Characterization and Identification of Poliovirus from the Environment in Indonesia 2015

Background: Poliomyelitis is a disease caused by the poliovirus which causes abnormalities in the nervous system, commonly affects children and can be prevented by immunization. Since March 27th, 2014, Indonesia has been declared to be free of polio and anticipate the mutation of poliovirus type 2 (vaccine-derived polioviruses / VDPV). Indonesia will change the use of policy vaccines from triOPV to biOPV by erasing the P2 type before switching from OPV to IPV. Before the policy was implemented, it is needed to have research to determine the level of immunity of children against poliovirus and type of poliovirus which circulate in the area of OPV and IPV in Indonesia.

Methods: The research study was conducted in five cities in five provinces in Indonesia in 2015. The serum was taken on 100 children between 12-59 months and feces were taken towards 150 children in the same age range. The examination of antibody titers in serum performed using the method of neutralization.

Result: Research shows that in regions that apply OPV as routine immunization, about 94.5% of children had antibodies against poliovirus type 1, 96.8% against type 2 and 93.3% of type 3. In areas which implement IPV as routine immunization, children have gained 85% immunity against poliovirus type 1, 92% against type 2 and 93% of type 3. In the environments that implement OPV, poliovirus was found in feces specimens (0.5%) or the mixed waste (58%). All the circulating virus is a virus originated from Sabin vaccine which mostly comes from type 2 (85% of mixed waste and 60% of feces).

Conclusion: From this study, it can be concluded that sabin polio virus is still circulating in the area which applies OPV as routine immunization and poliovirus type 2 is commonly found there. Immunity inflicted on children varies in each region. Children living in a regular immunization using OPV and IPV had immunity for about 85-90%. 

The relationship between anterior tooth loss and quality of life among elderly in Posbindu, Bojongnangka, Kelapa Dua Sub-District, Tangerang, Jakarta-Indonesia

Background: Oral health can affect the quality of life. Tooth loss, as an oral health problem in elderly, is mainly caused by caries and periodontal disease. This study aims to determine the effect of tooth loss on the quality of life among elderly

Methods: A cross-sectional analytic study was conducted at 5 Posbindu, Bojongnangka, Kelapa Dua Sub-District, Tangerang. There were 93 respondents aged ≥ 50 years old enrolled in this study by purposive sampling method. Self-administered Quality of Life questioner from Oral Health Impact Profile (OHIP-14) was carried out. Data were analyzed using chi-square and logistic regression.

Results: Mean value of tooth loss varied from 1 to 28 teeth about 11.24 ± 7.4, anterior tooth lost from 0 to 12 was 2.72 ± 3.47, while posterior tooth loss from 1 to 14 teeth was 8.52 ± 4.46. About 51.6% of elderly having a good quality of life. There was a significant relationship between age and quality of life (P = 0.000; OR 8.31) and between quality of both anterior (P = 0.017; OR 2.00) and posterior tooth loss (P = 0.031; OR 2.50). Quality of life had no significant relationship with gender, work status, and education (P > 0.05). In the last model of logistic regression, we got age and anterior tooth lost affect quality of life significantly (P = 0.000; OR 8.76 and P = 0.022; OR 2.97)

Conclusion: We concluded that age and anterior tooth lost are important factors of quality of life among elderly.

A comparative assessment of alveolar bone loss using bitewing, periapical, and panoramic radiography

Background: Radiology in dentistry has a pivotal role in obtaining information for diagnostic. There is some radiographic examination often used to measure alveolar bone loss such as bitewing, periapical and panoramic. This study aims to determine the accuracy of bitewing, periapical, and panoramic radiography on the assessment of alveolar bone loss.

Method: A cross-sectional analytic method was carried out to 11 samples using bitewing, periapical, and panoramic radiography respectively. Data were analyzed by T-independent sample test.

Results: The average mean value of alveolar bone loss measurement clinically in the skull was 2 mm, but 2.2 ± 0,36 mm, 2.3 ± 0.41 mm, and 2.6 ± 0.66 mm in the bitewing, periapical, and panoramic radiography respectively. The accuracy of bitewing radiographs had the highest percentage comparing with periapical and panoramic radiography (90%: 85%: 70% respectively). In addition, the study found there was no statistically different in among groups (P > 0.05).

Conclusion: Bitewing, periapical, and panoramic radiographic as a comparative assessment found no statistically different in the measurement of Alveolar Bone Loss.

Effect of aspirin desensitization on nasal polyps recurrence and remission based on imaging studies in patients with triple symptoms of asthma, aspirin sensitivity, and nasal polyps and the impact of this method on their quality of life

Introduction: Chronic rhinosinusitis with recurrent nasal polyps, asthma, and allergy to non-steroidal anti-inflammatory drugs (aspirin-induced asthma) is a condition that can severely affect patients' quality of life. This study was conducted to determine the effect of aspirin desensitization on nasal polyps recurrence and remission in patients with triple symptoms of asthma, aspirin sensitivity, and nasal polyps.

Materials and methods: In this clinical trial, samples consisted of 50 patients with aspirin-induced asthma were selected by Morgan table and were randomly divided into two groups, one case group, and one control group. The control group received no treatment while the case group received aspirin desensitization protocol using an ascending dose of aspirin from 25 mg every three hours to 325mg under direct supervision. After 3 months, pulmonary examination and imaging test were performed again. The patient’s quality of life was investigated before and after treatment using the questionnaire of quality of life (QoL) of polyposis patients.

Results: The quality of life in patients with rhinosinusitis (RDS) before and after aspirin desensitization was 48.38±5.21 and 46.06±4.85 respectively which was significantly improved (if this result is from another study, author and the year of the study should be written in the sentence, or if this result is from all sample, then it should also be stated in the sentence).  In the case group, the quality of life was also improved, with an average score of before and after treatment was 47.32±6.61 and 42.6±3.42 respectively (p<0.001) (the p-value already stated that the result was significant). Meanwhile, the quality of life in the control group was not improved, with average before and after treatment score was 49.44 ±2.79 and 49.52±3.23 respectively (p=0.9) (the p-value already stated that the result was not significant).

Conclusion: Aspirin desensitization leads to improvement of life quality and reduction of rhinosinusitis symptoms in patients with aspirin-induced asthma. 

BRAF V600E expression found in aggressive papillary thyroid carcinoma (PTC), lymph node metastasis, and extra-thyroid extension

Purpose: Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy. Most PTC patients have a good prognosis. However, about 10% cases showed aggressive behavior. Its association with BRAF V600E mutation is still controversy. The purpose of this study is to prove the association between BRAF V600E expression and PTC aggressiveness.

Material and methods: This cross-sectional analytic study involving 36 PTC patients. Tumor aggressiveness was determined based on at least one of these categories: tumor size, lymph node metastasis, extra-thyroid extension and vascular invasion. Immunohistochemistry staining VE1 was performed to assess BRAF V600E expression. Chi-square test was used to assess the association between BRAF V600E expression and tumor aggressiveness.

Results: BRAF V600E expression was found in 58.3% of cases of aggressive PTC group. There was a significant difference between BRAF V600E expression in aggressive and non-aggressive PTC group (p=0.021). There was a significant association between BRAF V600E expression and lymph node metastasis (p=0.005) and extra-thyroid extension (p=0.011), but no significant association between BRAF V600E expression and tumor size (p=0.252) and vascular invasion (p=0.367).

Conclusion: BRAF V600E expression has an association with tumor aggressiveness in PTC, as well as with lymph node metastasis and extra-thyroid extension.

Mean Platelet Volume (MPV) as an inflammatory marker in type 2 diabetes mellitus and obesity

Background: Type 2 diabetes mellitus and obesity are two important disorders which are associated with the enormous amount of morbidity and mortality. Inflammation plays a crucial role in development and complications of these diseases. Aim: We aimed to compare mean platelet volume (MPV) as an inflammatory marker in well and poorly controlled type 2 diabetic subjects and to observe its association with obesity indices, body mass index (BMI) and waist circumference. Method: Data of type 2 diabetic patients obtained from institutional database retrospectively analyzed. Patients were divided into two groups according to the HbA1c level as follows: HbA1c lower than 7% were classified as well-controlled, and HbA1c equal to or greater than 7% were classified as poorly controlled diabetics. Result: Both MPV, body mass index (BMI) and waist circumference were significantly higher in poorly controlled diabetics compared to patients with well-controlled type 2 DM. Conclusion: MPV could be considered as a marker of inflammatory burden in type 2 DM and obesity. Due to its cost-effective and easy to assess nature, MPV may be screened periodically in these patients, along with HbA1c and other measures to keep both physicians and patients aware of the inflammatory load of these diseases.

Comparison of insulin therapy outcomes (satisfaction with treatment, pain during injection, follow-up) in patients using insulin pen and insulin infusion with syringe

The purpose of this study was to compare the effects of insulin therapy (satisfaction with treatment, injection pain, follow-up) in patients using insulin pen and insulin injection with syringe. The present study is a comparative and interventional type. The community of diabetics includes 11o subjects who have a case in Kermanshah Diabetes Clinic. The sample size was determined 82 people,on the basis of previous study of comparing two groups. The sample was randomly selected. Sample members were selected through simple random sampling. To gather the data, a researcher-made questionnaire of satisfaction with the treatment method and a general follow-up questionnaire GAS and scale of pain Vonkorff questionnaire, was used .The face and content validity of the questionnaires was evaluated and confirmed. The questionnaires were determined ausing Cronbach's alpha coefficient and was determined 80%for each of the three questionnaires. In this research to analyze the data, spss21 in two descriptive and inferential statistics were used. For descriptive statistics, Statistical Mean and standard deviation was used for demographic and descriptive information .In the inferential statistics, Kolmogorov-Smirnov test was used to test the normal variables and according to the result of this test, to test research hypotheses the t-test (paired t-test) and chi-square test were used. In general, independent t-test results  showed that there was a significant difference between the average satisfaction of the treatment method, the treatment and the pain of the injection time between the patients using pen and syringe injection (p <0.05) . The results of t-correlation test showed that there is a significant difference between the mean pain, injection time and the follow-up of the treatment in the two stages of the primary and secondary measurement (p<0.05). Also, the results of chi-square test showed that there is no significant relationship between  the demographic variables (gender, education level and age group) and the consequences of insulin therapy (satisfaction with treatment method, pain during injection, follow-up of treatment (p<0.05).

The effectiveness of red betel leaf (Piper crocatum) extract against periodontal pathogens

Introduction: Red betel (Piper crocatum) has long been known as one of herbs that has antibacterial properties as it contains several useful compounds such as essential oils, flavonoid, alkaloids and tannins.  The objective of this study is to learn more about the effectiveness of red betel leaf extract based on in vitro test against periodontal pathogen bacteria such as Aggregatibacter actinomycetemcommitans (Aa) and Porphyromonas gingivalis (Pg).

Method: This study was conducted using diffusion method that has Kirby-Bauer test sensitivity. The experiment was performed eight times on four treatments consisting of 10% DMSO as negative control and 2.5%, 5% and 10% of red betel leaf extract. The sterile paper disc was soaked into sterile water and red betel leaf extract at each concentration before evaporation inside the incubator.  After that, the dry paper disc was placed in the Nutrient Agar (NA) that had previously been inoculated and incubated for 24 hours at 37° Celsius. ANOVA test was used to compare inhibition zone in four group intervention.

Result:  The result of the study shows that the 2.5%, 5% and 10% concentration of red betel leaf extract respectively could inhibit the growth of bacteria Aa and Pg. The result of the study also confirms that the 10% red betel leaf extract concentration created the largest inhibition zone (10.5786 mm for bacteria Aa and 10.7638 mm for bacteria Pg).

Conclusion: Red betel leaf extract, particularly at 10% concentration is significantly effective in inhibiting the growth of Aa and Pg bacteria. 

Achievement of psychological comfort in 5-6-Year-Old children with scoliosis against the background of daily medicinal-prophylactic clothes’ wearing for half a year

Introduction: Five to six years old children with scoliosis degree I to II were noted to have some increased level of anxiety and lowered confidence level against the background of (typical for the given state) their physical development inhibition.

Methods: Daily medicinal-prophylactic clothing was applied to the observed children 5-6 years for six months to relieve the symptoms of scoliosis.  The dynamics of morpho-functional indices, anxiety level and self-esteem in children at the end and at the end of the observation were taken into account.

Results: It was found out that the observed children with scoliosis wearing daily medicinal-prophylactic clothes for 6 months were noted to have lowered spinal curvature evidence and an increase of strength and tolerance of body muscles. In addition, there was a significant decrease in anxiety level and increase confidence and motivation level.  

Conclusion: To conclude, daily wearing of the designed variant of medicinal-prophylactic clothes for half a year can provide the removal of scoliosis signs in 5-6-year-old children and create psychological comfort bringing the accountable indices nearer the control values.

Orderly muscle activity in elimination of erythrocytes microrheological abnormalities in rats with experimentally developed obesity

Background: Difficulties of the earliest stages' detection of erythrocytes' microrheological abnormalities' development at obesity are connected with falling out of clinicians' field of view of persons with first signs of this pathology. It dictates the necessity of experimental investigations' fulfillment on laboratory animals with just developed obesity in them. Earlier in this pathology, there was shown high efficiency of non-medication impacts in relation lowering of the value of body mass and weakening of thrombocyte and vascular dysfunctions. At the same time, there is still no clarity in the question about the impact of regular exercise on erythrocytes' microrheological features at the beginning of obesity development.      

Methods: 91 of health male-rats of Vistar line at the age of 2.5-3 months ,  into the investigation. 29 animals of them had experienced no impacts and composed the control group. 62 rats had obesity developed by prescribing them cardioangionefopathogenic semisynthetic diet. Then these rats were casually divided into experimental (32 rats) group and control group (30 rats). Rats from the experimental group during 60 subsequent days experienced daily exercise on a horizontal treadmill. There were used biochemical, hematological and statistical methods of investigation.

Result: As the result of obesity development the rats turned out to have steady developing increase in systolic and diastolic pressure. At regular exercise, on the treadmill, the rats were noted to have a gradual decrease of their values during 60 days of investigation to the level of the norm. During obesity development lipids' peroxidation activated in rats' erythrocytes because of activity weakening of their antioxidant protection. On the background of muscle activity in rats with obesity the content of lipids' peroxidation products in erythrocytes progressively decreased and by the 60th day of experiment reached the control level of healthy rats. At obesity development in rats, there was found a reliable decrease of erythrocytes-discocytes quantity in blood. It was accompanied by the increase of reversibly and irreversibly changed erythrocytes' quantity in examined animals' blood. Their values were returning to control the level of healthy rats during 60 days of regular muscle activity. At obesity development in rats, there was found the quick rise of erythrocytes' sum in aggregate and these aggregates' quantity at lowering of free erythrocytes' number. Their quantity returned to control values to the end of 60 days of exercise. During experimental obesity modeling, we noticed very early in rats' blood decrease of erythrocytes-discocytes' quantity, the level rise of their reversibly and irreversibly varieties with a strengthening of their aggregative ability. It takes place in the background of the weakening of erythrocytes' antioxidant protection and activation of lipids' peroxidation in them. Regular lasting muscle activity can eliminate existing erythrocytes' microrheological features' abnormalities in rats with recently developed obesity.

Comparison of hemodynamic response between propofol and thiopental as an induction agent in neurosurgery anesthesia at Haji Adam Malik General Hospital Medan-Indonesa

Methanol extract of mangosteen peel (Garcinia mangostana L.) increase activity acetylcholinesterase and glutathione peroxidase and reduce MDA in diazinon exposed rat

Introduction: A study has been conducted on the methanol extract of mangosteen peel (MEMP) in rats exposed to diazinon pesticides (DZN). The purpose of this study is to prove that the methanol extract of mangosteen peel can increase the activity of AChE and GPx as well as decrease MDA concentration of rats that were exposed to DZN. Method: Thirty healthy male Wistar rats divided into five groups. The control group (K-), group II was exposed to DZN (K+), group III was exposed to DZN and given 200 mg/kg MEMP (P1), group IV was exposed to DZN and given 400 mg/kg MEMP (P2) and group V was exposed to DZN and given 600 mg/kg MEMP (P3), and performed for three weeks. Blood samples were taken for analysis of acetylcholinesterase (AChE) activity, glutathione peroxidase (GPx) activity, and MDA levels. Results: The results analyzed by ANOVA test followed by post hoc test. MEMP treatment showed significantly higher AChE activity (p<0.005) than exposed without MEMP. Compared with control group, the greatest increase is in P2 (1105.26 ± 1.53 U/L); GPx activity was also significantly higher (p <0.005) between the exposed treatment 990.00 ± 47.43 with P2 (1236.00 ± 12.76) and P3 (1530.00 ± 58.74). MDA levels were significantly lower (p <0.005) among the three treatments were exposed to the P1, P2, and P3, treatment gave the highest decrease in MDA is P2. Conclusions: The conclusion is MEMP can increase activity of AChE, GPx and decrease MDA concentration on rats exposed to DZN.

The Quantity and Leukocytes Components as Biological Dosimeters on the Radiation Workers at Radiology Installation RSUP Sanglah Hospital Denpasar

Abstract: Regularly, the radiation monitoring program is applied to all the  radiation workers using physical dosimeter, in the TLD form, badge films and others. The monitoring from the biological aspect is called biological dosimeter as an indicator of the organ damages that caused radiation exposure, especially on the radiation workers in the radiology installation RSUP Sanglah Hospital are not much studied.

Objective: This study aims are determining of the quantity and leukocytes components differences that caused environmental radiation exposure in direct contact radiation and direct non-contact radiation workers.

Data and method: The research data was obtained through the blood test at RSUP Sanglah Hospital Denpasar with diffraction count method. The extent of the leukocyte component is determined by the absolute count method. The population in this study were 70 people with the total sample were 35 direct radiation radiation workers (30 radiograper people, 5 medical physicists) and 35 direct non-contact radiation workers (12 nurses, 18 administrative personnel, 5 medical records) .

Results: Generally, the blood cell quantity values (hemoglobin-HGB, RBC-erythrocyte, leukocyte-WBC), as well as the percentage of WBC components (basifil-Baso, eosinophil-Eos, neotrifil-Neo, lymphocytes -Limfo and Monocyte-Mono) for radiation workers and non-radiation workers are in the normal range. However, in the normal range, radiation workers have a wider range than non-radiation workers, indicating that radiation workers have undergone a stochastic radiation effect. While the quantity of blood cells over the age range of radiation workers and non-radiation workers alike shows the stochastic effect tends to appear in the productive age of 31-40 years old. For the age of 21-30 years is still normal caused by a relatively new work mass. But at the age of 41-50 tends to approximate the deterministic effect, this can be understood because the mass of work that has been long enough.

Conclusions: For long time in the  radiation field area which increase the deterministic effect the cells of the human body response. Primarily, biological indicators of radiation as a dosimeter are used.

The correlation between ischemic lesions and tuberculoma incidence on head CT-Scan and clinical prognosis in tuberculous meningitis patients: A study at Hasan Sadikin Central General Hospital Bandung 2018

Background: Central nervous system (CNS) TB disease occurs only in 2-5% of all tuberculosis patients but has high mortality rate up to 30% and often causes residual symptoms of neurological deficits, only 18% of the patient can return to normal neurological function. Computed Tomography Scan (CT scan) is the initial modality for detecting unique neuroradiological abnormalities in patients with tuberculous meningitis such as ischemic lesions and tuberculoma. Ischemic lesions and tuberculoma are associated with increased neurological complications in patients with tuberculosis and affect the clinical prognosis of tuberculous meningitis patients that can be assessed using Modified Rankin Score (MRS). Objective: To review the correlation between ischemic lesion and tuberculoma on head CT-scan and clinical prognosis of tuberculous meningitis patient. Methods: This study was an observational analytic study with a cross-sectional design. Sampling was done by consecutive admissions sampling in January 2015 to September 2016. The data were analyzed statistically using Chi-Square test. Results: There were 22 subjects. The highest incidence is severe clinical prognosis, being highest found in 59.1% (13 patients). The result of the statistical test using Chi-Square test at 95% confidence degree shows that there is a statistically significant correlation between ischemic lesion and tuberculoma incidence on CT head examination and clinical prognosis of tuberculous meningitis patient Hasan Sadikin Central General Hospital Bandung (value p≤0.05). Conclusion: There is a significant correlation between ischemic lesion and tuberculoma incidence on CT head scan and clinical prognosis of tuberculous meningitis patient at Hasan Sadikin Central General Hospital Bandung with p-value = 0.032 (value p≤0.05).

A preliminary study of the effect of PPAR- γ agonist from Myristica fragrans houtt seed extract on the biogenesis of rat infant’s brain mitochondria and D1 dopamine receptor

Background: Myristica fragrans (nutmeg) seed extract (NuSE) has been reported as a ligand for Peroxisome Proliferator-Activated Receptor (PPAR)-γ due to hypoglycemic and antidiabetic effects. The recent study also finds the role of PGC-1α as the regulator of mitochondrial biogenesis and the co-activator of PPAR-γ as well. Dopamine 1 receptor (D1DR) is generally distributed in the brain with a various function, such as cognitive function. As a preliminary study, we explore a possibility the current knowledge of the mechanism of NuSE enhance dopamine 1 receptor via neuronal mitochondrial biogenesis on infant rat brain tissue. Aim: This study was aimed to investigate whether PPAR- γ agonist from NuSE can induce expression brain PGC-1α and D1DR (D1A and D1B). Methods: Seven male rats (4 weeks) as a control and another seven male rats (4 weeks) was giving 8.1 mg NuSE /day by gavage within 12 weeks. End of the day, the rats were sacrificed, and the forebrain was extraction. Expression mRNA PGC 1-α and DIDR  were analyzed. Results: The result showed significantly higher relatives expression of mRNA PGC-1α and mRNA D1DR in NuSE group (p<0.05). Conclusion: The findings provide preliminary support that PPAR-γ agonist from NuSE may offer a novel for the study brain mitochondrial biogenesis related mechanism of signaling dopamine receptor.

Leaflet and pocketbook as an education tool to change level of dental health knowledge

Introduction: Dental caries is a dental problem that often arises in children. One of the factors that affect higher oral health problem is a behavioral factor associated with its children knowledge about oral health, so it is important to educate children to increase their knowledge that will change their behavior in a positive direction.  The purpose of this study is to determine the differential effect of dental health education with leaflet and pocketbook in third-grade students.

Method: This type of research is Quasi-Experimental with the method that used in this study is non-equivalent control group design. Samples were taken using a quota sampling technique. Samples were taken from the health service of Padang city in 2014 that showed both of the elementary school (ES) ( ES 17 and ES 20) have the highest oral health problem. Total samples are 40 children, 20 children of ES 17 and 20 children of ES 20. Both groups were given a pre-test and then at ES 17 given education with media leaflet and at ES 20 class with the pocketbook. Post-test was done on day seven after giving education. This study used a  dependent sample t-test and independent sample t-test (p<0.05).

Result: Statistical analysis showed increasing knowledge significantly, the value before and after the given education used leaflet and pocketbook with the significant value of p=0.000 (p<0.05). There is different between both media in increasing knowledge, with the significant value of 0.003(p>0.05). The Leaflet shows an increase of knowledge is greater than the use a pocketbook.

Conclusion: Leaflet is an effective media to increase oral knowledge of dental health.

Laser acupuncture on ST36 promotes serum protein concentration in adolescent rats

Background: In the last decade, laser technology has been used in medicine for diagnostic and therapeutic purposes. The low-level laser has been applied to acupoints (laser acupuncture/LA) which had potential to stimulate the expression of enzyme and hormone in various biological processes. Since the enzyme and majority of hormone is a protein or its derivatives, this study aimed to measure serum protein concentration in adolescent rats treated with laserpuncture.

Methods: Forty male three weeks old Wistar rats weighed ≥ 40 g were randomly divided into either group A or B. Each group was evenly divided into four subgroups which were a negative control and treated with LA on GV20, ST 36 or combination of GV 20+ST 36 respectively. These acupoints were then stimulated by continuous wave cold red laser (635-680nm/5mW) generated by KX Laser GX-2000B. LA was performed at 60 seconds/day for ten days (group A) and 15 days (group B). Venous blood was collected from sinus orbitalis, and Serum protein concentration was measured using the Bradford assay. The data were analyzed using ANOVA test and p-value < 0.05 was considered as significant. Results: A higher protein concentration was observed in ST36A group (76.326±15.084 mg/ml) and GV20+ST36A group (75.044±15.346 mg/ml) compared with control group A (67.338±12,476 mg/ml).

Meanwhile,GV20A group had lower protein level than control group at 57.838±11.042 mg/ml. By contrast, all treated rats in group B had higher protein concentrations (74.158±12.754; 79.373±7.265 and 77.854±2.552 mg/ml respectively) compared to control group B (72.292±7.987 mg/ml). However, the difference in protein concentrations in both groups did not statistically significantly (p=0.161 and p=0.541 respectively). Conclusion: LA on the ST 36 acupoint has the greatest effect on increasing protein concentration in male adolescent Wistar rats although the difference was not statistically significant.

Associations between nutrition attitudes, socioeconomic status, and vitamin E intake on blood pressure among elderly with hypertension in Klaten, Central Java-Indonesia

Background: Hypertension is a health problem which affects many elderly patients. Indirectly, the attitude of elderly patients influences food selection. With a better attitude, elderly individuals will have a better understanding of the type and amount of food to be consumed. Good nutrition attitudes can reduce or prevent malnutrition, control hypertension and reduce cardiovascular complications. The mechanism of hypertension has been associated with oxidative stress, which is related with the intake of high antioxidant foods, such as vitamin E. Antioxidants, when consumed in an adequate amount, can help the adaptation or adjustment to the changes that occur in the body. Antioxidants also increase body cells turnover that has the potential to extend the life of elderly patients. Method: This study is a descriptive, observational, cross-sectional research. The study was conducted in May 2017. The sample size was 125 elderly patients with hypertension, taken with purposive random sampling method. Vitamin E intake was measured with 2x24 hour Food Recall and Qualitative Food Frequency Questionnaires (FFQ). Other data were collected through a questionnaire, then analyzed using multiple logistic regression. Results: Correlation test showed chi-square test results that there was a correlation between nutritional attitude (p = 0,026, OR = 6,650, CI 95%  = 1,319-33,517) and vitamin E intake (p = 0.043, OR = 2,147, CI 95% = 1,015-4,542) with blood pressure in elderly hypertension patients, but not on socioeconomic status (p = 0.230, OR = 0,583, CI 95% = 0,241-1,141). Conclusions: The multivariate analysis showed that nutritional attitude was dominant factors with statistically significant p = 0,023, OR = 1,50, CI 95% = 2,14-17,21.

Association between Matrix Metalloproteinase-2 with Bone Destruction Degree in Patients with Atticoantral Chronic Suppurative Otitis Media at Haji Adam Malik Central General Hospital, Medan, Indonesia

Chronis suppurative otitis media (CSOM) with cholesteatoma may disturb the balance between bone formation and resorption. The destruction caused by cholesteatoma growth can reach the surrounding areas due to dermal enzyme and acid production. Matrix metalloproteinase-2 (MMP-2) is a zinc proteolytic enzyme and calcium endopeptidase that degrades extracellular matrix. This cross-sectional analytical study aimed to determine the association between MMP-2 expressions and bone destruction degrees due to cholesteatoma in patients with atticoantral CSOM at Haji Adam Malik Central General Hospital, Medan Indonesia. Cholesteatoma was taken from 40 cases of CSOM and then made into paraffin blocks. MMP-2 overexpression was more dominant in paraffin blocks taken from patients with moderate degree bone destruction (47.5%). This study concluded that MMP-2 was significantly associated with the degree of bone destruction (p=0.002).

Current clinical status of hydrotherapy; an evidence based retrospective six-years (2012-2017) systemic review

Introduction: Hydrotherapy is an approach which uses water and its characteristics to maintain health, prevent and cure diseases. Hydrotherapy has been known throughout history in different regions. Recently it has been incorporated with conventional system of treatment also. The purpose of this literature is to view the current status of hydrotherapy in terms of clinical trials and research and to highlight the positive as well as negative aspects of hydrotherapy as compared to conventional system.

Methods: Various databases were extensively searched for articles consisting of clinical trials in humans using Google Scholar, PubMed, Web of science, and Sci Finder, etc. using the keyword such as hydrotherapy, clinical trials in hydrotherapy, randomized controlled clinical trials, clinical evidence in hydrotherapy, etc. This review article includes six retrospective years from 2012 to 2017.

Results: A total of nineteen clinical trials met the inclusion criteria. The hydrotherapy was used either alone or as an adjunct with a conventional system for treatment or reducing the symptoms severity as well as the quality of life in many conditions such as multiple sclerosis, fibromyalgia, postpartum pain, migraine, wound healing, musculoskeletal system, Parkinson’s disease, osteoarthritis, spastic paraparesis, hemophilia, etc.

Conclusions: People are using hydrotherapy as a treatment for various health conditions and its use in particular with the conventional system makes the outcome more effective and considerable in different diseases.

Optic Nerve Sheath Schwannoma of the Orbit: A case report

From the anatomical point of view schwannoma of optic nerve is anatomically impossible, as Schwann cells are absent in the optic nerve. However, there were five cases of optic nerve schwannoma had been reported. Among the five cases, three were located in the orbit.

The authors present a case of orbital schwannoma  arising from the optic nerve. A 26 year old female presented with gradual decreasing of vision followed by  proptosis of the right eye over four years duration. Three weeks before admission the patient was noted totally blind. The globe was straightproptosed with ocular motility was restricted to all direction. There was no perception of light. The pupil was dilated and fixed. The cornea was clear and the sensation was present. There were no birthmarks and family history suggesting neurofibromatosis. CT scan showed an ovoid homogenous enhanced tumor that filled most of the orbit and extended into cavernous sinus through the enlarged superior orbital fissure and into anterior portion of optic canal producing an enlargement of that structure. On the basis of CT scan findings, the preoperative diagnosis in this case included cavernous hemangioma, meningioma and optic nerveglioma.

Frontotemporal craniotomy with orbital osteotomy was performed. The optic canal and the superior orbital fissure were unroofed. The tumor was well encapsulated. Intratumoral decompression and piecemeal capsule resection were done. As the size of the tumor was decreased, the optic nerve just behind the globe was indentified and the medial side of this nerve fused with the mass.  Posteriorly optic nerve could not be identified due to it was engulfed by tumor itself. Extension of some tumors into superior orbital fissure and cavernous sinus limited their surgical resection. Postoperatively, the patient experienced temporary ptosis and ophthalmoplegia. The pathological report was optic nerve schwannoma  .