Indonesian Journal of Medicine (IJM)
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Blood Urea Nitrogen as a Predictor of In-Hospital Mortality in Acute Coronary Syndrome Patients
Get PDFBackground: Acute coronary syndrome (ACS) is one of the major causes of morbidity and mortality worldwide. Thus, it is important to effectively diagnose and determine prognosis and mortality risk. While criteria such as Thrombolysis in Myocardial Infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) score are clinically used to work out the prognosis of patients with ACS, the examination of Blood Urea Nitrogen (BUN) and creatinine alongside in predicting outcome may prove favorable as well. This study aimed to determine the efficacy of BUN and creatinine in mortality risk assessment of patients with ACS and to find which one is better.Subjects and Method: This was an analytical study with a cohort retrospective design included 1463 ACS patients in Dr. Moewardi hospital from January 2014 to July 2018. The relationship between admission BUN, creatinine level, and in-hospital mortality was analyzed with chi-square and logistic regression. Receiver Operating Characteristic (ROC) curve to determine which one better as a predictor of in-hospital mortality.Results: The mean age of patients was 60 years old (mean= 60.08; SD= 11.04), which 72.9% were men. From all sample, 232 (15.9%) patients were died. In binary log regression models, elevated BUN (>50 mg/dL) at admission was an independent predictor of in-hospital mortality (OR= 4.01; 95% CI= 1.0 to 7.0; p= 0.001). Similar results were obtained for elevated creatinine (>1.3 mg/dL) at admission (OR= 3.6; 95% CI= 2.2 to 5.8; p= 0.031). ROC curves showed that area under the curve (AUC) of BUN (0.87) was higher than AUC of creatinine (0.61).Conclusion: Elevated BUN and creatinine are independent predictors of in-hospital mortality in ACS patients. A high-level of BUN at admission is a more accurate predictor of in-hospital mortality than creatinine.Keywords: blood urea nitrogen, creatinine, acute coronary syndromeCorrespondence: 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] Journal of Medicine (2019), 4(3): 241-251https://doi.org/10.26911/theijmed.2019.04.03.0
Comparative Efficacy between Intravenous Iron and Oral Iron on Enhancing Hemoglobin Level among Pregnant Women with Iron Deficiency Anemia in Low and Middle Income Countries: A Meta-Analysis
Get PDFBackground: Iron deficiency was a major cause of anemia in pregnancy. The incidence of large deficiency anemia was mostly experienced in pregnancy which can result in general hematological disorders with considerable complications both for the mother and the fetus. This study aimed to compare the efficacy of intravenous iron administration and oral iron for the treatment of iron deficiency anemia in pregnancy. Subjects and Method: This was a meta-analysis conducted using PRISMA systematic guidelines. The process of searching articles was carried out between 2000 and 2018 using a database search engine consisting of; PubMed, Science Direct, Springer Link, and Google Scholar. Based on database searches, nine articles that met the Randomized Control Trial (RCT) criteria and study were conducted in lower middle income countries. This study involved 967 samples divided into two groups of 484 intravenous iron and 483 oral iron. The analysis was carried out with Review Manager (RevMan) software 5.3. The results were assessed for Mean Difference (MD) and the analysis was carried out for heterogeneity.Results: There was a high heterogeneity between experiments (I2= 91%; p <0.001) so that Random Effects Model (REM) was used. Intravenous iron administration can increase hemoglobin levels 0.70 g / dL higher than oral iron administration, and it was statistically significant (MD 0.70; 95 % CI: 0.37 to 1.02; p<0.001).Conclusion: Intravenous iron administration was more effective than oral iron for the treatment of iron deficiency anemia in pregnancy. Pregnant women given intravenous iron more quickly reach the desired hemoglobin level target than oral iron.Keywords: anemia, iron deficiency, intravenous iron, oral iron, meta-analysis Correspondence: Fiki Cahya Ningrum. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 081216494956.Indonesian Journal of Medicine (2019), 4(2): 135-144https://doi.org/10.26911/theijmed.2019.04.02.0
Path Analysis of the Effect of Waist-Pelvic Circumference, Body Mass Index, and Abdominal Circumference on the Occurrence of Prediabetes
Get PDFBackground: Diabetes mellitus is an important health problem in the world. Pre-diabetes is a state of blood sugar levels above normal but below the criteria for diabetes. American Diabetes Association (ADA) uses criteria for hemoglobin A1C (HbA1C) levels of 5.7% to 6.4% to define pre-diabetes. The prevalence of pre-diabetes was the highest in overweight individuals. In many studies, body fat levels were assessed by indicators of waist-pelvic circumference, abdominal circumference, and BMI. Among the three, it is still a debate which is more influential on the condition of pre-diabetes. The purpose of this study was to determine the effects of waist-pelvic circumference, BMI, and abdominal circumference in pre-diabetes.Subjects and Method: A cross-sectional study was conducted at Prodia Clinic, Surakarta, Central Java, from January to March 2019. A sample of 200 study subjects was selected by fixed disease sampling. The dependent variable was pre-diabetes. The independent variables were the waist-pelvic circumference, BMI, and abdominal circumference. The data on HbA1C was measured by NGSP standardized ion-exchange HPLC method. The data were analyzed by path analysis.Results: Abdominal circumference >90 cm in men and >80 cm in women (b= 0.87; 95% CI= 0.23 to 1.51; p= 0.008) and age ≥45 years old (b = 1.70; 95% CI = 0.93 to 2.46; p <0.001) were directly increased pre-diabetes. Pre-diabetes was indirectly affected by waist–pelvic circumference, gender, and obesity.Conclusions: Abdominal circumference >90 cm in men and >80 cm in women and age ≥45 years old are directly increased pre-diabetes. Pre-diabetes is indirectly affected by waist–pelvic circumference, gender, and obesity.Keywords: prediabetes, abdominal circumference, waist-pelvic circumference, body mass indexCorrespondence: Cindy Lestyani Loekito. Masters Program in Nutrition, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile:082134424950.Indonesian Journal of Medicine (2019), 4(3): 252-258https://doi.org/10.26911/theijmed.2019.04.03.0
Parenting Style in Early Marriage Mothers in Indonesia
Get PDFBackground: Mothers who were married too young have a higher risk of to experience psychological and emotional problems influencing parenting style, which may have an impact on child development. However, prevalence of parenting style in early marriage mothers in Indonesia is still unknown. This study aimed to determine the prevalence of adopted parenting style on early marriage mothers.Subjects and Method: A cross-sectional study was conducted in Martapura, Banjar Regency, South Kalimantan, Indonesia, from April 1 to May 30, 2018. Mothers who were married in early age (<21 years old) were enrolled using simple random sampling. The dependent variable was parenting style. The independent variables were education, family income, and number of children. Parenting style was measured by short version of parenting style and dimension questionnaire (PSDQ). The data were analyzed by Spearman test.Result: Authoritative parenting style is the most common parenting style (54.6%), followed by authoritarian (32.7%), and permissive (12.7%) parenting style. Education level (r= -0.07; p= 0.325) decreased parental parenting style, but it was statistically non-significant. Family income (r= 0.72; p= 0.302) and number of children (r= 0.27; p= 0.700) increased parental parenting style, but it was statistically non-significant.Conclusions: Education level decreases parental parenting style, but it is statistically non-significant. Family income and number of children increase parental parenting style, but it was statistically non-significant.Keywords: parenting style, early marriageCorrespondence: Irwanto. Department of Child Health, Faculty of Medicine, Universitas Airlangga. Jl. Prof. Dr. Moestopo 6-8, Surabaya, East Java, Indonesia. Email: [email protected]. Mobile +62816500818.Indonesian Journal of Medicine (2019), 4(4): 313-320https://doi.org/10.26911/theijmed.2019.04.04.0
Maternal Characteristics and the Effects of Early and Late-onset Types of Preeclampsia on Maternal and Perinatal Complications
Get PDFBackground: Preeclampsia is still the main cause of morbidity and mortality not only for mothers but also for fetal. The concept of early and late-onset preeclampsia is a more modern concept, and it is stated that these two entities have different etiologies and must be considered as different forms of the disease. This study aims to analyzing differences in maternal characteristics (age, number of parity, history of hypertension and diabetes mellitus) and laboratory results (platelet, ewitz, Lactic Acid Dehydrogenase/LDH) and to analyzing differences in maternal complications (maternal death, eclampsia, impending eclampsia, pulmonary edema, (hemolysis, elevated liver enzyme levels, and low platelet levels/HELLP syndrome) and perinatal complications (perinatal death, Intrauterine Growth Restriction/IUGR, fetal hypoxia and fetal distress) between early and late-onset preeclampsia. This study aimed to investigate the maternal characteristics and the effects of early and late-onset types of preeclampsia on maternal and perinatal complications.Subjects and Method: This was a retrospective cohort study. The study was carried out at Dr. Moewardi Hospital, Surakarta, from January 1, 2016, to December 31, 2017. A total of 548 pregnant mothers with preeclampsia was selected for this study. The dependent variable was the incidence of preeclampsia. The independent variables were age, parity, hypertension, diabetes Mellitus, platelets, LDH, and proteinuria. The data were obtained from the medical record and analyzed by a multiple linear regression.Results: The number of patients with early-onset (162) was less than late-onset (386). More patients have multiparity in early and late-onset. In early-onset preeclampsia, thrombocytopenia and LDH increase tend to be present, and ewitz >+1. Early-onset preeclampsia tends to result in more maternal and perinatal complications.Conclusion: The incidence of early-onset is less than late-onset, but early-onset provides worse complications for both maternal and perinatal.Keywords: Early-onset preeclampsia, late-onset preeclampsia, characteristics, maternal and perinatal complicationsCorrespondence: Sintia Damayanti. Department of Obstetrics and Gynecology, Dr. Moewardi Hospital/ Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia. Email: sintiadamayan[email protected]. Mobile: 082220020829.Indonesian Journal of Medicine (2019), 4(4): 329-338https://doi.org/10.26911/theijmed.2019.04.04.0
Relative Efficacy of Probiotics Compared with Oral Rehydration Solution for Diarrhea Treatment in Children under Five Years Old: a Meta-Analysis from Developing Countries
Get PDFBackground: Children under five experience an average of three episodes of diarrhea each year in developing countries. Based on World Health Organization (WHO) guidelines, therapy for acute diarrhea is oral rehydration fluid and zinc to treat fluid and electrolyte loss. But unfortunately, this therapy does not reduce the duration of diarrhea without the intestinal barrier function of pathogenic microorganisms. The ability to inhibit pathogens is one of the three main mechanisms of probiotics. This study aims to examine the efficacy of using probiotics compared to oral rehydration solution (ORS) in the treatment of acute diarrhea in children under five in developing countries.Subjects and Method: This study is a meta-analysis conducted using PRISMA systematic guidelines. The process of searching for articles was carried out between 2009 and 2019 using a database search engine consisting of PubMed, British Medical Journal (BMJ), CAB Direct, Oxford Academy, Clinical Key, ScienceDirect, and Scopus. Based on a database search, six articles that meet the criteria of the Randomized Controlled Trial (RCT) and research conducted in developing countries were found. The study involved 1234 children who were divided into two groups: 762 probiotic groups and 472 ORS groups. The analysis was performed with the Review Manager (RevMan) software 5.3. The results were assessed using Standardized Mean Difference (SMD).Results: There was heterogeneity between experiments (I2 = 91%; p <0.001) so Random Effects Model (REM) was used. Probiotics could reduce the duration of acute diarrhea in infants rather than just ORS, with a pooled estimate of 1.13 (SMD = -1.13; 95% CI = -1.54 to -0.72; p <0.001).Conclusion: Probiotics can reduce the duration of acute diarrhea in infants in developing countries rather than just the administration of ORS.Keywords: Diarrhea, probiotics, oral rehydration solution, meta-analysis.Correspondence:Nurul Aini Suria Saputri. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 085743401971Indonesian Journal of Medicine (2019), 4(4): 354-363https://doi.org/10.26911/theijmed.2019.04.04.08
Biopsychosocial Factors on Infertility among Men in Surakarta, Central Java
Get PDFBackground: Impaired fertility affects
The Association between Knowledge, Family Support, and Blood Sugar Level in Type 2 Diabetes Mellitus Patients
Get PDFBackground: Diabetes mellitus (DM) is a group of metabolic diseases characterized by hypergl
Difference in Computer Vision Syndrome between Laptop and Desktop Computer Users
Get PDFBackground: Occupational health is a key component of an industry. This is because a strong safety culture boosts productivity, employee morale, and employee retention. A strong ergonomics integration prevents injuries and increases productivity. They make the workplace safer and reduce costs. Ergonomics also must be incorporated and seen as a value. It needs to be built into a corporate culture and be integrated into everything any company does on a daily basis, including that in the administrative office where workers frequently use computers. This study aimed to analyze difference in computer-attributed vision problem between laptop and desktop computer users.Subjects and Method: This was a cross sectional study conducted in North Sumatera. A sample of 60 subjects consisting of 30 laptop users and 30 desktop users were selected for this study by purposive sampling. The dependent variable was vision problem. The independent variable was computer type. The data were collected by questionnaire and tested by Mann Whitney test.Results: Among the laptop users, 80% experienced neck pain, 77% eye strain, and 70% low back pain. Among the desktop-computer user, 50% experienced neck pain, 77% eye fatigue, and 33% eye irritation. Mean score of complaints in the laptop user group was 2.54 units higher than the desktop-computer user group (p= 0.001).Conclusion: Laptop users experienced more complaints than desktop-computer users. Workers using computers are suggested to have regular break to allow body organs to take a rest. Workers are also suggested to work at an ample distance between eyes and computer screen. Employers are responsible for providing a safe and healthful workplace for their workers.Keywords: vision problem, computer-attributed, laptop, desktop computer, agronomyCorrespondence
The Effect of Colchicine Administration on HsCRP Level and Mean Platelet Volume in Patients with Miocard Acute Infark
Get PDFBackground: Patients with coronary heart disease (CHD) who have received standard therapy to the fullest, are still at risk for further cardiovascular events. This is likely because the standard therapy fails to inhibit some inflammatory pathways and platelet aggregation which implies the disease. This study aimed to determine the effect of colchicine on reducing levels of high sensitive c-reactive protein (HsCRP) and mean platelet volume (MPV) in patients with Acute Myocardial Infarction (IMA) in the Intensive Cardiovascular Unit (ICVCU) Dr. Moewardi Hospital, Surakarta.Subjects and Method: Experimental study was conducted with pre and post design. The study was conducted from November 1 to December 31, 2016. A sample of 32 patients with Acute Myocardial Infarction was divided into two groups. The control group was given a placebo and the treatment group was given colchicine 0.5 mg orally for 5 days. Statistical analysis was done using two mean different tests with dependent t-test or Mann-Whitney and two mean analysis paired using independent t-test or Wilcoxon.Results: The HsCRP delta level in colchicine group (mean = 3.82; SD = 2.20) was higher than control group (mean = 0.57; SD = 3.12) and it was statistically significant (p<0.001). The delta MPV levels in colchicine group (mean = 2.01; SD = 1.16) were higher than control group (mean = 0.64; SD = 0.83) and it was statistically significant (p = 0.001).Conclusion: The administration of 0.5 mg colchicine by oral for 5 days was associated with levels of HsCRP and MPV among IMA patients. Keywords: Colchicine, HsCRP, MPV, Acute Myocardial InfarctionCorrespondence: Trisulo Wasyanto. Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta57126, Central Java, Indonesia. Email: [email protected] Journal of Medicine (2018), 162-167https://doi.org/10.26911/theijmed.2018.03.03.0