Accreditation
SINTA 2Nationally Accredited Journal
Vol. 6 No. 3 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Articles
-
Analysis of Family Planning Services in Mohammad Hoesin Hospital Palembang on 2016
Views: 658Downloads: 388Background. Family planning services in hospitals have been held since 1970 by the functional implementing unit led by obstetric and gynecologist specialists. Situational changes following decentralization in the 1990s caused policymakers and family planning practitioners' lack of attention to family planning services at province, district, and city levels. Data from 2002-2007 showed a decrease in family planning services from 6.2% to 4.9% in government hospitals and from 3.4% to 2.2% in private hospitals. The decrease in contraception use was affected by family planning users and providers. This study aims to analyze the factors contributing to family planning services in Mohammad Hoesin Hospital.
Methods. This was a descriptive-analytic study with a cross-sectional design. The author used primary and secondary data with quantitative and qualitative approaches through the study of documents, observation, questionnaire, in-depth interview, and focused group discussion.
Results. We identified various factors that play a role in the implementation of family planning services in almost all aspects, such as policy system, incomplete infrastructures; competence and the number of health workers; standard service procedure; sources and mechanism of the contraceptive tools; financial problems; recording and reporting system; quality control services; monitoring and evaluation; development services; also knowledge and behavior of the health workers.
Conclusion. Family planning services need support and more serious attention from the directors to improve and overcome the problems and obstacles. In addition, the board of directors requires better coordination effort and cooperation on the internal level (between divisions or departments within the hospital) and with the relevant instance.
-
Relationship between Primary Tumors of Nasopharyngeal Carcinoma with the Degree of Conductive Hearing Loss in Dr. Mohammad Hoesin Hospital Palembang
Views: 780Downloads: 2,245Background. Nasopharyngeal carcinoma is a malignant tumor that grows in the nasopharyngeal area with predilection in the fossa Rossenmuller and the nasopharyngeal roof adjacent to the Eustachian tube, so one of NPC’s early symptoms is ear symptoms. Hearing loss is a common symptom found in people with NPC due to dysfunction of the Eustachian tube, a continuing middle ear disorder that can result in conductive hearing loss.This study aims to find out the relationship between primary tumor of NPC and the degree of conductive hearing loss at dr. Mohammad Hoesin Hospital Palembang.
Methods. This is a cross sectional study that obtained 42 samples from the medical records at Dr. Mohammad Hoesin Hospital Palembang that met the inclusion and exclusion criteria. The study subjects collected in total sampling have been conducted audiometry examinations at the ORLHNS clinic of Dr. Mohammad Hoesin Hospital Palembang during the period January 2019 - April 2021.
Results. The proportion of hearing loss in NPC patients in this study was 30 subjects (71.4%) with the highest proportion of hearing loss complaints being 33.3%. The proportion of conductive hearing loss of nasopharyngeal carcinoma patients in the study was 33 subjects (78.5%) right ear and 28 subjects (66.7%) left ear. There was a significant association between the degree of the NPC primary tumor and the incidence of conductive deafness of the left ear, but there was no significant association in the right ear. There is a significant correlation between NPC primary tumors and left ear hearing thresholds at frequencies of 500 Hz and 4000 Hz, but there is no significant association between the degree of NPC primary tumor and right ear hearing loss.
Conclusions. There is significant correlation between the primary tumor of NPC and the hearing threshold of the left ear but there was no significant association in the right ear.
-
Electrocardiography Predictive Value on Coronary Slow Flow Phenomenon
Views: 755Downloads: 798Coronary Slow Flow Phenomenon (CSFP) is characterized by the slow flow of contrast in one or more epicardial coronary vessels without evidence of coronary artery stenosis during coronary angiography procedures. CSFP is fairly common at the time of elective angiography with an incidence of around 7% and accounts for about 4% of hospitalized unstable angina cases. Coronary angiography is currently still the only effective way to detect CSFP, but this procedure is an invasive procedure with high costs, there is a risk of allergy to contrast. Electrocardiography (ECG), as a widely available, inexpensive, and simple modality is felt to be an attractive alternative in early detection of this abnormality. The ECG parameters on CSFP discussed in this study include; p-wave dispersion, QT interval dispersion, QRS intrinsic (Tpeak-Tenddeflection duration), and QRS fragmentation. Further studies are needed on the ECG image in CSFP so that in the future ECG can be a cheaper and non-invasive diagnostic modality for CSFP compared to coronary angiography.
-
Microneedling Radiofrequency for Acne Vulgaris and Post-Acne Scarring: A Case Report
Views: 1,632Downloads: 1,258Background. There are various therapeutic modalities for acne and post acne scarring, but the best option is to have a safe, effective with affordable cost such as monotherapy or combination therapy. One of the recommended combination therapy for acne vulgaris with atrophic acne scars is microneedling radiofrequency which can improve skin structure.
Case presentation. A 25 years old male with moderate comedonal acne vulgaris and severe scarring. The patient came with complaints of uneven skin surface on both cheeks, forehead and chin which had been felt to increase since 3 years ago. The appearance of acne on the face has been felt since 12 years ago. The patient's parents and sister also had acne complaints. On dermatological examination, on the forehead, temples, cheeks, nose and chin found blackheads, whiteheads, papules, hyperpigmented macules, multiple atrophic acne scars. The treatment choice for this patient is microneedling radiofrequency in combination with topical therapy.
Discussion. The combination of microneedling with radiofrequency is one of the therapeutic modalities for acne vulgaris and also post-acne scarring with minimal side effects. In the evaluation for 2 weeks after the procedure, this patient did not complaint of any adverse events.
-
Lactobacillus Reuteri DSM 17938 in Infantile Colic: A Systematic Review and Meta-Analysis
Views: 1,415Downloads: 2,404Background. Infantile colic, defined as paroxysmal, excessive, and consolable crying without an identifiable cause. It is common in the first 3 months of life. There have been many RCT studies conducted. A systematic synthesis is required to summarize the results of these RCTs. This study was aimed to systematically analyze the benefits of Lactobacillus reuteri DSM 17938 for infantile colic.
Methods. This systematic review and meta-analysis used keywords: (“infantile colic” OR “abdominal cramps” OR “abdominal cramp” OR “infant colic”) AND “lactobacillus reuteri” AND (placebo OR placebos) AND (“randomized controlled trial” OR RCT). The databases used were: pubmed, science direct, and google scholar. Meta-analysis was conducted to combine the articles. The eligibility criteria were: patient with infantile colic, intervention with L. reuteri DSM 17938, control was placebo, RCT study design, outcome with dichotomous scale, all races, all ethnicities, all countries, all genders, in English, and not limited by year.
Results. The search resulted in 800 articles. After reducing duplication, the number of articles was 747. Screening with titles and abstracts resulted in 13 full teks articles. Six articles fitted the eligibility criteria. The results of the meta-analysis were as follows. The forest plot showed that the combined effect of the six articles showed an RR of 0.47 and was statistically significant (p <0.001).
Conclusion. Based on the results of this meta-analysis, L. reuteri DSM 17938 is recommended for infants with infantile colic. There were no significant side effects with the use of L. reuteri DSM 17938 on infantile colic.
-
Iron-Deficiency Anemia Related to Ancylostoma duodenale Infection in 67 Years Old Female Patient
Views: 4,663Downloads: 2,102Background. Ancylostomiasis is an infection caused by hookworms. It is estimated that hookworms infect 1.2 billion people worldwide and cause higher morbidity than other types, mainly due to iron deficiency anemia. Hookworm infection increases with age. The main clinical manifestations are abdominal pain, features of iron deficiency anemia and hypoproteinemia. Diagnosis is based on the finding of characteristic eggs in the stool.
Case presentation. A 67-year-old female patient had been administered into the Internal Medicine Ward of Dr. M. Djamil Padang Hospital with the main complaint of weakness, fatigue, and lethargy which had increased since 3 days before being admitted to the hospital. The patient also had complaints of pale skin, fever, heartburn, decreased appetite and weight loss. The patient was admitted to the hospital with awareness of compost mentis, cooperative, and his general condition appeared to be moderately ill, blood pressure 130/90 mmHg, pulse rate 104 x/minute, regular pulse, adequate filling, respiratory rate 22 x/minute, temperature 37.8 C. On physical examination, the conjunctiva of the pantient’s eyes were anemic. Laboratory examination revealed Hemoglobin 4 g/dl, Hematocrit 16%, MCV/MCH/MCHC 62fl/15pg/25g/dL, Reticulocytes 0.5%, SI/TIBC 22/315 mg/dL, Ferritin 8.5 ng/mL, and peripheral blood smear showing severe hypochromic microcytic anemia and relative eosinofilia. Ancylostoma duodenale worm eggs were found on routine stool examination. Final diagnosis was Severe microcytic hypochromic anemia caused by an iron deficiency and Ancylostomiasis. Severe microcytic hypochromic anemia caused by iron deficiency and ancylostomiasis was established based on the patient’s history, physical examination and laboratory investigations.
Conclusions. Hookworms infect many people worldwide and cause high morbidity, mainly due to iron deficiency anemia. The highest prevalence is found in the tropics and subtropics, including Indonesia. The main clinical manifestations are abdominal pain, features of iron deficiency anemia and hypoproteinemia. Diagnosis is based on the finding of characteristic eggs in the stool. Albendazole 400 mg single dose resulted in 80% cure and a dose of 200 mg/day for 3 days gave 100% cure. Treatment of anemia is by administering ferrous sulfate or ferrous gluconate orally 200 mg three times a day and continued for up to 3 months after normal hemoglobin levels are achieved to maintain iron stores.
-
Genu Sinistra Tuberculosis Arthritis with Drug-Induced Liver Injury Caused by Anti-Tuberculosis Drugs in Patients Confirmed with COVID-19
Views: 889Downloads: 468Background: Tuberculous arthritis is a form of extrapulmonary tuberculosis and has a significant effect on patient morbidity and mortality. This case report aims to describe clinical signs and symptoms, results of laboratory tests, radiology, and outcome of tuberculosis arthritis cases.
Case presentation: A 36-year-old woman came to the emergency room with the main complaint of pain, swelling, and warmth when palpating the knee for the past week. The pain felt worse during activities such as walking. The patient also complains of fever, loss of appetite, and unwanted weight loss. Physical examination showed sharp pain and swelling in the knee, limited range of movement (ROM), and a positive balloon sign, while laboratory tests showed increased leukocytes, neutrophils, and C-reactive protein. After the diagnosis of genu tuberculosis arthritis was established, the administration of anti-tuberculosis drugs (OAT) was started. After one week, the patient complained of pain in the left knee and progressive nausea. Liver function tests showed an increase in SGOT and SGPT. The patient then started OAT desensitization. A month later, the patient underwent an open synovectomy with liquefaction necrosis. Although the first desensitization of tuberculosis still causes drug-induced liver injury, the second desensitization involves gradually increasing doses of rifampicin accompanied by close monitoring of liver tests.
Conclusion: Early administration of anti-tuberculosis drugs in tuberculosis arthritis can improve healing, maintain joint function, and prevent further damage. Anti-tuberculosis drug desensitization is the primary management of drug-induced liver injury.
-
Accuracy of Heart Auscultation Examination by General Practitioners From Various Levels of Competency in Detection of Heart Abnormality in Basic School Children
Views: 980Downloads: 778Background. Most of heart defects in children do not show typical clinical symptoms. Ten percent of the cases are late detected. Echocardiography is an examination with high sensitivity and specificity in detecting heart defects in children, but it cannot be performed by all health workers, expensive and not always available in hospitals. Auscultation is an important part of a physical examination that inexpensive, easy examination, and becomes a competency of all doctors. The aim of this study to determine the accuracy of the screening method by listening to murmurs on heart auscultation by various levels of physician competence.
Methods. This is a diagnostic test of 250 elementary school children held in the pediatric ward of dr. Mohammad Hoesin Palembang from September to November 2019. The auscultation examination was performed by three pediatrics resident from three stages (i.e. junior, middle and senior), followed by echocardiography examinations by a pediatric cardiologist.
Results. The highest sensitivity of auscultation was found in senior resident, 42.4%, while the lowest was found in junior resident, 12.1%. The results of the kappa analysis of the cardiac auscultation examination on the three examiners showed a poor level of agreement on junior stage compared to senior resident (k = 0.189; CI = 0.033-0.346) and the level of agreement was sufficient in junior stage compared to middle stage resident (k = 0.297; CI = 0.134 -0.461) and middle stage compared to senior resident (k = 0.301; CI = 0.147-0.456).
Conclusion. Experience and length of learning will affect the accuracy of the auscultation examination in detecting heart defects in children.
-
Difference between Hypertrophic Pyloric Stenosis in Child with History of Prematurity and Aterm
Views: 949Downloads: 1,353Background: Hypertrophic pyloric stenosis (HPS) is an acquired condition in which the circumferential muscle of the pyloric sphincter becomes thickened, resulting in elongation and obliteration of the pyloric channel. HPS is the most common gastrointestinal disease in the first few weeks of life.
Case presentations: Two patient: a girl, 2 month old (aterm baby) and a boy, 2 months old (preterm baby) with diagnosis moderate dehydration ec vomiting, suspect HPS. Both patient got recurrent vomiting since 1 week before admission, and got dehydration, The vomiting was projectile, occuring after the patient was drink the formula milk. We found the olive sign in both patients, but it was not an obligation we should find olive sign, because it just found in 70% patients of HPS. In these patients were found sunken eyes, and slow return turgor that indicating dehydration. Patients were got Ultrasonography and planned for barium meal examination and Ph monitoring. These patients was undergone pyloromyotomi for definite therapy. After surgery preterm baby was still vomiting for 2-3 days in preterm baby, but not in aterm baby.
Conclusion: HPS in preterm baby got more complications after surgery than aterm baby, such as: longer length of stay, reflux post operative.
-
Gitelman Syndrome in a 32-Years-Old Female Patient
Views: 1,024Downloads: 668Introduction. Gitelman syndrome is an autosomal recessive disorder that is milder than Bartter syndrome and is often not diagnosed until late childhood or even adulthood. However, this syndrome is usually symptomatic and can result in serious clinical manifestations, such as muscle spasms that can be severe and involve the hands and feet. These symptoms are frequently observed in almost all patients, partly due to hypokalemia and hypomagnesemia.
Case presentation. A 32-year-old female patient is being treated in the Internal Medicine ward of Dr. M. Djamil Padang General Hospital with the main complaint of cramping of the left hand, which has gotten worse since 1 day ago. The patient also complained that both legs were prone to cramping that went on and on since 1 month ago. The patient had been hospitalized with the same complaint and is currently taking slow release potassium (KSR) medication. Examination of the patient's limbs revealed a positive trousseau sign and carpopedal spasms. Laboratory examination of the patient showed potassium levels of 1.8 mmol/L, calcium levels of 5.7 mg/dl, Magnesium levels of 0.8 mg/dl, and electrolyte disturbances in the patient's urine. ECG results revealed a prolonged QT interval.
Conclusion. Gitelman syndrome is an autosomal recessive disorder and often goes undiagnosed. However, this syndrome is usually symptomatic and can lead to serious clinical manifestations. Most patients require oral potassium and magnesium supplementation, as drug therapy is usually not fully effective.
-
Epilepsy as a Presenting Symptom of Covid-19 in a Tertiary Private Hospital in Northern Mexico
Views: 642Downloads: 401Background. Various manifestations of COVID-19 have been described in patients, including neurological. Few studies describe seizures as a presenting symptom. This study was aimed to identify clinical characteristics, type of epilepsy and electroencephalographic findings in patients with epilepsy as a presenting symptom of COVID-19 in a tertiary private hospital.
Methods. Descriptive, retrospective, observational and cross-sectional study. Inclusion criteria were patients with epilepsy as a presenting symptom of COVID-19 confirmed with Polimerase Chain Reaction (PCR) for SARS-CoV2 by nasopharyngeal swab from March 2020-July 2021 in a tertiary private hospital. Study variables were age, gender, type of epilepsy, comorbidities and electroencephalographic findings. It was classified into three groups: acute symptomatic seizures, onset of epilepsy, and uncontrolled epilepsy. Information was captured in Excel and analyzed in SPSS.
Results. Of 203,987 patientes with a confirmed diagnosis of COVID-19 in Nuevo León until July 2021, 10 patients (0.004%) were included with seizures. Two patients had acute symptomatic seizures (20%), four patients had onset seizures (40%) and four patients (40%) had uncontrolled epilepsy with an average epilepsy evolution time of 15.75 years. Focal seizures were predominant in 63%. Electroencephalogram was abnormal in 90% (50% focal frontotemporal sharp waves, 20% encephalopathic, 20% generalized spike wave). Two patients (20%) had status epilepticus.
Conclusion. This study is important in order to carry out early detection in suspects or with a previous neurological history and to avoid the spread of the coronavirus.
-
Bronchiectasis with Multiple Bullae Post-Extraction Corpus Alineum Comorbid with Pulmonary Tuberculosis
Views: 1,036Downloads: 1,502Background. Bronchiectasis is a chronic inflammatory airway disease characterized by chronic bronchial dilatation. The cause of bronchiectasis is still ideopathic but most of the bronchiectasis are caused by tuberculosis infection and will interfere with the patient's quality of life. In addition, bronchiectasis can be caused by aspiration of foreign bodies.
Case presentation. A 42-year-old male patient was treated at Dr, M Djamil Padang Hospital with complaints of coughing up blood, in addition the patient complained of coughing up yellowish phlegm, shortness of breath and fever. The patient had a history of foreign body aspiration 6 months ago. The patient had a chest X-ray and a chest CT scan and a picture of bronchiectasis and mulltiple bullae was found. The patient also had pulmonary tuberculosis infection where the X-pert gene examination in the patient found that MTB was not detected.
Conclusion. The patient had multiple bullae, which were complications of emphysema, and the patient had or had compensatory emphysema, where the abnormality was hyperinflation of certain parts of the lung due to atelectasis. The condition of bronchiectasis and multiple bullae makes the patient susceptible to infection, which in this case was found to have pulmonary tuberculosis infection. Management of bronchiectasis includes identification of acute exacerbations and the use of antibiotics, controlling microbial growth, treatment of the underlying condition, and reducing the excessive inflammatory response.
-
Effect of Artemisia vulgaris Extract on VEGF Expression, CD34, Microvascular Density, and Diameter of Mammary Adenocarcinoma Tumors: In vivo Study
Views: 599Downloads: 462Background. Breast cancer in Indonesia still has a high incidence. Surgery remains the main choice with other modalities such as chemotherapy, radiation, and immunotherapy such as Artemisia vulgaris (AV). This study aimed to prove that administration of AV extract reduced VEGF expression, CD34 and microvascular density (MVD), and tumor diameter in mammary adenocarcinoma.
Methods. This study used a "Posttest only control group design" design for 24 female C3H mice which were selected randomly and divided into four groups, namely: group K (control), P1 (chemotherapy), P2 (extract), and P3. (combination). Mammary adenocarcinoma was derived from the inoculation of donor mice. AC chemotherapy (Adriamycin 0.18 mg and Cyclophosphamide 1.8 mg) was given in 2 cycles. AV is given at a dose of 13 mg (0.2 ml) once a day orally. VEGF and CD34 expression were assessed by immunohistochemical staining whereas MVD was assessed by the hematoxylin-eosin stain. Tumor diameter was measured using tumor calipers.
Results. There was a significant relationship between CD34 expression and tumor diameter (p<0.001; r=0.927). There was a significant relationship between CD34 expression and MVD features (p<0.001; r=0.906). There was a significant relationship between CD34 and VEGF expression (p<0.001; r=0.986). There was a significant relationship between tumor diameter and VEGF expression (p<0.001; r=0.903). There was a significant relationship between tumor diameter and the appearance of MVD (p<0.001; r=0.882). There was a significant relationship between VEGF expression and MVD features (p<0.001; r=0.893).
Conclusion. AV extract gave a higher response to chemotherapy in mammary adenocarcinoma of C3H mice given AC. a chemotherapy regimen (p=<0.05).
-
Gynaecologic History During Adolescence to Predict Endometriosis Earlier
Views: 871Downloads: 858Background. Endometriosis is a chronic gynecological disorder that generally affects women of reproductive age which is characterized by implantation of endometrial tissue, both glands and stroma outside the uterus. Research shows that the initial onset of endometriosis patients begins in adolescence. The high prevalence with atypical symptoms leads to long term delay in establishing the appropriate diagnosis. Further developments in the field of early endometriosis screening will greatly assist clinicians, especially general practitioners in areas with limited health facilities, in early detection of endometriosis.
Methods. Using the electronic databases, comprehensive literature searches were conducted with the specific keywords. Full-text manuscripts published were reviewed for relevancy and importantly, reference lists were cross-checked for additional relevant studies.
Results. Dysmenorrhea, chronic pelvic pain, dyspareunia, dysuria, dyschezia, and glycoprotein were found dominantly in all analyzed literature. The occurrence of endometriosis affects the functioning of women in multiple aspects of life. Endometriosis places a significant burden on teens and adult women, their families, and society as a whole.
Conclusion. Combination of structured past history taking, and several biomarker level might be useful as a screening tool that easy to use and cost effective, as early diagnosis is expected to prevent further progression of endometriosis especially in adolescence.
-
Treatment of Systemic Lupus Erythematosus with Anti SSA and SSB Positive Pregnancies
Views: 2,072Downloads: 1,960Systemic lupus erythematosus (SLE) is autoimmune disease that results in inflammation in various organ systems, frequent recurrences in the clinical course characterized by the production of antibodies against core antigens. Pregnancy will trigger flares. Increased intravascular volume in pregnancy can worsen abnormal heart and kidney function. Increasing the glomerular filtration rate by 50% exacerbated previously stable proteinuria. Pregnancy-induced hypercoagulability increases the risk of thrombosis. Anti-Ro/SSA was found in 35% of SLE patients and anti-La / SSB was found in 15% of SLE patients. The presence of Ro and La antibodies puts the fetus at a risk of developing neonatal lupus erythematosus (NLE) 6-13% and can reach up to 25% if the mother has previously given birth to a child with NLE. Neonatal lupus erythematosus including congenital heart block or cutaneous lupus. Congenital heart block (CHB) is a very serious complication. The American College of Rheumatology (ACR) recommends serial fetal echocardiography from 16 weeks of gestation continuing through to 26 weeks. Pregnancies with grade I and II CHB are treated with oral dexamethasone 4 mg daily because fluorinated glucocorticoids such as dexamethasone and betamethasone can cross the placenta, however, this therapy cannot be given in third-degree heart block. Early diagnosis and therapy will reduce the risk of congenital heart block in neonates after birth.
-
Evaluation of Rationality in Prescribing Metformin (Biguanide Group) at Dr. Mohammad Hoesin General Hospital Palembang
Views: 971Downloads: 692Backgrounds. It is very important to evaluate and assess the rationality of the use of antidiabetic drugs, especially the biguanide (metformin) group to maintain the quality and quality of diabetes mellitus drug administration so that the target of diabetes mellitus control can be optimized. This study aims to evaluate the rationality of prescribing metformin oral antidiabetic at Dr. Mohammad Hoesin General Hospital Palembang.
Methods. The research design is a descriptive study using secondary data from medical records in the medical records section of Dr. Moh Hoesin Hospital Palembang. The object of research is all medical records of patients with type 2 diabetes mellitus who used metformin at RSMH Palembang in the period July 1st, 2019-July 31st, 2020, with complete medical record data and without serious comorbidities. The rationality for using metformin that was assessed in this study was the frequency of use, drug dose, route of administration, duration of administration, and drug interactions. The frequency of drug use is assessed by how many times the drug is taken in one day.
Results. The most age group of patients who received a prescription for metformin were 51-60 years old and 61-70 years old with a total of 17 patients (35.4%). The majority of patients were female as much as 60.4%. Drug interactions with metformin are still quite common, although the majority are synergistic and potentiating interactions. There are still 2 cases or 4.2 percent who experience antagonistic interactions.
Conclusion. The rationality for using metformin in patients with type 2 diabetes mellitus is based on the criteria for the right dose (100%), the right frequency of drug administration (100%), the right time for giving the drug (100%), the right way of giving the drug (100%), and the right drug interaction. (95.8%).
-
Overview of COVID-19 Vaccine Development Strategy
Views: 1,217Downloads: 1,115Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as the cause of coronavirus disease 20019 (COVID19) pandemic which first emerged in December 2019 in Wuhan city, China. Currently, a vaccine is urgently needed to control the COVID-19 pandemic. Several vaccine candidates are under development and some are in the final stage of clinical trials. The COVID-19 vaccination aims to reduce morbidity and mortality rates, achieve herd immunity to prevent and protect the society, strengthen the health system, maintain productivity and minimize social and economic impacts. Before approval, vaccines have to undergo several clinical trials to ensure its safety profile, efficacy, duration of immune system resistance, and adverse effect. Various strategies have been used in the development of vaccines including viral vector vaccines, nucleic acid vaccines, inactivated virus, live attenuated virus, subunit protein¸and virus-like particle vaccine. Each strategy has its own advantages and disadvantages.
-
The Effectiveness of Adding Rice Husk Nanosilica to the Flexural Strength of Opaque Porcelain Coatings on Metal Ceramic Dental Crowns
Views: 734Downloads: 554Background. Failure of dentures that are unable to withstand flexural forces is often a major problem in the use of metal-ceramic crowns. The use of rice husk nano-silica powder has been extensively researched in dentistry because of its ability to improve mechanical properties. This study aims to determine the effectiveness of nano-silica particles from rice husks on the flexural strength of the opaque layer on Co-Cr metal-ceramic crowns.
Methods. The type of research is experimental laboratories in vitro with posttest only control group design. The research samples were rectangular Co-Cr metal and porcelain plated on top of the metal center totaling 25 samples which were divided into 5 treatment groups. Flexural strength measurement with three-point bending at UTM. Data were analyzed by independent T-test and way ANOVA.
Results. flexural strength of Co-Cr metal ceramic crown with the addition of 0.25% rice husk silica; 0.5%; 0.75%.1% in the opaque layer is 70.431±4.168; 84.093±2.852; 100,672±4,182 and 115,092±3,821, respectively.
Conclusion. There is an increase in the flexural strength of metal ceramic crowns with the addition of 0.25% silica; 0.5%; 0.75%,1% on opaque coating.
-
Risk Factors of Vesicovaginalis Fistule in Obstetric and Gynecologic Division of Dr. Mohammad Hoesin General Hospital in 2018-2020
Views: 766Downloads: 1,437Background. A vesicovaginal fistula (FVV) is a direct pathological connection between the bladder and vagina resulting in uncontrolled leakage of urine into the vagina from the bladder. Based on the cause, fistulas are divided into two, namely obstetric fistula and gynecological fistula. The risk factors that influence the occurrence of FFV consist of obstetric risk factors (age, parity, delivery method, duration of delivery, birth weight) and gynecological risk factors (history of gynecological surgery, history of pelvic radiotherapy, history of gynecologic malignancy). The purpose of this study was to determine the relationship between risk factors and the incidence of vesicovaginal fistula.
Methods. This research is an observational-analytic study with a cross-sectional method. The number of samples obtained was 74 patients who met the inclusion criteria using secondary data from medical records. Analysis of the data used is the chi-square test.
Results. There were 37 people who experienced vesicovaginal fistula. Where there were 9 patients with obstetric vesicovaginal fistula (24.3%) and 28 people (75.7%). From the Chi-Square test analysis, there was a significant relationship between delivery method (p=0.029), birth weight (p=0.029), history of gynecological surgery (p=0.038), history of pelvic radiotherapy (p=0.016), history of gynecological malignancy (p=0.016). =0.010). Meanwhile, there was no significant relationship between age (p=0,347), parity (p=1,000), and duration of labor (p=0,082).
Conclusion. There was a significant relationship between the delivery method, birth weight, history of gynecological surgery, history of pelvic radiotherapy, history of gynecological malignancy. There was no significant relationship between age, parity, and duration of vaginal delivery.
