The Duration of Hemodialysis and its Implication to Barthel Score and Laboratory Parameters among End Stage Renal Disease Patients

Background: While it was proven that hemodialysis for treating patients with end stage renal disease (ESRD) provided the reduced mortality rate, the reports on its adequacy in the context of laboratory parameters and psychological function were limited. Aim: To assess the implication of hemodialysis duration on Barthel score and laboratory parameters among ESRD patients.  Methods: During the period, a cross-sectional study was conducted at Dr. Soetomo General Hospital. Information related to age, gender, history of hypertension, history of diabetes mellitus, and the levels of hemoglobin, albumin, calcium, and phosphor were retrieved from medical records. While, we performed the interview to each participant using Barthel index questionnaire to assess the function independence. We used multiple logistic regression analysis to determine the correlation and estimate of effect. Results: We totally include we included 65 patients with the hemodialysis duration of more than one year and 16 patients with the hemodialysis duration of less than one year. Our results found that the higher levels of albumin and hemoglobin were observed in patients with hemodialysis duration of more than one year. While, the duration of hemodialysis did not affect the Barthel score and serum mineral parameters. Conclusion:  The duration of hemodialysis of more than one year is associated with the improvement of albumin and hemoglobin level

THE EXPRESSION OF TGF-1 AFTER LOW LEVEL LASER THERAPY IN INFLAMMATION ANIMAL MODEL

Pain is the most common complaints in everyday practice. Pain is a clinical manifestation caused by stimuli due to potential tissue damage. Low level laser therapy (LLLT) has been used in reducing pain. One of indicator tissue healing is activation of transforming growth factor -b1(TGF-b1). Tissue healing will eliminate the pain. Do LLLT stimulate TGF-b1 expression? The objective of this study was to investigate the expression of TGF-b1 in low level laser therapy. Thirty male Wistar rats, body weight 250 – 300 gram, 3 month old, were divided into 3 groups, negative control (n=10), positive control (n=10) and treatment groups (n=10). The positive control and treatment groups were injected with Complete’s Freund Adjuvant (CFA) 100 mL at left footpad. The treatment group treated with low level laser therapy Lasermed type 2100 wavelength 905 nm, out power 25-500 mW, dose 1 joule/cm2;5 times with interval 24 hours on left footpad. Samples were taken from the skin of footpad and immunohistochemical examination with monoclonal antibody anti- TGF-b1. Calculations carried out on brown reaction in macrophage cell. Data were analyzed using the Games Howell with SPSS 17. There were significant differences in the expression of TGF-b1 in treatment group (15.8±3.1) compared with the positive control group (3.9±1.1) and negative control group (4.6±2.1). There were no significant differences between expression TGF-b1 in positive control group and negative control group. In conclusion, low level laser therapy increased the expression of TGF-b1

LDL Level in Ischaemic Stroke Patients at Dr. Soetomo General Hospital Surabaya

Introduction: Stroke is one of the top killers amongst the non-infectious diseases. Ischemic stroke dominates the rate by 87.0% amongst all type of strokes. One of the risk factors for stroke ischemic stroke is atherosclerosis which caused by lipid build-up in the arteries. Methods: This research is a retrospective study on secondary data. Admitted Ischaemic stroke patients. Lipid profile, and Barthel Index were collected from medical record and presented descriptively. Results: Of the 248 patients, 144 (58.1%) were men, mean age was 59.33. 61.7% ischemic stroke patients have their LDL level elevated, 59.7% HDL decreased, 39.1% total cholesterol elevated, and 33.9% TG elevated. This study also observe the dependency based on Barthel Index of the admitted stroke patients. 75% percents amongst subjects were categorized as “total dependece” are having their LDL level elevated. Conclusion: Most of stroke patients have elevated LDL and HDL while the TG and total cholesterol are mostly optimized. Stroke patients whose admitted with “total dependence” most likely to have elevated LDL in this study

Effect of Short Period Simultaneous Stimulation of Transcranial Direct Current Stimulation (tDCS) on Occupational Therapy to Motor Function of Upper Extremity in Stroke Subject

Objective: Stroke could cause upper extremity motor function disturbances that may affect to quality of life. The affected brain has an ability to get recovery by neuroplasticity process. Transcranial direct current stimulation (tDCS) is a non-invasive modality that could induce brain neuroplasticity Goal: To determine the effect of tDCS stimulation on recovery of upper extremity motor function in subacute ischaemic stroke patient. Methods: 22 stroke patients included in inclusion criteria, divided into 2 groups, control group and intervention group. Control group had occupational therapy for 5 days consecutively and intervention group had occupational therapy and tDCS stimulation simultaneously for 5 days consecutively. Upper extremity motor function was evaluated with Fugl-Meyer Assessment (FMA) before and after the treatment. Results: Significant improvement of FMA score on control group (p=0,018) and intervention group (p=0,000). Comparison of the result after the treatment revealed that the intervention group showed more significant improvement in FMA score than the control group (p=0,000). Conclusion: Application of tDCS stimulation on occupational therapy simultaneously showed improvement of upper extremity motor function in subacute ischaemic stroke patient better than only occupational therapy

Sun Bathing Affects Overweight-Obese Subjects Vitamin D Deficiency

Background: There are increasing number of studies that discuss the effect of sun exposure to overweight and obese individuals with vitamin D deficiency (which is UVB exposure can increase serum 25-Hydroxyvitamin D levels). However, until now there is no a literature review about these studies. This shows a weak correlation between sun bathing and serum 25-Hydroxyvitamin D elevation in overweight and obese people. Aim: Describe the effect of the sun bathing for overweight-obese patient with vitamin D deficiency. Material and Methods: Electronic searching tools (ScienceDirect, Pubmed, and Google Scholar) were conducted from the 1990s until the recent literature. A sensitive search strategy uses specific terms. Studies were included if the population with BMI > 25 Kg/m2; Sun Exposure intervention, the studies provided the comparison of implementation method, the studies provided 25-Hydroxyvitamin D status as the outcome. For the exclusion criteria: studies that included subjects metabolics syndrome. MMAT was used for eliminating biased research. Results: Two studies were fulfilled our inclusion criteria. The studies, were excluded, mainly because they lacked data, biased reseach, and failure to answer any authors questions. Conclusion: The sun exposure method has a positive corellation for increasing serum 25-Hydroxyvitamin D level in overweight and obese subjects with vitamin D deficiency, but internal factors (age and skin color) and external factors (season, temperature, dose, and duration) need to be considered to get effective result. Keywords: Obese, Overweight, Sun bathing, Vitamin D deficiency, 25-Hydroxyvitamin D

Comparison of functional outcome after early and delayed anterior cruciate ligament reconstruction: A systematic review

 This study aims to find the optimal timing for Anterior Cruciate Ligament (ACL) reconstruction by comparing the outcome of early versus delayed ACL reconstruction, meniscus, and chondral damage. A systematic literature search was performed from February to March 2021 from 4 databases. Inclusion criteria were English language Randomized Control Trial (RCT) and observational studies published in 2000-2020, 20-50 years old patients with an isolated ACL tear with/without meniscal injury underwent ACL reconstruction. Early ACL reconstruction was estimated at less than six weeks post-injury, and delayed ACL reconstruction was estimated at more than six weeks. Tegner and Lysholm were the functional outcomes to compare early and delayed ACL reconstruction with a meniscus tear and chondral damage. The search yielded 3094 studies. After removing duplicates, titles and abstracts were screened, leaving 154 potential studies. The studies were selected, and eight studies were eligible. No statistically significant difference between early and delayed ACL reconstruction in Lysholm and Tegner score (p>0,05) was found. Both scores were similar regarding whether the patient performs early/delayed ACL reconstruction. Therefore, early ACL reconstruction could be an optimal timing for the patient who will undergo ACL reconstruction

Immediate Effect of Kinesiotaping on Non-dominant Wrist Extensor Muscles:an Alteration in Handgrip Strength of Healthy Individuals

Background: Adequate function of wrist extensor muscles is essential for handgrip strength. Handgrip strength can be used as a health problem predictor in the future. Maintaining and increasing handgrip strength to reduce the risk of future mortality is noteworthy. Aim: To investigate the immediate effect of the kinesiotaping facilitation technique on the non-dominant wrist extensor muscles on handgrip strength of healthy individuals. Material and Methods: This study was conducted in August – September 2020. Twenty-two healthy men, aged 25 – 40 years and willing to participate in this study by signing the research agreement form was recruited from Medical Rehabilitation Departement RSUD Dr. Soetomo Surabaya, and randomized into kinesiotaping group and placebo taping group. The kinesiotaping group received kinesiotaping facilitation technique Y strip 50% stretched on the non-dominant wrist extensor muscles. The placebo taping group received non-elastic adhesive tape Y strip on the non-dominant wrist extensor muscles. Handgrip strength was measured using hydraulic handgrip dynamometer before and 30 minutes after kinesiotaping facilitation technique and placebo taping applied. Results: Alteration of handgrip strength is significant increase in kinesiotaping group compared to placebo taping group (p=0.036). Conclusion: Kinesiotaping facilitation technique on non-dominant wrist extensor muscles can immediately increase handgrip strength of healthy individuals

Risk Factors Of Body Mass Index (BMI), Age Of Menarche, Parity And Hormonal Contraception Of Genu Osteoarthritis In Female Patients

Osteoarthritis (OA) is a degenerative disease related to joint cartilage and commonly occurs in the knee joint. The 2013 National Survey recorded the prevalence of joint diseases in East Java was 26.9%. OA affected more women than men due to the estrogen and caused disabilities in many women. This study aimed to find the relationship between Body Mass Index (BMI), age of menarche, parity, and the use of hormonal contraceptives against OA in genu at Universitas Airlangga Hospital, Surabaya. This was an analytic observational study with a case-control approach. Data collection was carried out through a short interview using a questionnaire. The sample size was calculated using a formula and found that the study required 42 patients with OA in the case group and 42 patients without OA in the control group. The case group was dominated by patients with 56-60 years old age (62.1%), BMI 23-24.9 kg/m2 (58.7%), menarche age 12-13 years (53.6%), multiparous (52.6%), having contraception pill usage history (62.3%) particularly using combination pills (60.5%) with a mean duration of use > 1 year (56.8%). There was a relationship between BMI and type of hormonal contraceptive used against genu OA in female patients at Universitas Airlangga Hospital Surabaya

Effects of moderate intensity treadmill exercise with gradual increase in speed and inclination on serum C-reactive protein in male with type 2 diabetes mellitus

The aim of this study is to look at the effect of moderate-intensity treadmill exercise for 30 minutes with an increase in speed and inclination of male with type 2 diabetes patients in reducing the chronic low-grade inflammation. A randomized two-group study was carried out between July 2019 and September 2019. Ten male patients with type 2 diabetes (30-55 years old) without complications, with blood sugar controlled from Endocrine Polyclinic Internal Medicine RSUD dr. Soetomo, was recruited and allocated randomly into two groups. In the treatment group, each patient received moderate intensity treadmill training with increased speed and inclination. The exercise is carried out for 30 minutes for 4 weeks, 2-3 times a week. In the control group, each patient received standard treatment along with physical activity education for 150 minutes a week. Measurement of serum CRP levels was done on the first and last day. In the treatment group, serum CRP levels were measured 30 minutes after aerobic exercise. This study showed that aerobic exercise for 4 weeks did not reduce serum CRP levels in type 2 DM patients.&nbsp

Effect of the otago exercise program on the lower extremity muscle strength in older women

An increased risk of falls in the elderly is associated with decreased muscle mass and strength in the lower limbs. The Otago Exercise Regimen (OEP) is a moderately challenging walking, flexibility, strengthening, and balancing exercise regimen. The Otago Exercise Program has been demonstrated to reduce the incidence of falls in elderly individuals by improving balance and muscular strength. This research sought to ascertain how the Otago Exercise Program influenced the lower limb muscular strength of older women. The research was done from October 2020 to May 2021. 26 individuals, split into a treatment group and a control group (13 people each). The moderate intensity Otago Exercise Program was administered to the treatment group for eight weeks, lasting 30 minutes three times each week. In this study, the parameter that assessed the muscular strength in the lower extremities was examined using the 30 second sit-to-stand (30STS) test. Two measurements are made: once prior to and once following the eight-week OEP period.&nbsp