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"ABSTRACTBackground: resistive index (RI) is highly utilised to assess the graft function using Doppler ultrasonography. The RI has been shown as the best ultrasound parameter to assess kidney allograft dysfunction. Several studies have established the role of the RI as a predictor of transplant failure. However, these studies were using RI measurement in the later stages post transplantation. The present study has conducted to identify the association between early RI measurement and early graft function represented as delayed graft function (DGF) and immediate graft function (IGF), as well as long-term graft survival. Methods: an evidence based clinical review of studies published before May 2018 was conducted from Medline, Science Direct, EMBASE and Cochrane databases. Studies on early measurement of RI whereby the primary or secondary goals of the study related to graft function and/or graft survival were included. Studies using late RI measurement and without RI value groups were excluded. The Mantzel Haenzel method was used to analyse pooled risk ratio and 95% confidence interval, while the heterogeneity of the study was calculated through I2 value. Data analysis was performed using Review Manager 5.3. Results: nine studies with a total of 1802 patients who had undergone a kidney transplant were analysed. DGF was found in 19% (193/1015) of the low RI group and in 42.8% (337/787) of the high RI group (RR 2.04 (95% CI 1.72 - 2.41), p < 0.00001, I2 = 28%). IGF was found in 39.5% (62/157) of the low RI group and in 10.5% (28/268) of the high RI group (RR 0.26 (95% CI 0.17 0.40), p < 0.00001, I2 = 0%). Long term graft survival, with follow up between 60 144 months, was found in 83% (701/845) of the low RI group and in 69.4% (395/569) of the high RI group (RR 0.82 (95% CI 0.72 0.93), p = 0.002, I2 = 63%). Conclusion: the results of this study emphasise the association between early measurement of RI and early graft function, and longterm graft survival. An elevated RI provides the chance of recognizing the patients with poor longterm prognosis, from the first moment after kidney transplant."

"Juvenile hypertrophy of the breast (JHB) merupakan gigantomastia unilateral atau bilateral pada wanita peripubertal dan merupakan kasus jarang. Kelainan ini terbatas pada payudara berupa pertumbuhan dan perkembangan yang tidak normal. Pembesaran payudara bilateral atau unilateral tidak hanya mengakibatkan gangguan fisik tetapi juga psikis. Etiologinya sulit ditentukan, tetapi kelainan ini menggambarkan adanya hipersensitifitas organ akibat gangguan regulasi endokrin. Terapi terbaik berupa pembedahan yaitu mastektomi atau mammaplasti reduksi. Laporan ini menyajikan kasus seorang wanita berusia 30 tahun dengan JHB. Pertumbuhan payudara kirinya dimulai saat pubertas dan terus membesar selama setahun. Operasi dilaksanakan berupa reduksi mammaplasti dengan wise pattern based design. Setelah dua tahun pasien tidak memiliki tanda-tanda rekurensi dan kedua payudaranya tampak simetris dengan parut yang memuaskan.

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AbstractJuvenile hypertrophy of the breast (JHB) is a rare condition leading to gigantomastia unilaterally or bilaterally in peripubertal females. The pathology is limited usually to the breast, with otherwise normal growth and development and without any other deformities. The rapid bilateral or unilateral growth of the breast in adolescent girls leads to severe physical and psychological problems. The etiology remains elusive, but it is believed to represent an end-organ hypersensitivity during a period of intense endocrine regulatory stress. The best treatment is surgical whereas the younger patients better treated with mastectomy to anticipate the high recurrency rate, while older women is best treated with reduction mammaplasty. We report one case of a woman who had a unilateral JHB. The growth of the left breast started in her pubertal age and kept growing for one year. She was treated surgically with Wise pattern based design. After two years, she had no recurrent enlargement and aesthetically, the symmetry of both breasts is achieved with a satisfying scar. "

"Latar Belakang: Dibutuhkan waktu 14 hari donor kulit STSG sembuh. Kolagen berperan penting untuk menginduksi penyembuhan luka dan proses epitelisasi lebih cepat. Sementara gliserin menjaga kulit tetap lembab dan mendorong migrasi sel epitel. Penelitian ini dilakukan untuk mengetahui fungsi gel kolagen dan gliserin dalam mempercepat penyembuhan luka pada daerah donor STSG. Bahan dan Metode: Uji coba klinis non-acak dilakukan pada 18 pasien dewasa untuk membandingkan tingkat epitelisasi pada donor STSG antara kombinasi gel kolagen dan gliserin dibandingkan tulle yang dikombinasikan dengan kasa lembab. Luka dinilai pada hari ke 7, 10, dan 14 pascaoperasi. Persentase epitelisasi dievaluasi dan difoto. Setiap foto dianalisis dengan menggunakan program analisis warna Adobe Photoshop. Data dianalisis dengan menggunakan SPSS 20.0 dan diuji dengan independent t-test. Hasil: Delapan belas pasien yang membutuhkan pencangkokan kulit dimasukkan dalam penelitian ini. Terdapat 13 pria dan 5 wanita dengan usia rata-rata 33,34 tahun berkisar 15-50 tahun . Area donor rata-rata adalah 140,89 cm2 berkisar 100-240 cm2 . Persentase tingkat epitelisasi lebih besar dengan menggunakan kombinasi gel kolagen dan gliserin pada hari ke-7 pasca operasi 88,05 , 95 CI 85,75-90,63 vs 77,18 , 95 CI 73,39-81,02 ; p

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Background It usually takes 14 days for the split thickness skin donor site to heal. Collagen plays an important role to induce faster wound healing and epithelialization. Meanwhile, glycerin keeps skin moisturized and promotes epithelial cells migration. This study was conducted to identify the role of combined collagen and glycerin based gel in promoting faster wound healing on split thickness skin graft donor sites.Materials and Methods A non randomized clinical trial was performed on 18 adult patients to compare the dressing for split thickness skin graft donor site epithelialization rate between combination of collagen and glycerin based gel versus tulle grass combined with moist gauze. The wound was assessed on postoperative day 7, 10, and 14. The epithelialization percentage was evaluated and photographed. Each photo was analyzed using Adobe Photoshop color match program. Data was analyzed using SPSS 20.0 and tested with independent t test.Result Eighteen patients requiring skin grafting were included in this study. There were 13 men and 5 women with mean age 33.34 year old ranged 15 50 year old . The average donor area was 140.89 cm2 ranged 100 240 cm2 . Epithelialization rate was greater using combination of collagen and glycerin based gel on postoperative day 7 88.05 , 95 CI 85.75 90.63 vs 77.18 , 95 CI 73.39 81.02 p 0.05 and day 10 96.92 , 95 CI 96.02 97.82 vs 89.22 , 95 CI 87.6 90.85 p 0.05 . Meanwhile, there is no epithelialization rate difference on postoperative day 14 between both dressing types 100 vs 99.72 0.55 , p 0.05Conclusion Although showing better epithelialization rate at day 7 and 10, combination of collagen and glycerin based gel covered gauze showed no difference in the healing of split thickness skin graft donor sites in comparison with tulle grass combined with moist gauze at day 14. Keywords Donor site, STSG, collagen and glycerin based gel, epithelialization. "

"Penelitian ini merupakan penelitian deskriptif dengan desain penelitian kualitatif dan kuantitatif dengan tujuan melakukan analisis perhitungan biaya satuan tindakan bedah jantung Coronary Artery Bypass Graft (CABG) dalam satu episode rawatan dengan metode Activity Based Costing (ABC) di RSUP DR. M. Djamil Padang. Penelitian dilakukan di RSUP Dr M. Djamil Padang, Waktu penelitian November-Desember 2023. Terdapat 23 sampel pada penelitian ini. Semua sampel yang ada dibuatkan simulasi aktivitasnya berdasarkan telaah berkas klaim, wawancara, serta observasi langsung untuk mendapatkan gambaran terkait komponen biaya yang memengaruhi pelayanan pasien operasi bedah jantung CABG dalam satu episode rawatan. Berdasarkan hasil analisis biaya didapatkan bahwa biaya satuan pasien operasi bedah jantung CABG di RSUP M. Djamil Padang dalam satu episode rawatan didapatkan total unit cost sebesar Rp. 141.143.737,56. Total biaya langsung Rp. 124.767.235,56 dan biaya tidak langsung adalah sebesar Rp. 16.376.502,00. Kedisiplinan dalam menjalankan clinical pathway menjadi kunci utama bagi rumah sakit untuk melakukan efektivitas pembiayaan. Jumlah operasi memiliki potensi besar untuk ditingkatkan mengingat antrian bedah jantung terbuka di RSUP M. Djamil Padang sudah mencapai enam bulan lebih. Semakin banyak operasi yang dilakukan akan berdampak positif terhadap efektivitas biaya. Beberapa BMHP, alat-alat kesehatan, pemeriksaan laboratorium, pemeriksaan radiologi dan pemberian obat-obatan bisa lebih diefektifkan yang berdasarkan analisis penelitian ini mampu mengefektifkan biaya sampai dengan 25-30%.

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This is a descriptive study with a qualitative and quantitative design to analyze the unit cost of Coronary Artery Bypass Graft (CABG) heart surgery in one hospitalization episode using the Activity Based Costing (ABC) method at RSUP DR. M. Djamil Padang. The research was conducted at Dr. M. Djamil Hospital Padang in November-December 2023 with 23 samples. All existing samples were simulated activities based on a review of claims files, interviews, and direct observation to understand the cost components that influence the CABG heart surgery patients in one episode of hospitalization. Based on the cost analysis results, it was found that the unit cost for CABG heart surgery patients at M. Djamil General Hospital in Padang in one hospitalization period was Rp. 141,143,737.56. Total direct costs are Rp. 124,767,235.56 and indirect costs are Rp. 16,376,502.00. Discipline in implementing clinical pathways is the main key for hospitals to make financing effective. The number of operations has great potential to be increased considering that the queue for open heart surgery at M. Djamil Hospital in Padang has reached more than six months. The more operations performed will have a positive impact on cost-effectiveness. Several disposable medical materials, medical devices, laboratory examinations, radiological examinations, and administration of medicines can be made more effective, which based on the analysis of this analysis can reduce the costs by 25-30%."

"Tulisan ini melaporkan hasil studi blend biner yang mengandung setidaknya satu kopolimer random sebagai salah satu komponen, khususnya yang mengandung segmen cylohexyl maleimide termasuk poly (styrene-co-N-cyclohexylmaleimide) yang disintesa melalui reaksi polimerisasi yang dikontrol dengan N-Oxyl. Sistem blend type (A/B) (C/B) dipelajari dan dianalisa dalam kerangka model interaksi biner (binary interaction model). Dari data pencampuran yang didapatkan pada studi ini dan dengan menggunakan parameter-parameter interaksi biner yang telah dipubllikasi di literature, parameter-parameter interaksi biner baru yang berhubungan dengan sistem blend yang diselidiki dapat ditentukan, dan pada gilirannya, dengan menggunakan model interaksi biner, akan dapat digunakan untuk meramalkan sifat-sifat blend lain yang sama sekali baru. Parameter-parameter interaksi biner baru yang dihitung pada studi kali ini ternyata dapat menerangkan beberapa sistem blend yang dilaporkan di sini."

"[ABSTRAKSifat karet alam dapat ditingkatkan melalui modifikasi kimiawi secara reaksikopolimerisasi cangkok emulsi karet alam terdeproteinisasi (DPNR) denganmonomer vinil (MV) tunggal maupun paduannya menggunakan inisiatorammonium peroksidisulfat dan surfaktan sodium dodesil sulfat menghasilkankaret alam termoplastik (TPNR). Reaksi dijalankan secara eksitu pada suhu 65ºCselama 5 jam dilanjutkan pada 70ºC selama 1 jam dengan teknik batch padaberbagai komposisi DPNR terhadap MV dan rasio paduan MV (stirena (ST)terhadap metil metakrilat (MMA)). Hasil penelitian secara umum menunjukkanbahwa TPNR yang disintesis dari DPNR dengan paduan MV menggabungkansifat unggul TPNR yang diperoleh dari hasil reaksi DPNR dengan MV tunggal.Komposisi DPNR terhadap MV sebesar 60 : 40 dengan rasio ST terhadap MMAsebesar 2 : 1 ditetapkan sebagai kondisi teroptimum dalam reaksi kopolimerisasicangkok emulsi pembentukan TPNR.

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ABSTRACTNatural rubber properties can be improved by chemical modification suchemulsion graft copolymerization of deproteinized natural rubber (DPNR) witheither single or combination of vinyl monomers (MV) by using ammoniumperoxydisulfate as initiator and sodium dodecyl sulfate as surfactant to producethermoplastic natural rubber (TPNR). The reaction was run at 65ºC for 5 hourscontinued at 70ºC for an hour by exitu ? batch procedure at various proportion ofDPNR to single MV and combination of MV ratio (styrene (ST) to metylmethacrylate (MMA)). Generally, the result showed that TPNR synthesized fromDPNR and combination of MV integrated the prior properties of TPNRsynthesized from DPNR and single MV. The proportion of DPNR to MV as 60 :40 and ratio of ST to MMA as 2 : 1 were regarded as the best condition onemulsion graft copolymerization in the formation of TPNR., Natural rubber properties can be improved by chemical modification suchemulsion graft copolymerization of deproteinized natural rubber (DPNR) witheither single or combination of vinyl monomers (MV) by using ammoniumperoxydisulfate as initiator and sodium dodecyl sulfate as surfactant to producethermoplastic natural rubber (TPNR). The reaction was run at 65ºC for 5 hourscontinued at 70ºC for an hour by exitu – batch procedure at various proportion ofDPNR to single MV and combination of MV ratio (styrene (ST) to metylmethacrylate (MMA)). Generally, the result showed that TPNR synthesized fromDPNR and combination of MV integrated the prior properties of TPNRsynthesized from DPNR and single MV. The proportion of DPNR to MV as 60 :40 and ratio of ST to MMA as 2 : 1 were regarded as the best condition onemulsion graft copolymerization in the formation of TPNR.]"

"Biofilm is an aggregate of consortium bacteria that adhere to each other on a surface. It is usually protected by the exopolysaccharide layer. Various invasive medical procedures, such as catheterization, endotracheal tube installation, and contact lens utilization, are vulnerable to biofilm infection. The National Institute of Health (NIH) estimates 65% of all microbial infections are caused by biofilm. Periplasmic α-amylase (MalS) is an enzyme that hydrolyzes α-1, 4- glicosidic bond in glycogen, starch, and others related polysaccharides in periplasmic space. Another protein called hemolysin-α (HlyA) is a secretion signal protein on C terminal of particular peptide in gram negative bacteria. We proposed a novel recombinant plasmid expressing α-amylase and hemolysin-α fusion in pSB1C3 which is cloned into E.coli to enable α-amylase excretion to extracellular for degrading biofilm polysaccharides content, as in starch agar. Microtiter assay was performed to analyze the reduction percentage of biofilm by adding recombinant E.coli into media. This system is more effective in degrading biofilm from gram positive bacteria i.e.: Bacillus substilis (30.21%) and Staphylococcus aureus (24.20%), and less effective degrading biofilm of gram negative i.e.: Vibrio cholera (5.30%), Pseudomonas aeruginosa (8.50%), Klebsiella pneumonia (6.75%) and E. coli (-0.6%). Gram positive bacteria have a thick layer of peptidoglycan, causing the enzyme to work more effectively in degrading polysaccharides."

"Ganoderma lucidum (hereafter G. lucidum) has been known as a food and raw material used in the development of medications because of its high content of polysaccharides, or ?-glucans, which support the immune function. In this work, subcritical water was applied to utilize G. lucidum for the extraction of polysaccharides at temperatures of 373–463K and a pressure level of 4.0 MPa using a semi-batch system. Furthermore, these extracts were atomized and contacted with hot air to produce microsphere particles. During extraction, thermal softening of G. lucidum occurred, allowing the removal of the polysaccharides and protecting other constituents in G. lucidum via hydrolysis. Scanning electron microscope (SEM) images showed that the microsphere particles formed were spherical and dimpled or shriveled particles with diameters varying from 1 to 6 ?m. Characteristics of the molecular mass revealed that main massed peaks of water soluble products were distributed at around 688–2636 m/z with a peak-to-peak mass difference of 162 m/z, consistent with the repeating unit of the glucans."