Indonesian Journal of Medicine (IJM)
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Correlations between Age and Hypertension on Diabetic Foot Ulcer
Get PDFBackground: Diabetic foot ulcer is a wound located on the foot of a diabetic patient, which is related to peripheral neuropathy or arterial disease. Hypertension can be related to diabetic foot ulcer by its mechanism that caused peripheral artery disease. Age also can be the one of risk factors for diabetic foot ulcers, because aging occurs a reduction of insulin secretion, even insulin resistance. Insulin resistance occurs in macroangiopathy. The purpose of this study is to determine the correlation between age and hypertension with diabetic foot ulcers.Subjects and Method: This was a cross-sectional study conducted at Arafah Islamic Hospital Rembang, Central Java. The dependent variable is diabetic ulcers. The independent variables were age and hypertension. A sample of diabetic patients using medical records from January 2022-June 2022. Data were collected using purposive sampling and analyzed using the Chi-Square test, and regression logistic test.Results: Significant correlation was found between age (OR= 3.80; 95% CI= 1.38 to 10.57; p<0.001) and hypertension (OR= 8.12; 95% CI= 2.70 to 24.40; p<0.001) with a diabetic foot ulcer.Conclusion: There is a significant correlation between age and hypertension with diabetic foot ulcers.Keywords: age, hypertension, diabetes, diabetic foot ulcers.Correspondence: Nining Lestari. Bachelor of Medicine, Muhammadiyah University of Surakarta. Jl. A. Yani, Mendungan, Pabelan, Kartasura, Sukoharjo 57162, Central Jawa, Indonesia. Email: [email protected]. Mobile: +62852-2939-0353Indonesian Journal of Medicine (2023), 08(02): 179-185https://doi.org/10.26911/theijmed.2023.08.02.07
Green Synthesis of Silver Nanoparticles as a Wound Healing Agent: a Systematic Review of the Biological Activities
Get PDFBackground: The implication of nanotechnology includes silver nanoparticles to medical sciences, and has a revolutionary impact on therapeutic and diagnostics management. Many studies reported that silver nanoparticle (AgNPs) application can accelerate the wound healing process. This study aimed to systematically review the biological activities of silver nanoparticles as a wound-healing agent.Subjects and Method: This article was a systematic review study conducted by searching for articles from online databases such as EBSCO, PubMed, Science Direct, and World Scientific. Populations: laboratory animals; Intervention: green synthesis of silver nanoparticles; Comparison: a standard ointment for wounds such as povidone-iodine, etc; Outcome: wound healing. The independent variable is the green synthesis of silver nanoparticles, and the dependent variable is wound healing. The inclusion criteria for this study were full articles using an experimental study, with the publication year until 2022. The data extraction was focused on the biological activities of silver nanoparticles and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations for systematic reviews.Results: A total of 8 articles reviewed in this study were from countries: Egypt, India, Saudi Arabia, Singapore, and China. The green synthesis of AgNPs was accomplished using a natural aqueous extract from leaves such as Azadirachta indica, Tridax procumbens, the combinations of Catharanthus roseus and Azadirachta indica, Scutellaria barbata, the fungus Fusarium verticillioides, or cyanobacterial platforms (ex: Phormidium sp., Synechocystis sp, and arthrospira sp polysaccharides). All studies were animal-based experimental with wounds infected with bacteria and inflicted in regards to the experiment. All trials resulted in favor of the AgNPs ointment treated group compared to the untreated group or the standard ointment group.Conclusion: Our review suggested that all studies about the efficacy of AgNPs as wound-healing therapy showed positive results.Keywords: biological activities, silver nanoparticles, wound healing.Correspondence: Galih Priambodo. Faculty of Medicine, Universitas Diponegoro. Jl. Prof. Sudarto, Tembalang, Kec. Tembalang, Kota Semarang, Central Java. Email: [email protected]. Mobile: 085229998999.Indonesian Journal of Medicine (2023), 08(01): 100-113https://doi.org/10.26911/theijmed.2023.08.01.1
Meta-Analysis: Effectiveness of Scoliosis Brace to Reduce Scoliosis Curve Degree in Adolescent Idiopathic Scoliosis
Get PDFBackground: Adolescent Idiopathic Scoliosis (AIS) is a disorder of the spine that is curved laterally which includes rotation of the spine so that there is humpback on the ribs, which occurs in children aged 10-18 years. The use of a brace is an attempt to modify the mechanical shape and control the development of curves in the curvature of the spine by applying certain pressure points on the body. The purpose of this study was to determine the magnitude of the effect of using the scoliosis brace to reduce the degree of scoliosis in adolescents with idiopathic scoliosis.Subjects and Method: This study was conducted using a systematic review and meta-analysis study design using PICO, population: adolescent idiopathic scoliosis, intervention: using a scoliosis brace. comparison: not using a scoliosis brace, outcome: degree of scoliosis. The articles used in this study come from 3 databases, namely Google Scholar, PubMed, and Science Direct. With keywords including "Adolescent scoliosis" OR "scoliosis" AND "scoliosis brace" OR "brace" AND "degree of scoliosis" OR "Cobb Angle" AND "randomized control trial". The articles included in this study are full paper articles with experimental studies, research subjects of adolescent patients with scoliosis, articles published in the 2011-2021 period.Results: A meta-analysis was conducted on 10 primary randomized control trials conducted from Turkey, China, Canada, Switzerland, the United States, and Hong Kong, with a total sample size of 558. The meta-analysis concluded that adolescent patients with idiopathic scoliosis who received intervention The scoliosis brace had a lower grade of scoliosis 0.27 compared to adolescents who did not use the scoliosis brace, and the difference was statistically significant (SMD= -0.27; 95% CI= -0.45 to –0.09; p= 0.003).Conclusion: The use of a scoliosis brace can reduce the degree of scoliosis in adolescents with idiopathic scoliosis.Keywords: adolescent idiopathic scoliosis, scoliosis brace, cobb angleCorespondence: Etanaulia Marsim. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: [email protected]. Mobile: +6285840530580.Indonesian Journal of Medicine (2023), 08(01): 12-22https://doi.org/10.26911/theijmed.2023.08.01.0
Effect of Combinations of Quadriceps Exercise and Hip Abductor Exercise on Pain in Knee Osteoarthritis Patients in Orthopedic and Traumatology Outpatient Care
Get PDFBackground: Osteoarthritis is a disorder of the moving joints. Pain functioning are the main complaints of the disease osteoarthritis of the knee. The purpose of the study was to analyze the effect of a combination of quadricep exercise and hip abductor exercise on pain in knee among osteoarthritis patients.Subjects and Method: The study was carried out at the East Java Regional Hospital for the period of December 2022 to March 2023. The study population was knee joint osteoarthritis patients of degree 1 to degree 2. The sampling technique used in this study was purposive sampling, with inclusion and exclusion criteria. The number of samples in quantitative research was 60 respondents. The dependent variable is pain, while the independent variable is quadriceps exercise and hip abductor exercise. The instrument used is the WOMAC questionnaire. Analysis of the study was using the Wilcoxon test and the Mann Whitney test.Results: There was a significant difference in pain between the control and intervention groups after conducting a combination of quadriceps exercises and hip abductor exercises (p=0.043)Conclusion: The combination of quadriceps exercise and hip abductor exercise is effective on pain reduction in knee osteoarthritis patients.Keywords: quadriceps, hip abductor, osteoarthritis.Correspondence: Dia Metasari. Master of Nursing, Universitas Airlangga, Indonesia. Jl. Dr. Ir. H. Soekarno, Mulyorejo, Surabaya, East Java 60115. Email: [email protected]. Mobile: +628563040303.Indonesian Journal of Medicine (2023), 08(02): 186-193https://doi.org/10.26911/theijmed.2023.08.02.0
Clinical Demographics Characteristic of Total Knee Arthroplasty at Prof IGNG Ngoerah General Hospital, Bali, Indonesia
Get PDFBackground: Total knee arthroplasty (TKA) is a widespread surgical procedure for severe arthritis. By 2030, primary TKA would reach over 1.2 million procedures annually in the United States. In Indonesia, the prevalence of joint disease is about 19.5 million cases. This study aims to evaluate the clinical demographics characteristics of TKA in Prof. Ngoerah General Hospital, Bali, Indonesia.Subjects and Method: This is a descriptive study using a Cross-Sectional method with a total 57 adult patients undergoing TKA caused by Osteoarthritis grade III/IV in Prof IGNG Ngoerah Hospital from June 2020-June 2022. The dependent variable is the TKA procedure. Independent Variable is Age, gender, grade of knee osteoarthritis, comorbidities, and complications Data from the medical record was collected and stored in a Microsoft Office Excel 365 spreadsheet, the distributive table was analyzed and collected by using SPSS.Results: Patient characteristic is dominated by an elderly female (84.2%), with age group 61-70 (38.6%). Comorbidities in this study include hypertension (28.1%), type II diabetes (10.5%), and rheumatoid disease (1.8%). The main complication recorded in this study includes joint stiffness (3.5%), and persistent pain (5.3%).Conclusion: After Total Knee Arthroplasty was performed on 57 patients with a wide range of comorbidities, only a small number of complications occurred. This study implied that TKA could be performed even if the patient had some comorbidities as long as the patient pursued a complete pre and post-operative evaluation algorithm of the procedure.Keywords: knee arthroplasty, osteoarthritis, human and medicine, rehabilitationCorrespondence: IGN Wien Aryana, Consultant of Sports Medicine, Dept. Orthopaedic and Traumatology, Prof IGNG Ngoerah General Hospital, Faculty of Medicine, Udayana University. Jl. Diponegoro, Dauh Puri Klod. Denpasar City, Bali 80113 Email: [email protected]. Mobile: +62811385263.Indonesian Journal of Medicine (2023), 08(02): 128-135https://doi.org/10.26911/theijmed.2023.08.02.01
Anticoagulant Management of Mechanical Heart Valve Patients During Perioperative Surgery: A Case Report
Get PDFBackground: Patients with mechanical heart valves require lifelong oral anticoagulation. It will be a dilemma if a patient with a mechanical heart valve has surgery. This case report aims to discuss how to interrupt oral anticoagulants and bridging therapy in patients with mechanical heart valves who will be undergoing non-cardiac surgery.
Case Report: A 26-year-old pregnant woman, G1P0A0, aterm with a mechanical mitral valve, will have elective Sectio Caesarian Transperitonealis (SCTP) surgery and Intra Uterine Device (IUD) insertion. The patient had a history of mitral valve replacement surgery (MVR) in 2014 and was routinely treated with 4 mg of warfarin at night. From the examination, blood pressure was 120/80 mmHg, heart rate was 90 beats per minute, and pulse rate was 90 beats per minute. The ECG examination found sinus rhythm with 1st-degree atrioventricular block, right axis deviation, 90 beats per minute, and left atrial enlargement. We decided to have oral anticoagulant interruption and bridging therapy by stopping warfarin three days before surgery. When the international normalized ratio (INR) falls <2, patients are given heparin injections (UFH) with an APTT target of 1.5-2.0 times from basic APTT. When the patient was about to be operated on, UFH was stopped 6 hours before surgery and resumed 12 hours after surgery. Warfarin was given one day postoperatively. Patients were adjusted to the dose of UFH according to the target. This patient had no thromboembolic events or bleeding before, during, or after surgery. The patient was allowed to be an outpatient and was given home therapy with Warfarin 5 mg at night.
Results: We report a case of a 26-year-old female patient with a mechanical mitral valve who was going to undergo elective SCTP surgery and an IUD insertion. Patients at high risk of thrombo¬embolism due to surgery with a high risk of bleeding. Bridging therapy was performed using UFH. In the perioperative period, the patient did not experience thromboembolic events, and bleeding before, during, and after surgery could be well controlled.
Conclusion: Perioperative management of patients with mechanical heart valves must be done carefully. Interruption of oral anticoagulants should be carefully considered considering the risk of thromboembolism and bleeding during the perioperative period. Guidelines recommend that in patients with mechanical heart valves, anticoagulation interruption for minor surgeries is avoided. Whereas in patients with major surgery, it is necessary to do bridging therapy with fast-acting anticoagulants such as UFH or LMWH.
Keywords: mechanical heart valve, anticoagulant interruption, perioperative, bridging therapy
Correspondence: Trisulo Wasyanto. Department of Cardiology and Vascular Medicine, Faculty of Medicine, Sebelas Maret University / Dr. Moewardi Hospital. Jl. Kol. Sutarto 132, Surakarta 57126, Central Java, Indonesia. Email: [email protected]. ORCID ID: 0000-0001-9900-0497. Mobile: +62811294225
Relationship between Family Support and Family Burden in Families With Cancer: Meta-Analysis
Get PDFBackground: Cancer is a chronic disease caused by abnormal cell growth with special care needs that cause a burden on the family. Family support can have a significant impact on family burden. Adequate support from family members can lighten the burden on individuals or families and improve their overall well-being. This study aimed to estimate the relationship between family support on family burden in families with cancer obtained from several previous similar studies.Subjects and Method: This research was conducted using a systematic review and meta-analysis with PICO namely, Population: family with cancer; Intervention: good family support; Comparison: Lack of family support; Outcome: family burden. By searching articles in 4 databases namely PubMed, Google Scholar, Science Direct, and ProQuest published from 2014 to 2022, entering the following keywords “Family support” OR “Supportive Family” AND “Family Burden” OR “Family depresssion” AND “Chronic Disease” AND “Cancer” AND “Multivariate Analysis”. Articles were selected using PRISMA flow and data analysis using the Review Manager 5.3 application.Results: There 9 articles using the Cross-Sectional study design with a total sample of 2,832 subjects from India, Japan, USA, Swiss, Austria, Yunani, Germany, and Mexico which have been subject to systematic review and meta-analysis. The results showed that good family support are effective in decreasing family burden, and the results are statistically significant. Families with cancer who receive good family support are decrease family burden 0.57 times than families with cancer receive lack family support (aOR= 0.57; 95% CI= 0.38 to 0.85; p= 0.006).Conclusion: Good family support are effective in decreasing family burden.Keywords: family support, family burden, chronic disease, cancer.Correspondence: Sang Ayu Made Adyani. Nursing Department, Faculty of Health, Universitas Pembangunan Nasional Veteran Jakarta. Jl. RS. Fatmawati Raya, Pd. Labu, Cilandak, Depok, West Java. Email: [email protected]. Mobile: +62 819-3206-5946.Indonesian Journal of Medicine (2023), 08(02): 169-178https://doi.org/10.26911/theijmed.2023.08.02.0
Intrafracture Recombinant Platelet-Derived Growth Factor Improves Fracture Healing Process on Wistar Rat
Get PDFBackground: Femoral fracture is associated with high morbidity and mortality, especially in young adults with high-energy injuries. Abnormal fracture healing presents as a significant matter in management of femoral fracture. Platelet Derived Growth Factor (PDGFBB) is proposed as potential agent in fracture healing. Up to this point, PDGF has been scientifically studied improve wound healing by enhancing fibroblast proliferation, extracellular matrix synthesis, and revascularization. This study aims to evaluate role of PDGF on fractured bone healing.Subjects and Method: This was a randomized controlled trial conducted at Animal and Biomedical Laboratory of Udayana University, from March to September 2022. 36 male and healthy Wistar Rats at 34 months old and weighs 140160 grams were selected for this study. The dependent variables were Allen score, type I and type III collagen levels. The independent variable was administration of 10 mcg PDGFBB following femoral osteotomy and intramedullary wire fixation. Type I and III collagen levels are assessed using ELISA methods. Statistical analysis is performed using independent T-test in SPSS ver 25.0 software.Results: Allen score in the PDGFBB group (Mean= 3.89; SD= 1.40) was higher than control group (Mean= 2.28; SD= 1.48), with p=0.002. Type I collagen in the PDGFBB group (Mean= 4.97; SD= 0.54) was higher than control group (Mean= 4.41; SD= 0.74), with p=0.014. Type III collagen in the PDGFBB group (Mean= 12.1; SD= 2.49) was higher than control group (Mean= 10.01; SD= 1.61), with p=0.005.Conclusion: In comparison to the nonPDGFBB group, Wistar rats that had their femurs osteotomized and joined with intramedullary wire in the PDGFBB group has higher mean of Allen score, type I and type III collagen levels.Keywords: femoral fracture, allen score, type I collagen, type III collagen, PDGFBBCorrespondence: IGN Wien Aryana, Consultant of Sports Medicine, Dept. Orthopaedic and Traumatology, Prof IGNG Ngoerah General Hospital, Faculty of Medicine, Udayana University. Jl. Diponegoro, Dauh Puri Klod. Denpasar City, Bali 80113. Email: [email protected]. Mobile: +62811385263.Indonesian Journal of Medicine (2023), 08(02): 136141https://doi.org/10.26911/theijmed.2023.08.02.0
Factors Influencing Nursing Student's Satisfaction in the Clinical Practice Education Program: A Systematic Review
Get PDFBackground: Nursing education programs' major success is arguably linked to students' practical clinical practice. The practical clinical practice provides a realistic setting in which students can safely integrate theoretical nursing knowledge into practical nursing care while also developing the attitudes and abilities required for the profession. This study aimed to examine the factors influencing nursing students' satisfaction in the clinical practice education program.Subjects and Method: A systematic review were conducted by searching articles from PubMed, ResearchGate, Science Direct, Google Scholar, and EBSCO is an article published from 2012 to 2022. The keywords were “clinical practice” AND “education” AND “students, nursing” AND “satisfaction”. The inclusion criteria were cross-sectional study. The articles were selected by PRISMA flow diagram.Results: A total of 8 studies was included in this review. Individualized supervision model, the pedagogical atmosphere on the ward, the relationship with the clinical nurse supervisors, the relationship with the nurse teachers, leadership style, clinical nurse commitment, patient relationships, higher age, grade point average (GPA), completion of several clinical courses, type of service and center, the type of management, the preference in the choice of the practice center, the number of students per period per clinical educator, being a woman and being in the second-grade year group, unhealthy placement environments.Conclusion: Factors influencing the satisfaction of student nurses in the clinical practice education program are the type of management, service, and center; the premises of nursing in the ward; the pedagogical atmosphere on the ward; the Ward/ Nurse Manager’s leadership style; individualized supervision model; unhealthy placement environments, clinical tutors and nurse teacher.Keywords: clinical practice, learning, education, students, nursing, satisfaction.Correspondence: Arief Wahyudi Jadmiko. Nursing Department, Faculty of Health, Universitas Pembangunan Nasional Veteran Jakarta. Jl. RS. Fatmawati Raya, Pd. Labu, Cilandak, Depok, West Java. Email: [email protected]. Mobile: +62 856-4721-3628.Indonesian Journal of Medicine (2023), 08(02): 225-235https://doi.org/10.26911/theijmed.2023.08.02.1
Meta-Analysis the Effectiveness of Speech Therapy on Phonation Improvement in People Diagnosed with Parkinsons Disease
Get PDFBackground: Parkinson's disease (PD) is a complex, progressive neurodegenerative disease characterized by tremor, rigidity, slow movement, and postural instability. Phonation disturbances are the most frequently observed speech characteristics in PD patients. The purpose of this study was to estimate the effectiveness of speech therapy interventions for phonation improvement in people with a diagnosis of Parkinson's disease.Subjects and Method: This study is a meta-analysis of a number of Randomized Controlled Trial study designs. The articles used in this study were obtained from several databases including PubMed, Google Scholar, and Springer Link. The article search was carried out by considering the eligibility criteria defined using the PICO model. The population in the study were people with a diagnosis of Parkinson's disease with intervention in the form of speech therapy intervention, comparison, namely no speech therapy intervention, outcome in the form of phonation. The keywords to search for articles are as follows: “Intervention Speech Therapy” OR “Speech Therapy” OR “Phonation” OR “Voice” OR “Parkinson's Disease” AND “Randomized Controlled Trial” OR “RCT”. The articles included in this study are full-text articles with a Randomized Controlled Trial (RCT) study design. Articles are collected using PRISMA flow diagrams. Articles were analyzed using the Review Manager 5.3 application.Results: A total of 7 articles were reviewed in this study from the United States, North America, and Austria. The total sample size in this study was 213 subjects. A meta-analysis showed that speech therapy was effective for improving phonation in people with a diagnosis of Parkinson's disease (SMD = 2.52; 95% CI = 1.79 to 3.24; p<0.001).Conclusion: Speech therapy is effective for improving phonation in people with a diagnosis of Parkinson's disease.Keywords: speech therapy, phonation, voice, parkinson disease.Correspondence: Anitasari Kartika Putri. Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Jawa Tengah, Indonesia. Email: [email protected] Mobile: 0857-2777-7217Indonesian Journal of Medicine (2023), 08(03): 277-285https://doi.org/10.26911/theijmed.2023.08.03.0