Successful Triple Valve Surgery in an Undernourished Patient: What to Prepare?

ABSTRACT Valvular heart disease accountsfor 10% to 20% of all cardiac surgical procedures in the United States. The decision to intervene, as well as the type of intervention for a patient with severe valvular heart disease, should be based on an individual risk-benefit analysis. Once a patient is considered a candidate for cardiac surgery, a comprehensive patient evaluation of medical conditions and comorbidities helps improve operative outcomes and minimize the mortality rate. Patients with severe valvular heart disease with chronic heart failure at times, progressing to malnutrition. Patients undergoing cardiac surgery experience a systemic inflammatory response, which contributes to acute organ injury leading to a higher incidence of comorbidities and worse malnutrition. Therefore, preoperative risk and nutritional assessment are critical in performing safe cardiac surgical procedures. We report a case of a malnourished 17-year-old man with multiple valvular heart disease with optimal preparation, including good nutritional status leading to good outcome of complex cardiac surgery even in the high risk patients. Keywords : valvular heart disease, malnutrition, perioperative assessmentCorrespondence : [email protected]

Understanding Pacing-Induced Cardiomyopathy: a mini review

Patients with total atrioventricular block or sinus node dysfunction will need pacemaker implantation to improve the physiologic function of the heart. It is known that chronic pacing such as right ventricular pacing could deteriorate the cardiac function (decreased left ventricular ejection fraction) due to dyssynchrony. This condition is knows as pacing-induced cardiomyopathy (PICM). The incidence of PICM could reach 19.5% during 3 years follow-up. The right ventricle is one of the locations for implantation. Chronic right ventricular pacing may cause interventricular dyssynchrony and disrupt the contraction mechanism in the heart. These will lead to cardiac remodeling and eventually impair the left ventricular function. Therapy is needed in patients with PICM to improve the symptoms and maintain the cardiac function. This article will further highlight the definition, mechanism, risk factor, treatment and preventive strategy for patients with PICM.

Nephroprotective effect of virgin coconut oil in Plasmodium berghei ANKA infected Balb/c mice

Malaria is a parasitic infectious disease caused by Plasmodium, which remains a world health problem with an estimated 219 million cases worldwide. In severe malaria infection, several organs of the body can be affected, including the kidneys. One of the pathophysiology associated with the worsening of this disease is oxidative stress. The use of antioxidants is expected to prevent this, and one product that has a high antioxidant content is virgin coconut oil (VCO). This study aimed to analyze the effect of VCO on the kidney in Plasmodium berghei ANKA-infected mice. This study was an in vivo laboratory experimental study with a randomized post-test only control group design using 35 BALB/c mice infected with P. berghei ANKA, weighing 20-30 grams. VCO with the Javara® brand is used with doses of 1, 5, and 10 ml/kg body weight (kgBW)/ day. The parameter assessed were levels of BUN, creatinine, and renal histopathological changes. The administration of VCO on the treated group shows minimal tubular necrosis and glomerulonephritis compared to the negative control group. The BUN and creatinine levels in the treated group were also lower than the negative control group. The results showed that VCO has a nephroprotective effect against P. berghei ANKA infection in mice.Keywords: malaria, kidney, virgin coconut oil

Anosmia and covid-19 in Yogyakarta, Indonesia: a case series

ABSTRACTCovid-19 (coronavirus disease 2019) had spread to the whole world. This kind of virus attacks the human respiratory system, and it caused death. In other words, there were many symptoms of Covid-19, which attacks the respiratory system. One of the symptoms was anosmia or smell disorder. This research might provide information about the anosmia in Covid-19 patients. This study aimed to investigate and present a series about anosmia and Covid-19 in Yogyakarta on June 2020. Three cases from three patients of RT-PCR-confirmed SARS-CoV-2-infected patients diagnosed with smell disorder were presented, starting from the symptom until the patients were getting treatments. This research also explained anosmia as one of the symptoms of Covid-19. Anosmia or losing olfactory function or smell disorder which could distract people’s healthy. Then, in this situation, it could be one of the symptoms of Covid-19. Keywords : anosmia, smell disorder, covid-19Corresponding Author : [email protected]

The Effect of Thespesia populnea Against Plasmodium falciparum Enoyl Acyl Carrier Protein Reductase Receptor by Study In Silico

Indonesia is a country that has abundant natural resources; one of them is the Baru laut plant which is the latest breakthrough because it has an active substance that can be used as an anti-malaria medicine. It is very beneficial because there has been a case of resistance of artemisinin derivatives in Indonesia. The purpose of this study was to determine the potential of active compounds in Baru laut plants (Thespesia populnea (L.) Soland ex. Correa) against the Plasmodium falciparum enoyl acyl carrier protein reductase receptor in P. falciparum through in silico studies. This research is purely experimental using the One-Shot Experimental Study research design method. Observations were only made once between the variables studied through three analyzes, namely prediction analysis of active compound content, prediction analysis of the mechanism of action of active compound content, and prediction analysis of ADME active compound. The study results show that there are three active compounds in Baru laut plants that have antimalarial potential. The three compounds include gossypol, linoleic acid, and beta-sitosterol, have their respective potential in becoming a malaria drug. This study concludes that Baru laut plants have potential as anti-malaria drugs.

Relationship between modified Nutrition Risk in the Critically Ill (mNUTRIC) Score and nutrition intake with quadriceps femoris muscle thickness in critically ill patients

Muscle wasting in critical illness is seen from inadequate nutrition intake and stress catabolism. Modified Nutrition Risk in the Critically Ill (NUTRIC) Score is a screening tool that measures starvation, inflammation, disease severity, and organ dysfunction. Relationship between muscle strength and muscle thickness causes the evaluation of muscle thickness is quite relevant. This study aimed to analyze the relationship between modified NUTRIC score and nutrition with muscle wasting in critically ill patients. The study was conducted on 30 patients in the ICU Dr Soetomo Hospital Surabaya. Nutritional intake and thickness of the quadriceps femoris muscle were monitored for one week. There was a relationship between mNUTRIC score with quadriceps femoris muscle thickness on days 3rd, 5th, and 7th. In the comparison between the low risk group and the high-risk group, it was found that there was a significant difference in the change in the percentage of muscle thickness difference on the 3rd, 5th and 7th day observation. There is a relationship between protein debt with quadriceps femoris muscle thickness (p = 0.008) with a positive correlation with moderate correlation strength (r = 0.477) on day 7. In conclusion, the modified NUTRIC Score had a moderate relationship with quadriceps femoris muscle thickness in critical patients from day 3rd until day 7th. The calorie intake not had a relationship with quadriceps femoris muscle thickness. Protein intake had a moderate relationship with quadriceps femoris muscle thickness only on day 7th measurement in critical patients. Keywords : Modified NUTRIC Score, Nutrition, Quadriceps Femoris muscleCorrespondence : [email protected]

Risk Factors for Diabetes Mellitus Patients Against Covid-19

ABSTRACTCovid-19 patients with Diabetes mellitus (DM) ranked third after hypertension and cardiovascular disease with an estimated 36% of all Covid-19 cases. These patients have a risk of experiencing a higher complication possibility since their metabolic disorder can cause hyperglycemia to the patient. It is showed that the number of deaths reached 7,3%, which is higher than non-diabetes. The increase of DM patients caused by stress factors may trigger the onset of glucose in blood sugar, and the glucose variability became abnormal. This circumstance may cause a glycemic increase that causes the predisposition intensification of susceptible affected by Covid-19. Good management is truly needed for DM patients affected by Covid-19. It is hoped to reduce the risk factor, such as preventing complications and increasing life quality by regular medical check to have a good prognosis. Some research showed that Covid-19 patients with DM are essential in ICU and need more treatment attention as they may experience Acute Respiratory Distress Syndrome (ARDS). Diabetes mellitus patients' treatment strategy is to manage the blood glucose level, especially in post-prandial glucose. This literature aims to know the degree of serious illness of Covid-19 patients by the comorbidity of DM in this pandemic event. Keywords: Covid-19, Sars-Cov-2, Diabetes Mellitus, risk factors,Correspondence: [email protected]

Development of augmented reality-assisted health education posters on Covid-19

The changes in the social order of life in the new normal era due to the Covid-19 pandemic have caused various sectors of the work environment to create new habitual adaptation policies so that the service process continues to run well. One method used was to use poster media to be displayed in the office environment as a media for health protocol information. The purpose of this research was to create a poster based on augmented reality videos that were suitable for use as media for information on health protocols in public health centers in Kendari City. The research model for augmented reality media development uses a model developed by Lee & Owens that consists of four stages: assessment/analysis, design, development, implementation, and evaluation. Based on the findings in this study, obtaining the media expert's assessment results provided a feasibility level of 91.58%, categorized as very feasible. The tests conducted on material experts obtained a feasibility level of 89.09% that categorized as very feasible. Poster-based on augmented reality videos have been tested on Puskesmas health workers with a mean percentage of assessment of 80.42% that categorized as suitable for use. In comparison, the test results obtained from the public health services visitors obtained a percentage of 81.25% that have been categorized as suitable for use. The tests carried out on all test subjects showed that the poster-based on augmented reality videos was very suitable for use as a health promotion media at Puskesmas in Kendari City.

Prevalence and risk factors of Ascaris lumbricoides infection in children of Manusak Village, Kupang District, East Nusa Tenggara Province, Indonesia

ABSTRACT Worm infection is one of the health problems in all tropical countries, including Indonesia. The most frequent helminthiasis is the infection caused by the Soil-Transmitted Helminth. Primary school-age children are an age group that is susceptible to helminthiasis. Worm infections can cause a serious impact if left untreated with no clean and healthy lifestyle. This study was conducted to determine the prevalence and risk factors of STH in children of Manusak Village, East Kupang Subdistrict, Kupang District, East Nusa Tenggara Province, followed by the characterization of subjects. The analytic observational design with the cross-sectional study was applied to this research. Research subjects were 130 children aged 6-12 years old. The infection was diagnosed microscopically by the Katokatz method. Ascaris lumbricoides were the only species found infecting a total of 50 children (38.4%.). The distribution of ascariasis was higher in girls (30 or 23.08%) than in boys (20 or 15.38%), in children whose parents have no formal education (41 or 31.54%), and who their professions are a farmer. Poor hygiene and sanitation such as no washing hands with soap (27 or 20.77%) as well as the habit of not wearing footwear (47 or 36.2%) and bowel habit on the open areas (35 or 26.92%) are the risks factors causing the high incidence of A. lumbricoides in the studied area. Enlightenment to the parents regarding good personal and environmental hygiene and sanitation along with chemotherapy from the government and related agencies is needed to achieve a durable reduction of the burden of ascariasis and other STH infection. Keywords : Soil Transmitted Helminth, Ascaris lumbricoides, children, Kupang DistrictCorrespondence : [email protected]

Expression of Brain-Derived Neurotrophic Factor in the Brain of Depressed Mice: Systematic Literature Review

Introduction: Chronic stress exposure plays a role as a risk factor for depression. In chronic stress, there is prunning of nerve cell dendrites so that depression becomes irreversible. Depression is caused by low serotonin (5-HT2) neurotransmitters in the postsynaptic cleft. Recent findings in experimental animals indicate that serotonergic preparations are required to increase serotonin levels in the synapse opening, thereby triggering the formation of new dendrites to make depression reversible. The different results when these preparations create resistance in cases of chronic depression and actually increase the risk of uncomfortable and even fatal side effects with long-term use.Methods: This Systematic Literature Review uses the PubMed and Google Scholar databases for the period 2015-2020. A total of 322 articles at the beginning of identification and those that met the inclusion criteria in this study were six articles.Results: The results of data extraction showed that the depression condition caused by various stressors resulted in BDNF levels in the hippocampus decreased significantly by p≤0.005.Conclusion: Based on the literature study, it was concluded that in depressive conditions, BDNF levels in the brain decreased.