Background In 2013, the prevalence of stunting in Central Sulawesi province was 41%, which was higher than the national prevalence of 37.2%. Complementary feeding practice, infectious disease, history of exclusive breastfeeding, birth weight and birth length were assumed to contribute to the prevalence of stunting. The objective of the present study was to identify the risk factors for stunting among children aged 12 to 24 months. Methods This study was conducted using a case control design. Subjects were children aged 12-24 months, consisting of 58 cases and 58 controls. Data were obtained with a body length infantometer. Data on complementary feeding practices, history of exclusive breastfeeding, and history of infectious diseases were obtained using questionnaires. Nutrient intakes were measured by semi quantitative food frequency questionnaires. Data on birth weight and birth length were obtained from the buku KIA (maternal and child health record). Data were analyzed by chi-square and logistic regression tests. Results There was no difference in sex, BMI, and parental education between cases and controls (p>0.05). After controlling for history of exclusive breastfeeding and birth weight, the risk factors for stunting were inappropriate complementary feeding practice in terms of quantity and quality (OR=8.26; 95% CI: 2.69-25.44), history of diarrhea (OR=4.73; 95% CI: 1.08-20.69), birth length (OR=5.11; 95% CI: 1.69-15.46) and respiratory tract infection (OR=5.30; 95% CI: 1.03-27.23). Inappropriate complementary feeding practice was the most dominant factor for stunting. Conclusion Inappropriate complementary feeding practice increased the risk of stunting in 12-24 months old children by 8.26. This study confirms the need to scale up interventions during the first 2 years of life, including appropriate infant feeding practices.

Background Epithelial ovarian cancer (EOC) is one of the most common cancers diagnosed in Indonesian women. A combination of paclitaxel and carboplatin is used to treat EOC as standard chemotherapy which is known to have hematologic toxicities. This study aimed to investigate the effect of combined paclitaxel-carboplatin chemotherapy on hematologic status in EOC patients managed at Dr. Hasan Sadikin General Hospital, Bandung, West Java. Methods All patients with confirmed pathological diagnosis of EOC at Dr. Hasan Sadikin General Hospital in the period of 2013 to 2014 were registered. Only patients with complete hematologic data before and after chemotherapy were collected and compared using the paired non-parametric Wilcoxon and McNemar tests. Results In total there were 147 patients with EOC (median age 46 ± 12 years), with the most dominant pathological diagnosis of mucinous (32.7%) and serous (29.3%) types. Only 33 patients had hematologic data before the initiation of chemotherapy. There was a significant decrease after chemotherapy including hemoglobin level (12.0 vs 10.9 g/dL, p=0.013), erythrocyte count (4.53 vs 3.74 million/mL, p<0.001), leukocyte count (7,700 vs 4,000/mm3 p<0.001) and platelet count (343,000 vs 215,000/mm3, p<0.001). Interestingly, anemia cases after chemotherapy were predominant (87.9%) compared with erythopenia, leukopenia, thrombocytopenia i.e. 39.4%, 57.6%, and 27.3% respectively. Conclusions This study confirmed the hematologic toxicities after paclitaxel-carboplatin chemotherapy in EOC patients treated in Hasan Sadikin General Hospital, West Java. The hemoglobin concentration may serve as prognostic factor. Further studies directed to other factors such as genetic factor for polymorphisms may be encouraged to explore the decrease of the hematologic indices.

User You are logged in as... ritahema0404 My Profile Log Out Vol 35, No 3 (2016) Accreditation Journal Content Search Search Scope Browse By Issue By Author By Title Information For Readers For Authors For Librarians Font Size Make font size smaller Make font size default Make font size larger For Authors mev journal template Journal Statistics hit counter View My Stats Home About User Home Search Announcements Authors Reviewers Editorial Board Contact Us Publication Ethics Home > Vol 35, No 3 (2016) > Endeshaw Family history of hypertension increases risk of preeclampsia in pregnant women: a case-control study Mulualem Endeshaw, Fantu Abebe, Melkamu Bedimo, Anemaw Asrat, Abebaw Gebeyehu, Alemayehu Keno Submission date: Tuesday, 27 September 2016 Published date: Thursday, 01 December 2016 DOI: http://dx.doi.org/10.18051/UnivMed.2016.v35.181-191 Abstract Background Preeclampsia is one of the leading causes of maternal and fetal morbidity and mortalities worldwide. Despite extensive research, the underlying cause of preeclampsia remains poorly understood. This study aimed to offer compelling evidence on the important risk factors of preeclampsia in Amhara region, Ethiopia. Methods A case control study was conducted in public health facilities of Bahir Dar city from September 2014 to January 2015. A total of 453 (151 cases and 302 controls) pregnant women were enrolled in this study. Hemoglobin level and urinary tract infection (UTI) status were collected from clinical notes. Oral examination was performed by a dentist for detection of periodontal diseases. Univariate and multiple logistic regression analysis was conducted to determine the relationship of all the independent variables with the outcome variable. A p-value <0.05 was declared statistically significant. Result Advanced maternal age (AOR=4.79;95% CI 1.031-22.18), family history of hypertension (AOR=11.16;95% CI 5.41-41.43), history of diabetes mellitus (AOR=6.17;95% CI 2.11-20.33), UTI in the current pregnancy (AOR=6.58;95% CI 2.93-14.73), failure to comply with iron and folic acid supplement during pregnancy (AOR=8.32;95% CI 3.35-20.62), lack of exercise (AOR=3.33;95% CI 1.35-8.17), multiple pregnancy (AOR=4.05;95% CI 1.57-12.27), anemia (AOR=4.19;95% CI 1.27-13.92), and periodontal disease or gingivitis (AOR =3.51;95% CI 1.14-10.83) were associated with preeclampsia. Conclusion Family history of hypertension was the most dominant risk factor for preeclampsia in pregnant women. Encouraging pregnant women to have health seeking behavior during pregnancy would provide a chance to diagnose preeclampsia as early as possible.

Background Preeclampsia is one of the major contributors to maternal and fetal morbidity and mortality. Imbalance of soluble Fms-like tyrosine kinase (sFlt-1) as anti-angiogenic factor and vascular endothelial growth factor (VEGF) as pro-angiogenic factor plays a role in the pathogenesis of preeclampsia. Endothelial dysfunction in preeclampsia causes vascular cell adhesion molecule-1 (VCAM-1) to be expressed on its surface. This study aims to evaluate the effect of recombinant VEGF-121 on VCAM-1 expression in the placenta of a murine preeclampsia model. Methods An experimental analytical study conducted from February until March 2016 in the Biomedical Laboratory, Faculty of Veterinary Medicine, Airlangga University. The study sample consisted of 30 pregnant mice, divided into three groups, i.e. 10 normal pregnant mice, 10 mice with preeclampsia model and 10 mice with preeclampsia model and recombinant VEGF-121 therapy. All animals were subjected to immunohistochemical examination of VCAM-1 expression in their placentas. The results were assessed semiquantitatively according to a modified Remmele method. Data analysis was done using one-way ANOVA and Tukey’s multiple comparisons method. Results Mean VCAM-1 expression in normal (0.97 ± 0.54%) murine placentas, compared with placentas (2.94 ± 0.96%) of murine preeclampsia models (p=0.000), while mean VCAM-1 expression in placentas of murine preeclampsia models with VEGF intervention was 2.14 ± 0.68% (p=0.030). Conclusion Recombinant VEGF-121 can reduce VCAM-1 expression in placentas of murine preeclampsia models. The present study has shown the potential benefits of VEGF therapy, justifying serious consideration of this therapeutic approach for use in women with preeclampsia.

Background Cerebral malaria is a severe form of malaria caused by brain ischemia. Artesunate, an artemisinin derivative, is the standard WHO therapy for severe malaria. Tinospora crispa (brotowali) is a traditional plant with antiinflammatory, antioxidant and antiparasitic properties. The aim of this study was to determine the effect of combinations of artesunate and T. crispa extract on nuclear factor kappa-B (NFêB) and intercellular adhesion molecule-1 (ICAM-1) expression in the brain of mouse malaria models. Methods This was an experimental post-test only control group study using C57BL/6J mice infected with Plasmodium berghei, divided into 7 groups: negative control, positive control, group receiving artesunate 32 mg/kgBW, group receiving tinospora extract 3.5 mg/kgBW, and three groups receiving combinations of artesunate 32 mg/kgBW and tinospora extract 2.5 mg/kgBW, 3 mg/kgBW and 3.5 mg/BW, respectively. The expression of NFêB and ICAM-1 was measured by immunohistochemistry. One-way ANOVA was used to analyze the data. Results NFkB and ICAM-1 expression increased significantly in the positive controls compared to all other groups (p=0.000). NFkB expression was significantly lower in the groups receiving artesunate and tinospora at 3 mg/kgBW and 3.5 mg/kgBW, as compared with the artesunate only group (p=0.003; p=0.005) and the tinospora extract only group (p=0.001; p=0.003). NFkB expression in all combination treatment groups was similar to that in the negative controls (p>0.05), whereas ICAM-1 expression did not differ between single and combination treatment groups (p>0.05). Conclusion The combination of artesunate and T. crispa extract is better in decreasing NFêB and ICAM-1 expression in the brain of mouse malaria models.

Background Stunting in children is caused by past nutritional problems, adversely affects the physical and mental characteristics of children and is a well-established child-health indicator of chronic malnutrition. Socio-cultural factors can affect parenting, thereby indirectly affecting child growth. The objective of this study was to determine socio-cultural factors and parental short stature as risk factors of stunting in children aged 2 to 5 years. Methods The study used a quantitative approach with case control design and a qualitative approach with in-depth interview. The study subjects were children aged 2-5 years, consisting of 45 cases of stunting and 45 controls (normal subjects). Socio-cultural data were obtained through interviews with the mothers, while height was measured with a stadiometer. Data were analyzed using chi square and logistic regression tests to calculate the odds ratio (OR). Results The logistic regression test showed that maternal perception of sickness as a curse (OR=7.43; 95% CI: 2.37-23.21), stopping breastfeeding at <24 months (OR=6.01;95% CI: 1.83-19.69) and low household expenditure for food (OR=5.78;95% CI: 1.28-26.01) were risk factors of stunting incidence with a probability of 73.8%. The most dominant risk factor of stunting was maternal perception of sickness (OR=7.43 95% CI: 2.37-23.21). Conclusion Maternal perception of sickness was the most dominant risk factor of stunting in children 2-5 years of age. A multidisciplinary approach is needed to address the range of raised issues and so combat stunting in children.

Background Soil-transmitted helminth (STH) infection can cause malnutrition and vice versa, and decrease serum zinc concentrations. No previous studies were found on the effect of STH treatment on serum zinc concentrations in elementary school children. The objective of this study was to evalaute the effect of STH treatment on serum zinc concentration in elementary school children in Jakarta. Methods A pre-experimental study (one group pre and post) was conducted on 3rd - 5th grade students in one elementary school in North Jakarta. FLOTAC examination was used to determine infection status and STH intensity, while serum zinc concentrations were measured by atomic absorption spectrometry. All children were given albendazole 400 mg for three consecutive days. Stool and blood samples were collected before and three weeks after treatment with albendazole. A paired t test was used to analyze the data. Results The STH prevalence was 63.4%; these were mainly Ascaris lumbricoides and Trichuris trichiura infections. Before treatment, children infected with A.lumbricoides and T.trichiura had significantly higher serum zinc concentrations (p=0.028; p=0.014). After treatment, children with A.lumbricoides had significantly lower serum zinc concentrations (p=0.039), while children with T.trichiura had slightly lower serum zinc concentrations (p=0.659) than before treatment. Conclusions Albendazole treatment produces lower serum zinc concentration in elementary school children with A.lumbricoides infections. A profound understanding of the interaction between helminth infections and zinc may assist in guiding integrated and sustainable intervention strategies among affected children throughout the world.

Background Rupture and bleeding from esophageal varices are major complications of portal hypertension and associated with a high mortality rate. Non-invasive serum markers of liver fibrosis could be used as predictors of esophageal varices in cirrhotic patients. The objective of this study was to assess the performance of Forns index as a noninvasive predictor in diagnosing esophageal varices. Methods A cross-sectional study was done in 51 cirrhotic patients who were admitted to Adam Malik hospital, Medan. Demographic and clinical data were recorded and laboratory tests were performed, so that Forns index could be calculated. The difference between Forns index and size of esophageal varices as determined by endoscopy was tested by independent-t and Mann-Whitney analysis. The diagnostic performance was assessed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, likelihood ratios and areas under the receiver operating characteristic curves (AUROC). Results Of the 51 patients with esophageal varices included in this study, the size of esophageal varices comprised F2 (37.3%), F3 (33.3), and F1 (29.4%). Most patients were of Child-Plug C type (52.6%). There was a significant difference between Forns index and grade of esophageal varices. The AUROC for Forns index was 0.717 (95% CI: 0.561 - 0.872) and the cut-off >7.92 was highly predictive to diagnose large esophageal varices with a sensitivity of 63.9%, specificity of 73.3%, PPV of 85.2%, NPV of 45.8% and accuracy of 71.7%. Conclusion Forns index was significantly increased in large esophageal varices. Forns index is a good noninvasive predictor of esophageal varices in cirrhotic patients.

Background One of the extra-skeletal roles of vitamin D for health is associated with cardiovascular disease. Poor vitamin D status has been associated with vascular endothelial dysfunction. There were controversial results about the association between vitamin D deficiency and matrix metalloproteinase 9 (MMP-9) concentration. The purpose of the present study was to determine the concentrations of 25(OH) vitamin D [25(OH)D] in an elderly population and to find any association between 25(OH)D and MMP-9 concentrations. Methods This study was of cross-sectional design involving 160 male and female subjects aged 55–65 years, in South Jakarta, Indonesia. Determination of MMP-9 and 25(OH)D concentrations was done concurrently on subjects who met the inclusion and exclusion criteria after all study subjects had been selected. 25(OH)D and MMP-9 concentrations were assessed by direct competitive chemiluminescence immunoassay (CLIA) and enzyme-linked immunosorbent assay (ELISA) respectively. Statistical analysis used chi square and t tests. Results Mean 25(OH)D concentration in the study subjects was 14.4 ± 6.4 ng/mL. A total of 68.8% of subjects had a 25(OH)D level of <20 ng/mL, and 31.2 % had a 25(OH)D level of >20 ng/mL.There was an increased MMP-9 concentration in male subjects with a 25(OH)D level of <20 ng/mL compared with subjects with 25(OH)D level of >20 ng/mL (p=0.011), but not among female subjects (p=0.809). Conclusion The MMP-9 concentration was increased among male subjects with low level of (OH)D. This study confirmed that 25(OH)D concentration may have a potential role in endothelial function.

Background Dengue fever (DF) and dengue hemorrhagic fever (DHF) are differentiated by the occurrence in DHF of plasma leakage into the interstitial space as shown by pleural and peritoneal effusion, hemoconcentration, and intravascular hypovolemia. Perfusion dysfunction causes anaerobic metabolism, which leads to increased serum lactate. This study was to determine serum lactate as prognostic predictor and diagnostic biomarker of plasma leakage in adult dengue patients. Methods A cross-sectional retrospective cohort study was conducted on 57 adult dengue patients hospitalized in the internal medicine ward of Cipto Mangunkusumo Hospital and Persahabatan Hospital in Jakarta. Serum lactate was examined to determine its mean difference between DF and DHF. The data was analyzed by independent t-test and the cut-off points were identified for presence as well as absence of plasma leakage, then the receiver operating characteristics (ROC) curve was used to determine sensitivity and specificity. Results Mean serum lactate was significantly higher in DHF than in DF. From the ROC curve, the cut-off point for serum lactate as prognostic predictor on day 3 of fever was ³2.65 mmol/L with AUC of 0.626 (95% CI 0.480-0.772; p=0.108). The cut-off point for diagnostic biomarker of plasma leakage on day 5 of fever was ³2.55 mmol/L with sensitivity 66.6%, specificity 54.2%, and AUC 0.668 (95% CI 0.550-0.826; p=0.016). Conclusion There was a significant difference in serum lactate between DF and DHF. In the critical phase, serum lactate of ³2.55 mmol/L could be used as plasma leakage diagnostic marker of low accuracy.