Auricular Acupuncture on Uterine Point on PGF2α Levels and First-Stage of Labor Duration among Primigravida Women

Duration of labor is influenced by four factors, including the power or uterus contraction. Labor contractions begin with a decrease in the progesterone hormone levels and an increase in the oxytocin hormone levels which is initiated by prostaglandins (PGF2α). Auricular acupuncture on uterine point is located in the triangular fossa which is innervated by the trigeminal nerve and the vagus nerve. Stimulation on the uterine point can send a wave of stimulation to the central nervous system in the posterior hypothalamus to produce oxytocin. This study aims to analyze the effectiveness of auricular acupuncture on uterine point on PGF2α levels and the duration of the first stage of labor among primigravida women. This was a true experimental study with a two-group pretest-posttest design. The total sample of the study was 48 women in labor who were selected through a randomized control trial and met the inclusion criteria of low-risk pregnancy. Data were analyzed using the Wilcoxon and Mann Whitney tests. The results of the study revealed that auricular acupuncture on uterine point significantly increased PGF2α levels (ρ=0.002), (201.29±132.916) compared to the deep-breath relaxation group 132.08±93.530. Auricular acupuncture on uterine point was proven to shorten the duration of the first stage of labor (440.3 ± 72.94; 440.00) when compared to the deep breathing relaxation group (517.6 ± 101.00; 507.50) with a very significant difference (ρ=0.004). In conclusion, auricular acupuncture on uterine point was effective in shortening the duration of labor by increasing PGF2α levels.Lama persalinan dipengaruhi oleh empat faktor, diantaranya faktor power atau kontraksi. Kontraksi persalinan diawali dengan penurunan hormone progesterone dan meningkatnya hormone oksitosin yang diinisiasi oleh prostaglandin (PGF2α).  Akupunkur auricular titik uterus terletak pada trianggula fossa yang dipersarafi nervus trigeminus dan nervus vagus. Menstimulasi titik Uterus dapat mengirim gelombang rangsangan ke susunan saraf pusat pada hipotalamus posterior memproduksi Oksitosin. Tujuan untuk menganalisis efektifitas akupunktur auricular titih Uterus terhadap PGF2α dan lama persalinan kala I primigravida. Metode penelitian true experimental design dengan metode two-group pretest-posttest design. Jumlah sampel penelitian 48 ibu inpartu kala I yang dipilih secara rundomice control trial dan memenuhi kriteria inklusi primigravida resiko rendah. Data dianalisis menggunakan uji Wilcoxon dan Mann Whitney. Hasil penelitian akupunktur aurikular titik Uterus meningkatkan kadar PGF2α (ρ=0,002), meningkat bermakna (201,29±132,916) dibandingkan dengan kelompok relaksasi nafas dalam 132;08±93,530). Akupunktur aurikular titik Uterus memperpendek lama persalinan kala I (440,3±72,94; 440,00) jika dibandingkan dengan kelompok relaksasi nafas dalam (517,6±101,00; 507,50) sehingga ada perbedaan yang sangat bermakna (ρ=0,004). Kesimpulannya akupunktur aurikular titik Uterus efektif memperpendek lama persalinan dengan meningkatkan kadar PGF2α

THE INFLUENCE OF 10% TRICHLOROACETIC ACID ON COVERING OF TYMPANIC MEMBRANE PERFORATION WITHOUT BRIDGE

Background: Up to now, the covering of tympanic membrane perforation on human either or without operation has always been using the bridge. The covering of tympanic membrane perforation without operation by attempting epithelization of perforation edge which initially perform by injuring the perforation edge. The material that can be used to make the injuring is 10% trichloroacetic acid (TCA). The covering of perforation without bridge was conductive on guinea pig and proven that spontaneous covering take place. And there for the covering of tympanic membrane perforation without bridge can also happened on human being, by making the injuring on the perforation edge using 10% TCA.Objective: The objective of the research to prove that application of 10% TCA on the edge of tympanic membrane perforation can cause the perforation covering although without using the bridge.Method: This is the experimental research using pre and post test design. The chronic tympanic membrane perforation patiens without infection with normal Eustachii tube function, the size of tympanic membrane perforation 25% were treated with 10% TCA application on their perforation edge every 2 weeks until the covering take place or maximal 5 times application if no covering take place. Measurement of perforation size was conducted prior to first application and after the treatment.Result: From 36 ears suffering chronic tympanic membrane perforation with normal Eustachii tube function and without infection with the size of perforation 25% were selected to the sample of the research. The perforation that can be covered after the treatment of 10% TCA application were higher in number than those were not covered (63,9%:39,1%).Conclusion: The application of 10% TCA on the edge of tympanic membrane perforation can cause perforation covering although without the use of bridge.Keywords: Tympanic membrane perforation, Trichloroacetic aci

Randomized Controlled Trial of Tranexamic Acid’s Effect on Bleeding Length: A Study on DMPA Users with Abnormal Uterine Bleeding Who Receive Low-Dose Oral Contraceptive Pill

ABSTRACTBackground: Contraceptive injection is the most common contraception used in Indonesia. Among the contraceptive injections, depomedroxy progesterone acetate (DMPA) is the most effective method with pregnancy rate of 0,3 pregnancy in 100 women annually. Abnormal uterine bleeding (AUB) is a common side effect occurred in DMPA users which leads to the discontinuation of contraception.Objective: To explore the effect of tranexamic acid on bleeding length for DMPA users with AUB who receive low dose Oral Contraceptive Pills (OCP).Methods: We performed double blind randomized control trial between  two groups to investigate the effect of tranexamic in managing AUB in DMPA users who receive low dose OCP. This study was performed in Dr. Kariadi Hospital Semarang, Indonesia. Forty-four subjects were divided into two groups, equally. Group 1 received 250 mg tranexamic acid four times a day for 5 days and OCP once a day for 28 days, while Group 2 received placebo four times a day for 5 days and OCP once a day for 28 days. Both groups were evaluated for bleeding length during treatment and were analyzed using Mann Whitney for post treatment with tranexamic acid.Results: The mean bleeding length was 5.2±3.62 days and 9.2±6.16 days in group 1 and 2 respectively. These bleeding lengths were significantly different between both groups (p=0.018). The precentage of subjects in whom bleeding was stopped during the first week after initial treatment was significantly higher in  group  1 than group 2 (77,3 % vs 45,5 %, p<0,030).Conclusion: Tranexamic acid significantly reduced the bleeding length in DMPA users who use OCP

The Differences of Malondialdehyde Serum Level, Expression of Tumor Necrosis Factor Alpha and Vascular Endothelial Growth Factor, and the Area of Endometriotic Implants in Administration of Kebar Grass Extract (Biophytum petersianum) and Green Tea Extract (Camelia sinensis) to Mice

The pathological pathway of endometriosis remains unclear and involves complex etiologies. Increased oxidative stress is understood to be related to this disease. Oxidative stress produces reactive oxygen species, causes inflammation that is characterized by recruiting lymphocytes and phagocyte activation, produces cytokines that induce oxidation enzyme, and supports epithelium growth. Oxidative stress conjointly will increase angiogenesis and promotes the proliferation of endometriosis tissue within the peritoneal cavity. Kebar grass and green tea contain high antioxidants, are expected to extend antioxidant defense leading to reduced oxidative stress, inflammation, angiogenesis, and reduced endometriosis tissue implants. The objective is to analyze the consequences of Kebar grass and green tea extract to MDA serum level, TNF-α, and VEGF expression, and the area of the endometriotic implants in the mice models.  The study was an experiment designed. It has been conducted within the Department of Obstetrics Gynecology, Faculty of Medicine Diponegoro University and Faculty of Veterinary Medicine Airlangga University. Twenty-one mice were divided into three groups, i.e., the first group of mouse models was given Kebar extract 3 mg/day; the second group was assigned green tea extract 1.1 mg/day; therefore the third group was a control group contains the untreated endometriosis mice. Each treatment was given for fourteen days. MDA serum level was measured by specto-photometric examination, the area of the endometriotic implants was measured by computer tracing technique, whereas TNF-α and VEGF expression of endometriotic implants were measured by IHC using Rammele Scale Index (ImmunoReactive Score). The MDA serum levels of the groups treated with Kebar grass extract and green tea extract were significantly lower than the control group (0.09±0.022 mmol, 0.07±0.019 mmol, and 0.30±0.062 mmol, respectively; p=0.001). TNF-α expression of the groups supplied with each treatment also lower than the control groups (2.43±1.521, 3.66±1.422, and 7.26±2.898, respectively; p=0.002). However, VEGF expression was not significantly different between Kebar grass extract group, green tea group, and the control (4.34±2.402, 4.57±1.998, 7.40±3.495, respectively; p=0.089). Finally, the area of the endometriotic implants of the mice models administered with all treatment was smaller than the control group (0.01±0.025 mm2, 8.76±18.776 mm2, and 34.80±13.079 mm2, respectively; p=0.003). Conclusion: Kebar grass extract, as well as green tea extract administration to endometriosis model mice, resulted in lower MDA serum level and TNF-α expression, smaller the area of endometriotic implants compared, but not resulted in a significant difference of VEGF expression

The Suppression Effect of Kebar Extract on Endometriosis Lesion MDA and TNF -a Independent to VEGF A Study in Endometriosis Mice Mode: Efek Supresi Ekstrak Kebar terhadap Lesi Endometriosis, MDA dan TNF-a, tidak Bergantung pada VEGF: Studi pada Model Tikus Endometriosis

Background: The pathogenesis of endometriosis remains unclear, and involves multifactorial etiologies. The increase in oxidative stress is known to be associated with this disease. Oxidative stress increases angiogenesis and supports the proliferation of endometriosis tissue in the peritoneal cavity. Kebar grass, a medicinal plant, is expected to increase antioxidant defense resulting in decreased oxidative stress, inflammation, angiogenesis, and reduced endometrial tissue implants. &nbsp; Objective: To investigate the effects of Kebar grass extract administration to MDA serum levels, TNF-a and VEGF expression, and the extension of the endometriotic lesions in mice model. &nbsp; Methods: This study was experimentally designed. It was conducted in the Department of Obstetrics Gynecology, Faculty of Medicine Diponegoro, University and Faculty of Veterinary Medicine, Airlangga University. Twenty-one mice were divided into three groups: the first group is control of 7 untreated endometriosis mice model, the second group consisted of 7 mice injected with leuprolide acetate 1mg/kgBB single dose, and the last group consisted of 7 mice fed with Kebar grass extract 3mg/day for 14 days. MDA serum level was measured by spectrophotometry, TNF-a&nbsp; and VEGF expression by IHC using Rammele Scale Index (ImmunoReactive Score), whereas the extension of the endometriotic lesions was measured using computerize tracing. &nbsp; Results: Both Kebar grass extract and leuprolide acetate administration significantly decrease MDA serum levels in endometriosis mice model, compare with the control group, (0.09±0.02 nmol, 0.11±0.07 nmol, and 0.30±0.06 nmol, respectively; p=0.001). TNF-α expression of the group treated with Kebar grass extract was lower than leuprolide acetate and control group (2.43±1.521 %, 4.86±0.458 %, and 7.26±2.898 %, respectively; p=0.002). However, there was no significant difference in VEGF expression among study groups (4.34±2.40 %, 5.11±1.95 %, and 7.40±3.49 % respectively; p=0.116). Finally, the extension of the endometriotic lesions of the mouse models administered with Kebar grass extract and leuprolide acetate was smaller than the control group (0 mm2, 4.54±7.75 mm2, and 34.80±13.09 mm2 respectively; p=0.005). &nbsp; Conclusion: Kebar grass extract has the effect of decreasing MDA serum levels and reducing TNF-α expression, resulted in smaller endometriotic lesions in mice, even though it does not affect VEGF expression. &nbsp; Keywords: malondialdehyde, tumour necrosis factor alpha, vascular endothelial growth factor, endometriotic lesion, kebar grass extract, endometriosis mous

Effect of Metformin on Bcl-2/Bax Expression Ratio and Endometrial Implants: A Mouse Model in Endometriosis Study

Background: Endometriosis is a gynaecological disorder characterised by the presence of endometrial tissue outside the uterine cavity. Apoptosis, regulated by the balance of Bcl-2/Bax, plays an important role in the endometrial improvement. Metformin, an insulin sensitizer that is known to have beneficial effect in the endometriosis treatment, is expected to lower Bcl-2/Bax expression ratio and reduce endometrial implants.Objective: To explore the effect of metformin on the Bcl-2/Bax expression ratio and endometrial implant area of endometriosis-induced mice.Methods: This experimental study used 3-month old 33 BALB/c mice of endometriosis that were randomly and equally divided into three groups (P0, P1, and P2). On the 15th day, the P0 group was first terminated for Bcl-2/Bax examination and the size of endometrial implants. The P1 group was given aquabidest, whereas the P2 group was given metformin 4 mg/day for 14 days. The immunohistochemistry of Bcl-2/Bax expression were performed from cavum abdomen and pelvis peritoneal tissues of the mice and measured by the Remmele Scale Index, whereas the extracted mice’ endometrial implants were analysed with computer tracing method. All data normality test was calculated with Shapiro-Wilk test. The mean difference test of all groups was analysed using the one-way ANOVA test, whereas the mean difference test between groups was completed using the Unpaired T-test (LSD/Least Significance Difference).Results: The Bcl-2/Bax expression ratio and endometrial implant area in the P2 group were significantly lower compared to P0 and P1 (p0.05)Conclusion: Metformin may be a potential effective drug treatment for endometriosis by decreasing Bcl-2/Bax expression ratio and endometrial implants

Antioxidant Herbs Supplementation Inhibits Endometriosis Extension in Mice

Background: Increased oxidative stress causes inflammation and increases angiogenesis. It presumed to promote the proliferation of endometriosis tissue. Kebar grass (Biophytum petersianum) and other herbs such as green tea and Cucumis melo, which contain high antioxidants, are expected to decrease oxidative stress, inflammation, angiogenesis, and reduced endometriosis implants.Objective: To investigate the effects of Kebar grass, green tea, and Cucumis melo to malondialdehyde serum, tumor necrosis factor alpha, and vascular endothelial growth factor expression, and the area of the endometriotic implants.Methods: Twenty-eight mice were divided into four groups, i.e., the first group of endometriosis mice was given Kebar grass extract; the second group was assigned green tea extract, the third group was given the combination of Cucumis melo extract–gliadin, and the last containing the untreated endometriosis mice as the control. Each treatment was given for 14 days. The data of MDA serum level, the area of the endometriotic implants, TNF-α, and VEGF expression were collected and analyzed.Results: The MDA serum levels of the groups treated with Kebar grass extract, green tea extract, and Cucumis melo extract – gliadin were significantly lower (p=0.001) than the control group. TNF-α expression of the groups provided with each treatment also lower than the control groups (p=0.002). However, only the administration of the Cucumis melo extract–gliadin resulted in lower VEGF expression compare with the control (p=0.017). Finally, the area of the endometriotic implants of the mice models administered with each treatment was smaller than the control group (p=0.003).Conclusion: Kebar grass as well as green tea and Cucumis melo–gliadin inhibits endometriotic implants extension by decreasing MDA serum and TNF-α expression

Rancang Bangun Mesin Sekur Klep Dengan Sistem Pneumatik

The purpose of this research is to design and create a machine that can be used in the process mensekur valve on the engine block motorcycle using pneumatic system as a clamp block engine and a driving rack and pinion steering as a function of substitute motions human hand so it can be set up and operated automatic in order to penyekuran saves time, because the process of manually penyekuran usual can take a long time about 90 minutes. How to operate the machine sekur valve by using the development of electoral observation in the form of alternative designs, design, manufacturing, assembly up until the testing process and data retrieval. Results of machinery sekur valve with pneumatic system can repair a valve leak on a motorcycle with penyekuran process an average of 7 minutes.Keywords: Sekur valve, engine block, motorcycle, and pneumatic

Optimizing Virtual Resources Management Using Docker on Cloud Applications

This study aims to optimize servers with low utility levels on hardware using container virtualization techniques from Docker. This study's primary focus is to maximize the work of the CPU, RAM, and Hard Drive. The application of virtualization techniques is to create many containers as each of the containers is for the application to run a cloud storage system with the CaaS service infrastructure concept (Container as a Service). Containers on infrastructure will interact with other containers using configuration commands at Docker to form an infrastructure service such as CaaS in general. Testing of hardware carried out by running five Nextcloud cloud storage applications and five MariaDB database applications running in Docker containers and tested by random testing using a multimedia dataset. Random testing with datasets includes uploading and downloading datasets simultaneously and CPU monitoring under load, RAM, and Disk hardware resources. The testing will be done using Docker stats, HTOP, and Cockpit monitoring tools to determine the hardware capabilities when processing multimedia datasets