Journal Of The Indonesian Medical Association

Effects of Acalypha indica Root Extract on Aging Process and Myasthenia Gravis

Erni Herawati Purwaningsih — 2023-05-05

Berdasarkan data dari Badan Pusat Statistik Tahun 2021, lebih dari 10% penduduk di Indonesia merupakan lansia atau berjumlah 29,3 Juta Jiwa. Jumlah tersebut diprediksi akan mengalami peningkatan. Diketahui sejak tahun 2000, persentase peningkatan populasi lansia di Indonesia melebih 7% sehingga Indonesia dikatakan masuk dalam negara kelompok berstruktur tua (aging populations). Diproyeksikan pada tahun 2045, satu per lima dari total populasi di Indonesia adalah lansia. Di Dunia pun pada tahun 2030 diprediksi akan ada 1 dari 6 orang yang merupakan lansia. Pada lansia, terjadi akumulasi kerusakan molekuler dan seluler yang dilanjutkan dengan penurunan fungsi organ sehingga terjadi peningkatan morbiditas dan mortalitas. Beberapa penyakit yang dialami lansia di antaranya adalah hipertensi, jantung, penyakit sendi, stroke, kanker, alzheimer, hingga penyakit langka seperti Myasthenia gravis (MG). Berdasarkan studi epidemiologi, diketahui terjadi peningkatan insiden Myasthenia gravis (MG) pada lansia.

The Association Between Anxiety Level and Compulsive Buying Disorder among Preclinical Students of The Faculty of Medicine

Clarisa Silviany — 2023-05-05

Introduction: At a certain level, excessive anxiety could lead to anxiety disorders and adversely affect daily life. Medical students had a higher prevalence of anxiety disorders than the general population. This anxiety might lead to negative behavioral tendencies and certain mental disorders, such as Compulsive Buying Disorder (CBD). This study aimed to determine whether there was an association between anxiety level and CBD among preclinical students of the Faculty of Medicine.
Method: This research was an analytic observational study which was conducted using a cross-sectional study method on 107 preclinical students of Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia as respondents by filling out the Depression Anxiety Stress Scale (DASS-42) and Revised Edwards Compulsive Buying Scale (ECBS-R) questionnaire. The data was analyzed using the Chi-square test.
Results: The results of statistical tests showed that there was a significant relationship between anxiety levels and CBD with p<0.001. The results showed that the prevalence of anxiety disorders in preclinical students was 33.6%, with the highest prevalence being at moderate anxiety levels (16.8%), and the prevalence of CBD was 25.2%.
Conclusion : In conclusion, there was an association between the level of anxiety and CBD among preclinical students of the faculty of medicine.

The Role of Interleukin-10 Gene Promoter Polymorphism in Leprosy: A Systematic Review

Desi Oktariana — 2023-05-05

Introduction: Leprosy remains a significant problem in Indonesia as the number of cases has not been eliminated until now. One of the cytokines that plays a role in the disease is interleukin-10 (IL-10), which has a dominant anti-inflammatory effect and influences the immunopathogenesis of leprosy. Genetic factors, including the IL-10 gene promoter polymorphism, affect the amount of IL-10 produced, thereby increasing the risk of leprosy. Therefore, the objective of this study is to gather information on the role of IL-10 gene promoter polymorphism in the development of leprosy.
Method: A systematic review method was used to identify, evaluate, and extensively discuss published works through national and international journals such as Google Scholar, Science Direct, Elsevier, EBSCO, Medline, PubMed, Proquest, and Wiley. The study was conducted by searching relevant keywords related to the research topic in these databases. Subsequently, article selection was performed based on predetermined inclusion and exclusion criteria. The selected articles were then evaluated for quality to ensure accuracy and reliability of the presented information. Finally, the results of this systematic review were used to obtain accurate and up-todate information regarding the role of IL-10 gene promoter polymorphism in leprosy.
Results: This systematic review analyzed a total of 14 articles and revealed that results varied among study populations. However, there is consistent evidence to suggest that the IL-10 gene promoter polymorphism is associated with leprosy, which was found in the majority of the study populations.
Conclusion: IL-10 gene promoter polymorphism tends to be associated with leprosy.

The Effect of Biliary Atresia on the Development of Cognitive and Motor Functions in Children: A Systematic Review

Jason Theola — 2023-05-05

Introduction: Biliary atresia is the most common cause of progressive liver disease in children. Studies have shown that biliary atresia causes impairment of cognitive and motor development in children. This study was conducted to establish a systematic review that examines the relationship between biliary atresia and developmental disorders in children.
Methods. Literature searching from electronic databases (PubMed, Cochrane, and SCOPUS) and hand searching were performed. Inclusion and exclusion criteria were applied to the selected studies. The selected studies were assessed for the risk of biases of each study. The results of each study were summarized and compared in a summary table.
Result. A total of nine relevant studies were obtained from a systematic search through the electronic databases and external resources using specific keywords. Seven of nine studies reported that biliary atresia affects both children’s cognitive and motor development.
Conclusion. Children with biliary atresia are generally suspected of having impaired cognitive and motor development. The relationship between surgical intervention in children with biliary atresia with cognitive and motor development in children is still unclear. Further studies are needed to determine the cognitive and motor development of children with biliary atresia before and after surgical intervention.

Difficult Intubation Predictor: Comparison Between Ratio Of Height To Thyromental Distance, Mallampati Score And Thyromental Distance

Riyadh Firdaus — 2023-05-05

Introduction: The Mallampati score and thyromental distance (TMD) are frequently used to identify challenging laryngoscopies, but their reliability in predicting difficulty is uncertain. This study aims to assess the effectiveness of using the ratio of height to thyromental distance (RHTMD) in predicting difficult visualization of the larynx (DVL) when compared to the Mallampati score and TMD.
Method: To achieve this goal, 277 patients who received general anesthesia during elective surgery were evaluated using the Mallampati score, TMD, and RHTMD. The Cormack and Lehane (CL) classification was used to grade the laryngeal view, with CL grade 3 and 4 indicating difficult visualization. The study then determined and compared the area under the curve (AUC), sensitivity, and specificity for each airway predictor.
Results: The AUC of RHTMD (85.5%) was better than TMD (82.7%) and significantly better than the Mallampati score (61.4%).
Conclusion: RHTMD is more accurate in predicting difficult laryngoscopy than both the Mallampati score and TMD.

Pityriasis Lichenoides et Varioliformis Acuta pada Wanita Dewasa dengan Bakteriuria Asimptomatik: Sebuah Pemicu Lain?

Theo Audi Yanto — 2023-05-05

Introduction: Pityriasis Lichenoides et Varioliformis Acute (PLEVA) is a rare and benign inflammatory skin disease. This acute form is distinguished from the milder chronic condition, Pityriasis Lichenoides Chronica (PLC). The etiology of PLEVA itself remains unclear, although it has been associated with infection as a trigger.
Case: Here, we present the case of a 34-year-old woman who presented with abrupt, generalized, pruritic skin eruptions for two months.
Case Discussion: The eruptions started as red scaly papules and vesicles and resolved as hyperpigmentations. She denied having any previous dermatological diseases, routine medications, or vaccinations. On examination, she showed generalized multiple hyperpigmented macules, scaly papules, and vesicles over the trunk, extremities, and face, with erosions and crusts in several areas. Eosinophilia and asymptomatic bacteria were found in her urinalysis. A skin biopsy showed diffuse lymphocytic infiltration in the dermal/epidermal junction and perivascular region, with parakeratosis and lymphocyte exocytosis. While the pathogenesis of PLEVA itself remains unclear, a triggering factor of inflammatory reaction, such as infection, may contribute to the development of the disease.
Conclusion: Asymptomatic bacteriuria is associated with inflammatory responses, and thus, it can be one of many possibilities. More studies are needed to confirm this association with PLEVA. Due to the lack of a clear pathogenesis and the benign nature of the disease, this rare entity may present difficulties in diagnosis and therapy

Perioperative Management of Thyroid Surgery: A Literature Review

Bonfilio Neltio Ariobimo — 2023-05-05

Thyroidectomy is one of the frequently performed surgery worldwide with indications of malignant or benign tumors, or functional abnormalities in thyroid gland. Surgery on the neck is actually a high-risk procedure because it is performed on structures attached to blood vessels, nerves and airways, so adequate perioperative management is warranted. This literature review aims to summarize the latest perioperative management of thyroid surgery. Preoperative management includes control of signs and symptoms of hyperthyroidism or hypothyroidism, fasting, administration of prophylactic antibiotic, and airway management. During surgery, special attentions are needed related the use of anesthetic drugs, hemodynamic monitoring, and efforts to prevent nerve injury. In addition, several postoperative complications that need to be detected and treated early, including hypocalcemia, hematoma, injury of recurrent laryngeal nerve, postoperative pain, nausea, and vomiting, and tracheomalacia. All those perioperative management requires multidisciplinary collaboration.