Indonesian Journal of Medicine (IJM)
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Spatial Autocorrelation of Population Density, HIV/AIDS, and Diabetes Mellitus with Pulmonary Tuberculosis in Kupang, East Nusa Tenggara, Indonesia
Full text linkBackground: The 2023 Global Tuberculosis (TB) Report ranks Indonesia second in the world for TB cases, with approximately 1,060,000 new cases and 134,000 deaths annually—equating to 17 deaths per hour. In East Nusa Tenggara (NTT) Province, pulmonary TB cases increased from 5,361 in 2020 to 5,184 in 2021, and significantly rose to 8,035 in 2022. Kupang Regency reported the highest number of TB cases in 2022. This study aimed to analyze the impact of risk factors, including population density, HIV/AIDS, and Diabetes Mellitus, on pulmonary TB cases using spatial analysis with the GeoDa application.
Subjects and Methods: This ecological study, conducted in Kupang, Indonesia, between October and November 2024, uses secondary data from 2021 to 2023 as the research sample. The study includes all recorded pulmonary TB patients from the Kupang Health Office, with 441 cases in 2021, 785 cases in 2022, and 979 cases in 2023.
Results: The Local Indicator of Spatial Association (LISA) test results show a low-high spatial relationship between HIV and TB variables in the Maulafa district for 2022-2023. Additionally, the diabetes mellitus (DM) and TB variables exhibit a High-Low spatial pattern in 2021 and a Low-High pattern in 2022 within the district. Regarding population density in 2021, a clustered spatial autocorrelation was observed (p-value = 0.049 < 0.05; [I] = 0.051 > E[I] = -0.200; Mean = 0.116; SD = 0.120), with a High-Low pattern in the Kota Lama district and a Low-Low pattern in Maulafa. From 2022 to 2023, a Low-High spatial pattern was identified in the Maulafa district.
Conclusion: The results of this study indicate spatial autocorrelation between population density and pulmonary TB cases in Kupang City in 2021. However, from 2022 to 2023, no spatial autocorrelation was observed, and the same pattern was found for Diabetes Mellitus and HIV/AIDS
Factors Related to HIV/AIDS Risk Behavior in Ship Crew at Tenau Kupang Port
Full text linkBackground: In 2022, East Nusa Tenggara recorded the highest number of HIV-AIDS cases in the province, with a total of 151 patients. HIV-AIDS infections are spread across six districts: Oebobo (27.8%), Maulafa (18.5%), Kelapa Lima (22.5%), Alak (16.5%), Kota Lama (4.6%), and Kota Raja (10%). HIV cases in Indonesia have fluctuated from 2019 to 2022 due to a significant percentage of high-risk behaviors exhibited by high-risk groups, including ship crew members. This study aims to analyze the factors related to HIV/AIDS risk behaviors in ship crew members.
Subjects and Method: This was a cross-sectional study conducted at Tenau Port, Kupang, East Nusa Tenggara, Indonesia from November to December 2024. The study population consists of all crew members (ABK) on domestic cargo ships arriving and docking at Tenau Kupang Port in 2024, estimated to be 225 ABK. A simple random sampling technique was used, with 96 samples selected based on the Lemeshow formula. Data were collected using a questionnaire.
Results: The chi-square test results revealed a significant relationship between knowledge (p = 0.029; OR = 2.734; 95% CI: 1.188–6.296), ship docking duration (p = 0.014; OR = 3.215; 95% CI: 1.342–7.702), and peer support (p = 0.000; OR = 27.586; 95% CI: 3.476–218.930) with HIV/AIDS risk behavior. Attitude (p = 0.272; OR = 0.455; 95% CI: 0.145–1.427), education (p = 1.000; OR = 1.136; 95% CI: 0.089–18.711), income (p = 0.587; OR = 0.587; 95% CI: 0.516–5.093), frequency of going home (p = 0.657; OR = 0.753; 95% CI: 0.324–1.752), and marital status (p = 1.000; OR = 0.948; 95% CI: 0.424–2.127) showed no significant relationship. It is necessary to increase socialization to raise awareness of HIV/AIDS prevention among ABK members and foster positive social support within the crew.
Conclusion: There is a need to increase knowledge about the risks of HIV/AIDS through outreach and counseling
The Application of the Health Belief Model in the Selection of Acupuncture Therapy for Low Back Pain Patients
No full textBackground: Low back pain (LBP) is one of the health problems experienced by 50–80% of adults. LBP affects individual, physical, social, and psychological aspects. Individuals suffering from LBP require comprehensive treatment to ensure the success of therapy. The study aims to determine the patient's perception of the choice of LBP therapy using the Health Belief Model theory.
Subjects and Method: This research was conducted using a cross-sectional study conducted in Surakarta, from September to October 2024. A total of 200 acupuncture patients and physiotherapy patients were selected using fixed disease sampling. The independent variables were vulnerability perception, severity perception, benefit perception, obstacle perception, cues to action perception, self-efficacy. The bound variable is the choice of therapy. The data using questionnaires were analyzed using multiple logistic regression.
Results: Perceived susceptibility was less likely to use acupuncture therapy (OR= 0.51; 95% CI= 0.14 to 1.79; p=0.293). Perceived severity was more likely to use acupuncture therapy (OR=3.99; 95% CI= 1.17 to 13.54; p= 0.027). Perceived benefits were more likely to use acupuncture therapy (OR=43.90; 95% CI= 9.45 to 203.99; p<0.001). Perceived barriers were less likely to use acupuncture therapy (OR=0.03; 95% CI p< 0.01 to 0.20; p< 0.001). Cues to action were more likely to use acupuncture therapy (OR=7.10; 95% CI p= 2.20 to 22.91; p< 0.001). High self-efficacy has a greater likelihood of using acupuncture therapy (OR=142.49; 95% CI= 14.17 to 1432.86; p<0.001).
Conclusion: The Health Belief Model for the selection of acupuncture therapy increased with the perception of severity, perception of benefits, action signals, and self-efficacy. The choice of acupuncture therapy decreased with a high perception of resistance. Perception of vulnerability was statistically not significantly associated with therapy selection. The independent variables in the model were able to explain the variation in therapy selection (acupuncture vs physiotherapy) by 68.69%
Assessment of Muscle Strength in Para Sport Athletes: A Systematic Review
Full text linkBackground: Accurate and reliable muscle strength assessment is essential for monitoring injury risk, monitoring the effectiveness of rehabilitation or strength training programs, and for sport classification purposes. This study aims to look at measurement tools to assess muscle strength in para-athletes, look at the characteristics of muscle strength assessment methods, and determine the validity and reliability of several muscle strength measurement tools.
Subjects and Method: This systematic review used methods described in the Cochrane Handbook for Systematic Reviews of Interventions and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data searches in several databases (PubMed, Scopus, and Google Scholar) were conducted using the boolean search method. The keywords used in the literature search were “muscle strength” OR “muscle power” AND “assessment” OR “outcomes” AND “isometric contraction” OR “isotonic contraction” AND “para-sports” OR “para-athletics” AND “paralympic”.
Results: Isometric strength testing was shown to be valid and reliable (ICC 0.85) but limited to static measurements; isokinetic testing was shown to be valid and reliable (ICC 0.81-0.95) but required expertise, specialized equipment, and was time-consuming. MMT, although frequently used, shows variable validity and reliability and is highly subjective.Conclusion: Muscle strength assessment with isometric and isokinetic tests is effective for para-athlete classification. However, more standardized muscle strength assessment methods are needed to ensure a more objective classification of para-athletes
Application of Artificial Intelligence (AI) and Machine Learning (ML) in Health Applications for HIV/AIDS Prevention: A Systematic Review
Full text linkBackground: HIV/AIDS has become a global problem that continues to increase every year, despite various prevention efforts such as health education and HIV screening. To overcome this challenge, innovative strategies are needed by integrating artificial intelligence and digital technology to develop more effective HIV/AIDS prevention interventions.
Method: The research method used was a desk review or systematic review related to artificial intelligence and machine learning in HIV prevention and PrEP use. The databases used are PubMed, Science Direct, and Google Scholar with study criteria published in 2015-2024. The keywords used are “Artificial Intelligence and Machine Learning and HIV”,“Artificial Intelligence and HIV”, “Machine Learning and HIV, ‘Artificial Intelligence and HIV’ and Systematic Review”, “Artificial Intelligence and Machine Learning in HIV/AIDS Prevention”.
Results: Based on the results of the review, AI and ML have proven to be effective in improving HIV/AIDS prevention programs. Benefits include the use of digital data to detect at-risk groups, virtual reality programs to help with status disclosure, chatbots for education, and data analysis to understand the causes of transmission and how to prevent it. An HIV prevention chatbot that can aid in prevention messaging, encourage self-testing, and personalized treatment strategies would be transformational in a low-resource setting.
Conclusion: AI and ML approaches can be an important solution in improving the effectiveness of HIV/AIDS prevention programs, although they are still at an early stage and face various challenges. Future research should identify the potential of AI and ML to be developed and implemented more widely.
Nutrition Disc as Media for Increasing Skills of Integrated Health Post Cadres at Jaten II Community Health Center, Karanganyar, Central Java, Indonesia
Full text linkBackground: Stunting is the main nutritional problem faced by children in Indonesia. Nutrition discs can be used as one of the first steps to detect children with stunting. This study aimed to find whether nutrition discs are an effective medium for improving the measurement skills of health cadres to detect stunting early.
Subjects and Method: This was a quasi-experimental study conducted in the Jaten II Community Health Center, Karanganyar, Central Java, from September 2022 to February 2023. A sample of 33 health cadres was selected using total sampling. The dependent variable was cadre skills. The independent variable was nutritional disc media. The instrument in this study used a questionnaire sheet containing 10 numbers regarding stunting knowledge and 25 numbers regarding anthropometric measurement skills. The data were examined using Wilcoxon sign rank test run on SPPS IBM 25.
Results: The results of the univariate analysis showed that most of the respondents were aged 40-60 years (78.8%) with a high school educational background, 18 people (54.5%), 18 people (54.5%) had been cadres for 2-10 years and 24 people (72.7%) were not working. Bivariate analysis using the Wilcoxon sign rank test showed p=0.001 (OR=0.35; RR= 0.77 to 1.11; CI 95%).
Conclusion: Nutrition discs are an effective medium for improving the measurement skills of health cadres to detect stunting early
The Influence of Working Posture on the Risk of Musculoskeletal Disorders in Batik Makers
Full text linkBackground: Complaints of musculoskeletal disorders (MSDs) such as feelings of pain, soreness or soreness in the skeletal muscles felt by batik makers both during work and after work. This study aimed to examine the influence of work posture on the risk of MSDs in batik craftsmen.
Subjects and Method: This was a cross-sectional study. Total sample was 200 batik craftsmen was selected by cluster random sampling. The dependent variables were pain and musculoskeletal disorders. The independent variables were age, work posture, work duration, work period, and type of batik craftsmen. Pain was measured using visual analog scale (VAS). MSDs was measured using the Nordic Body Map (NBM). Other variables were collected using questionnaire. The data were analyzed using a multiple logistic regression.
Results: Batik craftsmen with non-ergonomic working postures (OR= 2.98; 95% CI=1.27 to 6.99; p= 0.012), age ≥40 years old (OR= 3.45; 95% CI=1.28 to 10.49; p= 0.015), works ≥5 hours/day (OR= 3.52; 95% CI= 1.46 to 8.47; p= 0.012), tenure ≥5 years (OR= 7.04; 95% CI= 3.00 to 16.53; <0.001) significantly increased the risk of MSDs. There was no significant association between type of batik craftsmen and MSDs (OR= 2.76; 95% CI= 0.81 to 9.38; p= 0.102). Nagelkerke R2= 30.8%.
Conclusion: Non-ergonomic working postures, age ≥40 years old, works ≥5 hours/day, tenure ≥5 years significantly increase the risk of MSDs. There is no significant association between type of batik craftsmen and MSDs.
Keywords: musculoskeletal disorder, pain, work duration, work period, age, batik makin
The Impact of Inducing Compelled Body Weight Shifts in Improving Dynamic Balance on Non-Hemorrhagic Stroke Patients
Full text linkBackground: Stroke is a brain attack that occurs suddenly where there is partial or complete disruption of brain function as a result of disruption of blood flow due to blockage or rupture of certain blood vessels in the brain, causing brain cells to lack blood, oxygen or nutrients and ultimately can cause These cells die in a relatively short time. In general, strokes are divided into 2, namely hemorrhagic and non-hemorrhagic strokes. Balance disorders due to loss or decreased motor function make stroke patients vulnerable to falls. The aim of this research is to determine the effect of giving Compelled body weight shift on non-hemorrhagic stroke to improve dynamic balance.
Subjects and Method: This research was a quasi experiment conducted in Sri Meranti Village, Rumbai, Pekanbaru, Indonesia, from June 2023. 12 non-hemorrhagic stroke patients were selected using purposive sampling. The dependent variable was dynamic balance. The independent variable was compelled body weight shift. Body dynamic balance was measured using Berg balance scale. Body dynamic balance before and after intervention was examined using .
Results: There was a significant increase in balance between the control group and the experimental group in non-hemorrhagic stroke sufferers after the compelled body weight shift was carried out (p<0.001).
Conclusion: Compelled body weight shift balance training can be used to improve the body dynamic balance in non-hemorrhagic stroke patients
Massive Mature Mediastinal Teratoma With Malignant Transformation: An Unusual Case Report
Full text linkBackground: Teratoma is a type of germ cell tumor that is rarely found in the anterior mediastinum. Meanwhile, mature mediastinal teratoma with malignant transformation is rare and develops rapidly, with a poor prognosis. This article aims to report one of the uncommon cases of mature teratoma and discuss its imaging features thereby adding insight in providing an accurate diagnosis of this condition.
Case Report: This study presents a case of a 26-year-old male patient who has complained of shortness of breath for 3 months and worsening in the last 3 days. The patient passed through a chest radiographic examination and was diagnosed with a mediastinal tumor. The contrast-enhanced chest computed tomography showed a huge mediastinal mass occupying the right and left hemithorax, measuring 16.9 cm x 20.5 cm x 20.9 cm and pressing against the chest wall, esophagus, trachea, great vessels, and the vital organs, lungs as well as heart, causing several complications in patients.
Conclusion: Knowledge of the teratoma radiological appearance and the characteristics of the various subtypes is very important in the diagnosis of mediastinal teratoma diagnosis for immediate and appropriate treatment
Effectiveness of Manual Therapy on Function in Neck Pain Patients: A Systematic Review and Meta-Analysis
Full text linkBackground: Neck pain is a musculoskeletal disorder that occurs in the neck due to various factors such as incorrect ergonomic position when carrying out an activity. One intervention that can be carried out to improve the function of neck pain sufferers is by providing manual therapy. This study aims to determine the effectiveness of manual therapy for functional use in patients with neck pain.
Subjects and Method: This was a meta-analysis study using PICO as follows, P=Patients with neck pain, I=manual therapy, C=non-manual therapy, O=functional improvement. The articles used in this research were obtained from several databases such as Google Scholar, NCBI, PubMed, Springer Link, Science Direct. The keywords used are "Randomized control trial" AND "neck pain" OR "cervical pain" OR "Cervicalgia" Upper cervical pain" AND "manual therapy" OR "Manipulation treatment" OR "thoracic manipulation in neck pain" OR "Cervical spine manipulation” OR “Passive therapy” OR “Ostheopathic” OR “neck pain rehabilitation” AND “Disability” OR “Functional” OR “Neck pain disability index”. The articles included in this research are full text articles with the study design used being a Randomized Controlled Trial. The full text review application uses PRISMA flow diagrams.
Results: A total of 8 articles that have been analyzed come from Spain, the Netherlands, Minensota, Canada, Australia and Turkey. This study shows that there is an effect on neck pain sufferers who are given manual therapy intervention - 0.08 units of influence compared to non-manual therapy, this effect is not statistically significant on function and this effect has a statistically significant effect (SMD = - 0.08; CI 95% CI= -0.35 to 0.20; p= 0.590).
Conclusion: The manual therapy has an impact on mobile range of motion of the joint in neck pain patients compared to those without manual therapy