JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia

In vitro evaluation of antibacterial activity of Annona squamosa Linn leaf extract against Escherichia coli

2024-03-07T00:30:29+00:00

Background. Escherichia coli is normal bacterial flora that located in the lower gastrointestinal tract. Most of Escherchia coli strains are harmless, however some of them can cause mild infection until severe life-threatening complication. Recently, it has been reported that rapidly rising antibiotics resistance on this bacteria because the relatively high use of antibiotics. Therefore, new innovations are needed to reduce the increasing number of antibiotic resistant bacteria. One of them is by using medicinal plants that has antimicrobial activity. Flavonoids, alkaloids, tannins, and terpenoids contents on Annona squamosa L. leaf extract have been proved potentially as antibacterial. Objectives. This study aimed to evaluate the potential activity of Annona squamosa L. ethanolic leaf extract against the growth of Escherichia coli bacteria. Methods. This is an experimental laboratory study using the agar well diffusion method in the Microbiology Laboratory, Faculty of Medicine, University of North Sumatra. The fresh leaves of Annona squamosa L. were extracted by maceration method using the 96% ethanol. The various concentration of the extract (6.25%, 12.5%, 25%, and 50%) were added to Muller Hinton agar that already applied with 24-hours old culture of Escherichia coli ATCC 25922, with gentamicin as positive control and DMSO as negative control. Results. The diameters of the inhibition zone with concentrations of 6.25%, 12.5%, 25%, 50% Annona squamosa L. leaf extract consecutively 5,525 0,450 mm, 6,275 0,350 mm, 6,525 0,471 mm, 7,925 1,072 mm. Conclusion. In conclusion, the ethanolic leaf extract of Annona squamosa L. has antibacterial activity against Escherichia coli.

HUBUNGAN LAMA MENDERITA DIABETES MELITUS DENGAN DERAJAT RETINOPATI DIABETIK DI RUMAH SAKIT MATA SMEC MEDAN KLINIK EKSEKUTIF

2024-03-07T00:30:31+00:00

ABSTRACT

Diabetic Retinopathy is an important long-standing complication of Diabetes Mellitus. It is caused by high incidence and it’s worse prognosis i.e actuity visual loss such as blindness.The objective of the study is to find the relation duration endure of diabetic to the severity of Diabetic Retinopathy at Rs Mata SMEC Medan Klinik Eksekutif.

The study involved 51 patients were recorded as a patient in hospital SMEC Eye Clinic Medan Medan. Analyzed using chi-squar.The results showed that there was a significant relationship duration endure of diabetic with the degree of diabetic retinopathy, with a value of p = 0.002 (p> 0.05). This means that the longer a person suffering from diabetes melitus is increasingly at risk of increasing the degree of diabetic retinopathy.

Keywords : duration of diabetic, degree of diabetic retinopathy.

Potensi Pemanfaatan Serum Mir 122-5p Sebagai Biomarker Dalam Deteksi Dini Infark Miokard Akut Pada Pasien Lanjut Usia

2024-03-07T00:30:29+00:00

Acute myocardial infarction is the first manifestation of CAD which is the leading cause of death worldwide. The increasing incidence is often associated with increasing age where eldery are mostly affected with this disease. Although there are several biomarkers such as troponin I and T in detecting the risk of developing AMI, it has been found that populations over 70 years have elevated troponin I levels and increased troponin T levels in non-AMI cases. Because of that, a specific biomarker that can specifically detect AMI is needed. This literature review is aimed to discuss the possibility by using miR-122-5p serum for specific biomarker in detecting AMI in eldery population. The literature search was conducted based on journal searching related to the topic such as, PubMed, Science Direct, and Google Scholar. Based on the literature research we have done and our topic, we have obtained the results as follows. Pathogenesis of AMI, the underlying mechanism of miR-122-5p in association with AMI, the specificity of miR-122-5p for AMI, and the comparison of miR-122-5p with other AMI biomarkers. From the pathogenesis of AMI, we have obtained the basis of the disease, the underlying mechanism explains the potential relation to AMI and the detection, through the specificity we can see how it may be effective as a biomarker, and the comparison may reveal it’s potential and how it compares to other biomarkers.

Potensi Pemanfaatan Myeloid Leukemia 1 (MCL-1) Inhibitor Melalui Jalur Apoptosis Intrinsik pada Terapi Metastatic Castration-Resistant Prostate Cancer (mCRPC) : Sebuah Tinjauan Pustaka

2024-03-07T00:30:31+00:00

Pendahuluan: Kanker prostat merupakan penyakit yang menyerang pria dengan prevalensi tertinggi ke-2 serta penyebab kematian ke-5 dengan perkiraan mencapai 1,4 juta kasus dan mortalitas berjumlah 375.000 di seluruh dunia. Terdapat 112 dari 185 negara melaporkan kejadian kanker prostat. Di Indonesia jumlah kasus kanker prostat mencapai 13.563 jiwa. Data menunjukkan bahwa 10-20% pasien dengan metastatik kanker prostat mengembangkan metastatic castration-resistant prostate cancer (mCRPC) selama 5 tahun serta memiliki keberlangsungan hidup sekitar 14 bulan. Namun belum terdapat terapi yang efektif dalam kasus mCRPC. Dengan adanya potensi yang dimiliki oleh Myeloid Leukemia 1 (MLC-1) inhibitor yang menargetkan langsung pada jalur intrinsik apoptosis sehingga bisa menekan anti-apoptosis sel dapat dijadikan inovasi terapi pada mCRPC.

Metode: Kajian literatur yang bersumber dari Google Scholar, Pub Med, Science Direct. Tahapan pemilihan artikel yaitu identifikasi, skrining serta kesesuaian terhadap variabel inklusi dan eksklusi sehingga didapatkan 11 artikel.

Pembahasan: Pemanfaatan potensi MCL-1 sebagai terapi mCRPC tentunya membutuhkan senyawa yang akan bekerja sebagai inhibitor protein anti-apoptosis MCL-1. Senyawa-senyawa tersebut memiliki jalur inhibisi yang berbeda-beda untuk dapat menurunkan MCL-1. Berbagai penelitian in vitro dan in vivo menjelaskan mekanisme senyawa yang berpotensi menjadi MCL-1 inhibitor melalui berbagai metode untuk membuktikan bahwasannya senyawa tersebut dapat menurunkan protein anti-apoptosis MCL-1 sehingga menghasilkan efek terapeutik terhadap mCRPC.

Simpulan: Dengan demikian, MLC-1 inhibitor diharapkan dapat menjadi sebuah inovasi dalam pengobatan terapi bagi pasien mCRPC dengan hasil yang lebih baik dan memuaskan.

BEDAQUILINE AS A MANAGEMENT OF MULTIDRUG-RESISTANT TUBERCULOSIS (MDR-TB): A SYSTEMATIC REVIEW AND META ANALYSIS

2024-03-07T00:30:32+00:00

ABSTRAK

Background: MDR TB is TB that is resistant to at least 2 types of first-line anti-tuberculosis drugs, namely isoniazid and rifampicin. Treatment requires a longer duration and is accompanied by worse side effects, high costs, and logistical constraints. Bedaquiline (BDQ) is a diarylquinoline compound which exhibits earlier culture conversion and minimal side effects, compared to other MDR TB drugs, making it possible to eliminate adherence problems in MDR TB patients. This meta-analysis aims to assess the effect of BDQ administration on MDR TB patients and other related aspects.

Methods: Systematic studies were carried out following the PRISMA rules using online databases, namely PubMed, ScienceDirect, and Cochrane. Studies assessing the effect of BDQ in MDR TB patients and compliance with inclusion criteria were included in this systematic review. The risk of bias of each inclusion study was assessed using the CONSORT, TREND and STROBE criteria. Meta-analysis with the fixed-effects method was then performed to obtain the combined Mean Difference (MD) of all inclusion studies along with the 95% Confidence Interval (CI).

Discussion: 17 studies involving 2454 patients were included in this systematic review. It was found that administration of BDQ in MDR TB patients increased the likelihood of conversion culture becoming negative with an RR of 1.39 (95% CI = 1.26-1.53 ; I2 = 29% ; p <0.00001), and decreased the likelihood of relapse with RR of 0.40 (95% CI = 0.21-0.75 ; I2 = 0% ; p = 0.004) significantly compared to the control group. As well as being able to reduce the death rate from MDR TB.

Conclusions: BDQ administration showed a positive effect on the possibility of earlier culture conversion, the possibility of relapse, and the mortality rate

POTENTIAL UTILIZATION OF SOLID LIPID NANOPARTICLES AS A SOLUTION TO OPTIMIZE THE BIOAVAILABILITY OF ANTIDEPRESSANT DRUG SSRI IN IMPROVING THE EFFECTIVENESS OF DEPRESSION TREATMENT: A LITERATURE REVIEW

2024-03-07T00:30:33+00:00

Background: Currently, more than 264 million people globally suffer from major depressive disorder. Pharmacological treatments that are the main choice in cases of depression such as antidepressants are still constrained by low bioavailability, especially in the brain. Recent research shows the potential of solid lipid nanoparticles (SLN) as a specific antidepressant drug carrier agent and is able to increase bioavailability in the brain.

Methods: This literature review was compiled based on article searches in international databases, such as PubMed, Scopus, and Cochrane for the last 10 years until November 11, 2022. Study inclusion criteria included clinical and in vitro studies that measured differences in bioavailability of antidepressant drugs with and without SLN.

Discussion: In the research that has been conducted to date, it is known that SLN can carry duloxetine through the blood brain barrier effectively. This is evidenced by the behavioral despair test and BDNF concentrations that show a significant cure for depression and can match normal or control rats. In addition, in the biosafety test, SLN has also been shown to be safe for use in in vitro and in vivo experiments, namely through dermal administration mainly, and oral and parenteral, although it still requires further study.

Conclusion: In conclusion, SLN is a very potential solution to optimize the bioavailability of SSRI antidepressant drugs. Further clinical research is needed to confirm the efficacy and safety of using SLN as a carrier for antidepressant drugs in humans, especially in oral and parenteral administration due to the lack of data to date.

WANITA 41 TAHUN HAMIL ATERM DENGAN CEPHALO PELVIC DISPROPORTION (CPD)

2024-03-07T00:30:29+00:00

Pendahuluan: Disproporsi kepala panggul merupakan keadaan yang menggambarkan ketidakseimbangan antara kepala janin dan panggul ibu sehingga janin tidak bisa keluar melalui vagina. Secara global, mortalitas akibat partus macet yang disebabkan oleh CPD berjumlah 3-8%. Kejadian ini lebih sering terjadi di Asia, karena orang-orang Asia cenderung memiliki tinggi badan yang lebih rendah dari orang barat

Ilustrasi Kasus : . Dalam laporan ini menyajikan kasus wanita hamil 41 tahun, G2P1A0 39+5 minggu, datang dengan keluhan kencang-kencang. Pasien merupakan rujukan rujukan dari bidan Pemeriksaan tanda vital dalam batas normal, Pemeriksaan pada fundus uteri didapatkan hasil setinggi 28 cm, ditemukan denyut jantung janin normal dan reguler, pemeriksaan VT dengan pembukaan 4, hodge I, batas bawah anak adalah kepala, floating. Tataksana dilakukan Sectio Caesaria.

Diskusi: Disproporsi kepala panggul yaitu suatu keadaan yang timbul karena tidak adanya keseimbangan antara panggul ibu dengan kepala janin disebabkan oleh panggul sempit, janin yang besar sehingga tidak dapat melewati panggul ataupun kombinasi keduanya.

Simpulan: Pasien Ny. H usia 41 tahun keadaan umum pasien baik dan janin dalam batas normal sesuai dengan usia kehamilannya. Pada pemeriksaan laboratorium dalam batas normal. Pasien didiagnosis G2P1A0 Hamil 39+5 minggu. Terminasi dilakukan Sectio saecaria bayi berjenis kelamin laki-laki, berat badan lahir 3050gr, panjang badan lahir 47cm, Lingkar kepala 35cm, Lingkar dada 31 cm. Terdapat testis (+), penis (+), anus (+), cacat (-).

MILIARY TUBERCULOSIS AND ELEVATED TRANSAMINASE ENZYMES IN AN UNTREATED HUMAN IMMUNIDEFICIENCY VIRUS (HIV) PATIENT: A CASE REPORT

2024-03-07T00:30:31+00:00

Introduction Tuberculosis (TB) is closely related to Human Immunodeficiency Virus (HIV) and causes 25% death in HIV patients. Miliary TB is a complication of a focus of tuberculosis infection that is spread hematogenously, in the form of fine spots that are generally evenly distributed throughout the lung fields. Giving Anti Tuberculosis Drugs can have side effects in some TB patients including drug-induced hepatitis, therefore it is necessary to check liver function. Liver function tests that are commonly used are transaminase enzymes, namely SGOT and SGPT levels which will show an increase if there is damage or inflammation in liver tissue. In HIV positive patients, it is recommended to have liver function tests every month.

Case illustration Here we report a case of a male patient diagnosed with miliary TB and HIV who had an increase in the transaminases enzyme at the beginning of the diagnosis with chief complainnts of cough with phlegm, fluctuating fever, night sweats, weakness, nausea, vomiting, and weight loss 0f 14 kg since three months before being admitted to the hospital. The patient appeared moderately ill with composmentis consciousness, temperature 38,8C, saturation 98% with oxygen, BMI underweight (13,4kg.m2), anemic conjunctiva and sclera are not icteric. The laboratory finding anemia left shift hypochromic microytic with thrombocytopenia (Hb 9,8g/dl, Hematocrit 28,3%, leukocytes 2470/Ul, platelets 157000/uL MCV 87fl, MCH 28,7pg, MCHC 33,0g/dl), increase transaminase enzymes (SGOT:398U/L SGPT:90U/L), hypoalbuminemia (2,17g/dL), normal kidney function, hiponatremia (124), HbsAg and Anti HCV: non Sputum BTA I/II/II: +1/+2/+2, Gene Xpert: MTB detected, Rifampicin resistance was not detected. Reactive HIV test, CD4: 26 sel/UL. Ro Thorax examination: Inhomogeneous nodular opacity in both lung fields, suspected pneumonia, USG: Chronic liver disease. The patient received Co-trimoxazole therapy, modified Anti Tuberculosis Drugs and Antiretrovirals. After being given modified anti-tuberculosis and antiretroviral therapy, clinical and laboratory improvement occurred.

Conclusion The need for monitoring of liver function in patients who show symptoms of hepatitis and examination of liver function.

HERBAL BALM INNOVATION FROM JERIANGAU (ACORUS CALAMUS) EXTRACT: A REVIEW OF SUPPORTIVE MEDICAL POTENTIAL AS AROMATHERAPY AND PAIN RELIEF

2024-03-07T00:30:30+00:00

Background: Indonesia is an area that has various types of medicinal plants, but until now only about 1,200 species are used as raw materials for traditional medicines or herbs. A. calamus (Acoraceae) or jeriangau is a medicinal plant that has a rhizome. Jeriangau is used as a raw material for traditional medicine for various therapeutic purposes. This is because jeriangau contains chemical glycosides, flavonoids, saponins, tannins, polyphenols, and essential oils that can be used as aromatherapy.

Discussion: Jeriangau is an annual herb used as a traditional medicine. This plant is an aromatic plant with a spicy taste. Jeriangau rhizome has anti-spasmodic, aromatic, expectorant, anti-nausea, sedative properties, stimulant effects, mental illness, diarrhea, and bronchitis. Jeriangau essential oil serves as a pain reliever for toothaches and headaches. The rhizome of the Jeriangau plant contains 1,2,4-trimethoxy-5-(1-prophenyl)-benzene essential oil or better known as asarone. Asarone is the main content in leaves while acorenon is the main content in rhizomes. It suggests the presence of atropine-like anticholinergic effects. Jeriangau compound has analgesic, sedative and neurodepressive properties which can have a sedative effect. In neonates with diarrhea, the spasmolytic and antisecretory effect of the extract can reduce the frequency of watery bowel movements, inhibitory responses to different spasmogens, and airway relaxation.

Conclusion: Jeriangau with essential oil and several bioactive components such as asarone and isocalamendiol has the potential as a pain reliever and aromatherapy