implementation of the National Health Insurance program, there has been significant growth in the number of hospitals in Indonesia, with the most notable growth occurring in private hospitals. This growth has been followed by increased competition between government hospitals (GH) and private hospitals (PH). This study aims to examine the differences in perceptions of service quality and patient satisfaction between RSP and PH. The study is analytical quantitative research with a cross-sectional design, conducted at GH and PH in Medan City in May 2025. The sample for this study consisted of 422 respondents, selected using incidental sampling techniques. Data were collected using a valid and reliable questionnaire. This study has been approved by the Ethics Committee of the Health Research Department at Universitas Prima Indonesia. The study found that the majority of patients at GH perceived service quality as poor across all dimensions (>50%) and were largely dissatisfied with the services they received (53.4%). In contrast, the majority of patients at PH perceived service quality as good across all dimensions (>60%) and were generally satisfied with the services they received (89.4%). At GH, all dimensions of quality were found to be significantly related to patient satisfaction (p < 0.001), whereas at PH, only overall quality was related to satisfaction. Furthermore, there were significant differences between GH and PH in terms of the dimensions of tangibility, empathy, overall quality, and patient satisfaction, with satisfaction at PH being more than twice as high as at GH. It can be concluded that there are significant differences in the perceptions of service quality and patient satisfaction between GH and PH.
Analysis of Toddlers' Malnutrition Incidence and Adherence to Clean and Healthy Living Behavior in Sei Kepayang Timur Health Center
Undernutrition is a health problem that has a long-term impact on child growth and development, which can occur due to insufficient intake or excessive energy use. One of the factors contributing to undernutrition is the failure to implement clean and healthy living behaviors (PHBS). However, the national PHBS achievement has only reached 39.1% and the prevalence of children with undernutrition in Indonesia has reached 7.5%. This study aims to determine the effect of PHBS on the incidence of undernutrition among toddlers in the Sei Kepayang Timur Community Health Center (CHC) area. This study is a quantitative analytical study involving 200 families with children under five years of age, selected incidentally. Data were collected using direct observation checklists and basic information questionnaires. The majority of families in the Sei Kepayang Timur CHC work area (92%) still did not achieve PHBS, and 42% had children with undernutrition. Data analysis showed that overall PHBS was significantly associated with malnutrition (p<0.05). Among the ten PHBS indicators, only the second, third, fifth, and tenth indicators were found to influence malnutrition, with the tenth indicator being the most influential factor (p<0.05: OR: 3.855). Achieving clean and healthy living behaviors, such as exclusive breastfeeding, monthly weighing of infants, washing hands with soap and running water, and not smoking indoors, plays a crucial role in preventing malnutrition among infants.
RELATIONSHIP BETWEEN EEG PATTERN AND LEVEL OF CONSCIOUSNESS WITH CLINICAL OUTCOMES IN HEMORRHAGIC STROKE PATIENTS
Hemorrhagic stroke, characterized by cerebral blood vessel rupture and bleeding within the brain tissue or surrounding areas, remains a critical global health issue that significantly contributes to morbidity and mortality rates. This cross-sectional study aimed to analyze the relationship between electroencephalogram (EEG) patterns and the level of consciousness and clinical outcomes in stroke patients with intracerebral hemorrhage (ICH). This study included 43 patients with hemorrhagic stroke diagnosed with ICH at Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia. Demographic data were obtained from medical records, clinical outcomes were assessed using the modified Rankin Scale (mRS), and level of consciousness was evaluated using the Glasgow Coma Scale (GCS). Most patients (62.8%) had good clinical outcomes, whereas 37.2% had poor outcomes. Hypertension was the most prevalent comorbidity (48.8%) and non-lobar hemorrhage was the most frequent (72.1%). A significant relationship was found between EEG patterns and clinical outcomes (p=0.012) as well as between the level of consciousness and clinical outcomes (p=0.000). The mean GCS score for patients with favorable outcomes was 13.93, while for patients with unfavorable outcomes was 10.25. Abnormal EEG patterns may potentially lead to post-stroke seizures, and alterations in EEG characteristics significantly increase risk factors for future post-stroke epilepsy. The integration of EEG data with clinical evaluations of the level of consciousness can improve prognosis, tailor rehabilitation efforts, and enhance overall clinical outcomes in patients with hemorrhagic stroke.
CHARACTERISTICS OF ANEMIA IN PREDIALysis CHRONIC KIDNEY DISEASE PATIENTS AT PROF. DR. I.G.N.G. NGOERAH IN 2022
Background:Anemia is a common complication in patients with chronic kidney disease (CKD), especially in the predialysis stage. It mainly occurs due to insufficient erythropoietin production as a result of kidney damage. Anemia worsens with increasing severity of CKD and contributes to reduced oxygen delivery to tissues, decreased quality of life, and increased morbidity and mortality. Determining the characteristics of anemia in predialysis CKD is essential to guide proper management. Methods:This study is a descriptive observational design using a total sampling method involving 90 patients with predialysis CKD at Prof. Dr. I.G.N.G. Ngoerah Hospital in 2022. Inclusion criteria included complete medical records with confirmed diagnosis of CKD and documented anemia without undergoing hemodialysis. Data were obtained retrospectively from the hospital information system and included patient demographics, CKD stage, hemoglobin levels, and erythrocyte indices (MCV, MCHC). Results:Among 90 patients, 52.2% were male and 48.9% were aged 46–65 years. The most common CKD stage was stage 3 (28.9%). The most frequent anemia severity was mild anemia (67.8%) based on hemoglobin levels. Regarding erythrocyte morphology, normochromic normocytic anemia was the most prevalent, found in 71.1% of the cases. A smaller proportion had microcytic hypochromic anemia (23.3%) and macrocytic normochromic anemia (5.6%). Conclusion:The majority of anemia in predialysis chronic kidney disease patients at Prof. Dr. I.G.N.G. Ngoerah Hospital in 2022 was found to be of mild severity with normocytic normochromic morphology. These findings highlight the need for early screening and classification of anemia in CKD patients to optimize treatment.
Chronic Kidney Disease, Anemia, Predialysis
PERCEPTION AND ATTITUDE OF UDAYANA UNIVERSITY MEDICAL STUDENTS TOWARDS CADAVERIC OBSERVATION BY ONLINE AND OFFLINE LEARNING
Human anatomy practicum using cadavers has been carried out for a long time and is considered the gold standard for learning anatomy. Practicum using cadavers has its own advantages and disadvantages and is starting to be replaced by other anatomical practicum methods. Students have their own perceptions of practicum using cadavers. This research aims to determine the perceptions and attitude of students in the Undergraduate Medicine Study Program at Udayana University regarding human anatomy practicum using cadavers with online and offline learning. This research is a descriptive observational study with a cross-sectional approach. The sample collection technique used was purposive sampling and 216 students were taken as minimum samples. Data collection was carried out by distributing questionnaires with a Likert scale online and offline. The results of research from 301 samples show that students of the Undergraduate Medicine Study Program at Udayana University have a positive perception of human anatomy science practicum using cadavers, both with online and offline learning. The majority of students agreed that cadaver observation deepens understanding (69.5%), increases respect for the human body (88.1%), makes learning more interesting (82.7%), and helps remember what is learned (65.4%). Students also accept cadaver as a learning method and have respect and empathy for cadavers. Students have a positive perception of human anatomy science practicum using cadavers. Cadaveric observation should not be replaced by other practical methods and more time should be allocated for cadaveric observation.
Anatomy practicum, cadaver, online learning, offline
Overview Of Knowledge Levels Among The Class Of 2023 Medical Students At Udayana University Regarding Cervical Cancer Vaccination
Cervical cancer remains a significant health issue for Indonesian women due to its high incidence and mortality rates. It is the second most common cancer among women globally, and in Indonesia, it ranks second after breast cancer. In Bali Province, the prevalence of cervical cancer in 2018 was 2.3 per 1000 people, according to the Basic Health Research (Riskesdas). Knowledge about cervical cancer and preventive measures is crucial for reducing the number of cases. The objective of this study is to assess the level of knowledge among the class of 2023 medical students at Udayana University regarding an overview of cervical cancer, the purpose of cervical cancer vaccination, as well as the dosage and method of administration of the cervical cancer vaccine. This study is a descriptive study with a cross-sectional design. Consecutive sampling was used as the sampling technique. Data were collected using a questionnaire distributed via Google Forms to the class of 2023 medical students at Udayana University. The results of the study showed that among 120 student respondents, the majority had good knowledge of the general overview of cervical cancer (79.2%), the majority had good knowledge of the purpose of cervical cancer vaccination (42.5%), and the majority had moderate knowledge of the dosage and administration of the cervical cancer vaccine (41.7%). Good knowledge regarding cervical cancer can improve the attitude toward undergoing cervical cancer vaccination and our finding in this study can serve as a reference in providing education about cervical cancer vaccination to the public.
OVERVIEW OF THE CAUSES OF AUTOPSIED SUDDEN DEATH AT PROF. DR. I.G.N.G. NGOERAH CENTRAL GENERAL HOSPITAL FOR THE 2014-2023 PERIOD
Sudden natural unexpected death is death due to disease process that occurs naturally. Sudden death due to illness has been increasing, with the cardiovascular system as the highest cause of death. While many causes of sudden death have been identified, some cases remain unexplained even after thorough examinations. Based on background, it is necessary to discuss the causes of sudden death. The study was conducted to determine causes and characteristics of autopsied sudden death at Prof. Dr. I.G.N.G. Ngoerah Central General Hospital for the 2014-2023 period. This study used a descriptive cross-sectional method with a retrospective study approach. Sampling was carried out using a total sampling technique, in which the number of samples was 82 bodies. Research data were obtained from secondary data in the form of postmortem examination reports in the 2014-2023 period. The study results showed that the causes of autopsied sudden deaths consisted of 69.5% sudden natural deaths due to disease and 30.5% sudden deaths of unknown causes. The elderly population or ≥60 years old dominated in these cases (39.0%). Most of samples who experienced sudden death were male (78.0%). In addition, about 91.5% of the samples were foreigners, and the highest BMI owned by the samples was obesity class I (34.1%). Autopsied sudden deaths were dominated by sudden natural deaths, with cardiovascular (80.7%), respiratory (5.3%), central nervous (5.3%), hepatobiliary (3.5%), immune (3.5%), and renal (1.8%) system diseases as the cause of death.
Clinical Profile and Characteristics of Hypertension in Pregnant Women
Background; Hypertension in pregnancy contributes to 14% of maternal deaths, with pre-eclampsia as one of the most common complications. Pre-eclampsia is characterized by increased blood pressure and the presence of protein in the urine after 20 weeks of gestation. The selection of antihypertensive therapy in pregnant women requires special consideration because some drugs can increase the risk of teratogenicity in the fetus. This study aims to analyze the profile and clinical characteristics of hypertension (pre-eclampsia) in pregnant women at the South Tangerang City Hospital. Methods: This study used a retrospective descriptive method with secondary data obtained from medical records of pre-eclampsia patients from January–December 2023. Results: The results showed that 60.5% of patients experienced severe pre-eclampsia, while 39.5% experienced mild pre-eclampsia. The antihypertensives used included nifedipine, methyldopa, amlodipine, and bisoprolol. The characteristics of the most pre-eclampsia patients were mothers aged 26–35 years (40.8%) with a gestational age of 29–42 weeks (81.6%). Conclusion: the antihypertensive therapy in pregnancy requires special attention to reduce the risk to the mother and fetus. The accuracy of drug use and routine examinations in pregnant women are important factors in preventing and treating pre-eclampsia.
pregnancy-induced hypertension, preeclampsia, antihypertensive therapy, drug rationality, pregnancy
INHIBITORY EFFECTIVENESS OF WHITE TURMERIC (Curcuma zedoira) EXTRACT AGAINST Eschericia coli ATCC 25922
The use of natural ingredients as antibacterial agents has been increasingly studied as an alternative in infection treatment. White turmeric (Curcuma zedoaria) contains active compounds such as curcuminoids, flavonoids, and essential oils, which are presumed to have antibacterial potential. However, its effectiveness against Escherichia coli ATCC 25922 has not been widely proven scientifically. This study aimed to determine the effectiveness of white turmeric extract against the growth of E. coli. This true experimental study with a post-test only control group design used Escherichia coli ATCC 25922 isolates divided into five groups: negative control (DMSO), positive control (ciprofloxacin), and white turmeric extract at concentrations of 50%, 70%, and 90%. The antibacterial test was carried out using the disk diffusion method on Mueller Hinton Agar, with five replications. The inhibition zones were measured after incubation for 18– 24 hours at 37°C, and the data were analyzed using the Kruskal–Wallis test. Observations showed that inhibition zones appeared only in the positive control group (ciprofloxacin), with a mean diameter of 32.4 mm. The negative control (DMSO) and all white turmeric extract groups (50%, 70%, 90%) showed no inhibition zones (0 mm). White turmeric extract has not demonstrated effectiveness against the growth of Escherichia coli ATCC 25922. Further research using different methods or concetrations is recommended.
Curcuma zedoaria, Escherichia coli, inhibition zone, antibacterial, disk diffusion
RELATIONSHIP BETWEEN BODY MASS INDEX AND CREATININE AND UREUM LEVELS IN CHRONIC KIDNEY DISEASE PATIENTS UNDERGOING HEMODIALYSIS AT SANJIWANI HOSPITAL
Chronic kidney disease (CKD) is a condition characterized by sustained changes in kidney structure and function lasting for more than three months. The hemodialysis (HD) procedure can impact the nutritional status of CKD patients through increased degradation of body proteins. This degradation is reflected in elevated blood levels of creatinine and urea. The aim of this study was to analyze the relationship between body mass index (BMI) and serum creatinine and urea levels in CKD patients undergoing HD at Sanjiwani Hospital, Gianyar. This was an analytical observational study with a cross-sectional design, involving 95 CKD patients undergoing HD who met the inclusion and exclusion criteria. The study population was predominantly male (63.2%), with a median age of 50 years (range 21–63 years). The average BMI was 24.15 ± 4.56 kg/m², the mean serum creatinine level was 9.67 ± 2.83 mg/dL, and the mean serum urea level was 126.08 ± 35.50 mg/dL. Pearson correlation analysis revealed a significant, but weak, positive correlation between BMI and serum creatinine levels (r = 0.246, p = 0.016). In contrast, the correlation between BMI and serum urea levels was not significant (r = 0.147, p = 0.155). Based on these results, we conclude that while there is no significant relationship between BMI and serum urea levels, there is a weak, significant relationship between BMI and serum creatinine levels, indicating that higher BMI may be associated with increased serum creatinine levels in HD patients.
body mass index, chronic kidney disease, creatinine, urea
THE EFFECTIVENESS OF THE USE OF NASAL IRRIGATION WITH PHYSIOLOGICAL SALINE SOLUTION IN CHRONIC RHINOSINUSITIS PATIENTS AFTER ENDOSCOPIC SINUS SURGERY AT RSPAL DR. RAMELAN SURABAYA PERIOD 2021-2024
Chronic rhinosinusitis (CRS) is a prevalent condition affecting individuals across all age groups, often leading to symptoms such as depression, fatigue, reduced work productivity, and sleep disorders. The CRS therapy management includes medical therapy and surgical procedures such as functional endoscopic sinus surgery (FESS) in Asia. Current management of CRS involves both medical therapy and functional endoscopic sinus surgery (FESS). Postoperative medical treatment, particularly nasal irrigation with normal saline, is crucial to optimise surgical outcomes. This retrospective cohort study aimed to evaluate the effectiveness of nasal irrigation using physiological saline in patients with CRS following FESS at RSPAL Dr. Ramelan Surabaya during the period 2021 to 2024. Medical records of 244 patients undergoing FESS were reviewed, with 64 patients meeting the inclusion criteria. Evaluation based on the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) 2020 criteria demonstrated a significant improvement in symptoms, including nasal congestion (P = 0.006), rhinorrhea (P = 0.000), and facial pain (P = 0.001). Objective nasal endoscopy findings post-treatment also revealed significant reductions in nasal secretions (P=0.000), mucosal colouration abnormalities (P=0.011), and crust formation (P=0.001). These findings underscore the efficacy of saline nasal irrigation as an adjunctive therapy following endoscopic sinus surgery in patients with CRS.
Nasal irrigation, Physiological Saline Solution., Chronic Rhinosinusitis,
Khoirun Nisa Putri Sisandi Khoirun Nisa Putri Sisandi
THE RELATIONSHIP BETWEEN ASPARTATE AMINOTRANSFERASE (AST) AND ALANINE AMINOTRANSFERASE (ALT) WITH DISEASE SEVERITY IN COVID-19 INPATIENTS AT UDAYANA UNIVERSITY HOSPITAL FROM JANUARY 2020 TO DECEMBER 2021
The COVID-19 pandemic had a significant impact on global health. In addition to its high transmission rate, the clinical presentation of the disease varied, ranging from asymptomatic to critical cases. Previous studies found differences in laboratory results between critical and non-critical patients. One of these laboratory results was Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT). However, the relationship between AST and ALT with the disease severity in COVID-19 patients remained unclear. This study aimed to determine the relationship between AST and ALT with the disease severity in COVID-19 patients at Udayana University Hospital. This study used a cross-sectional approach involving 126 COVID-19 patients who were hospitalized at Udayana University Hospital. Data were collected through consecutive sampling from the medical records of COVID-19 patients from January 2020 to December 2021. Among the 126 COVID-19 patients studied, 64 were critical patients and 62 were non-critical patients. The median (min-max) age of critical patients was 59.5 years (18-76), while non-critical patients had a median age of 45.5 years (20-70). Laboratory data showed that 90.6% of critical COVID-19 patients had elevated AST levels and 64.1% had elevated ALT levels. The results of multivariate logistic regression analysis indicated a significant relationship between AST (PR: 3.929, 95% CI: 1.177-13.117) and ALT (PR: 2.881, 95% CI: 1.053-7.883) levels with the disease severity in COVID-19 patients. There was a significant relationship between AST and ALT levels with disease severity in COVID-19 patients at Udayana University Hospital.
Mode of Delivery in Women With Hypertensive Disorders of Pregnancy
Abstrak Latar belakang: Hipertensi dalam kehamilan (HDK) adalah kondisi serius yang meningkatkan risiko kematian dan komplikasi pada ibu dan bayi, termasuk hipertensi kronis, gestasional, preeklamsia, dan eklamsia. Penelitian ini bertujuan untuk menggambarkan metode persalinan pada ibu HDK. Metode: Penelitian observasional deskriptif terhadap rekam medis dilakukan dengan desain potong lintang di RSUP Prof. Dr. I. G. N. G. Ngoerah tahun 2021–2022 yang memenuhi kriteria lalu dianalisis melalui SPSS. Hasil: Penelitian melibatkan 86 kasus HDK dengan mayoritas ibu mengalami preeklamsia (73.3%), berusia 20-34 tahun (72.09%), memiliki IMT 25–30 kg/m² (39.53%), dan merupakan multigravida (60.46%) dan multiparitas (56.97%). Sebagian besar persalinan dilakukan dengan seksio sesarea (79.06%), sementara persalinan pervaginam spontan hanya 20.93% dan diantaranya dibantu dengan forsep (4.65%). Bayi aterm lahir sebanyak 58.13% dengan mortalitas perinatal 9.3%. Kesimpulan: Hasil penelitian ini menunjukkan tingginya angka operasi SC (Sectio Caesarea) pada ibu HDK dibandingkan pervaginam spontan berserta gambarannya pada ibu dan bayi baru lahir terdampak. Abstracts Backgrounds: Hypertensive disorders of pregnancy (HDP) including chronic hypertension, gestational hypertension, preeclampsia, and eclampsia are among the major conditions that raise the risk of death and complications for both the mother and the unborn child. The purpose of this study is to characterize the delivery technique used in HDP women. Methods: A descriptive observational study of medical records was conducted with a cross-sectional design at Prof. Dr. I. G. N. G. Ngoerah General Hospital in 2021-2022 which met the criteria and was analyzed through SPSS. Results: Of the 86 HDP patients in the study, most of the women had preeclampsia (73.3%), were between the ages of 20 and 34 (72.09%), had a BMI of 25–30 kg/m² (39.53%), and were multigravida (60.46%) and multiparity (56.97%). The majority of deliveries (79.06%) were cesarean sections, whilst only 20.93% were vaginal, and some required forceps assistance (4.65%). 58.13% of term babies were born with a perinatal mortality of 9.3%. Conclusions: This study finds that cesarean sections as the mode of delivery are more common in pregnant women with hypertensive disorders than spontaneous vaginal birth, and both the moms and the newborn babies who are impacted have been described in this study.
Characteristics of Melasma Patients in Dermatology and Venereology Polyclinic Ngoerah Hospital Denpasar Bali From 2020 to 2022
Background: Melasma is a common hypermelanosis condition caused by sun exposure. Melasma causes lack of self-confidence which affects quality of life. This research is to determine the prevalence and characteristics of melasma patients at Dermatology and Venereology Polyclinic, Ngoerah Hospital, Denpasar, Bali. Method: Research method using cross sectional descriptive observational study at Dermatology and Venereology Polyclinic and Medical Records Installation in February until May 2024. Result: Total of 69 (6.56%) new patients diagnosed with melasma, 67 (97.10%) female patients and 2 (2.90%) male patients and predominantly aged 41-50 years in 40 (57.97%) patients. Total of 50 (72.25%) patients had family history of melasma, 43 (62.32%) patients exposed to sunlight > 2 hours/day, 45 (65.72) patients used hormonal contraception, 2 (2.90%) patients had cysts ovary. The dominant type of melasma was centrofacial in 47 (68.27%) patients with epidermal depth in 47 (68.11%) patients. Umbrella were dominant as photoprotection in 35 (50.09%) 69 (100%) patients used sunscreen. Conclusion: The ratio of melasma in men: women is 1:34 and dominant at age 41-50 years. Risk factors include family history, sun exposure, and contraception. Centrofacial type with epidermal depth, umbrella as photoprotection found to be dominant.
Melasma; Characteristic; Cross sectional.
ASSOCIATION BETWEEN THE RS2280091 POLYMORPHISM IN THE ADAM33 GENE AND CHILDHOOD ASTHMA
Background:Asthma is a non-communicable disease that remains a global health concern, influenced by both environmental and genetic factors. The disintegrin and metalloproteinase 33 (ADAM33) gene has been identified as a susceptibility gene for asthma. This study aimed to investigate the association between the rs2280091 polymorphism in the ADAM33 gene and the risk of asthma in Indonesian children. Methods:A total of 60 buccal swab samples were collected from children aged 4–18 years, consisting of 13 asthma cases and 47 healthy controls. Genotyping of rs2280091 was performed using polymerase chain reaction (PCR) followed by restriction fragment length polymorphism (RFLP) analysis. Results:The AA and GG genotypes were more frequent among asthma cases (69.23% and 7.69%, respectively) compared to controls (63.83% and 6.38%). Similarly, the A allele was detected more frequently in asthma cases (80.77%) than in controls (78.72%). However, no significant association was observed between the rs2280091 polymorphism and asthma risk (P = 1.0, OR [95% CI] = 0.8 [0.0779–8.592]). In addition, asthma was more commonly observed in boys (84.62%) than in girls (15.38%). Conclusion:This study did not find a significant association between the rs2280091 polymorphism in the ADAM33 gene and childhood asthma. Further research involving larger sample sizes and additional ADAM33 polymorphisms is warranted to better understand the genetic susceptibility to asthma in children.
Asthma., ADAM33., rs2280091., Genetic Susceptibility., PCR-RFLP
RELATIONSHIP BETWEEN EXPRESSION CLUSTER OF DIFFERENTIATION 44 (CD44) WITH MITOSIS, GRADE AND BRAIN INVASION IN MENINGIOMA
Meningioma is the most common brain tumor. Most cases are benign with slow growth. WHO grade 2 and 3 meningiomas have a more aggressive behavior and with high recurrence. CD44 is a cell surface glycoprotein that has an important role in proliferation, cellular adhesion, migration, and angiogenesis. This study is a cross sectional study with a sample of 40 cases of meningioma at Prof. Dr. I.G.N.G. Ngoerah Hospital in 2019-2022 consisting of 20 grade 1 cases, 14 grade 2 cases, and 6 grade 3 cases. Clinical and radiological data were obtained from SIMRS. Hematoxylin-Eosin slide re-evaluation was performed to assess mitosis and tumor invasion into the brain. CD44 expression was evaluated by immunohistochemistry. Descriptive analysis to determine the frequency of the characteristics of the study subjects and chi square analysis to analyze the relationship between CD44 expression with mitosis, grade, and brain invasion. Significance was determined at p < 0.05. The results obtained were 25 cases (62.5%) aged in the fourth decade, 30 (75%) cases were female, 24 (60%) cases were located in non-convexity, 26 (65%) cases with size <6 cm, 20 (50%) cases grade 1, 7 (17.5%) cases showed brain invasion and 26 (65%) cases had mitosis <4/10 LPB. CD44 expression was weak in 11 (27.5%) cases, moderate expression in 17 (42.5%) cases and strong expression in 12 (30%) cases. In bivariate analysis, there was a significant association between CD44 and mitosis (p = 0.011), grade (p = 0.004), and brain invasion (p = 0.023). In conclusion, there is a significant association between CD44 expression with mitosis, grade, and brain invasion in meningioma.
meningioma., CD44., mitosis., grade., brain invasion.
ASSOCIATION BETWEEN CD4 CELL COUNT AND OCULAR SYPHILIS IN HIV-INFECTED POPULATION: A CROSS-SECTIONAL ANALYSIS
Background: Ocular syphilis (OS) often presents with symptoms similar to other eye diseases and can be an initial indicator of HIV infection. CD4 cell count serves as an important marker of immune status in HIV-positive individuals. This study aimed to investigate the relationship between CD4 cell counts and ocular syphilis manifestations in people living with HIV. Methods: A cross-sectional retrospective review was conducted on medical records of 21 HIV-positive patients diagnosed with OS at the Voluntary Counseling and Testing Clinic of Prof. dr. I.G.N.G. Ngoerah General Hospital between 2018 and 2023. Data collected included demographics, CD4 counts, ocular symptoms, and visual acuity. Results: Among 21 patients, 18 were male (85.7%) and 3 female (14.3%), with a mean age of 35.8 ± 10.7 years. The most common ocular manifestation was bilateral panuveitis. Statistical analysis revealed no significant association between CD4 cell count and ocular manifestations or visual acuity in this population. Conclusion: Although no significant link was found between CD4 counts and ocular syphilis features, the frequent coexistence of HIV and syphilis supports routine HIV testing for all syphilis patients. Early detection and management of co-infection remain critical for improving clinical outcomes.
Ocular syphilis., CD4 cell count., uveitis
HISTOPATHOLOGICAL CHARACTERISTICS OF PATIENTS WITH BASAL CELL CARCINOMA AT NGOERAH HOSPITAL DERMATOLOGY AND VENEREOLOGY POLYCLINIC: A STUDY FROM JANUARY 2021 TO DECEMBER 2023
Introduction: Basal cell carcinoma (BCC) is a carcinoma that originates from the basal cells of the epidermis and/or hair follicles. Epidemiologically, basal cell carcinoma is the most common skin malignancy. Objective: This study aims to determine the incidence and histopathological characteristics of BCC in patients visiting Prof. Dr. IGNG Ngoerah Hospital Dermatology dan Venereology Clinic. Methods: This study used an observational descriptive design with a cross-sectional approach. Data came from secondary data from medical records of basal cell carcinoma patients who sought treatment and control at Prof Dr IGNG Ngoerah Hospital Dermatology dan Venereology Clinic, January 2021-December 2023. The study subjects were taken from the population who met the inclusion criteria, namely patients who had been diagnosed histopathologically and with complete medical record data. Based on the results of collecting and processing patient data, 31 cases were obtained that met the study inclusion criteria. Results: The data shows that the incidence rate of basal cell carcinoma has increased from 2020. Based on gender, more were found in women (70.97%). Based on age, most patients were found to be 60-79 years old (61.29%). The face is the most common location for BCC lesions (93.54%). The most common histopathologic feature is nodular BCC (54.85%). Conclusion: Based on the results of the study, it was found that basal cell carcinoma often occurs in the female population, age group 60-79 years, with the most common type being low- risk nodular BCC in patients visiting Prof. Dr. IGNG Ngoerah Hospital Dermatology dan Venereology Clinic in the period January 2021 to December 2023
skin cancer., malignant., basal cell carcinoma
THE EXPRESSION OF VEGF IN VAGINAL TISSUE OF MENOPAUSAL ANIMAL MODELS AFTER TREATED WITH ETHANOL EXTRACT OF PURPLE SWEET POTATO (IPOMEA BATATA L.)
Vaginal atrophy is a common complain in menopausal women as the sexual organ dysfunction. The features of vaginal atrophy including thinning of epithelium and decreasing in collagen fiber in the stroma therewith reduced blood vessels and vascularization by reason of decreased angiogenesis factors stimulation. Vascular endothelial growth factor (VEGF), a crucial mediator regulated by estrogen in angiogenesis, is involved in this process. Hormone Replacement Therapy (HRT) has proven effective in alleviating vaginal atrophy symptoms and enhancing vaginal wall vascularization, but it poses potential serious side effects. Phytoestrogens serve as a safer alternative to estrogen, demonstrating the ability to increase VEGF expression in the vaginas of ovariectomized mice and improve vaginal atrophy symptoms. Anthocyanins, a group of flavonoids with known phytoestrogenic activity both in vitro and in vivo, are found in high concentrations in purple sweet potato tubers. Several studies confirmed the phytoestrogenic activity of ethanol extracts from purple sweet potato tubers. Previous research indicates that these extracts increased iepithelial thickness, epithelial maturation index, and the expression of estrogen receptors α and β, whilst maintaining vaginal pH. This pure experimental study followed a Post Test Only Control Group Design, aiming to investigate the effects of ethanol extract from purple sweet potato tubers on VEGF expression in the vaginal tissue of a menopausal animal model. Thirty-eight female Wistar rats, aged 16-18 weeks, subjected to bilateral ovariectomy, were divided into two groups: treatment group (P1) and control group (P0). After 30 days of treatment, the experimental animals were sacrificed, and vaginal tissues were collected for histological preparation and VEGF immunohistochemical staining. The research findings revealed that VEGF expression in the P1 group was 3.59±1.23, while in the P0 group, it was 0.8±0.57. Independent Sample T-test results indicated a significant difference (p<0.05) in VEGF expression between the two groups. In conclusion, the group treated with ethanol extract purple sweet potato tubers exhibited significantly higher VEGF expression in vaginal tissue compared to the control group.
Anthocyanin.,Vaginal Atrophy., Phytoestrogen., Purple Sweet Potato., VEGF