DIFFERENCES OF MASS AND DIAMETER MUSCLE RATTUS NORVEGICUS IN GIVING KETOGENIC DIETS AND EXERCISE

Introduction: Saturated ketogenic diet without exercise can lead to muscle mass decrease and disturb body metabolism. Therefore, the researcher is interested in discovering the differences between a saturated and unsaturated ketogenic diet with exercise to muscle mass and diameter. Purpose: This study aimed to analyze the difference in muscle mass and diameter of Rattus norvegicus, which were given a ketogenic diet and exercise. Method: This experimental research used Rattus norvegicus that had been adapted for two weeks. Rats are divided into five groups; control (K), a saturated ketogenic diet (P1), a saturated ketogenic diet with exercise (P2), an unsaturated ketogenic diet (P3), and anunsaturated ketogenic diet with exercise (P4). Upright running wheel exercise was given to the group with exercise for 10 minutes daily. The ketogenic diet was given with oral gavage. Muscle mass was examined in the second and fourth weeks. Muscle diameter was examined before treatment, second week, and fourth week. Results: There are differences in mass and diameter muscle Rattus norvegicus that givenketogenic diet and exercise (p=0,000). In second week, there are significant increase inmuscle diameter for saturated ketogenic diet without exercise (P1(p=0,000)) and significantdecrease in muscle diameter for three other group (P2(p=0,000), P3(p=0,001), P4(p=0,000)). In the fourth week, there is a significant increase in muscle diameter for an unsaturated ketogenic diet with exercise (P4). Conclusion: An unsaturated ketogenic diet with exercise could increase the mass anddiameter of quadriceps muscle at the end of this research.

DIFFERENCE OF BREAST CANCER ESTROGEN RECEPTOR (ER) BETWEEN OBESE PRE-MENOPAUSE WOMEN AND OBESE POST-MENOPAUSE WOMEN

Background: One of the risk of breast cancer is Obesity (BMI > 23Kg/m2) related to estrogen production between pre-menopause and post-menopause.Aim: To investigate the difference of breast cancer estrogen receptor (ER) in obese women based on menopausal status.Methods: This study was retrospective cross-sectional from secondary data (Medical Records) from Poliklinik Onkologi Satu Atap (POSA) RSUD Dr. Soetomo (ICD-10 C50) from 2013-2017 with inclusion criteria was BMI >23Kg/m2. Data were analyzed using Chi-Square.  Results: There were 138 patient medical records collected which is 63 were obese pre-menopause and 75 were obese post-menopause. There were statistically a significant difference (p<0,05) based on Chi square test of breast cancer estrogen receptor for obese post-menopause women (66,7%) to obese pre-menopause (39,7%). Obese post-menopause women have 1,68 times greater risk factor to become estrogen receptor positive (ER+) compared to obese pre-menopause women. (PR = 1,68; 95% CI = 1,191-2,370)  Conclusion : There is a significant difference of breast cancer estrogen receptor in obese post-menopause women more frequent than obese pre-menopause women

Pengaruh kualitas layanan dan medical expenses terhadap kepuasan pasien pada pusat kesehatan masyarakat (Puskesmas) Cimahi Tengah

This study aimed to analyze the effect of service quality and medical expenses on patient satisfaction at the Community Health Center (Puskesmas) in Central Cimahi, West Java. This research was conducted using quantitative methods with a descriptive verification approach. The population in this study were patients at the Cimahi Tengah Health Center in 2020, and the number of samples taken was 100 respondents. The questionnaire in this study was measured using a Likert scale to determine respondents' perceptions of service quality, medical expenses, and the satisfaction they felt. The data obtained were processed using multiple regression analysis with SPSS 23 software. The results of this study indicate that there is a positive effect of service quality and medical expenses on patient satisfaction at the Cimahi Tengah Health Center. The findings of this study can provide views for managers, doctors, nurses, and health workers, especially those at the Cimahi Tengah Health Center, so that patient satisfaction can be further improved

ASSOCIATION BETWEEN DIABETES MELLITUS AND OCULAR ANTERIOR SEGMENT MANIFESTATIONS IN COVID-19 PATIENTS

Background: COVID-19 is an acute respiratory disease caused by the infection of SARS-CoV-2, which was also found to have ocular manifestations. In the previous study, SARS-CoV-2 was found in patients' conjunctival swabs and tear specimens. The SARS-CoV-2 binding sites were found on the conjunctiva and cornea of the eye. Diabetes mellitus is one of the most common comorbidities found in COVID-19 patients, at the same time, hyperglycemia in diabetes mellitus increases the risk of eye infections. This study aims to determine the association between diabetes mellitus and anterior segment ocular manifestations in COVID-19 patients.Methods: This research is an observational analytic cross-sectional study. Anterior segment ocular manifestations data were collected by patient-reported questionnaire due to high infection risk.Results: In the total of 169 COVID-19 patients in this study, 35 patients (20,7%) experienced anterior segment ocular manifestations, 50 patients (29,6%) had diabetes mellitus, and 12 patients (7,1%) experienced both. The most common ocular manifestations experienced were watery eyes (34,3%), red eyes (20,0%), and blurred vision (20,0%), as well as other complaints in the form of discharge from the eyes, itching, burning, foreign body sensation, pain, and glare at the light. While 12 of 50 diabetes mellitus patients (24%) had anterior segment ocular manifestations, 23 of 119 patients without diabetes mellitus (19.32%) experienced similar conditions. The results of data analysis with Chi-Square (p≥0.05) showed no significant association.Conclusions: There is no association between diabetes mellitus and anterior segment ocular manifestations in COVID-19 patients

THE RELATIONSHIP BETWEEN THE LEVEL OF ANXIETY AND THE INCIDENCE OF DYSPEPSIA SYNDROME AMONG THE STUDENTS OF THE FACULTY OF MEDICINE AT WIDYA MANDALA CATHOLIC UNIVERSITY SURABAYA

Background: Students’ anxiety results from multiple demands placed on them as medical students. Anxiety affects the body's functional systems, including the gastrointestinal system. Dyspepsia syndrome is one of the common symptoms.Objective: To determine whether there is a relationship between anxiety levels and dyspepsia syndrome among students at Widya Mandala Catholic University of Surabaya’s Medical Faculty.Methods: This research is an observational analytic study with a cross-sectional research design. The subjects are obtained using purposive sampling methods from the forces of 2018, 2019, 2020, and 2021. This research uses HARS questionnaires to measure anxiety levels and Rome III criteria to measure dyspepsia syndrome. Statistical analysis is performed by using Pearson Chi-Square.Result: Anxiety levels have a strong, substantial correlation with the incidence rate of dyspepsia syndrome (p=0.000). It is found that there are 4 out of 17 students (23.53%) with mild anxiety have dyspepsia syndrome, 44 out of 55 students (80%) with mild–moderate anxiety have dyspepsia syndrome, and 7 out of 8 students (87.5%) with moderate–severe anxiety have dyspepsia syndrome.Conclusion: There is a significant relationship with a positive correlation, so it can be concluded that if the level of anxiety is higher, the greater the prevalence of dyspepsia syndrome

The Role Of Rose (Rapid Onsite Evaluation) On Spinal Lesion Surgery Decision

Introduction: Exposure and instrumentation of the spine must be meticulous and thorough regardless the techniques and approach selected. Management of the whole surgery process should be decided based on the best available evidence whenever possible. ROSE (Rapid Onsite Evaluation) cytology wrap up the surgical decision. Case Description: Fifteen cases comprise of lytic lesions and/or single pathological fractures of the corpus vertebrae will be presented and discuss as to how the surgical techniques and approaches are assisted by ROSE. ROSE cytology was performed in the operating theater during the surgery. Samples were taken after exposure of the minimal lesion using (18–21) G trocar needle or under fluoroscopy guided. Direct smear, air dried fixation, and Diff Quik staining would take about 10 minutes. Pathologist evaluated the specimen and provided the result in about 20 minutes. The overall 30 minutes allowed surgeon to prepare the further steps. Results would be malignant or benign without pursuing further detail diagnostic. Benign results should be categorized as infection, suspicious of granulomatic tuberculosis, or normal host population cells. The cases outcome were 8 normal host population cells advanced for vertebroplasty to fill the porotic bone. Three spondylitis tuberculosis were debrided without unnecessary instrumentation, and four malignant processes were assured to have enough samples for immunohistochemistry evaluation afterward. All ROSE cytology was confirmed accordingly by the histopathology result afterward. Conclusion: ROSE is easy and offers accurate sampling from the lesion itself. It is quick, therefore during surgery surgeon could decide the best management for the patient

Do Age and Co-morbidy, Among other Factors, affect Length of Hospital Stay following Total Knee Arthroplasty

Introduction: The only treatment for grade IV knee osteoarthritis is total knee arthroplasty (TKA) irrespective of the age of the patient. Most of the grade IV OA patient are elderly and most likely to have some comorbidities. Age and comorbidities are the major reasons for patient’s reluctance to undergo TKA. A clinical pathway with standard length of stay (LOS) could justify the patient’s hesitation for TKA. The aim of this study was to determine the factors, including age and comorbidity, that affect the LOS of patients treated with TKA. Materials and Methods: This is a retrospective study of TKA patients in Surabaya Orthopedics and Traumatology Hospital from January 2011 to July 2017. Preoperative comorbidities were scored using Charlson Comorbidity Index (CCI) and physical status by ASA (American Society of Anesthesiologist), classification for age, sex, BMI, blood loss, operation time, method of anaesthesia and postoperative day of rehabilitation were recorded as factors potentially affecting LOS. The discharge criteria for the patients were ability to ambulate to the bathroom and clean operative wound with no complications. The data obtained were analysed statistically. Results: The average LOS was 5.58 days, ranging from three to eight days. There were no demographic factors that affected the patients’ LOS. BMI, ASA, CCI, and blood loss did not significantly affect LOS. Operation time was between 90-140 minutes, and spinal anaesthesia showed significant longer LOS, but within the average. Conclusion: Age and comorbidity did not affect length of stay in TKA patients

Effect of Polymethylmethacrylate-Hydroxyapatite Composites on Callus Formation and Compressive Strength in Goat Vertebral Body

Introduction: Percutaneous vertebroplasty (PV) is one of the available treatments for vertebral compression fracture (VCF). Polymethylmethacrylate (PMMA) is the most common bone substitute used in the procedure, but it has several disadvantages. Bioceramic material, such as hydroxyapatite (HA), has better biological activity compared to PMMA. The aim of this study was to find an optimal biomaterial compound which offers the best mechanical and biological properties to be used in PV. Materials and Methods: This was an experimental study with goat (Capra aegagrus hircus) as an animal model. The animals’ vertebral columns were injected with PMMA-HA compound. Animal samples were divided into four groups, and each group received a different proportion of PMMA:HA compound. The mechanical and biological effects of the compound on the bone were then analysed. The mechanical effect was assessed by measuring the vertebral body’s compressive strength. Meanwhile, the biological effect was assessed by analysing the callus formation in the vertebral body. Results: The optimal callus formation and compressive strength was observed in the group receiving PMMA:HA with a 1:2 ratio. Conclusion: A mixture of PMMA and HA increases the quality of callus formation and the material’s compressive strength. The optimum ratio of PMMA:HA in the compound is 1:2

A Comparison of Osteoblast Cell Proliferation and Osteocalcin Expression in Cuttlefish Bone and Bovine Bone Xenograft

Background: Cuttlefish bone Xenograft, calcium phosphate (CaP)-based biomaterial graft, offers an alternative and has been accepted for osteoconductive and probable osteo-inductive attributes. This study aims to compare the bone healing potential between the bovine-derived (BHA) and cuttlefish bone-derived (CHA).Materials and Methods: The study compared osteoblast cell proliferation of 27 New Zealand rabbits in 2.5 mm bone defect made in the femoral bone. The samples were divided into three groups, which were control, BHA and CHA group. The chemical and physical characteristics of BHA and CHA were determined for the content of hydroxyapatite by FourierTransform Infrared Spectroscopy (FTIR) and X-Ray Diffraction (XRD), then tested by Scanning Electron Microscopy (SEM) to evaluate the porosity. In the end of the second week, histopathologic and immunohistochemistry examinations were performed to evaluate the amount of osteoblast and osteocalcin expression.Results: The FTIR, XRD and SEM analysis showed both BHA and CHA samples were hydroxyapatite according to Joint Committee on Powder Diffraction Standards (JCPDS). The CHA was significantly higher (297.22±19.772) compared to BHA (258.22±30.926) and control (131.67±34.213). Osteocalcin expression in CHA (7.82±2.230) compared to BHA (6.09±3.724) and control (4.07±3.606), was not significant (p>0.05). Conclusion: CHA group has the highest osteoblast cell proliferation and osteocalcin expression, meaning has a good potential as future source of bone graft.Keywords: cuttlefish bone, bovine, bone graft, osteoblast cel