Indonesian Journal of Medicine (IJM)
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Determinants of Delay in Diagnosis and Treatment in Multi Drug-Resistant Tuberculosis Patients in Health Facilities
Get PDFBackground: Multidrug-resistant tuberculosis (MDR-TB) is a serious threat to global TB control programs. According to WHO, there are 23,000 cases of TB multidrug-/rifampicin-resistant (MDR/RR-TB) in Indonesia. In 2017, there were 442,000 of TB cases. There were 8,600 - 15,000 MDR/RR-TB cases, of which 2.4% were new cases and 13% were previously treated TB cases. This study aims to determine the factors that influence the delay in diagnosis and treatment of MDR-TB patients.Subjects and Method: This study was a cross-sectional study conducted at Dr. Moewardi hospital, from September to October 2017, Surakarta, Central Java. A sample of 73 MDR-TB patients with disabilities on medical records was selected for this study. The dependent variables were delay in diagnosis and delay in therapy of MDR-TB cases. The independent variables were age, gender, distance to health facilities, and type of health facilities. Data were collected from medical records of MDR-TB patients who were treated from March 2012 to March 2017. Data were analyzed using the chi-square model.Results: Median delay in diagnosis = 4 days. Median treatment delay = 12 days. The average patient who had delayed MDR-TB therapy (≥4 days) was 44 years old (Mean= 44.19; SD= 12.64). Delay in MDR-TB diagnosis was not significantly associated with gender (OR= 0.53; 95% CI= 0.18 to 1.57; p= 0.264), distance to health facility (OR= 1.56; 95% CI= 0.58 to 4.21; p= 0.389), and type of health facility (OR= 0.60; 95% CI= 0.26 to 1.41; p= 0.983). The average of patient who had delayed MDR-TB therapy (≥12 days) was 41 years old (Mean= 41.39; SD= 12.69). Treatment delay was not significantly related to gender (OR= 0.45; 95% CI= 0.16 to 1.26; p= 0.137), distance to health facility (OR=1.44; 95% CI= 0.55 to 3.78; p= 0.466), and type of health facility (OR= 2.31; 95% CI= 1.03 to 5.21; p= 2.967).Conclusion: There was no statistically significant relationship between gender, distance from the patient's home to health facilities, and type of health facility with the delay in diagnosis and treatment of MDR-TB patients.Keywords: diagnosis, treatment, TB-MDRCorrespondence: Yusup Subagio Sutanto. Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta. Jl. Kolonel Sutarto No.132, Jebres, Surakarta, Central Java 57126. Email: [email protected]. Mobile: 0811284165.Indonesian Journal of Medicine (2021), 06(01): 14-22https://doi.org/10.26911/theijmed.2021.06.01.0
Effect of Curcuma Longa Rhizome Extract on Fasting Blood Sugar Levels and HbA1C in Type 2 Diabetes Mellitus: A Meta-Analysis
Get PDFBackground: Diabetes mellitus (DM) is a metabolic disease that is developing into a serious global problem. Diabetes mellitus is characterized by an increase in blood levels that are more than the normal reference. In type 2 DM generally occurs due to reduced insulin secretion and sensitivity over time. Control of blood sugar levels can improve the patient's quality of life. This study aimed to analyze the effect of curcuma longa rhizome extract on fasting blood sugar levels and HbA1C in patients with type 2 diabetes.Subjects and Method: This was a meta-analysis of a number of randomized controlled trials. The articles were obtained from PubMed, Google Scholar, Springerlink, BMJ, and Sciencedirect databases, published from 2010-2020. The article search was carried out by considering the eligibility criteria defined using the PICO model. P: Type 2 diabetes patients, I: Curcuma longa rhizome extract, C: Placebo, and O: Fasting blood sugar levels and HbA1C. The keywords to find articles are as follows: "Curcuma longa", OR "Curcumin" OR "Tumeric" OR "Curcuma" AND "Fasting blood glucose" AND "HbA1C" OR "Glicemic" OR "Diabetes Mellitus" AND "Randomized Controll Trials". Articles were collected using PRISMA flow diagrams. Articles were analyzed using the Review Manager 5.3 application.Results: A total of 14 articles were reviewed in this study. Meta-analysis of 12 articles showed that the curcuma longa rhizome extract reduced fasting blood sugar levels (Standardized Mean Difference= -0.48; 95% CI= -0.61 to -0.34; p <0.001). The meta-analysis of 11 articles showed that administration of curcuma longa rhizome extract decreased HbA1C levels (Standardized Mean Difference= -0.40; 95% CI= -0.59 to -0.20; p <0.001). This meta-analysis combines primary studies from Iran, Japan, Thailand, China, Mexico, Brazil, and AustraliaConclusion: Curcuma longa rhizome extract reduces fasting blood sugar and HbA1C levels in patients with type 2 diabetes.Keywords: Curcuma longa, Fasting blood sugar levels, HbA1C, diabetes mellitus type 2, randomized controlled trialCorrespondence: Riska Fajar Fatony. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected] Journal of Medicine (2021), 06(02): 119-134https://doi.org/10.26911/theijmed.2021.06.02.01
The Effectiveness of Electro-acupuncture in Reducing Body Weight in Obese Patients: A Meta-Analysis
Get PDFBackground: Obesity is a problem that is starting to be found, not only in urban areas with high socioeconomic status but also in children living in rural areas, even from middle to lower socioeconomic groups. This study aimed to examine the effectiveness of electro-acupuncture in obesity cases.Subjects and Method: Meta-analysis was carried out with PICO: The population in this study were obese patients aged 16-65. The intervention was in the form of electro-acupuncture therapy. Comparison in the form of sham/ placebo acupuncture. The outcome is weight loss. A meta-analysis study was applied with electronic data sources: Clinical Key, Google Scholar, MEDLINE/PubMed, Science Direct, Scopus. The articles included were full-text with a Randomized Control Trial (RCT) study design. There were 10 articles used in this study with a sample size of 818 people who were divided into two groups (455 people in the acupuncture group and 363 people in the sham/placebo acupuncture group). Articles were analyzed using the Review Manager 5.4 application. The data were analyzed using Standardized Mean difference (SMD) and the heterogeneity of the research sample.Results: There was high heterogeneity between one experiment and another (I2= 86%; p<0.001), so the Random Effect Model (REM) was used. Electroacupuncture therapy was effective in reducing body weight with a Standardized Mean Different (SMD) of 0.50 compared to false acupuncture (SMD= -0.50; 95% CI= -0.92 to -0.08; p= 0.020).Conclusion: Acupuncture therapy can lose weight in obesity cases with a Standardized Mean Different (SMD) of 0.50 compared to fake acupuncture.Keywords: acupuncture, obesityCorrespondence: Nurmila Mutiah. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta, Central Java, Indonesia. Email: [email protected]: +6287730797747.Indonesian Journal of Medicine (2021), 06(03): 325-335https://doi.org/10.26911/theijmed.2021.06.03.10
Meta-Analysis of Re-perfusion Injury and Ischaemic Conditioning in Limb Surgery
Get PDFBackground: Pneumatic tourniquet commonly used for orthopedic surgery is associated with morbidity related to ischemia-reperfusion injury. Ischaemia conditioning (IC) had shown beneficial effects to attenuate these outcomes. This study aimed to systematically review the evidence of IC effect on outcomes of the patient undergoing orthopedic surgery.Subjects and Method: This was a systematic review and Meta-Analysis conducted through the online database search from PubMed, Central, Clinicaltrials.gov, and Scopus with topics related to IC and all possible orthopedic surgical interventions. Articles were searched with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocols used keywords "Ischemic conditioning," "Reperfusion injury," "Orthopaedic surgery." The data were extracted from the eligible study within inclusion and exclusion criteria. Two independent reviewers collected the study characteristics. Each study was examined for the risk of bias. The pooled data were analyzed using RevMan 5.3 in Standardized Mean Difference (SMD) as a summary measure with 95% Confidence Interval (CI).Results: Out of 12 eligible studies collected for qualitative analysis, eight studies with the same outcomes were analyzed for quantitative analysis. A random-effect model was used for analysis with high heterogeneity. The pooled SMD data for IC compared to control for postoperative pain were -0.50 (95% CI= -0.95 to 0.06; p<0.001). Outcome measures for hemodynamic stability, systemic inflammation, and end-organ injury were pooled with MD= 4.81 (95% CI= 3.19 to 6.44); SMD= -1.33 (95% CI= -2.06 to -0.60); SMD= 0.15 (95% CI= -0.14 to 0.71); respectively.Conclusion: Ischaemic conditioning significantly reduces postoperative pain, inflammation response and maintains hemodynamic stability. A better study design with a higher population number is needed for further study.Keywords: ischaemic conditioning, reperfusion injury, orthopedic surgery, Meta-AnalysisCorrespondence: Pamudji Utomo. Dr. Soeharso Ortopedic Hospital. 157th Ahmad Yani St. Sukoharjo 57162, Central Java, Indonesia. pamudji_utomo@staff.uns.ac.id.Indonesian Journal of Medicine (2021), 06(03): 271-284 https://doi.org/10.26911/theijmed.2021.06.03.0
Association between Community Perception and Willingness to Vaccinated Againts COVID-19 in Surakarta, Central Java, Indonesia
Get PDFBackground: Covid-19 has been declared a pandemic since March 2020 until now, so the government requires the provision of a covid-19 vaccine for all people. The government's vaccination campaign has received various responses from the public, some people accept and some reject the Covid-19 vaccine. This study aims to determine the relationship between public perception of the acceptance of the COVID-19 vaccine in Surakarta.Subjects and Methods: The cross sectional study was conducted in Surakarta. A sample of 65 people aged >12 years was selected by random sampling. The dependent variable was the willingness to receive the covid-19 vaccine. Tthe independent variable was perception. Data was collected by online questionnaire (google form). Data were analyzed by chi square test.Results: There is a relationship between public perception of vaccination and acceptance of the covid-19 vaccine (OR=5.45 ; 95% CI= 2.57 to 11.53 ; p<0.001)Conclusion: There is a significant relationship between perceptions related to vaccines and people's willingness to receive the COVID-19 vaccine.Keywords: covid-19, acceptance, knowledge, rejection, vaccinationCorrespondence: Annita Viesta Nirmala Dewi. Midwifery Study Program, Faculty of Medicine, Universitas Sebelas Maret. Jl. Ir Sutami 36 Surakarta, Central Java. Email: [email protected]. Mobile: +6285103027268.Indonesian Journal of Medicine (2021), 06(04): 430-438https://doi.org/10.26911/theijmed.2021.06.04.0
Meta-Analysis of the Effect of Telemonitoring on Blood Sugar Levels and Quality of Life in Diabetes Patients
Get PDFBackground: Type 2 diabetes mellitus (DM), a chronic disease, requires continuous monitoring and treatment to have a better quality of life. Telemonitoring is a medium that may help in monitoring patients with type 2 DM. This study aimed to analyze the effect of using telemonitoring on blood sugar levels and quality of life of patients with type 2 DM with a meta-analysis study.Subjects and Method: This was a systematic review and meta-analysis conducted with PRISMA flow diagram. The articles were collected through journal databases, including PubMed, Google Scholar, Science Direct, and ProQuest, published in 2000-2021. The keywords used were ("telemedicine" OR "tele-monitoring" OR "tele-monitoring") AND ("diabetes" OR "diabetes mellitus" OR "diabetes mellitus type 2") AND ("glucose level") AND ("quality of life"). The searching of articles used the PICO model. Population: people with type 2 diabetes mellitus, Intervention: telemonitoring, Comparison: not using telemonitoring, Outcome: blood sugar level and quality of life. Inclusion criteria were full-text articles with Randomized Controlled Trial (RCT) study design, published in English, with the effect measure of Mean SD. Eligible articles were analyzed using Revman 5.3.Results: A meta-analysis of 11 primary studies on the use of telemonitoring of blood sugar level showed a decrease in blood sugar (HbA1c) levels in patients with type 2 diabetes by 0.20 times compared to not using telemonitoring (SMD= -0.20; 95% CI= -0.39 to -0.01; p= 0.040). A meta-analysis of 6 primary studies on the use of telemonitoring on quality of life showed an increase in quality of life in type 2 diabetes patients by 0.16 times compared to not using telemonitoring (SMD= -0.16; 95% CI= -0.29 to -0.03; p= 0.020).Conclusion: Telemonitoring can improve blood sugar levels and the quality of life of patients with type 2 diabetes.Keywords: telemonitoring, type 2 diabetes mellitus, quality of life, meta-analysisCorrespondence: Anisa Asri Sholihah. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 085740972908.Indonesian Journal of Medicine (2021), 06(03): 246-257https://doi.org/10.26911/theijmed.2021.06.03.02
The Effect of Scoliosis Orthosis on the Reduction of Cobb Angle in Scoliosis Patients: A Meta-Analysis
Get PDFBackground: Scoliosis is a spinal deformity that often occurs in adolescents with a prevalence of 0.47% -5.2% worldwide. The prevalence of scoliosis in Asia was about 2.25% of the population. In Surabaya, Indonesia, 6.37% of students from 784 schools who conducted scoliosis screening tests positively had scoliosis. In addition, 9 out of 300 students in Surakarta positively had scoliosis. This study aimed to estimate the effect of using scoliosis orthosis in reducingcobb angle in scoliosis patients by conducting a meta-analysis on theseveral similar articles.Subjects and Method: This study used a meta-analysis by systematically reviewing the several similar articles from PubMed, ScienceDirect, and Google Scholar. The keywords were "scoliosis" AND "scoliosis orthosis" OR "scoliosis brace" AND "cobb angle" OR "curve" AND "randomized control trial". The intervention was the use of a scoliosis orthosis with a comparison of non-scoliosis orthosis and the scoliosis patients as the study subjects. The outcome of the study was a reduction of cobb angle. The included articles were full-text articles with a randomized controlled trial design that showed the effect size (mean and standard deviations). The articles were collected using PRISMA flow diagrams and analyzed using the Review Manager 5.3 application.Results: Based on a meta-analysis result of 9 randomized controlled trial articles from the United States, Canada, Germany, Sweden, Denmark, Poland, and Hong Kong, scoliosis orthosis reduced cobb angle in scoliosis patients (SMD= -0.67; 95% CI= -1.02 to -0.33; p <0.001). The heterogeneity I2=75%.Conclusion: Scoliosis orthosis affects the reduction of cobb angle in scoliosis patients.Keywords: scoliosis, cobb angle, scoliosis orthosisCorrespondence: Dody Suprayogi. Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: [email protected]. Mobile: 08562772052.Indonesian Journal of Medicine (2020), 05(04): 356-367https://doi.org/10.26911/theijmed.2020.05.04.11.
Dietary Pattern As a Risk Factor of Diabetes Mellitus and Obesity: Meta-Analysis
Get PDFBackground: Non-Communicable Disease is a disease that is considered unable to transmit or spread from one person to another but is a cause of death globally, especially diabetes mellitus and obesity. According to WHO, the number of deaths due to PTM in 2016 was 40.5 million (71%) worldwide. Diet is one of the risk factors for Diabetes Mellitus and Obesity. This study aims to analyze the effect of diet as a risk factor for diabetes mellitus and obesity.Subjects and Method: This study was a systematic review and meta-analysis using a cross-sectional design. The articles used in this study were obtained from several databases, including PubMed, Google Scholar, Springerlink, and ScienceDirect. The articles used in this study were those published from 2011-2020. The article search was carried out by considering the eligibility criteria defined using the PICO model. P: adults, I: unhealthy eating patterns, C: healthy eating patterns, and O: Diabetes Mellitus and Obesity. The keywords to search for articles were "dietary pattern", "risk", "obesity", and "diabetes mellitus," and "adjusted odds ratio". The articles included in this study were full-text articles with cross-sectional study design. Articles were collected using PRISMA flow diagrams. Articles were analyzed using the Review Manager 5.3 application.Results: A total of 15 articles were reviewed in this study. The meta-analysis showed that an unhealthy diet increased the risk of Diabetes (aOR= 1.65; 95% CI= 1.29 to 2.11; p <0.001). The meta-analysis of 9 articles also showed that an unhealthy diet increased the risk of obesity (aOR= 1.42; 95% CI= 1.21 to 2.66; p <0.001). This meta-analysis combines primary studies from Swaziland, China, Ethiopia, Kenya, America, Malaysia, Ghana, Romania, Nepal, Ireland, and Korea.Conclusion: Unhealthy diet is a risk factor for diabetes mellitus and obesity.Keywords: dietary pattern, diabetes mellitus, obesity, cross-sectionalCorrespondence: Linda Wahyu Septiananwati. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected] Journal of Medicine (2021), 06(01): 82-94https://doi.org/10.26911/theijmed.2021.06.01.09.
The Effect of Hypnotherapy on Postpartum Pain and Depression in Women with Post Caesarean Delivery
Get PDFBackground: Postoperative pain is one of the most common problems in women after cesarean section. Caesarean section is also associated with post-partum depression. Hypnotherapy is one of the complementary therapy options that are effective and efficient in reducing pain symptoms and post-partum depression. This study aimed to analyze the effect of hypnotherapy on the level of pain and post-partum depression in post-cesarean section patients.Subjects and Method: This was an experimental single-blind randomized controlled trial with a post-test group design, which was conducted from January to April 2021, at the Dr. Moewardi and Universitas Sebelas Maret Hospitals, Surakarta. A sample of 80 patients with cesarean section was divided into two groups, namely 40 patients in the hypnotherapy group and 40 patients in the control group. The independent variable was hypnotherapy. The dependent variables were pain and depression. Hypnotherapy was carried out by self-hypnosis using audio recordings of hypnotherapy in 2 sessions before and after the cesarean section procedure. The pain was measured by the Numeric Rating Scale. Post-partum depression was measured by the Edinburgh Postnatal Depression Scale. The data were analyzed by an independent t-test.Results: Post-cesarean section pain in the group of hypnotherapy (Mean= 4.58; SD= 1.20) was lower than without hypnotherapy (Mean= 6.48; SD= 1.01), and it was statistically significant (p<0.001). Postpartum de-pression in the group of hypnotherapy (Mean= 6.08; SD= 1.60) was lower than non-hypnotherapy group (Mean= 8.48; SD= 3.78), and it was statistically significant (p <0.001).Conclusion: Hypnotherapy has a significant effect on reducing pain and post-partum depression in post-cesarean section patients.Keywords: Hypnotherapy, pain levels, post-partum depression, post-cesarean sectionCorrespondence: Araafi Hariza Mahandaru. Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta, Jl. Kolonel Sutarto, Jebres, Surakarta 57126, Central Java. Email: [email protected] Journal of Medicine (2021), 06(02): 194-205https://doi.org/10.26911/theijmed.2021.06.02.08
Association between Troponin I and Mortality in COVID-19 Patients: Meta-Analysis Study
Get PDFBackground: COVID-19 is a new disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 became a pandemic disease that killed 4 million people for almost 2 years. COVID-19 patients with comorbidities or risk factors are more prone to have a worse prognosis, one of which is heart disease which can be checked through troponin I values. This study aimed to determine the relationship between troponin I levels and mortality in patients with COVID-19.Subjects and Method: This was a systematic review and meta-analysis by searching for articles from databases such as Science Direct, Springer, Google Scholar, and PubMed using the keywords: troponin I, cohort, fatality, cardiac biomarker, death, coronavirus, COVID-19 mortality, and COVID-19. Ten accredited articles published between 2019-2021 were included for meta-analysis. The subjects of this study were 10,499 COVID-19 patients. The intervention in this study was high troponin I levels, while the comparison was normal troponin I levels. The outcome of this study is mortality in COVID-19 patients. Data processing using Review Manager software version 5.3 for the relationship between troponin I levels and mortality in COVID-19 patients.Results: From a meta-analysis of 10 primary research articles in China, Spain, New York (United States), France, Turkey, and Philadelphia (United States) showed an association between high troponin I levels and an increased risk of mortality in COVID-19 patients (aOR= 3.07; 95% CI= 1.68 to 5.61; p<0.003).Conclusion: High troponin I levels increase the risk of mortality in COVID-19 patients.Keywords: troponin I, heart disease, mortality, COVID-19.Correspondence: Hesthi Krisnawati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +6285278067840.Indonesian Journal of Medicine (2021), 06(03): 347-353https://doi.org/10.26911/theijmed.2021.06.03.12