Indonesian Journal of Medicine (IJM)
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Correlation between Mortality of COVID-19 Patients with Hypertension and Thorax Radiography Treated in the Intensive Care Unit of Dr. Moewardi Hospital
Get PDFBackground: Coronavirus 2019 or COVID-19, caused by the new SARS-CoV2 virus, has become a pandemic and attacked more than 200 countries, including Indonesia. The most comorbid disease in COVID-19 patients was hypertension. Chest radiography can predict prognosis and mortality in COVID-19 cases and one of the methods that can be used for chest radiographic assessment is the Brixia Score, specifically designed for COVID-19 patients to measure and analyze the severity of lung abnormalities in patients with COVID-19. This study aimed to find the correlation between the mortality of COVID-19 patients with hypertension and chest radiography using the Brixia Score treated in the intensive care unit (ICU) of Dr. Moewardi Hospital.Subjects and Method: This study used an analytic observational study with a cross-sectional approach. The subjects were 84 COVID-19 patients with hypertension who met the exclusion and inclusion criteria. The independent variable is chest radiography and dependent variable is mortality. Sampling was collected by purposive sampling and the data obtained were analyzed using the contingency coefficient test.Results: There was a significant correlation between the mortality of COVID-19 patients with hypertension and chest radiography as assessed using the Brixia Score (p<0.001). The youngest patient was 20 years old and the oldest was 87 years old.Conclusion: There was a correlation between the mortality of COVID-19 patients with hypertension and chest radiography treated in the ICU RSUD Dr. Moewardi, Surakarta.Keywords: COVID-19, mortality, hypertension, chest radiography, Brixia Score, intensive care unitCorrespondence: Widiastuti Soewondo. Faculty of Medicine Universitas Sebelas Maret Surakarta. Jl. Ir. Sutami 36A, Surakarta 57126, Indonesia. Email: [email protected]. Mobile: 082134368592.Indonesian Journal of Medicine (2022), 07(03): 269-277https://doi.org/10.26911/theijmed.2022.07.03.03
Analysis of the COVID-19 Severity Based on NLR and the Mortality Rate of Pregnant Women with COVID-19 at Dr. Moewardi General Hospital, Surakarta, Central Java, Indonesia
Get PDFBackground: Coronavirus Disease 2019 (COVID-19) is a disease of the human respiratory system. Pregnant women are more susceptible to respiratory infections due to physiological changes in the immune and cardiopulmonary systems. Routine laboratory biomarkers such as lymphocytes, neutrophils, and NLR are considered prognostic in COVID-19. This study aimed to analyzed the severity of COVID-19 based on NLR on the mortality of pregnant women with COVID-19 at Dr. Moewardi, Surakarta.Subjects and Method: This study used analytic observational with a cross-sectional. The study subjects were 82 pregnant women with confirmed COVID-19, aged over 18 years, and being treated at RSUD Dr. Moewardi Surakarta between March 2020 to January 2022. The samples were taken using the consecutive sampling technique. The independent variable is the severity of COVID-19 based on clinical presentation. The dependent variable is the laboratory results in lymphocytes, neutrophils, and NLR. Data were collected from medical records and anlayzed using SPSS software.Results: There was correlation between NLR on the severity of pregnant women with COVID-19 (Mean= 10.11; SD= 4.10; p= 0.026) and there was a significant correlation between NLR on the mortality rate of pregnant women with COVID-19 (Mean= 9.92; SD= 3.94; p<0.001).Conclusion: NLR affected the severity and the mortality rate among pregnant women with COVID-19.Keywords: COVID-19, pregnancy, lymphocytes, neutrophils, NLR, mortalityCorrespondence: Dhea Fitria Rachma. Faculty of Medicine Universitas Sebelas Maret Surakarta. Jl. Ir. Sutami 36A, Surakarta 57126, Indonesia. Email: [email protected]. Mobile: 085702594898.Indonesian Journal of Medicine (2022), 07(04): 401-410https://doi.org/10.26911/theijmed.2022.07.04.05
Meta Analysis the Effect of Cadmium Exposure on Chronic Renal Filure in Adults
Get PDFBackground: Heavy metals, such as cadmium, are heavy metals that are hazardous to health. Chronic exposure to cadmium is associated with decreased glomerular filtration rate and increased risk of chronic renal failure. This study was conducted to determine how much influence cadmium exposure has on the incidence of chronic kidney failure in adults. The purpose of this study was to analyze the effect of cadmium exposure on the incidence of chronic kidney failure in adults.Subject and Method: This study is a systematic review and meta-analysis using the PRISMA flowchart with PICO as follows, Population: Adults. Intervention: Exposure to Cadmium. Comparison: No Cadmium Exposure. Outcome: Chronic Renal Failure. Search articles using several databases including PubMed, Google Scholar, and Science Direct with the search keywords “adults” AND “cadmium exposure” AND “chronic kidney failure”. The articles submitted ranged from 2013 to 2021. Analysis was performed using RevMan 5.3 as a statistical program.Results: There are 11 articles, originating from the continents of Asia and Europe. The results of the meta-analysis showed that exposure to cadmium increased the risk of developing chronic renal failure in adults by 2.81 times compared with adults who were not exposed to cadmium and was statistically significant (aOR = 2.81; 95% CI = 1.74 to 4.51; p < 0.001).Conclusion: Cadmium exposure may increase the risk of chronic kidney failure in adults.Keywords: cadmium, chronic renal failure, adultsCorrespondence: Fathia Mutiara Zahra. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +62 815-6798-7661.Indonesian Journal of Medicine (2022), 07(01): 61-72https://doi.org/10.26911/theijmed.2022.07.01.0
Correlation of Brixia Score Changes with Length of Stay in Patient with COVID-19
Get PDFBackground: The increase in Covid-19 cases in Indonesia as well as the hospital length of stay is unpredictable. The degree of lung damage in Covid-19 largely determines the severity of the disease, a serial chest X-ray using Brixia score can be used to assess changes in pulmonary parenchymal damage and could predict the length of hospitalization. This study aims to analyze the correlation of Brixia score with the length of hospitalization in Covid-19 patients.Subjects and Method: This cross-sectional study was conducted at Sumber Waras Hospital from November 2021 until January 2022. The samples are Covid-19 confirmed patients who were treated at Sumber Waras hospital. Independent variable is Brixia score and dependent variable is length of hospitalization. Brixia's score assessment from two serial chest X-rays was divided into 4 categories: low to low, low to high, high to low, and high to high. All the categories were analyzed using Kruskall-Wallis method then continued with Mann-Whitney U test. The multivariate variable was analyzed using linear regression.Results: There are 190 samples, the median score of Brixia at the beginning of treatment is 4 (range 0-18), and the median score of Brixia on serial examination is 6 (range 0-18). Patients in low to low category had median 10 days length of hospitalization, low to high category and high to low category had median 11 days, and high to high category had median 8 days. There was no statistically significant correlation between Brixia score and length of hospitalization (p= 0.377).Conclusion: There is no significant relationship between the median Brixia score changes with the length of hospitalization of covid-19 patients.Keywords: Covid-19, hospitalized, Brixia score changes, length of stayCorrespondence: Widiastuti Soewondo. Faculty of Medicine Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java, Indonesia. Mobile: +6282134368592. Email: [email protected] Journal of Medicine (2022), 07(03): 262-268https://doi.org/10.26911/theijmed.2022.07.03.0
Meta Analysis: Correlation between Diabetes Mellitus and Surgical Wound Infection
Get PDFBackground: Surgical wound infections complicate 10-20% of operations with a considerable burden of increasing morbidity, mortality, and health care costs. One third of postoperative deaths are associated with surgical wound infections. The risk of surgical site infection is associated with the presence of risk factors for diabetes mellitus. This causes patients undergoing surgery with diabetes mellitus to have a higher risk of developing surgical site infections. This study aims to examine the effect of diabetes mellitus on the incidence of surgical wound infection.Subjects and Method: This research was conducted using a systematic review design and meta-analysis using PRISMA flow diagrams. The article search was conducted by selecting articles published between the years 2000-2022 which were obtained from several databases of PubMed, Google Scholar, Science Direct, and Springer Link. The keywords used to search for articles were “Diabetes Mellitus”, “Surgical Site Infection”, “cohort”, “Diabetes Mellitus” AND “Surgical Site Infection”, “Diabetes Mellitus” AND “Surgical Site Infection” AND “adjusted odd ratio”. The analysis was carried out using RevMan 5.3 software.Results: Meta-analysis of 9 articles of diabetes mellitus (aOR= 2.54; 95% CI= 1.93 to 3.34; p<0.001) affected the incidence of surgical wound infection.Conclusion: Diabetes mellitus increases the incidence of surgical wound infections.Keywords: diabetes mellitus, surgical wound infectionCorrespondence: Chattrin Fahrezi. Masters Program in Public Health, Universitas Sebelas Maret, Jl.Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: [email protected]. Mobile: 08812532292.Indonesian Journal of Medicine (2022), 07(02): 122-130https://doi.org/10.26911/theijmed.2022.07.02.0
Meta-Analysis the Effect of Acupressure in Lowering Pain of Dysmenorrhea
Get PDFBackground: Dysmenorrhea is the most common cause of lower abdominal pain and has a negative impact on women's quality of life resulting in activity limitations. Non-pharmacological management can be used as an intervention in the management of dysmenorrhea. Acupressure is a therapy that is given by massaging or pressing certain points. The purpose of this study was to analyze the effect of acupressure therapy on reducing dysmenorrhea pain.Subject and Method: This study was a meta-analysis with the following PICO, population: Women aged 16-30 years old with primary dysmenorrhea. Intervention: administration of Acupressure Therapy. Comparison: Acupressure therapy was not performed. Results: Decreased pain in primary dysmenorrhea. The articles used in this study were obtained from three databases, namely Google Scholar, Pubmed, and Science Direct. Keywords to search for articles “Acupressure” OR “Acupressure Therapy” AND “Sanyinjiao Point (SP6)” AND “Hequ Point (LI4)” AND “Dysmenorrhea” OR “Primary Dysmenorrhea” OR “Menstrual Pain” AND “Randomized Controlled Trial”. The articles included are full-text English with a Randomized Control Trial study design from 2007 to 2022. The articles were selected using PRISMA flow diagrams. Articles were analyzed using the Review Manager 5.3 application.Results: Meta-analysis of 9 randomized controlled trial articles from Asia and Europe concluded that acupressure therapy can reduce pain in primary dysmenorrhea (SMD= -0.66; 95% CI = -0.96 to -0.36; p < 0.001).Conclusion: Acupressure therapy can affect pain reduction in women with complaints of primary dysmenorrhea.Keywords: Acupressure, pain relief, primary dysmenorrheaCorrespondence: Anisya Fajar Rahmawati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Mobile: +6285715840985. Email: anisyafajar25@gmail.com.Indonesian Journal of Medicine (2022), 07(01): 51-60https://doi.org/10.26911/theijmed.2022.07.01.0
Comparison of The Effectiveness of Remifentanyl versus Fentanyl in Pediatric Undergoing Methotrexate Therapy
Get PDFBackground: Anesthesia procedure is routinely performed for some painful pediatric oncologic procedures such as lumbar puncture (LP) and bone marrow examination (BME). Several studies mentioned that fentanyl and remifentanyl are often used as anesthetic agent of this procedure, but none of them compare the recovery time of both agent. This study aims to compare the recovery time of fentanyl and remifentanyl in pediatric patients undergoing methoterexate therapy.Subjects and Method: This was a double-blind randomized controlled trial on 36 patients who underwent intratechal methotrexate chemoterapy under general anesthesia anesthesia in pediatric intervention room of Moewardi General Hospital Surakarta that met inclusion criteria. The dependent variable was recovery time and the independent variable were fentanyl and remifentanyl. The samples were divided into 2, Fentanyl (F) and Remifentanyl (R) group. Recovery time was recorded after the procedure until the subject reached Pediatric Glasgow Comma Scale (PGCS) of 15. Statistical analysis was Mann Whitney U Test using SPSS 25 for Windows.Results: The mean recovery time of F group was 373.39 ± 29.48 seconds, while R group was 124.67±11.55 seconds. There was a significant difference in recovery time between patients in the Fentanyl group and the Remifentanyl group (p= 0.000).Conclusion: Remifentanyl recovery time was significantly faster than with fentanyl in pediatric patients undergoing intrathecal methotrexate chemotherapy.Keywords: Fentanyl, Methotrexate, Outpatient anesthesia, Recovery time, RemifentanylCorrespondence: Ferdy Pamungkas. Anesthesiology Department, Moewardi General Hospital, Surakarta. Jalan Kolonel Sutarto 132 Jebres, Kecamatan Jebres, Surakarta City 57126. Central Java, Indonesia. [email protected]. +6281230269501.Indonesian Journal of Medicine (2022), 07(01): 115-121https://doi.org/10.26911/theijmed.2022.07.01.1
Probiotics and Its Effects on the Cognitive Development in Children: A Meta-Analysis
Get PDFBackground: Due to its high morbidity and mortality rate, diarrhea is still a major health problem among children, particularly toddlers, in developing countries. One of the causes of diarrhea in children is the side effect of antibiotics or known as antibiotic-associated diarrhea (AAD). Evidences of studies conducted in several countries indicated the high use of antibiotics among children that put the group at a high risk of enduring AAD. Probiotics has shown efficacy in preventing and curing various medical conditions, especially those involving digestive tract in children.Subject and Method: It was a systematic review and meta- analisis study. Data collection was conducted by obtaining from databases, namely: Google Scholar, PubMed, Scopus and Science Direct. The study was analyzed by using RevMan 5.3 software. Inclusion criteria used were full paper in English with Randomized controlled trial design during the period of 2000-2022. Keywords used were “Probiotic” AND “Antibiotic Associated Antibiotic” AND “Child” AND “Randomized Controlled Trial”.Results: Meta-analisis was conducted to 9 primary studies from several countries such as Poland, Italy, Korea, Iran, and Australia. Mata-analysis concludes that there were effects of probiotics toward antibiotic-associated diarrhea. Children who were given probiotics had one-third time risk of diarrhea episodes compared to those who were not given probiotics (RR= 0.32; 95% CI= 0.23 to 0.44; p<0.001). Heterogeneity of between-study effect estimates of the meta-analysis data was (I2= 0%; p= 0.096) therefore, calculation of effect estimates was written by using fixed effect approach. Funnel plot did not identify the occurrence of publication bias out of the meta-analysis. Therefore, the funnel plot did not identify the occurrence of publication bias.Conclusion: Probiotics have effects in reducing antibiotics-associated diarrhea incidences in children.Keywords: probiotics, diarrhea, antibiotics.Correspondence:Anggraini Ambarsari. Masters Program in Public Health, Sebelas Maret University. Jalan Ir. Sutami 36A, Surakarta 57126, Jawa Tengah, Indonesia. Email: [email protected]. Mobile: 085600184363Indonesian Journal of Medicine (2022), 07(02): 232-241https://doi.org/10.26911/theijmed.2022.07.02.1
Meta-Analysis the Effect of Chlorhexidine and Povidone Iodine Mouthwashes on Viral Load SARS-CoV-2-Saliva
Get PDFBackground: The strategy to reduce the risk of transmission of COVID-19 is to reduce the salivary SARS-CoV-2 viral load. Chlorhexidine and povidone iodine mouthwash are common active ingredients in oral antiseptics that have efficient viral activity against salivary SARS-CoV-2. This study aims to combine the results of several effect sizes regarding the effect of using chlorhexidine and povidone iodine mouthwash on the salivary SARS-CoV-2 viral load from various countries.Subject and Method: This study is a meta-analysis with the following PICO model, P: COVID-19 patients. I: use of chlorhexidine and povidone iodine mouthwash. C: no mouthwash. O: salivary SARS-CoV-2 viral load. A search for the articles used in this study was carried out using the keywords “COVID-19” OR “SARS-CoV-2” OR “viral load” OR “SARS-Cov-2 viral load” OR “Chlorhexidine mouthrinse” OR “Povidone Iodine mouthrinse ” OR “Randomized Controlled Trial” OR “RCT” between 2012-2022 from the PubMed, Springerlink, Elsevier, Google Scholar and Wiley Online Library databases. The inclusion criteria used in this study were full-text articles using a Randomized Controlled Trial (RCT) design. The analysis used was multivariate with Standardized Mean Difference (SMD). The articles collected were then critically reviewed using the PRISMA checklist, then the data were analyzed using the Review Manager 5.4 tool.Results: This meta-analysis examined 10 articles with a Randomized Controlled Trial (RCT) study design originating from Singapore, Saudi Arabia, Iran, Brazil, Italy, South Korea and Malaysia. A meta-analysis of 7 articles showed that the use of chlorhexidine mouthwash could reduce salivary SARS-CoV-2 viral load by 0.12 units lower than without the use of mouthwash (SMD= -0.12; 95% CI= -0.33 to 0.09; p=0.250). Meanwhile, 7 articles showed that the use of povidone iodine mouthwash could reduce the salivary SARS-CoV-2 viral load by 0.64 units lower than without the use of mouthwash (SMD= -0.64; 95% CI= -1.51 to 0.23; p=0.150).Conclusion: The use of chlorhexidine and povidone iodine mouthwashes can reduce the amount of salivary SARS-CoV-2 viral Keywords: mouthwash, chlorhexidine, povidone iodine, COVID-19, salivary SARS-CoV-2 viral load.Correspondence: Danti Narulita. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Jawa Tengah. Email: [email protected]. Mobile: +6282158818400.Indonesian Journal of Medicine (2022), 07(04): 387-400https://doi.org/10.26911/theijmed.2022.07.04.0
Long Covid-19, Radiological Findings, and Its Management: A Systematic Review
Get PDFBackground: COVID-19 is a disease caused by SARS-CoV-2 and has numerous clinical spectrums. Mild respiratory infection is the common clinical manifestation of COVID-19, and the less common is pneumonia accompanied by fever, cough, and breathing difficulty. Long COVID can be defined as prolonged signs and symptoms which cannot be explained for other reasons 4 weeks after being diagnosed with SARS-CoV-2. This study aimed to describe the cause of illness is confirmed or suspected COVID-19 patients, specifically on long COVID.Subjects and Method: We performed literature searches of the latest articles with Medline, CINAHL (EBSCO), Global Health (Ovid), WHO Global Research on COVID-19 database, LitCovid and Google Scholar databases published from 2019 to 2020. Two reviewers searched all articles independently (P and W, with 7 and 10 years of experience, respectively). We conducted a systematic review to provide recent evidence of symptoms and complications in long COVID. We followed PRISMA guidelines.Results: A total of 22 papers was identified and screened for eligibility from medical databases. There were 15 papers included in this review. Reason for the continuous symptoms covid an extent of organ destruction, continuous response of chronic inflammation or immunology reaction, non-specific effect of hospital admission, some critical disease, post ICU syndrome, complications from COVID-19 infection, morbidities and adverse effects of medications used. Common symptoms are fatigue, shortness of breath, cough, chest pain, palpitations, dizziness, arthralgia, myalgia and weakness, sleep problems, sharp pain, gastrointestinal problems, rash and hair loss, impaired balance and ataxia, neurologic problems such as dementia, concentration disorders and poor quality of life.Conclusion: The incidence of long-term manifestations of COVID-19 has been increasing and systemic clinical symptoms affect many organs and systems. This can be due to numerous reasons like post-ICU syndrome, post-viral fatigue syndrome, permanent organ deterioration or others. Correspondence: Widiastuti Soewondo. Department of Radiology, Dr. Moewardi General Hospital/ Faculty of Medicine, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Indonesia. Email: [email protected] Journal of Medicine (2021), 06(04): 387-392https://doi.org/10.26911/theijmed.2021.06.04.0