Indonesian Journal of Medicine (IJM)
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The Effect of Complementary Vitamin D on Sputum Conversion in Pulmonary TB Patients
Get PDFBackground: Pulmonary TB is one of the most important health problems in Indonesia. The number of pulmonary TB patients ranked second after India. Vitamin D has a complex effect in the immune system. One of the effects of vitamin D is to stimulate the production of Cathelicidin which increases macrophage phagocytosis. This study aimed to analyze the effect of complementary vitamin D on sputum conversion in pulmonary tuberculosis patients.Subjects and Method: This study was a randomized controlled trial conducted at several health centers in Deli Serdang, North Sumatera, from November 2015 to June 2016. A total sample of 80 patients with positive acid-resistant bacilli (BTA) was selected for this study by consecutive sampling. The sample was allocated randomly into two groups: (1) TB drug group + 2.5 mg vitamin D; (2) TB drug group + placebo. The dependent variable was sputum conversion. The independent variable was complementary vitamin D. Pre and post vitamin D levels were examined by ELISA technique. Sputum conversion was examined by TB laboratory worker at the health center where patients received TB drug treatment. Difference in percent of sputum conversion between the two groups was tested by chi-square test. Difference in mean of sputum conversion time between the two groups was tested by t-test.Results: The mean serum vitamin D level in the intervention group (62.05±22.08) was higher than the control group (28.56±7.48) after the intervention, and it was statistically significant (p<0.001). After 56 days, all subjects in the vitamin D group experienced sputum conversion (100%) with a median sputum conversion time of 28 days, whereas 90% of subjects in the placebo group experienced sputum conversion with a median sputum conversion time of 48 days (p= 0.002).Conclusion: Adding vitamin D to anti-TB drug treatment effectively improves and accelerates sputum conversion of patients with tuberculosis acid-fast bacilli smear positive.Keywords: Vitamin D, sputum conversion, pulmonary tuberculosisCorrespondence: Nita Andriani Lubis. Department of Health Analysis, School of Health Polytechnics Medan, North Sumatera. Jl. William Iskandar Pasar V Barat No. 6 Medan 20137, North Sumatera, Indonesia. Email: [email protected] Journal of Medicine (2017), 2(3): 169-174https://doi.org/10.26911/theijmed.2017.02.03.0
Effect of Cardiac Rehabilitation on NT-Pro BNP, METS, and Quality of Life, in Patients with Coronary Artery Disease after Undergoing Percutaneous Coronary Intervention
Get PDFBackground: Percutaneous coronary intervention (PCI) is one of the most effective therapies in patients with coronary artery disease (CAD) after the attack. Cardiac rehabilitation (CR) makes an important contribution to secondary prevention of cardiac events. The World Health Organization defines CR as the sum of activities required to influence favorably the underlying cause of the disease, as well as to ensure the best possible physical, mental and social conditions, so that they may, by their own efforts, preserve or resume when lost as normal a place as possible in the life of the community. This study aimed to estimate the effects of CR on NT-proBNP and METs among patients with CAD after PCI.Subjects and Method: This was a cohort study carried out at Dr. Moewardi Hospital, Surakarta, Central Java, from November to February 2018. A sample of 18 patients with CAD after PCI was selected for this study. The dependent variables were NT-proBNP, METs, and quality of life. The independent variable was CR. The three outcome variables were measured before and after CR. The data before and after CR were compared and tested by t-test.Results: NT-proBNP level in CAD patients after PCI (Mean= 97.17 ng/ml) was lower than before PCI (Mean= 1,629.4 ng/ml), and it was statistically significant. METS value in CAD patients after PCI (Mean= 8.31 ml/kg) was higher than before PCI (Mean= 6.41 ml/kg), and it was statistically significant. The quality of life also increased significantly.Conclusion: Cardiac rehabilitation is effective to lower NT-proBNP level, as well as to increase METS value and quality of life of CAD patients.Keywords: coronary artery disease, cardiac rehabilitation, NT-proBNP, METs, quality of lifeCorrespondence: Noer Rachma. Department of Physical Medicine and Rehabilitation, Dr. Moewardi Hospital, Surakarta, Central Java.Indonesian Journal of Medicine (2018), 3(3): 146-150https://doi.org/10.26911/theijmed.2018.03.03.0
Hepcidin and Feritin Levels in Obese Pregnant Women and Normal Body Weight before Pregnancy
Get PDFBackground: Obesity is associated with a decrease in iron status, possibly it is an increase in hepcidin, an inflammatory protein that reduces iron absorption. Hepcidin is associated with iron homeostasis and inflammation. This study aims to determine differences in levels of hepcidin and ferritin of obesity pregnant women and normal weight before pregnancy.Subjects and Method: This was an analytic observational study with a case control design. A total of 62 pregnant women was selected by consecutive technique sampling and divided into 2 groups, namely obesity and normal weight before pregnancy. The study was conducted at RSIA BadrulAini Medan and at RSUP H.Adam Malik Medan from September to December 2016. The dependent variable of this study was the weight before pregnancy. The independent variable washepcidin levels examined by ELISA method, ferritin content with Immunochemiluminescent method. The data analysis employed Mann Whitney's different test.Results: Median of hepcidin level in obese pregnant women before pregnancy was higher than pregnant mother with normal weight of 7.08 ng / mL (2.14 to 78.18). There was no difference in hepcidin level in both groups (p = 0.578). Median ferritin levels in obese pregnant women were higher than the normal weight of 20.57 ?g / L (3.66 to 102.25). There was no difference of ferritin levels in both groups (p = 0.598).Conclusion: This study showed no difference in hepcidin levels and ferritin levels in obese pregnant women and normal weight before pregnancy.Keywords: Feritin,hepcidin, obesity before pregnancy, normal body weight before pregnancyCorrespondence: Hadiyatur Rahma. Department of Pharmacology, Faculty of Medicine, Islam Sumatera Utara University, Medan. Email: [email protected] Journal of Medicine (2018), 3(1): 22-26https://doi.org/10.26911/theijmed.2018.03.01.0
Circadian Rhythm Sleep Disorder among Nurses in Emergency Department: A Systematic Review
Get PDFBackground: Circadian Rhythm Sleep Disorders (CRSD) is a sleep pattern disorder that can be caused by a shift work system, especially the night shift. This disorder can cause various cardiovascular diseases, psychological, decreased concentration, even Alzheimer's. Some professions that demand high precision such as nurses who work with night shifts in the Emergency Room are very vulnerable to CRSD and if not handled, it can lead to work negligence. The purpose of this review is to review CRSD due to work shifts, possible risks to the ED nurse and how to overcome them.Subjects and Method: This article uses CRSD-related reviews published from 2000-2018 from various databases: PubMed, PMC Central and Elsevier open-access. The search was conducted on 1-14 July 2018 with keywords: "Circadian Rhythm Sleep Disorders", "treatment AND CRSD", "the effect of CRSD", "CRSD AND nursing, and" CRSD in night workers ".Results: Based on the 20 articles reviewed, CRSD is a sleep pattern disorder that can be caused by endogenous factors and exogenous factors. One exogenous factor is a disturbance due to working time with the shift work disorders (SWD) system. There are several ways to overcome CRSD due to working hours, including: taking a nap before work, modifying the environment by avoiding light if going to sleep, but approaching light if you have to wake up, resetting your sleep schedule, and giving melatonin.Conclusions: CRSD due to work disorders is called SWD which can be overcome by rearranging sleep, modifying the environment to fit the circadian rhythm, and consuming melatonin if needed.Keywords: Circadian rhythm sleep disorders, shift work disorders, nursesCorrespondence: Arief Wahyudi Jadmiko. Study Program of Nursing, Faculty of Health Sciences, Universitas Pembangunan Nasional Jakarta. Email: [email protected] Journal of Medicine (2018), 3(1): 27-32https://doi.org/10.26911/theijmed.2018.03.01.0
Functional Knee Score in Knee Osteoarthritis with Tibial Defect Performed Total Knee Arthroplasty with Screw Augmentation
Get PDFBackground: Long-standing knee osteoarthritis also is a common cause of severe bone deficiency (especially proximal tibia). Total knee arthroplasty is indicated in patient with knee osteoarthritis who did not able to perform activity daily living. This study aimed to evaluate the functional knee score of the patient with knee osteoarthritis who performed total knee arthroplasty with screw augmentation.Subjects and Method: This was an analytic observational study conducted at Soeharso Orthopaedic Hospital, Surakarta, Central Java, from January to December 2016. A sample of 30 patients with knee osteoarthritis with tibial defect who performed total knee arthroplasty with screw augmentation was selected for this study. The dependent variable was functional knee score. The independent variable was knee arthroplasty with screw augmentation. Knee function was measured by knee society score. The difference of knee function score between before and after total knee arthroplasty with screw augmentation was analyzed by t test.Results: There were 30 patients (25 females and 5 males) with age between 54 to 73 years old. Mean of knee society score post operative (mean= 82.7; SD= 6.29) was higher than pre operative (mean= 30.5; SD= 6.74) and it was statistically significant (p=0.001).Conclusion: Knee society score after total knee arthroplasty with screw augmentation is higher than before surgery.Keywords: functional knee score, osteoarthritis, screw augmentationCorrespondence: Fajar Baskoro Gardjito, Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi Hospital/Prof. Dr. R. Soeharso Orthopaedic Hospital. Email: [email protected] Journal of Medicine (2018), 3(3): 134-138https://doi.org/10.26911/theijmed.2018.03.03.0
Procalcitonin as A Predictor of Left Ventricular Systolic Dysfunction in Sepsis Patients
Get PDFBackground: Release of cytokines in sepsis can cause left heart failure and left ventricular systolic dysfunction (LVSD). In sepsis, there is a releasing of Procalcitonin (PCT) and tumor necrosis factor-α (TNF-α) because of the stimulation of cytokine pro inflammation affected by activated NF-kB. This study aimed to examine PCT as a predictor of LVSD in sepsis, the value of Area Under the curve (AUC), sensitivity, specificity, cut off point, and a probability of PCT and TNF-α as a predictor of LVSD, and then to identify the best diagnostic predictor of LVSD.Subjects and Method: This was a cross-sectional study. A sample of 71 sepsis patients aged >18 years old admitted to the intensive care unit (ICU) from November 2016 to March 2017was selected for this study. The dependent variable was left ventricle ejection fraction (LVEF). The independent variables were PCT and TNF-α. LVEF and diastolyc function were measured by transthoracic echocardiography. Data on PCT and TNF-α level were obtained from the medical record.Results: As many as 22 patients had mild sepsis (30.9%), 40 patients had severe sepsis (56.4%), and 9 patients had a septic shock (12.7%). The AUC value of PCT level was 0.81 (95% CI 0.71-0.91; p<0.001). The optimal cut-off point was ≥7.88 ng/mL and Diagnostic Odd Ratio (DOR) was 5.55. The AUC value of TNF-α level was 0.73 (95% CI 0.60-0.86; p= 0.002). Optimal cut off point was ≥7.36 pg/ml and DOR was 5.03. The multivariate analysis resulted that PCT was the best predictor of LVSD (AUC 0.70), and TNF-α (0.69). The combination of PCT + TNFα would increase diagnostic value with AUC 0.77.Conclusion: PCT was a better predictor of LVSD than TNF-α. This finding is significant since it will enable clinicians to easily diagnose LVSD by measuring PCT. The combination of PCT and TNFα was the best efficient diagnostic predictor of LVSD.Keywords: Left Ventricular Systolic Dysfunction, predictor, PCT, TNF-α Correspondence: Trisulo Wasyanto. Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: trisulo.wasyanto@gmail.com.Indonesian Journal of Medicine (2018), 3(3): 139-145https://doi.org/10.26911/theijmed.2018.03.03.03
Social Economic Factors, Depression, and Resilience among Women with Breast Cancer in Surakarta
Get PDFBackground: Women with breast cancer will experience physical and psychological changes that can cause depression. Social factors related to depression can affect the resilience of breast cancer sufferers. This study aimed to determine the factors that affect depression and resilience in women with breast cancer.Subjects and Method: This was a cross-sectional study conducted in Kerten, Surakarta, from November to December 2018. A total of 200 women was selected for this study using simple random sampling. The dependent variable was the resilience of women with breast cancer. The independent variables were depression, family support, peer support, group support, self-efficacy, and coping mechanism. The data were collected by questionnaire and analyzed by path analysis run on Stata 13.Results: Resilience was directly affected by depression (b= -0.09; 95% CI= -0.14 to -0.05; p <0.001), family support (b = 0.22; 95% CI= 0.11 to 0.32; p<0.001), peer support (b = 0.23 ; 95% CI= 0.12 to 0.34; p <0.001), group support (b= 0.18; 95% CI= 0.06 to 0.29; p= 0.002), self-efficacy (b = 0.15; 95% CI= 0.06 to 0.24; p = 0.001), and coping mechanism (b= 0.05; 95% CI= 0.03 to 0.09; p= 0.001). Resilience was indirectly affected by family support, peer support, group support, and self efficacy.Conclusions: The resilience of women with breast cancer is directly affected by depression, family support, peer support, group support, self-efficacy, and coping mechanism, but it is indirectly affected by family support, peer support, group support, and self-efficacy.Keywords: resilience, breast cancer, depression, support, self-efficacy, the coping mechanismCorrespondence: Gayatri Kintan Larasati. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36 A, Surakarta, Central Java 57126. Email: [email protected]. Mobile: +6285655084332.Indonesian Journal of Medicine, (2018), 3(2): 110-118https://doi.org/10.26911/theijmed.2018.03.02.0
The Effect of Coconut Water in Reducing Fatigue among Workers in North Sumatera
Get PDFBackground: Fatigue can reduce working performance, worker motivation, and work productivity. Fatigue due to exposure to heat pressure which causes excessive sweating must be overcome through the provision of fluids that are right for workers. Coconut water contains electrolytes, so it is very good to replace lost body fluids during activities throughout the day. The purpose of this study is to analyze differences in work fatigue with interventions giving 4 liters of drinking water and giving 1 liter of young coconut water (Cocos nucifera L.) accompanied by giving 3 liters of drinking water.Subjects and Method: This study is a quasi-experimental design with a research design of one group pre and post-test design. The study population was the production of cassava chips factory workers with a total sample of 20 people. The sampling technique is purposive sampling. The dependent variable is work fatigue while the independent variable is giving 4 liters of drinking water and giving 1 liter of young coconut water (Cocosnucifera L) accompanied by giving 3 liters of drinking water. The type of data collected is primary data in the form of work fatigue (in milliseconds) measured using the Reaction Timer. Bivariate analysis was conducted using the paired T-test.Results: Fatigue after giving 1 liter of young coconut water and 3 liters of drinking water was lower (mean = 118.00; p = 0.001) than the group given 4 liters of drinking water (mean 164.94; p= 0.001).Conclusion: Work fatigue in the group given 1 liter of young coconut water and 3 liters of drinking water was lower than the group given 4 liters of drinking water.Keywords: fatigue, young coconut water, drinking water, heat pressureCorrespondence: Bona Rina Ria Rajagukguk. Department of Occupational Health and Safety, Faculty of Public Health, Universitas Sumatera Utara, Medan, North Sumatera. Email: [email protected]. Mobile: 081370185933.Indonesian Journal of Medicine (2018), 3(3): 173-179https://doi.org/10.26911/theijmed.2018.03.03.0
Does HBA1C Correlate with Lipid Profile in Type 2 Diabetes Mellitus? A New Evidence from Medan, North Sumatera
Get PDFBackground: Diabetes mellitus (type 2 DM) is now ranked first in health problems and its prevalence tends to increase worldwide. The Diabetes Control and Complication Trial (DCCT) study showed that lowering HbA1c rates may delay or prevent chronic complications. One of the risk factors for CHD in type 2 DM is dyslipidemia, i.e lipid metabolism disorders in the form of elevated total cholesterol, triglyceride (TG), low-density lipoprotein (LDL), and decreased levels of high-density lipoprotein (HDL). This study aimed to determine the correlation between HBA1C and blood sugar, as well as the lipid profile in patients with type 2 DM.Subject and Methods: This was an analytic observational study with a cross-sectional design. The study was conducted at the Endocrinology and Metabolic polyclinic Pirngadi Hospital, Medan, North Sumatera, from January to February 2018. A total sample of 10 patients diagnosed with type 2 diabetes mellitus with obesity was selected for this study. The independent variables were blood sugar, lipid profile including total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglyceride. The dependent variable was the HbA1c level. Lipid profile was measured by blood serum examination. HbA1c level was measured by blood serum examination. The data were analyzed by Pearson correlation.Results: Hba1c was positively correlated with blood sugar levels and was statistically significant (r= 0.81; p= 0.005). HbA1c correlated weakly and was statistically non-significant with total cholesterol (r= 0.14, p= 0.702), LDL (r= 0.15; p= 0.683), HDL (r= 0.04; p= 0.922), and triglycerides (r= 0.06; p= 0.860).Conclusion: HbA1c correlates with blood sugar levels but does not show a correlation with lipid profiles.Keywords: HBA1C, lipid profile, blood sugar, type 2 diabetes mellitusCorrespondence
Path Analysis: The Effect of Smoking on the Risk of Periodontal Disease
Get PDFBackground: Periodontal diseases are prevalent both in developed and developing countries and affect about 20-50% of global population. Several risk factors such as smoking, poor oral hygiene, diabetes, medication, age, hereditary, and stress are related to periodontal diseases. The purpose of this study was to determine the effect of smoking on the risk of periodontal disease, using path analysis.Subjects and Method: A case-control study was carried out in Tasikmalaya community health center, West Java, from October to November 2018. A sample of 200 patients was selected by fixed disease sampling. The dependent variable was periodontal disease. The independent variables were age, knowledge on oral health, education, income, smoking behavior, oral and dental health behavior, plaque, and calculus. The data were obtained from medical record and questionnaire. The data were analyzed by path analysis.Results: The risk of periodontal disease directly increased by smoking behavior (b= 0.92; 95% CI= 0.09 to 1.75; p= 0.030), after controlling for the effect of calculus (b= 1.23; 95% CI= 0.40 to 2.07; p= 0.004) and age (b=1.63; 95% CI= 0.76 to 2.50; p<0.001). The risk of periodontal disease directly decreased by better knowledge on oral and dental health (b=-0.92; 95% CI= -1.72 to -0.12; p= 0.023) and high income (b= -1.47; 95% CI= -2.32 to -0.60; p<0.001). It was indirectly affected by plaque and education.Conclusion: The risk of periodontal disease directly increases by smoking behavior, after controlling for the effect of calculus and age. In addition, the risk of periodontal disease directly decreases by better knowledge on oral and dental health and high income. It is indirectly affected by plaque and education.Keywords: periodontal disease, smoking, factors, path analysisCorrespondence: Hilmiy Ila Robbihi. Masters Program in Public Health, Universitas Sebelas Maret, Surakarta, Jl. Ir. Sutami 36 A, Surakarta, Central Java 57126. Email: [email protected]. Mobile: +628975565050.Indonesian Journal of Medicine (2018), 3(2): 99-109https://doi.org/10.26911/theijmed.2018.03.02.0