Nur Samsu | University of Brawijaya (original) (raw)

Papers by Nur Samsu

Research paper thumbnail of SUPPLEMENTARY FILE:PREDICTORS IN-HOSPITAL MORTALITY OF SEPTIC VS NON-SEPTIC ACUTE KIDNEY INJURY PATIENTS: AN OBSERVATIONAL COHORT STUDY.xlsx

Research paper thumbnail of Comparison Of The Effect Of Vitamin E And Rosmarinic Acid On Expression Of P65 NF-KB Subunit In Diabetes Rat

Journal of Agromedicine and Medical Sciences, 2020

One of the causes of diabetic nephropathy (ND) that have important role is the increase of free r... more One of the causes of diabetic nephropathy (ND) that have important role is the increase of free radicals due to high levels of glucose which causes oxidative stress. Oxidative stress activates Angiotensin II and the transcription factor of Nuclear Factor kappa B (NFKb). Prevention and slowing down of ND progression is by using antioxidants. The example of antioxidants are Vitamin E and Rosmarinic Acid (RA). Vitamin E is a conventional antioxidant while RA is a potent antioxidant that also has anti-inflammatory effects. This laboratory experimental study aimed to compare the effects of Vitamin E and RA on the expression of NFKb p-65 in glomelurus of type 2 diabetes rats. NFKb expression of p-65 of positive control increased significantly compared to negative controls (p <0.001), Vitamin E and RA were able to reduce NFKb expression compared to positive controls (p = 0.022 and p = 0.001). respectively there was no significant difference between NFKb expression in the Vitamin E group...

Research paper thumbnail of Jurnal Ilmiah di Indonesia: Kondisi Masa Lalu, Saat Ini dan Potensi Kedepan

Jurnal Klinik dan Riset Kesehatan, 2021

Alhamdulillah, atas berkat dan rahmat Tuhan Yang Maha Esa, akhirnya redaksi Jurnal Klinik dan Ris... more Alhamdulillah, atas berkat dan rahmat Tuhan Yang Maha Esa, akhirnya redaksi Jurnal Klinik dan Riset Kesehatan (JK-RISK) dapat menerbitkan edisi perdananya. JK-RISK merupakan jurnal ilmiah online, open access, dan peer-reviewed yang dikelola oleh tim Penelitian dan Pendidikan Rumah Sakit Umum Daerah dr. Saiful Anwar, Malang, Indonesia. JK-RISK bertujuan utama untuk menyebarluaskan informasi dibidang Kesehatan dan Kedokteran, sehingga menambah khazanah ilmu pengetahuan, mengembangkan ilmu pengetahuan dan teknologi serta mendorong semakin meningkatnya kuantitas dan kualitas penulisan artikel ilmiah di Indonesia pada umumnya.

Research paper thumbnail of Profil Kejadian Bakteriuria Asimtomatik serta Faktor-Faktor yang Terkait dengan Kejadian Bakteriuria Asimtomatik pada Ibu Hamil di Puskesmas Janti Kota Malang

Infeksi saluran kemih (ISK) adalah infeksi yang paling umum dijumpai selama kehamilan. Bakteriuri... more Infeksi saluran kemih (ISK) adalah infeksi yang paling umum dijumpai selama kehamilan. Bakteriuria asimtomatik didefinisikan sebagai bakteriuria yang terdiri dari ≥ 10 5 colony forming unit per milliliter (cfu/mL) dengan satu jenis bakteri pada urin pancaran tengah serta tidak terdapat tanda dan gejala infeksi simptomatik. Sebanyak 25 % dari bakteriuria asimtomatik yang tidak diobati dapat menyebabkan infeksi simptomatik akut selama kehamilan. Tujuan penelitian ini untuk mengetahui profil ibu hamil yang menderita bakteriuria asimtomatik serta faktor-faktor sosial ekonomi yang terkait dengannya. Desain penelitian menggunakan cross sectional . Penelitian ini dilakukan di Puskesmas Janti, Malang. Subjek adalah 43 orang ibu hamil dengan 13 orang menderita bakteriuria asimtomatik. Hasil penelitian ini menunjukkan bahwa prevalensi bakteriuria asimtomatik pada ibu hamil adalah 30,2 %. Proporsi bakteriuria asimtomatik relatif tinggi pada ibu hamil berusia 20-29 tahun (69,2 %), nullipara (...

Research paper thumbnail of Management of hypertension in pregnancy

Acta medica Indonesiana, 2015

Hypertension-related maternal mortality reaches 16% when it is compared to other causes of matern... more Hypertension-related maternal mortality reaches 16% when it is compared to other causes of maternal mortality such as sepsis, bleeding or abortus. Pregnant women with hypertension disorder are at increased risk for experiencing numerous complications including disseminated intravascular coagulation (DIC), cerebral hemorrhage, liver dysfunction and acute renal failure; while to the fetus, it may cause intrauterine growth retardation, prematurity and perinatal mortality. Hypertension in pregnancy should be managed appropriately to reduce maternal and fetal morbidity and mortality rate, i.e. by preventing women from getting the risks of increased blood pressure, preventing disease progression and preventing the development of seizure and considering termination of pregnancy in life-threatening situation for maternal and fetal health.

Research paper thumbnail of Challenges in Diagnostic and Management of Nephritic Syndrome in Diabetic Nephropathy Patient: a Case Report

Clinical and Research Journal in Internal Medicine, 2021

The clinical presentation of patients with acute glomerulonephritis (GN) varies widely, from asym... more The clinical presentation of patients with acute glomerulonephritis (GN) varies widely, from asymptomatic to clinical presentations of acute kidney injury (AKI), edema, and hypertension. Diagnosis of GN in patients with diabetic nephropathy (DN) is a challenge due to pre-existing edema, hypertension, and decreased renal function. Likewise in terms of management of steroid immunosuppressants related to blood sugar regulation. It has been reported that 35-year-old male patients with diabetes mellitus (DM) with DN whose kidney function deteriorated rapidly. The patient complained of cola-red urine and decreased urine volume the day before admission. Physical examination showed blood pressure of 160/95 mmHg, bilateral leg edema, active chronic ulcer in the left lower leg, hemoglobin level was 8.7 g / dl, leukocytes 17.400 / ul, serum urea level 96 mg / dl, serum creatinine level 7.01 mg / dl (baseline level was 2.3 mg / dl), ASTO titer + 800 IU / ml, macroscopic hematuria, and albuminur...

Research paper thumbnail of Diabetic Nephropathy: Challenges in Pathogenesis, Diagnosis, and Treatment

BioMed Research International, 2021

Diabetic nephropathy (DN) is the leading cause of end-stage renal disease worldwide. Chronic hype... more Diabetic nephropathy (DN) is the leading cause of end-stage renal disease worldwide. Chronic hyperglycemia and high blood pressure are the main risk factors for the development of DN. In general, screening for microalbuminuria should be performed annually, starting 5 years after diagnosis in type 1 diabetes and at diagnosis and annually thereafter in type 2 diabetes. Standard therapy is blood glucose and blood pressure control using the renin-angiotensin system blockade, targeting A 1 c < 7 % , and <130/80 mmHg. Regression of albuminuria remains an important therapeutic goal. However, there are problems in diagnosis and treatment of nonproteinuric DN (NP-DN), which does not follow the classic pattern of DN. In fact, the prevalence of DN continues to increase, and additional therapy is needed to prevent or ameliorate the condition. In addition to conventional therapies, vitamin D receptor activators, incretin-related drugs, and therapies that target inflammation may also be pro...

Research paper thumbnail of Carotid Intima-Media Thickness (CIMT), Hypertension, and CVD Event

Clinical and Research Journal in Internal Medicine, 2020

Research paper thumbnail of The superiority of rosmarinic acid over vitamin e in preventing development and inhibiting progression of diabetic nephropathy in rats

Background: Oxidative stress plays an important role in podocyte injury and hence in the developm... more Background: Oxidative stress plays an important role in podocyte injury and hence in the development and progression of diabetic nephropathy (DN). The present study was to compare the effect of antioxidant rosmarinic acid (RA) and vitamin E (VtE) in preventing development and inhibiting progression of DN in rats. Methods: Sixteen male Wistar rats were divided into 4 groups each of 4. The 1st group acts as normal rats. The 2nd group acts as untreated-diabetic rats. The 3rd group acts as treated diabetic rats with RA at doses 75 mg/kg/day, and the 4th group acts as treated diabetic rats with VtE at dose 400 mg/kg/day and treatment continued for 8 weeks. Urinary level of podocin, nephrin, albumin, and serum cystatin C levels were measured at the end of the study by ELISA. Immunohistochemistry were used to examined the expression of p65 NF-kB whereas the expression of podocin and nephrin glomerulus were examined by immunofluorescence. Results: The excretion of nephrin, podocin and album...

Research paper thumbnail of Obesity and COVID-19: Two Pandemics with Poor Outcomes

Clinical and Research Journal in Internal Medicine, 2021

Research paper thumbnail of Differences in Carotid Intima-Media Thickness and Left Ventricular Mass Index in Mild Hypertensives with Elevated Awakening Blood Pressure: PP.25.26

Journal of Hypertension, 2010

AE 1.6 years, p < 0.05), body mass index (BMI; 29.0 AE 0.3 and 30.3 AE 0.8, p < 0.05), GWBQ scale... more AE 1.6 years, p < 0.05), body mass index (BMI; 29.0 AE 0.3 and 30.3 AE 0.8, p < 0.05), GWBQ scale III (7.7 AE 0.3 and 9.1 AE 0.5, p < 0.01) and VI (7.9 AE 0.3 and 9.0 AE 0.5, p < 0.05). MH in group I was associated with: GWBQ scales II, V, VI; intake of metoprolol and amlodipine (positive correlation [þ]). MH in group II correlated with: increased orthostatic BP, ECG criteria of left ventricular hypertrophy, GWBQ scales I, IV, VI (þ); age, BMI, previous antihypertensive medication, alcohol intake (negative correlation). Conclusions: The prevalence of MH in medicated hypertensive patients may depend on initial patients' characteristics, prescribed drugs and the factor of repeated visits to the clinic (due to CBP regression to the mean).

Research paper thumbnail of Predictors in-hospital mortality of septic vs non-septic acute kidney injury patients: an observational cohort study

F1000Research

Background: To compare the predictors In-hospital mortality of patients with septic Acute Kidney ... more Background: To compare the predictors In-hospital mortality of patients with septic Acute Kidney Injury (S-AKI) and non-septic AKI (NS-AKI). Methods: a cohort study of critically ill patients with AKI admitted to the emergency room at a tertiary hospital from January to June 2019. The primary outcome was hospital mortality. Results: There were 116 patients who met the inclusion criteria. Compared with NS-AKI, patients with S-AKI had significantly lower mean MAP, median eGFR, and urine output. (UO). S-AKI had higher mortality and vasopressor requirements and had a lower renal recovery than NS-AKI (63.2% vs 31.4%, p=0.001; 30.8% vs 13.7%, p=0.031, and 36.9% vs 60.8%, p=0.011, respectively). AKI stage 3 and vasopressor requirements were dependent risk factors for both S-AKI and NS-AKI mortality. Meanwhile, SOFA score > 7 and the need for dialysis are dependent and independent risk factors for mortality in S-AKI. Worsening and/or persistence in UO, serum urea and creatinine levels at...

Research paper thumbnail of Association Between the Effectiveness and Immunogenicity of Inactivated SARS-CoV2 Vaccine (CoronaVac) with the Presence of Hypertension among Health Care Workers

Clinical and Experimental Hypertension, 2022

ABSTRACT Objective This study aimed to observe the association between the presence of hypertensi... more ABSTRACT Objective This study aimed to observe the association between the presence of hypertension with Covid-19 vaccine effectiveness among healthcare workers who received CoronaVac vaccination. Methods We conducted a prospective cohort study in Saiful Anwar General Hospital, Malang, Indonesia on 155 healthcare workers aged 18–59 years old who already received twice of the CoronaVac (Sinovac Life Science, Beijing, China) injection with 14-day intervals. Hypertension was diagnosed according to the 2020 International Society of Hypertension. Subjects were monitored for six months. The primary outcome was the rate of Covid-19 diagnosed by the pharyngeal swab for the real-time reverse transcription-polymerase chain reaction (RT-PCR) examination. The secondary endpoints were: (1) severity of Covid-19 among infected participants; (2) rate of hospitalizations; and (3) anti-SRBD antibody levels measured by ECLIA. Results Among 155 participants, 18.7% of them were diagnosed with hypertension, and 31.0% had the desirable BP target according to the current guidelines. Subjects with hypertension, especially those with uncontrolled blood pressure, had a higher incidence of Covid-19 infection than subjects without hypertension. Subjects with symptomatic Covid-19 and hospitalized because of Covid-19 were higher in participants with hypertension. The anti-SRBD antibody levels were lower in the second month after CoronaVac vaccination in hypertensive subjects. In contrast, comparable anti-SRBD levels were seen from both groups at sixth months after vaccination. Conclusion Hypertension was associated with lower vaccine effectiveness in healthcare workers. Subjects with hypertension had a higher risk of being infected with Covid-19 despite getting a complete dose of vaccination and lower antibody production.

Research paper thumbnail of Transfusion-Related Acute Lung Injury (TRALI) In Donor Kidney Transplantation Patient A Case Report

Transfusion-related acute lung injury (TRALI) is defined as noncardiogenic pulmonary edema relate... more Transfusion-related acute lung injury (TRALI) is defined as noncardiogenic pulmonary edema related to transfusion therapy. It is a potentially life-threatening, underrecognized and under-reported complication of transfusion. Symptoms usually begin within 1-2 hours up to 6 hours and severity may range from mild to severe (life threatening). Clinically indistinguishable from acute respiratory distress syndrome (ARDS). The diagnosis of TRALI relies on excluding other diagnoses and based primarily on clinical simptoms and signs, not laboratory findings. The minimum requirements for diagnosis of TRALI was occurrence of acute repiratory distress during or within 6 hrs of transfusion, absence of signs of circulatory overload, and radiographic evidence of bilateral pulmonary infiltrates. The pathogenesis of TRALI may be explained by a two-hit hypothesis, with the first hit being an underlying condition of the patient. The second hit may involve the presence of biologically active lipids or ...

Research paper thumbnail of Recent Advances in Nephropathy Biomarker Detections Using Paper-based Analytical Devices

Analytical Sciences

Nephropathy or kidney disease is the deterioration of kidney functions, causing severe diseases s... more Nephropathy or kidney disease is the deterioration of kidney functions, causing severe diseases such as proteinuria, chronic kidney diseases, and kidney failure. Currently, nephropathy that develops into kidney failure is increasing globally, as indicated by the increasing number of patients undergoing hemodialysis. Some developed analytical methods for nephropathy using albumin, creatinine, uric acid, and urinary albumin-to-creatine ratio biomarkers, including spectrophotometry, turbidimetric immunoassay, and ELISA, have been reported so far, providing good accuracy and precision. However, WHO has established guidelines for developing diagnostic tools that meet several criteria: Affordable, Sensitive, Specific, User-friendly, Rapid and Robust, Equipment-free, Delivered to those who need it. It means that nephropathy detection can be carried out using a simple method compatible with point of care that allows independent urine analysis by patients. For this purpose, the use of paper-based analytical devices (PADs) as the alternative platform for detection of albumin, creatinine, uric acid, and urinary albumin-to-creatine ratio were reviewed.

Research paper thumbnail of Efek Penambahan Asam Rosmarinat pada Tikus Diabetes yang Diberikan Telmisartan terhadap Penurunan Ekspresi NF-kβ Glomerulus

Jurnal Penyakit Dalam Indonesia

Pendahuluan. Nefropati diabetik merupakan komplikasi diabetes yang sering terjadi, salah satunya ... more Pendahuluan. Nefropati diabetik merupakan komplikasi diabetes yang sering terjadi, salah satunya akibat peningkatan radikal bebas melalui akivasi NF-kβ serta Angiotensin II. Asam rosmarinat bermanfaat sebagai antioksidan dan antiinflamasi, sedangkan telmisartan merupakan agonis parsial PPAR-γ yang memiliki efek antifibrotik. Penelitian ini dilakukan untuk mengidentifikasi efek asam rosmarinat dan telmisartan terhadap penurunan ekspresi subunit p65 NF-kB pada glomerulus tikus diabetes. Metode. Penelitian eksperimental laboratorik, post-test only controlled group menggunakan tikus Rattus norvegicus yang terbagi menjadi kelompok kontrol negatif, kontrol positif, asam rosmarinat 75 mg/kg/hari, telmisartan 1 mg/kg/hari, serta kombinasi asam rosmarinat 75 mg/kg/hari dan telmisartan 1 mg/kg/hari setiap hari yang dibedah pada minggu ke-8 setelah tikus menjadi diabetes. Gula darah lebih dari 270 mg/dL menunjukkan telah terjadi diabetes pada tikus. Pengukuran albuminuria dengan metode ELISA dan ekspresi subunit p65 NF-kβ dengan metode imunofluorosensi.

Research paper thumbnail of Rosmarinic acid monotherapy is better than the combination of rosmarinic acid and telmisartan in preventing podocyte detachment and inhibiting the progression of diabetic nephropathy in rats

Biologics: Targets and Therapy

Background: Podocyte injury and its subsequent detachment play a critical role in the development... more Background: Podocyte injury and its subsequent detachment play a critical role in the development and progression of diabetic nephropathy (DN). The objective of this study was to investigate the effect of rosmarinic acid (RA) in preventing podocyte detachment and inhibiting the progression of DN in streptozotocin (STZ)-induced diabetic in rats. Methods: We used 20 adult male Wistar rats as experimental animals, which were randomly divided into 5 groups (n=4 per group): nondiabetic rat group (negative control) and 4 groups of STZ-induced diabetic rats, namely, 1 group untreated diabetic rats (positive control) and 3 groups treated diabetic rats with RA 75 mg/kg, telmisartan (TMS) 1 mg/kg and combination of RA 75 mg/kg with TMS 1 mg/kg), respectively. After 8 weeks of therapy, urinary levels of podocin, nephrin and albumin and also serum cystatin C levels were examined by ELISA. The expression of p65 nuclear factor-kB by immunohistochemistry whereas expression of podocin and nephrin glomerulus were examined by immunofluorescence. Results: In the treated diabetic groups, we found that urinary level of podocin and nephrin, albumin urine excretion and serum cystatin C levels were significantly lower than the positive control group. Compared to negative controls, the group of treated diabetic rats did not differ significantly in preventing increased excretion of urinary nephrin and podocin. Meanwhile, treatment with RA monotherapy was significantly better than TMS or a combination of RA with TMS in reducing albumin excretion and preventing decreased kidney function. Conclusion: In STZ-induced diabetic rats, RA can prevent podocyte detachment. Treatment with RA and TMS either monotherapy or in combination can inhibit the development and progression of DN. However, the combination of both did not show a synergistic effect, even have higher urinary albumin excretion and worse kidney function compared to the RA monotherapy.

Research paper thumbnail of Global prevalence and pathogenesis of headache in COVID-19: A systematic review and meta-analysis

F1000Research

Background: This study was conducted to determine the prevalence of headache in coronavirus disea... more Background: This study was conducted to determine the prevalence of headache in coronavirus disease 2019 (COVID-19) and to assess its association as a predictor for COVID-19. This study also aimed to discuss the possible pathogenesis of headache in COVID-19. Methods: Available articles from PubMed, Scopus, and Web of Science were searched as of September 2nd, 2020. Data on characteristics of the study, headache and COVID-19 were extracted following the PRISMA guidelines. Biases were assessed using the Newcastle-Ottawa scale. The cumulative prevalence of headache was calculated for the general population (i.e. adults and children). The pooled odd ratio (OR) with 95% confidence intervals (95%CI) was calculated using the Z test to assess the association between headache and the presence of COVID-19 cases. Results: We included 104,751 COVID-19 cases from 78 eligible studies to calculate the global prevalence of headache in COVID-19 and 17 studies were included to calculate the associati...

Research paper thumbnail of Renal Artery Stenosis: Diagnostic and Management Problems

Clinical and Research Journal in Internal Medicine

Renal artery stenosis is one common clinical problem. It has wide spectrum of pathophysiology wit... more Renal artery stenosis is one common clinical problem. It has wide spectrum of pathophysiology with 3 most common clinical syndromes, ischemic nephropathy, hypertension, and cardiac destabilization syndrome. Aim: To date there was not any specific diagnostic criteria for renal artery stenosis. Method: Clinicians only used some clinical syndromes to guide the diagnostic possibility of renal artery stenosis. RADUS as one sensitive and specific diagnostic method, still had some disadvantages. Results: it gives false negative results in 10-20% of patients due to confounding factors such as operator capability, obesity, or abdominal gas distribution. CTA and MRA was excellent, but possessed some risks for the patient. Therefore, CTA was mostly recommended in patient with the planning of revascularization. Management of renal artery stenosis was still debated between optimal medical management and revascularization because the complexities of mechanisms underlying the renal artery stenosis...

Research paper thumbnail of The Impact of Blood Flow Rate and Duration of Dialysis Session on Nutritional Status in Hemodialysis Patients

Global Journal of Health Science

BACKGROUND: Blood flow rate (BFR) and time of dialysis are important determinants of dialysis ade... more BACKGROUND: Blood flow rate (BFR) and time of dialysis are important determinants of dialysis adequacy. This study aimed to determine the impact of higher BFR and longer dialysis time on nutritional status in chronic hemodialysis (HD) patients. METHODS: Real-world evidence (RWE) studies of 3 HD units in different hospitals that differ in BFR and/or dialysis time. Group I, HD 5 hr and BFR 200-250 mL/min; group II, HD 4 hr and BFR 270-320 mL/min, and group III, HD 4 hr and BFR 200-250 mL/min. All HD units use the same dialysate flow and dialysis frequency. Nutritional status was assessed using a 3-point scale Subjective Global Assessment. RESULTS: A total of 233 chronic HD patients were included, mean of age was 52 ± 12.9 years, 46.5% were male. There are 69.5% on SGA class A, 27.5% on SGA class B, and 3% on SGA class C. The proportion of SGA class A in group II was highest compared to group II and III (93.5% vs 79.0% vs 32.1% (p <0.05). There was no SGA class C in group II, wherea...

Research paper thumbnail of SUPPLEMENTARY FILE:PREDICTORS IN-HOSPITAL MORTALITY OF SEPTIC VS NON-SEPTIC ACUTE KIDNEY INJURY PATIENTS: AN OBSERVATIONAL COHORT STUDY.xlsx

Research paper thumbnail of Comparison Of The Effect Of Vitamin E And Rosmarinic Acid On Expression Of P65 NF-KB Subunit In Diabetes Rat

Journal of Agromedicine and Medical Sciences, 2020

One of the causes of diabetic nephropathy (ND) that have important role is the increase of free r... more One of the causes of diabetic nephropathy (ND) that have important role is the increase of free radicals due to high levels of glucose which causes oxidative stress. Oxidative stress activates Angiotensin II and the transcription factor of Nuclear Factor kappa B (NFKb). Prevention and slowing down of ND progression is by using antioxidants. The example of antioxidants are Vitamin E and Rosmarinic Acid (RA). Vitamin E is a conventional antioxidant while RA is a potent antioxidant that also has anti-inflammatory effects. This laboratory experimental study aimed to compare the effects of Vitamin E and RA on the expression of NFKb p-65 in glomelurus of type 2 diabetes rats. NFKb expression of p-65 of positive control increased significantly compared to negative controls (p <0.001), Vitamin E and RA were able to reduce NFKb expression compared to positive controls (p = 0.022 and p = 0.001). respectively there was no significant difference between NFKb expression in the Vitamin E group...

Research paper thumbnail of Jurnal Ilmiah di Indonesia: Kondisi Masa Lalu, Saat Ini dan Potensi Kedepan

Jurnal Klinik dan Riset Kesehatan, 2021

Alhamdulillah, atas berkat dan rahmat Tuhan Yang Maha Esa, akhirnya redaksi Jurnal Klinik dan Ris... more Alhamdulillah, atas berkat dan rahmat Tuhan Yang Maha Esa, akhirnya redaksi Jurnal Klinik dan Riset Kesehatan (JK-RISK) dapat menerbitkan edisi perdananya. JK-RISK merupakan jurnal ilmiah online, open access, dan peer-reviewed yang dikelola oleh tim Penelitian dan Pendidikan Rumah Sakit Umum Daerah dr. Saiful Anwar, Malang, Indonesia. JK-RISK bertujuan utama untuk menyebarluaskan informasi dibidang Kesehatan dan Kedokteran, sehingga menambah khazanah ilmu pengetahuan, mengembangkan ilmu pengetahuan dan teknologi serta mendorong semakin meningkatnya kuantitas dan kualitas penulisan artikel ilmiah di Indonesia pada umumnya.

Research paper thumbnail of Profil Kejadian Bakteriuria Asimtomatik serta Faktor-Faktor yang Terkait dengan Kejadian Bakteriuria Asimtomatik pada Ibu Hamil di Puskesmas Janti Kota Malang

Infeksi saluran kemih (ISK) adalah infeksi yang paling umum dijumpai selama kehamilan. Bakteriuri... more Infeksi saluran kemih (ISK) adalah infeksi yang paling umum dijumpai selama kehamilan. Bakteriuria asimtomatik didefinisikan sebagai bakteriuria yang terdiri dari ≥ 10 5 colony forming unit per milliliter (cfu/mL) dengan satu jenis bakteri pada urin pancaran tengah serta tidak terdapat tanda dan gejala infeksi simptomatik. Sebanyak 25 % dari bakteriuria asimtomatik yang tidak diobati dapat menyebabkan infeksi simptomatik akut selama kehamilan. Tujuan penelitian ini untuk mengetahui profil ibu hamil yang menderita bakteriuria asimtomatik serta faktor-faktor sosial ekonomi yang terkait dengannya. Desain penelitian menggunakan cross sectional . Penelitian ini dilakukan di Puskesmas Janti, Malang. Subjek adalah 43 orang ibu hamil dengan 13 orang menderita bakteriuria asimtomatik. Hasil penelitian ini menunjukkan bahwa prevalensi bakteriuria asimtomatik pada ibu hamil adalah 30,2 %. Proporsi bakteriuria asimtomatik relatif tinggi pada ibu hamil berusia 20-29 tahun (69,2 %), nullipara (...

Research paper thumbnail of Management of hypertension in pregnancy

Acta medica Indonesiana, 2015

Hypertension-related maternal mortality reaches 16% when it is compared to other causes of matern... more Hypertension-related maternal mortality reaches 16% when it is compared to other causes of maternal mortality such as sepsis, bleeding or abortus. Pregnant women with hypertension disorder are at increased risk for experiencing numerous complications including disseminated intravascular coagulation (DIC), cerebral hemorrhage, liver dysfunction and acute renal failure; while to the fetus, it may cause intrauterine growth retardation, prematurity and perinatal mortality. Hypertension in pregnancy should be managed appropriately to reduce maternal and fetal morbidity and mortality rate, i.e. by preventing women from getting the risks of increased blood pressure, preventing disease progression and preventing the development of seizure and considering termination of pregnancy in life-threatening situation for maternal and fetal health.

Research paper thumbnail of Challenges in Diagnostic and Management of Nephritic Syndrome in Diabetic Nephropathy Patient: a Case Report

Clinical and Research Journal in Internal Medicine, 2021

The clinical presentation of patients with acute glomerulonephritis (GN) varies widely, from asym... more The clinical presentation of patients with acute glomerulonephritis (GN) varies widely, from asymptomatic to clinical presentations of acute kidney injury (AKI), edema, and hypertension. Diagnosis of GN in patients with diabetic nephropathy (DN) is a challenge due to pre-existing edema, hypertension, and decreased renal function. Likewise in terms of management of steroid immunosuppressants related to blood sugar regulation. It has been reported that 35-year-old male patients with diabetes mellitus (DM) with DN whose kidney function deteriorated rapidly. The patient complained of cola-red urine and decreased urine volume the day before admission. Physical examination showed blood pressure of 160/95 mmHg, bilateral leg edema, active chronic ulcer in the left lower leg, hemoglobin level was 8.7 g / dl, leukocytes 17.400 / ul, serum urea level 96 mg / dl, serum creatinine level 7.01 mg / dl (baseline level was 2.3 mg / dl), ASTO titer + 800 IU / ml, macroscopic hematuria, and albuminur...

Research paper thumbnail of Diabetic Nephropathy: Challenges in Pathogenesis, Diagnosis, and Treatment

BioMed Research International, 2021

Diabetic nephropathy (DN) is the leading cause of end-stage renal disease worldwide. Chronic hype... more Diabetic nephropathy (DN) is the leading cause of end-stage renal disease worldwide. Chronic hyperglycemia and high blood pressure are the main risk factors for the development of DN. In general, screening for microalbuminuria should be performed annually, starting 5 years after diagnosis in type 1 diabetes and at diagnosis and annually thereafter in type 2 diabetes. Standard therapy is blood glucose and blood pressure control using the renin-angiotensin system blockade, targeting A 1 c < 7 % , and <130/80 mmHg. Regression of albuminuria remains an important therapeutic goal. However, there are problems in diagnosis and treatment of nonproteinuric DN (NP-DN), which does not follow the classic pattern of DN. In fact, the prevalence of DN continues to increase, and additional therapy is needed to prevent or ameliorate the condition. In addition to conventional therapies, vitamin D receptor activators, incretin-related drugs, and therapies that target inflammation may also be pro...

Research paper thumbnail of Carotid Intima-Media Thickness (CIMT), Hypertension, and CVD Event

Clinical and Research Journal in Internal Medicine, 2020

Research paper thumbnail of The superiority of rosmarinic acid over vitamin e in preventing development and inhibiting progression of diabetic nephropathy in rats

Background: Oxidative stress plays an important role in podocyte injury and hence in the developm... more Background: Oxidative stress plays an important role in podocyte injury and hence in the development and progression of diabetic nephropathy (DN). The present study was to compare the effect of antioxidant rosmarinic acid (RA) and vitamin E (VtE) in preventing development and inhibiting progression of DN in rats. Methods: Sixteen male Wistar rats were divided into 4 groups each of 4. The 1st group acts as normal rats. The 2nd group acts as untreated-diabetic rats. The 3rd group acts as treated diabetic rats with RA at doses 75 mg/kg/day, and the 4th group acts as treated diabetic rats with VtE at dose 400 mg/kg/day and treatment continued for 8 weeks. Urinary level of podocin, nephrin, albumin, and serum cystatin C levels were measured at the end of the study by ELISA. Immunohistochemistry were used to examined the expression of p65 NF-kB whereas the expression of podocin and nephrin glomerulus were examined by immunofluorescence. Results: The excretion of nephrin, podocin and album...

Research paper thumbnail of Obesity and COVID-19: Two Pandemics with Poor Outcomes

Clinical and Research Journal in Internal Medicine, 2021

Research paper thumbnail of Differences in Carotid Intima-Media Thickness and Left Ventricular Mass Index in Mild Hypertensives with Elevated Awakening Blood Pressure: PP.25.26

Journal of Hypertension, 2010

AE 1.6 years, p < 0.05), body mass index (BMI; 29.0 AE 0.3 and 30.3 AE 0.8, p < 0.05), GWBQ scale... more AE 1.6 years, p < 0.05), body mass index (BMI; 29.0 AE 0.3 and 30.3 AE 0.8, p < 0.05), GWBQ scale III (7.7 AE 0.3 and 9.1 AE 0.5, p < 0.01) and VI (7.9 AE 0.3 and 9.0 AE 0.5, p < 0.05). MH in group I was associated with: GWBQ scales II, V, VI; intake of metoprolol and amlodipine (positive correlation [þ]). MH in group II correlated with: increased orthostatic BP, ECG criteria of left ventricular hypertrophy, GWBQ scales I, IV, VI (þ); age, BMI, previous antihypertensive medication, alcohol intake (negative correlation). Conclusions: The prevalence of MH in medicated hypertensive patients may depend on initial patients' characteristics, prescribed drugs and the factor of repeated visits to the clinic (due to CBP regression to the mean).

Research paper thumbnail of Predictors in-hospital mortality of septic vs non-septic acute kidney injury patients: an observational cohort study

F1000Research

Background: To compare the predictors In-hospital mortality of patients with septic Acute Kidney ... more Background: To compare the predictors In-hospital mortality of patients with septic Acute Kidney Injury (S-AKI) and non-septic AKI (NS-AKI). Methods: a cohort study of critically ill patients with AKI admitted to the emergency room at a tertiary hospital from January to June 2019. The primary outcome was hospital mortality. Results: There were 116 patients who met the inclusion criteria. Compared with NS-AKI, patients with S-AKI had significantly lower mean MAP, median eGFR, and urine output. (UO). S-AKI had higher mortality and vasopressor requirements and had a lower renal recovery than NS-AKI (63.2% vs 31.4%, p=0.001; 30.8% vs 13.7%, p=0.031, and 36.9% vs 60.8%, p=0.011, respectively). AKI stage 3 and vasopressor requirements were dependent risk factors for both S-AKI and NS-AKI mortality. Meanwhile, SOFA score > 7 and the need for dialysis are dependent and independent risk factors for mortality in S-AKI. Worsening and/or persistence in UO, serum urea and creatinine levels at...

Research paper thumbnail of Association Between the Effectiveness and Immunogenicity of Inactivated SARS-CoV2 Vaccine (CoronaVac) with the Presence of Hypertension among Health Care Workers

Clinical and Experimental Hypertension, 2022

ABSTRACT Objective This study aimed to observe the association between the presence of hypertensi... more ABSTRACT Objective This study aimed to observe the association between the presence of hypertension with Covid-19 vaccine effectiveness among healthcare workers who received CoronaVac vaccination. Methods We conducted a prospective cohort study in Saiful Anwar General Hospital, Malang, Indonesia on 155 healthcare workers aged 18–59 years old who already received twice of the CoronaVac (Sinovac Life Science, Beijing, China) injection with 14-day intervals. Hypertension was diagnosed according to the 2020 International Society of Hypertension. Subjects were monitored for six months. The primary outcome was the rate of Covid-19 diagnosed by the pharyngeal swab for the real-time reverse transcription-polymerase chain reaction (RT-PCR) examination. The secondary endpoints were: (1) severity of Covid-19 among infected participants; (2) rate of hospitalizations; and (3) anti-SRBD antibody levels measured by ECLIA. Results Among 155 participants, 18.7% of them were diagnosed with hypertension, and 31.0% had the desirable BP target according to the current guidelines. Subjects with hypertension, especially those with uncontrolled blood pressure, had a higher incidence of Covid-19 infection than subjects without hypertension. Subjects with symptomatic Covid-19 and hospitalized because of Covid-19 were higher in participants with hypertension. The anti-SRBD antibody levels were lower in the second month after CoronaVac vaccination in hypertensive subjects. In contrast, comparable anti-SRBD levels were seen from both groups at sixth months after vaccination. Conclusion Hypertension was associated with lower vaccine effectiveness in healthcare workers. Subjects with hypertension had a higher risk of being infected with Covid-19 despite getting a complete dose of vaccination and lower antibody production.

Research paper thumbnail of Transfusion-Related Acute Lung Injury (TRALI) In Donor Kidney Transplantation Patient A Case Report

Transfusion-related acute lung injury (TRALI) is defined as noncardiogenic pulmonary edema relate... more Transfusion-related acute lung injury (TRALI) is defined as noncardiogenic pulmonary edema related to transfusion therapy. It is a potentially life-threatening, underrecognized and under-reported complication of transfusion. Symptoms usually begin within 1-2 hours up to 6 hours and severity may range from mild to severe (life threatening). Clinically indistinguishable from acute respiratory distress syndrome (ARDS). The diagnosis of TRALI relies on excluding other diagnoses and based primarily on clinical simptoms and signs, not laboratory findings. The minimum requirements for diagnosis of TRALI was occurrence of acute repiratory distress during or within 6 hrs of transfusion, absence of signs of circulatory overload, and radiographic evidence of bilateral pulmonary infiltrates. The pathogenesis of TRALI may be explained by a two-hit hypothesis, with the first hit being an underlying condition of the patient. The second hit may involve the presence of biologically active lipids or ...

Research paper thumbnail of Recent Advances in Nephropathy Biomarker Detections Using Paper-based Analytical Devices

Analytical Sciences

Nephropathy or kidney disease is the deterioration of kidney functions, causing severe diseases s... more Nephropathy or kidney disease is the deterioration of kidney functions, causing severe diseases such as proteinuria, chronic kidney diseases, and kidney failure. Currently, nephropathy that develops into kidney failure is increasing globally, as indicated by the increasing number of patients undergoing hemodialysis. Some developed analytical methods for nephropathy using albumin, creatinine, uric acid, and urinary albumin-to-creatine ratio biomarkers, including spectrophotometry, turbidimetric immunoassay, and ELISA, have been reported so far, providing good accuracy and precision. However, WHO has established guidelines for developing diagnostic tools that meet several criteria: Affordable, Sensitive, Specific, User-friendly, Rapid and Robust, Equipment-free, Delivered to those who need it. It means that nephropathy detection can be carried out using a simple method compatible with point of care that allows independent urine analysis by patients. For this purpose, the use of paper-based analytical devices (PADs) as the alternative platform for detection of albumin, creatinine, uric acid, and urinary albumin-to-creatine ratio were reviewed.

Research paper thumbnail of Efek Penambahan Asam Rosmarinat pada Tikus Diabetes yang Diberikan Telmisartan terhadap Penurunan Ekspresi NF-kβ Glomerulus

Jurnal Penyakit Dalam Indonesia

Pendahuluan. Nefropati diabetik merupakan komplikasi diabetes yang sering terjadi, salah satunya ... more Pendahuluan. Nefropati diabetik merupakan komplikasi diabetes yang sering terjadi, salah satunya akibat peningkatan radikal bebas melalui akivasi NF-kβ serta Angiotensin II. Asam rosmarinat bermanfaat sebagai antioksidan dan antiinflamasi, sedangkan telmisartan merupakan agonis parsial PPAR-γ yang memiliki efek antifibrotik. Penelitian ini dilakukan untuk mengidentifikasi efek asam rosmarinat dan telmisartan terhadap penurunan ekspresi subunit p65 NF-kB pada glomerulus tikus diabetes. Metode. Penelitian eksperimental laboratorik, post-test only controlled group menggunakan tikus Rattus norvegicus yang terbagi menjadi kelompok kontrol negatif, kontrol positif, asam rosmarinat 75 mg/kg/hari, telmisartan 1 mg/kg/hari, serta kombinasi asam rosmarinat 75 mg/kg/hari dan telmisartan 1 mg/kg/hari setiap hari yang dibedah pada minggu ke-8 setelah tikus menjadi diabetes. Gula darah lebih dari 270 mg/dL menunjukkan telah terjadi diabetes pada tikus. Pengukuran albuminuria dengan metode ELISA dan ekspresi subunit p65 NF-kβ dengan metode imunofluorosensi.

Research paper thumbnail of Rosmarinic acid monotherapy is better than the combination of rosmarinic acid and telmisartan in preventing podocyte detachment and inhibiting the progression of diabetic nephropathy in rats

Biologics: Targets and Therapy

Background: Podocyte injury and its subsequent detachment play a critical role in the development... more Background: Podocyte injury and its subsequent detachment play a critical role in the development and progression of diabetic nephropathy (DN). The objective of this study was to investigate the effect of rosmarinic acid (RA) in preventing podocyte detachment and inhibiting the progression of DN in streptozotocin (STZ)-induced diabetic in rats. Methods: We used 20 adult male Wistar rats as experimental animals, which were randomly divided into 5 groups (n=4 per group): nondiabetic rat group (negative control) and 4 groups of STZ-induced diabetic rats, namely, 1 group untreated diabetic rats (positive control) and 3 groups treated diabetic rats with RA 75 mg/kg, telmisartan (TMS) 1 mg/kg and combination of RA 75 mg/kg with TMS 1 mg/kg), respectively. After 8 weeks of therapy, urinary levels of podocin, nephrin and albumin and also serum cystatin C levels were examined by ELISA. The expression of p65 nuclear factor-kB by immunohistochemistry whereas expression of podocin and nephrin glomerulus were examined by immunofluorescence. Results: In the treated diabetic groups, we found that urinary level of podocin and nephrin, albumin urine excretion and serum cystatin C levels were significantly lower than the positive control group. Compared to negative controls, the group of treated diabetic rats did not differ significantly in preventing increased excretion of urinary nephrin and podocin. Meanwhile, treatment with RA monotherapy was significantly better than TMS or a combination of RA with TMS in reducing albumin excretion and preventing decreased kidney function. Conclusion: In STZ-induced diabetic rats, RA can prevent podocyte detachment. Treatment with RA and TMS either monotherapy or in combination can inhibit the development and progression of DN. However, the combination of both did not show a synergistic effect, even have higher urinary albumin excretion and worse kidney function compared to the RA monotherapy.

Research paper thumbnail of Global prevalence and pathogenesis of headache in COVID-19: A systematic review and meta-analysis

F1000Research

Background: This study was conducted to determine the prevalence of headache in coronavirus disea... more Background: This study was conducted to determine the prevalence of headache in coronavirus disease 2019 (COVID-19) and to assess its association as a predictor for COVID-19. This study also aimed to discuss the possible pathogenesis of headache in COVID-19. Methods: Available articles from PubMed, Scopus, and Web of Science were searched as of September 2nd, 2020. Data on characteristics of the study, headache and COVID-19 were extracted following the PRISMA guidelines. Biases were assessed using the Newcastle-Ottawa scale. The cumulative prevalence of headache was calculated for the general population (i.e. adults and children). The pooled odd ratio (OR) with 95% confidence intervals (95%CI) was calculated using the Z test to assess the association between headache and the presence of COVID-19 cases. Results: We included 104,751 COVID-19 cases from 78 eligible studies to calculate the global prevalence of headache in COVID-19 and 17 studies were included to calculate the associati...

Research paper thumbnail of Renal Artery Stenosis: Diagnostic and Management Problems

Clinical and Research Journal in Internal Medicine

Renal artery stenosis is one common clinical problem. It has wide spectrum of pathophysiology wit... more Renal artery stenosis is one common clinical problem. It has wide spectrum of pathophysiology with 3 most common clinical syndromes, ischemic nephropathy, hypertension, and cardiac destabilization syndrome. Aim: To date there was not any specific diagnostic criteria for renal artery stenosis. Method: Clinicians only used some clinical syndromes to guide the diagnostic possibility of renal artery stenosis. RADUS as one sensitive and specific diagnostic method, still had some disadvantages. Results: it gives false negative results in 10-20% of patients due to confounding factors such as operator capability, obesity, or abdominal gas distribution. CTA and MRA was excellent, but possessed some risks for the patient. Therefore, CTA was mostly recommended in patient with the planning of revascularization. Management of renal artery stenosis was still debated between optimal medical management and revascularization because the complexities of mechanisms underlying the renal artery stenosis...

Research paper thumbnail of The Impact of Blood Flow Rate and Duration of Dialysis Session on Nutritional Status in Hemodialysis Patients

Global Journal of Health Science

BACKGROUND: Blood flow rate (BFR) and time of dialysis are important determinants of dialysis ade... more BACKGROUND: Blood flow rate (BFR) and time of dialysis are important determinants of dialysis adequacy. This study aimed to determine the impact of higher BFR and longer dialysis time on nutritional status in chronic hemodialysis (HD) patients. METHODS: Real-world evidence (RWE) studies of 3 HD units in different hospitals that differ in BFR and/or dialysis time. Group I, HD 5 hr and BFR 200-250 mL/min; group II, HD 4 hr and BFR 270-320 mL/min, and group III, HD 4 hr and BFR 200-250 mL/min. All HD units use the same dialysate flow and dialysis frequency. Nutritional status was assessed using a 3-point scale Subjective Global Assessment. RESULTS: A total of 233 chronic HD patients were included, mean of age was 52 ± 12.9 years, 46.5% were male. There are 69.5% on SGA class A, 27.5% on SGA class B, and 3% on SGA class C. The proportion of SGA class A in group II was highest compared to group II and III (93.5% vs 79.0% vs 32.1% (p <0.05). There was no SGA class C in group II, wherea...