Indonesian Journal of Medicine (IJM)
Not a member yet
390 research outputs found
Sort by
Factors Influencing Hyperuricemia: Evidence from Sukoharjo, Central Java, Indonesia
Get PDFBackground: Hyperuricemia is an elevated serum uric acid level. It causes urate deposits in the joints, tendons, and other tissues as physiological prerequisites for gout. Hyperuricemia is also related to the existence and severity of several comorbidities, such as hypertension, cardiovascular disease, diabetes, and metabolic syndrome. The result of basic health research in 2018 showed that the prevalence of joint disease in Indonesia based on a doctor's diagnosis was 7.3%. The highest prevalence was in Aceh (13.3%). The lowest prevalence was in West Sulawesi (3.2%). This study aimed to examine factors associated with hyperuricemia.Subjects and Method: This was an analytical observational study with a case control design. The study was conducted in Sukoharjo, Central Java, from January to April, 2018. A sample of 90 study subjects was selected by consecutive sampling. The dependent variable was hyperuricemia. The independent variables were age, sex, stress, purine-rich foods intake, and family history of gout. Stress was measured by depression, anxiety, and stress scale (DASS 42). The other variables were collected by questionnaire. The data were analyzed by a multiple logistic regression.Results: Older age (OR= 13.80; 95% CI= 3.36 to 56.66; p<0.001), female (OR= 1.94; 95% CI= 3.36 to 7.62; p= 0.345), purine-rich foods intake (OR= 5.01; 95% CI= 1.48 to 16.97; p= 0.010), and stress (OR= 6.14; 95% CI= 1.83 to 20.60; p= 0.003) increased the risk of hyperuricemia. Family history of gout (OR= 1.47; 95% CI= 0.43 to 5.04; p= 0.537) increased the risk of hyperuricemia, but it was statistically non-significant.Conclusion: Age, female, purine-rich foods intake, and stress increase the risk of hyperuricemia. Family history of gout increases the risk of hyperuricemia, but it was statistically non-significant. Keywords: hyperuricemia, purine-rich food, stressCorrespondence: Dewi Wulandari. School of Health Sciences Mitra Husada. Jl. Ahmad Yani 167, Gapura Papahan Indah, Papahan, Tasikmadu, Karanganyar 57722, Central Java. Email: mujahidfiisabiilillah@gmail.com. Mobile: 089695098491.Indonesian Journal of Medicine (2019), 4(4): 321-328 https://doi.org/10.26911/theijmed.2019.04.04.0
A High Incidence of Multidrug Resistant Strains as the Agents Causing Bloodstream Infection in Hospital in Indonesia
Get PDFBackground: Various bacteria have been identified as the agents causing bloodstream infection. Multidrug resistant (MDR) strains, such as Gram-negative pathogens producing extended-spectrum beta-lactamases (ESBL) and Methicillin-resistant S.aureus (MRSA) are potential bacterial agents causing bloodstream infection in the hospital setting. The increase of these MDR strains in bloodstream infection is alarming since there are limited antibiotic choices for treatment. This study aimed to investigate the agents causing bloodstream infection and to investigate their antibiotics susceptibility profiles. Subjects and Method: Samples were venous blood collected from patients admitted to hospital from January 2014 to December 2016. Bacteria were grown in-automated BACTEC® blood culture (BD, New Jersey, USA). The identification of MRSA strain was conducted using oxacillin susceptibility test. The bacterial identification and identification of ESBL-producing bacteria was conducted using colorimetric assay using Vitek2®system (bioMérieux).Results: The antibiotic profiles of all bacteria isolated from venous blood samples were analysed. The most bacteria isolated from the blood stream were K. pneumonia, A. baumannii, E. coli, P. Aeruginosa, E. cloacae, S. marcennes, S. haemolyticus, S. hominis, S.epidermidis, and S. aureus. Conclusions: The resistant profiles of bacteria isolated from blood stream showed that there was a high incidence of MDR bacteria, including potential ESBL-producing bacteria, carbapenemase-producing bacteria and MRSA strains.Keywords: Bloodstream Infection, Staphylococcus aureus, Extended Spectrum Betalactamase, Antibiotic Resistance.Correspondence: Betty Suryawati. Department of Microbiology, Faculty of Medicine, Universitas Sebelas Maret, Jl. Ir. Sutami No 36A, Surakarta 57126, Central Java, Indonesia. Email: [email protected] Journal of Medicine (2019), 4(1): 28-34https://doi.org/10.26911/theijmed.2019.04.01.0
The Difference of Stroke Risk Factor between Bataknese and Non-Bataknese at H. Adam Malik General Hospital Medan
Get PDFBackground: Stroke risk factors disparities in race-ethnic. Bataknese is the most stroke rates compared to non-Bataknese at H. Adam Malik General Hospital Medan. This may be due to genetics and lifestyles that have a link to increase stroke risk factors in Bataknese. Bataknese has a characteristic lifestyle that is more eating, typical foods also contain lots of cholesterol, and have a habit of drinking traditional alcoholic beverages.Subjects and Method: This was a cross-sectional study selected by consecutive sampling techniques, clinically proven stroke patients and computed tomography (CT) scan studied at H. Adam Malik General Hospital Medan from June to November 2018. This study aimed to know the difference of stroke risk factor between stroke patient of Bataknese and non-Bataknese.Results: This study recruited 70 samples consisting of 45 Bataknese and 25 non-Bataknese. There were no significant differences in risk factors for hypertension, dyslipidemia, heart disease, diabetes mellitus, smoking, and obesity among stroke patients in the Bataknese and non-Bataknese. But the distribution of hypertension was higher in Bataknese (50%) compared non-Bataknese (30%) (PR=0.67, 95%CI= 0.19 to 2.40, p= o.755). Dislipidemia was higher in Bataknese (38.6%) compared non-Bataknese (18.6%) (PR=1.39, 95% CI= 0.52 to 3.71, p=0.692). Heart disease was higher in Bataknese (17.1%) compared non-Bataknese (8.6%) (PR=1.15, 95% CI= 0.37 to 3.57, p= 1.000). Diabetes mellitus was higher in Bataknese (17.1%) compared non-Bataknese (10%) (PR=1.10, 95% CI= 0.31 to 2.87, p=1.000). Smoke was higher in Bataknese (27.1%) compared non-Bataknese (14.3%)(PR= 1.59, 95% CI= 0.38 to 6.61, p=1.000). Obesity was higher in Bataknese (11.4%) compared non-Bataknese (4.3%) (PR=1.59, 95% CI= 0.38 to 6.61, p=0.735). There was significant differences in risk factors for alcohol consumption between stroke patients in the Bataknese and non-Bataknese, where alcohol consumption was higher in the Bataknese (15.7%) compared non-Bataknese (1.4%) (PR=7.77, 95% CI= 0.94 to 64.22, p=0.045).Conclusion: A significant difference in stroke risk factors between stroke patients in Bataknese and non-Bataknese was alcoholic consumption.Keywords: stroke, risk factor, Bataknese, Non-BatakneseCorrespondence: Laura PancaSusilaTambunan. Neurology Resident, Department of Neurology, Faculty of Medicine, Universitas Sumatra Utara/H. Adam Malik General Hospital, Medan, North Sumatra, Indonesia. Email: [email protected]. Mobile: 081361525456.Indonesian Journal of Medicine (2019), 4(2): 122-134https://doi.org/10.26911/theijmed.2019.04.02.0
The Effect of Patients’ Characteristics and the Dosage of Methadone Maintenance on Retention of Methadone Therapy in H. Adam Malik General Hospital, Medan
Get PDFBackground: The maintenance phase in methadone maintenance therapy required a long time until the patient was declared recovered, so that it often caused saturation and results in high dropout rates. Therapy retention or survival of patients in the process of therapy was one indicator of the success of this methadone therapy. This study aims to determine the effect of patient characteristics and methadone maintenance therapy dose on the retention of methadone therapy at H. Adam Malik General Hospital Medan.Subjects and Method: This study used a cross sectional design and was carried out at H. Adam Malik General Hospital in Medan. The number of samples in this study was the total population of 63 patients in the maintenance phase January 2017 to January 2018. The dependent variable was the retention of methadone therapy and the independent variables included age, education level, marital status, work status, domicile, and average maintenance dose even. The data in this study were obtained from the medical record data of maintenance phase methadone patients and the data analysis was done using multiple logistic regression tests.Results: The results showed that the average maintenance dose had an effect on retention of methadone therapy (OR = 5.94, 95% CI 1.06 to 33.18, p = 0.042).Conclusions: The maintenance dose of ≥60 mg affects the retention of methadone therapy 6 times higher than the dose of <60 mg.Keywords: Therapy retention, patient characteristics, maintenance dosesCorrespondence: Dian Natalya Simangunsong, Master’s Program in Public Health of Universitas Sumatera Utara, Jl. Jahe 7 No. 14 Simalingkar A, Medan Tuntungan District, Medan, Email: [email protected]. Mobile: 0821-1133-5324Indonesian Journal of Medicine (2019), 4(2): 176-182https://doi.org/10.26911/theijmed.2019.04.02.1
Correlation between Obesity and Contraceptive Method on Estrogen and Progesterone Receptors and Human Epidermal Growth Factor Receptor–2 Expression among Breast Cancer Patients in Dr. Moewardi Hospital, Surakarta
Get PDFBackground: Breast cancer is the number 2 cancer in Indonesia after cervical cancer. Breast cancer increases every year. The formation of breast cancer is stimulated by various factors such as obesity and a history of family planning. In breast cancer, there are three important receptors, namely estrogen (ER) receptors, progesterone receptors (PR), and HER-2/Neu. The purpose of this study was to determine the association of obesity and history of family planning with the estrogen hormone receptor (ER), progesterone hormone receptor (PR), and HER-2/Neu expression in breast cancer patients in the dr. Moewardi Hospital in Surakarta, Central Java.Subjects and Method: This was an analytic observational study carried out at Dr. Moewardi Hospital, Surakarta, Central Java. A sample of 117 pre- and post-menopausal women who performed examinations at the oncology surgical clinic at Dr. Moewardi hospital, Surakarta was selected by total sampling. The dependent variables were estrogen and progesterone receptors and HER-2/Neu expressions. The independent variables were obesity and history of contraceptive method. Data were obtained from the medical record and analyzed by multiple logistic regression.Results: Obesity (OR= 0.29; 95% CI= 0.13 to 0.68; p= 0.004) reduced estrogen hormone receptors and it was statistically significant. History of contraceptive method (OR= 1.18; 95% CI= 0.55 to 2.52; p= 0.680) increased estrogen hormone receptors but it was not statistically significant. Obesity (OR=0.41; 95% CI= 0.18 to 0.96; p= 0.040) and history of contraceptive method (OR= 0.41; 95% CI= 0.19 to 0.88; p= 0.022) reduced progesterone hormone receptors. Obesity and history of contraceptive method increased Her-2/Neu expression.Conclusion: Obesity reduces estrogen hormone receptors. History of the contraceptive method increases estrogen hormone receptors. Obesity and history of contraceptive method reduce progesterone hormone receptors. Obesity and history of contraceptive method increase Her-2/Neu expression.Keywords: Obesity, contraceptive method, estrogen, progesterone hormones, Her-2/neuCorrespondence: Silvia Ari Agustina. Study Program in Midwifery, School of Health Sciences Achmad Yani, Yogyakarta. Jl. Ringroad Barat Ambarketawang, Gamping, Sleman, Yogyakarta. Phone: (0274) 4342000. Email: [email protected]. Indonesian Journal of Medicine (2019), 4(3): 259-265https://doi.org/10.26911/theijmed.2019.04.03.0
Glasgow Coma Scale and Full Outline of Unresponsiveness Score Instruments to Determine Patient Outcome: A Systematic Review
Get PDFBackground: Glasgow Coma Scale (GCS) and Full Outline of Unresponsiveness Score (FOUR score) are instruments to determine the level of patient consciousness. These instruments require good sensitivity and specificity, so that they can be used quickly and easily. This study aimed to determine the validity and reliability of GCS and FOUR score instruments in determining adult patient outcome.Subjects and Method: This study was a systematic review study. The search for the articles involved the client population treated in the ICU, Emergency Installation and neurology room, patients who did not receive sedation or neuro blockers, were observed by health workers. The outcomes were in the form of death of patients in the hospital, mRS, Glasgow outcome score, and APACHE II. This study were carried out using EBSCO, Sciencedirect, Pubmed, and Google Scholar, restricted articles from 2007-2017, and observational study. The number of articles that was in accordance with the inclusion and exclusion criteria for this study was 9 articles. All articles found were used as sample.Results: The average sensitivity and specificity values of the GCS instrument and FOUR Score were close to 1 or 100%. From the 8 articles found, all got sensitivity and specificity values by >50%.Conclusion: The FOUR instrument score can be used as a substitute for GCS to assess the level of patient consciousness with patient outcomes (death) in ICU.Keywords: glasgow coma scale, full outline of unresponsiveness score, outcomeCorrespondence: Ika Silvitasari. School of Health Sciences Aisyiyah, Surakarta, Central Java. Jl. Ki Hajar Dewantara 10, Surakarta 57126, Central Java. Email: mouse_02april@yahoo.com.Indonesian Journal of Medicine (2019), 4(4): 339-345https://doi.org/10.26911/theijmed.2019.04.04.0
The Effects of Ethanol Extract and Ethyl Acetate Fractionation of Sechium Edule Jacq. Swartz on Triglyceride Levels in Male Rats with Type 2 Diabetes Mellitus
Get PDFBackground: The prevalence of diabetes mellitus (DM) from year to year is increasing. Hyperglycemia that occurs in DM is caused by oxidative stress that damages pancreatic β cells. This situation can be controlled with synthetic hypoglycemic drugs, but it requires high medical costs. Therefore, alternative therapies that are easily available, relatively inexpensive, have potential anti-hypoglycemia and anti-cholesterolemia which is found in conjoined flasks (Sechium edule (Jacq.) Swartz) which contains flavonoids are needed. The purpose of this study was to analyze the effectiveness of ethanol extract and fractionation of ethyl acetate extracts of Sami (pumpkin) (Sechium edule (Jacq.) Swartz) as anti-hipoglycemia and anti-hypertriglycerides in white male wistar rats (Rattus novergius sp.) induced by STZ-NA-HFDD.Subjects and Method: A randomized controlled trial was conducted to assess the effectiveness of ethanol extract and fractionation of pumpkin fruit ethyl acetate extract. The sample included white male wistar rats (Rattus novergius sp.) Hyperglycemia induced by STZ-NA-HFD. The dependent variable was triglyceride levels. The independent variables were administration of ethanol extract and fractionation of pumpkin fruit ethyl acetate extract.Results: Ethyl acetate fraction 45 mg/kgBW better reduce triglyceride levels but statistically does not have significant differences between groups.Conclusion: The group that received Metformin and the group that was given ethanol extract 45 mg/kgBW had lower triglyceride levels compared to the other therapy and control groups.Keywords: Hipertrigliseridemia, diabetes mellitus, STZ-NA-HFDCorrespondence: Jekson Martiar Siahaan. Department of Physiology, Faculty of Medicine, Universitas Methodist Indonesia. Jl. Setia Budi Pasar II Tj. Sari, Medan 20132, North Sumatera. Email: Jekson.siahaansked@gmail.comIndonesian Journal of Medicine (2019), 4(4): 371-375https://doi.org/10.26911/theijmed.2019.04.04.10
Effect of Early Spironolactone on the ST2 Level and Clinical Changes in Acute Decompensated Heart Failure Patients
Get PDFBackground: In spite ofmajor advances in therapy, morbidity, and mortality due to acute decompensated heart failure (ADHF) remain poor. Early initiation of mineralocorticoid antagonist (spironolactone) may increase the suppression of negative effect of renin-angiotensin-aldosterone system (RAAS) activation, even though it already uses ACEI/ARB accompanying ADHF and give a better outcome. This study aims to determine the effect of early spironolactone 100 mg a day for 3 consecutive days on the suppression of tumorigenicity 2 (ST2) level and clinical changes in patients with ADHF.Subjects and Method: This was a randomized single blind controlled trial. Thirty eight consecutive patients with ADHF hospitalized at Dr. Moewardi Hospital, Surakarta were randomized into two groups: spironolactone group (standard therapy plus spironolactone 100 mg per day for 3 day, n=19) and control group (standard therapy, n=19). Clinical sign and simptom of ADHF was monitored everyday and the difference of clinical changes was evaluated at the day-3. Venous blood samples were collected from all patients at the first day prior therapy and day-4 after therapy. The dependent variable was ST2 level. The independent variable wasSpironolacton therapy. The data were analyzed by independent t-test.Results: Decreased levels of ST2 in the spironolactone group (mean= 36.96; SD= 21.29) was higher than the control group (mean= 19.73; SD= 16.48) and it was statistically significant (p= 0.008). Spironolacton therapy 100 mg once daily at the first 3 day in patient with ADHF was safe, no hiperkalemia, or worsening renal function. There was decreasing risk of hipokalemia up to 33% (RR= 0.33; 95% CI= 0.1 to 1.0; p= 0.036) and greater proportion patient with improvement clinical simptom and sign of ADHF at day-3 in the spironolactone group vs control group.Conclusion: Administration of spironolactone 100 mg at the first 3 day plus standard therapy decreases levels of ST2, safe, decreases risk of hipokalemia and give greater proportion of clinical improvement patients ADHF.Keywords: Spironolactone, ADHF, ST2Correspondence: Trisulo Wasyanto. Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi Hospital. Jl. Kol. Sutarto 132, Surakarta 57126. Indonesia. Email: [email protected]. Indonesian Journal of Medicine (2019), 4(3): 232-240https://doi.org/10.26911/theijmed.2019.04.03.0
Factors Affecting Ankle Functional Scores at Spastic Diplegia Cerebral Palsy Patients that Have Been Performed Single Event Multi Level Surgery
Get PDFBackground: Single Event Multi Level Surgery (SEMLS) is the treatment most often used to correct deformities and functional in children with Spastic Diplegic Cerebral Palsy. There is no research in Indonesia that assesses the ankle function in patients with Spastic CP Diplegic has done SEMLS. The purpose of this study was to determine the influence of age, gender and time period after surgery with functional ankle patients with CP Spastic Diplegic that has been done SEMLS in the RSO. Prof. Dr. R. Soeharso Surakarta (RSO).Subjects and Method: This study was a cross sectional study in 43 patients (25 male and 18 female) patients with Spastic Cerebral Palsy Diplegia that has been done SEMLS in pediatric orthopedics clinic RSO. Prof.dr.R.Soeharso Surakarta at least 3 months postoperatively, since January 1st 2013 to December 31st 2014. We assessed ankle function using the Oxford Ankle Foot Questionnaire for Children. From the results of the questionnaire we value outcomes as a percentage and we regrouped into 4 groups: value of 91% - 100% for excellent value, 81% - 90% for good, 71% - 80% for fair and if less than 70% for poor. Then we did impact assessment for age, sex and time of the postoperative with functional ankle score of patients with examination of linear regression model analysis.Results: There were 52 patients with Spastic CP Diplegi have done SEMLS but only 43 patients who qualified the inclusion criteria, the youngest patient was 5 years old and the oldest 15 years old with a mean age of 8.3 years. From the 43 patients, 25 are men and 18 were women. Postoperative time with the fastest time of observation was 5 months and the longest was 26 months with a mean of 14.3 months postoperatively SEMLS. From the 43 patients there are 11 patients (25%) function are excellent, 21 patients (49%) are good, 8 patients (19%) are fair, and 3 (7%) are poor. Age factor significantly influence the functional ankle score (p = 0.013) and postoperative time factors also significantly influence the functional score Ankle with (p = 0.04). While gender has no effect on the functional ankle score (p= 0.266).Conclusion: Paediatri Orthopaedic clinic at RSO. Prof. Dr. R. Soeharso has succed treated patients with CP Spastic Diplegic that have performed SEMLS. Age and time of postoperative significantly influence the functional ankle score in patients with CP Spatik Diplegic that have been done SEMLS. While the sex of the patients had no effect on the functional ankle score in patients with CP Spastic Diplegic that have been done SEMLS.Keywords: RSO Prof. Dr. R. Soeharso, CP Spastic Diplegic, SEMLS, Ankle Functional ScoreCorrespondence: Aryo Budiyogo Andryanto. Student of Orthopaedic and Traumatology school of Medicine, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java.Indonesian Journal of Medicine (2019), 4(3): 228-231https://doi.org/10.26911/theijmed.2019.04.03.0
The Effect of Changes in Postural Position Angle Degree on Central Venous Pressure Measurement
Get PDFBackground: Central venous pressure is often used in intensive care, especially in patients who experience impaired fluid balance, heart failure, evaluation of therapeutic response and media for therapy or hypertonic fluid. The patient's hemodynamic condition during treatment in the intensive care unit (ICU) is constantly changing (unstable), therefore, serial monitoring of central venous pressure is needed and the patient's position must be constant. Changing the position of the patient in a place is sometimes something that cannot be avoided when the patient is in intensive room. This study aimed to examine the effect of changing the position of patients in bed at 00, 150, 300, and 450 on central venous pressure (CVP) values. Subjects and Method: This was quasi-experimental study, using a post test without control group with repeated measures. This study was conducted in the ICU/ICCU Room at Tarakan Hospital, North Kalimantan, from May to June 2019. A total of 30 patients was selected by accidental sampling. The dependent variable was central venous pressure. The independent variable was the position of the patient when a central venous pressure examination was carried out, with the degree of positions which were 00, 150, 300, and 450. The data was obtained from observation sheet. CVP was measured by water manometer. The data were analyzed by Anova.Results: The lowest mean CVP was achieved at 0º (Mean=15.13; SD= 5.79). The highest mean CVP was achieved at 45º (Mean=18.18; SD=5.35). The different mean between 0º and 45º was statistically significant (p=0.001). The mean CVD at 15º was mean=16.35; SD=5.73. The mean CVD at 30º was mean=17.07; SD=5.42). The different mean between 15º and 30º was statistically significant (p=0.047). Conclusion: The best position for perform central venous pressure is 45o.Keywords: central vein pressure, intensive care, patient positionCorrespondence: Hendy Lesmana. Nursing Department, Faculty of Health, Universitas Borneo Tarakan. Email: [email protected] Journal of Medicine (2019), 4(3): 192-200https://doi.org/10.26911/theijmed.2019.04.03.0