Indonesian Journal of Medicine (IJM)
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Spinal Tuberculosis: Spectrum of MR Findings with Laboratory Evaluation
Get PDFBackground: Tuberculosis infections are endemic diseases in Asian countries. Although the incidence is rare, tuberculous spondylitis manifests as a severe and life-threatening disease. This study aims to correlate the abnormal result of erythrocyte sedimentation rate (ESR) and magnetic resonance (MR) imaging findings.
Subjects and Method: MR imaging of 60 patients with characteristics of spinal tuberculosis in 4-year 5 month period (January 2019 – May 2023) from Siloam Lippo Village is retrospectively analyzed and reviewed. Data were collected from Infinitt PACS and analyzed by SPSS. Dependent variables in this study are clinical suspicion for tuberculosis infection, erythrocyte sedimentation rate (ESR), and tuberculosis infection in different organs. Meanwhile, the independent variables in this study are multilevel vertebral involvement, multilevel disc involvement, abscess formation, and myelopathy.
Results: Association with elevated ESR (erytrocyte sedymentation rate) are seen in 11 out of 31 patients aged >40 (OR=0.45; CI 95%= 0.16 to 1.26; p=0.120), 19 out of 37 patients with clinically suspected for tuberculosis infection (OR=1.98; CI 95% 0.68 to 5.78; p=0.210); 27 out of 55 patients with multilevel vertebral body involvement (OR=0.8; CI 95%= 0.12 to 5.17); p=1); 13 out of 30 patients with intervertebral disc involvement (OR=0.87; CI 95% 0.32 –to2.42); p=0.8); 20 out of 50 patients with abscess formation(OR=0.29; CI 95%=0.66 to 1.24; p=0.08); 5 out of 12 patients with tuberculosis infection on other organs(OR=0.84; CI 95%=0.24 – 3.04; p=0.8); and 5 out of 6 patients with myelopathy(OR=7.3; CI95%=0.79 TO 66.6; p=0.04).
Conclusion: MR has an important role in detecting extrapulmonary tuberculosis lesions, especially in the spine. Elevated ESR results play important roles for physicians in identifying patients with the possibility of spondylitis TB
Effectiveness of Erythropoetin Alpha and Eryhtropoetin Beta in Patients With End-Stage Kidney Disease with Anemia Undergoing Hemodialysis: A Meta-Analysis Study
Get PDFBackground and Objectives: One of the causes of anemia in ESRD (End Stage Renal Disease) is due to lack of erythropoietin (EPO) production. The use of short-lived ESA preparations such as Erytrhopoietin alpha and Erytrhopoietin beta still differs in opinion about the effectiveness between the two ESA agents. So the purpose of this study is to review the findings from various studies to provide a better understanding of the effectiveness of the use of ESA.
Method The results of the study sought were the effectiveness of erythropoietin alpha and erythropoietin beta which were assessed by the hemoglobin levels in the study. This study uses a meta-analysis design in accordance with the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Data search using PUBMED, ResearchGate, and ScienceDirect databases
Results A total of 458 studies were identified through database sources. After adjusting for inclusion and exclusion criteria, there were 6 studies to be reviewed in a meta-analysis with a total of 220 patients given erythropoietin alpha therapy and 227 patients given erythropoietin beta therapy. The results of the meta-analysis showed that there was no significant difference in the erythropoietin alpha and erythropoietin beta groups after 1 month of therapy (P = 0.20, MD = 0.16, 95% CI [ -0.57, 1.17], I2 = 0% [P = 0.56]), nor after 3 months of therapy (P = 0.19, MD = -0.27, 95% CI [-0.68, 0.13], I2 = 0%, [P = 0.58])
Conclusions There was no significant difference between the effectiveness of erythropoetin alpha and erythropoetin beta in increasing patients' hemoglobin levels. These two ESA agents are effective in increasing hemoglobin levels in ESRD patients
Mobile Health Assisted Self Monitoring in Heart Failure Patients To Ensure Quality of Life: A Scoping Review
Get PDFBackground: Heart failure leads to reduced quality of life, high hospitalization rates, mortality rates, and treatment costs where out-of-hospital self-monitoring can help with management and prevention of hospitalization and digital apps can help with this. The purpose of this review was getting all information of the studies regarding self-monitoring assisted by mobile health or digital application for heart failure patients.Subjects and Method: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols for a Scoping Review (PRISMA-ScR), literature searches were developed by searching the databases: PubMed.gov, ScienceDirect, SpringerLink, Google Scholar. Following the eligibility criteria, articles that included were analyzed to get the result.Results: Mostly the studies were conducted in 2016 and 2017 (20% each, n=5), less studies in 2018, 2019, 2020, and increased again in 2021 (16%, n=4). The studies were done 57% in USA (n=13), both Australia and Canada were 9% (n=2), and other countries. The designs of the studies were mostly RCT (74%, n=17). Sample size was variative mostly less than 50 participants (39%, n=9). There were 65% of the studies measured the daily body weight (n=15), others used vital signs 57%, medication adherence 39%, and other items. QoL was the most in the outcome (61%, n=14). Main findings mostly showed positive impact on self-monitoring with digital application.Conclusion: Using mobile apps for heart failure patients’ self-monitoring created the positive impacts in the expected outcomes, mostly for quality of life
Combination of Acupuncture and Hypnotherapy on Blood Pressure Reduction
Get PDFBackground: Hypertension is "the silent killer" the number 2 highest cause of death in Indonesia. One of the non-pharmacological therapies that can be used to reduce hypertension is acupuncture and hypnotherapy. This study aims to analyze the effectiveness of the combination of acupuncture and hypnotherapy (hypnotherapy) on lowering blood pressure.
Subjects and Method: The Randomized Controlled Trial (RCT) research was conducted at three clinics, namely Klinki Dr. Singgih, Kusuma Husada Clinic, and Griya Sehat Sinergi from March to September 2023. A total of 160 hypertensive patients were divided into four groups: (1) Acupuncture intervention group (n= 40); (2) Hypnotherapy intervention group (n= 40); (3) Hypnopunk intervention group (n= 40); and (4) The control group was given standard care (n=40). The dependent variable is hypertension. The independent variable was hypnopuncture. The difference in the mean decrease in blood pressure of systole and diastole in each group was analyzed using the ANOVA test.
Results: The mean systole blood pressure was lower in the hypnopuncture group (Mean = 145.43; SD= 3.39) than the acupuncture group (Mean= 154.55; SD= 7.42), hypnotherapy group (Mean= 150.95; SD= 11.92), as well as the control group (Mean= 177.22; SD= 7.87), and this result was statistically significant (p <0.001). The average diastole blood pressure was lower in the hypnopuncture group (Mean = 86.47; SD= 1.57) than the acupuncture group (Mean= 87.25; SD= 10.34), hypnotherapy group (Mean= 87.25; SD= 2.89), as well as the control group (Mean= 95.03; SD= 2.90), and this result was statistically significant (p <0.001).
Conclusion: Hypnopuncture is effective in lowering systole and diastole blood pressure levels in hypertensive patients
Comparison of Sleep Quality Between Acupuncture Therapy and Blue Pela Flower Tea in Adolescents: A Randomized Controlled Trial
No full textBackground: Reduced sleep quality will have an impact such as decreased concentration, emotional disturbances, health and daily activities. There are several factors outside of puberty (hormonal) that cause the percentage of insomnia sufferers to be higher among adolescents, including lifestyle and environment which are the causes of insomnia in adolescents. Positive findings have been found in a study reporting that acupuncture and herbal butterfly pea flower tea can improve patient health and sleep quality. This study aims to determine the comparison of acupuncture therapy and herbal butterfly pea flower tea.
Subjects and Method: This study is a quantitative study with a Randomized Controlled Trial (RCT) design. This study was conducted at SMKN 5 Merangin in March-April 2024. A sample of 120 students was selected using simple random sampling. The dependent variable in this study is sleep quality in cases of insomnia. The independent variables in the study are acupuncture therapy and butterfly pea herbal tea.
Result: The best intervention for improving sleep quality was acupuncture (Mean= 3.65; SD= 1.12), which was better than butterfly pea tea (Mean= 2.13; SD= 1.09) or nothing (Mean= 0.20; SD= 1.20), and the difference between the groups was statistically significant (p<0.001).
Conclusion: The best intervention to improve sleep quality was acupuncture compared to butterfly pea herbal tea
Correlation between HbA1c Levels and Red Distribution Cell Width in Type 2 Diabetes Mellitus Patients
Get PDFBackground: HbA1c is used as a parameter for diagnosis and monitoring of diabetes mellitus (DM). Apart from that, HbA1c, red blood cells also experience changes which result in changes in erythrocyte structure and hemodynamic characteristics. The parameter that changes in this case is red cell distribution width (RDW). This study aimed to analyze correlation between HbA1c levels and RDW in type 2 DM patients.
Subjects and Method: This a cross sectional study conducted at H. Adam Malik General Central Hospital, Medan, North Sumatera, Indonesia, from December 2022-April 2023. Total sample of 75 type 2 DM patients was selected consecutively. The dependent variable was RDW. The independent variable was HbA1c. Data of RDW and HbA1c were collected from complete blood count test. Data were analyzed using the Spearman correlation.
Results: HbA1c was negatively associated with RDW, but it was statistically non-significant (r= -0.08; p= 0.508).
Conclusion: HbA1c is negatively associated with RDW, but it is statistically non-significant.
Keywords: diabetes melitus, HbA1c, red cell distribution widt
Effectiveness of Manual Therapy for Pain in Neck Pain Patients: A Systematic Review and Meta-Analysis
Get PDFBackground: Neck pain (NP) is a musculoskeletal public health problem that is often experienced, especially by modern society, with a high prevalence that can cause disability. Neck pain can be treated with various physiotherapy modalities, one of which is manual therapy/manipulation of the cervical spine. This study aims to determine the effectiveness of manual therapy in reducing pain in neck pain patients.
Subjects and Method: This research is a systematic review and meta-analysis study, using PICO as follows, P= neck pain patients, I= manual therapy, C= other than manual therapy, O= reduction in pain. The articles included in this research were articles taken from several databases including Google Scholar, PubMed, NCBI, Science Direct, Embase, and Springer Link between 2010 and 2023. The keywords used to search for articles were: "neck pain" OR " chronic neck pain” OR “cervical pain” OR “cervicalgia” OR “upper cervical pain” OR “nonspecific neck pain” OR “nonspecific chronic neck pain” AND “manual therapy” OR “mobilization” OR “musculoskeletal manipulation” OR “cervical manipulation ” AND “RCT” OR “randomized controlled trial” OR “randomized controlled trial”. This research analysis was carried out using the RevMan 5.3 application. The results of the meta-analysis were reported using PRISMA flow diagrams.
Results: A total of 9 articles have been analyzed originating from Spain, Canada, Germany, Turkey, and Pakistan. The study showed that patients with neck pain who received manual therapy experienced -2.01 units lower pain than those who did not receive manual therapy (SMD=-2.01; 95%CI=-3.00 to -1.03; p=0.001).
Conclusion: Manual therapy significantly reduces neck pain compared to usual care
Citicoline in Acute Ischemic Stroke: Case Report
Get PDFBackground: Stroke is the third most common disease after heart disease and cancer and a leading cause of disability worldwide. The most common type of stroke is non-hemorrhagic stroke (SNH) or Acute Ischemic Stroke, which accounts for about 85-87% of all cases. The purpose of this case report is to examine the benefits of citicoline in a patient with SNH.
Case Presentation: In this case, a 63-year-old man was admitted to the Emergency Room of the Agung Mulia Inpatient Clinic on February 25, 2023 with complaints of inability to move his right arm and leg since 5 days before entering the clinic. The complaint was felt suddenly when the patient woke up in the morning. The patient also complained of weakness and difficulty speaking and slurred speech accompanied by difficulty swallowing. The voice could still speak but was unclear but the patient understood what was being said to him. Other complaints such as headaches, nausea, vomiting, bowel and urination disorders, and fainting were denied by the patient. The patient was treated at a hospital near his house on February 21, 2023 and underwent a CT scan of the head and was treated as an outpatient. The results of the CT scan on February 21, 2023, axial section of the head without intravenous contrast, obtained the following results: Infraterritorial cerebellum and 4th ventricle appear normal, Supreterritorial hypodense lesions appear on the left lateral periventricular and in the left parietal, No midline shift, Cortical sulci and prominent ventricular system. It was concluded that the left lateral periventricular and left parietal cerebral infarction were in accordance with Non-Hemorrhagic Stroke (SNH). Senile cerebral atrophy. Based on anamnesis, physical examination, and supporting examinations. The clinical diagnosis in this case was right hemiparesis and paresis of nerves VII, IX, and X, et causa non-hemorrhagic stroke (SNH) with electrolyte disorders (Electrolyte Imbalance), given general and specific management.
Results: For general management that can be given is semi-fowler position, oxygen administration, administration of antihypertensive drugs and maintaining fluid and nutritional intake. While specific management with pharmacology by administering citicoline and clopidogrel is given to this patient.
Conclusion: Citicoline works to prevent brain damage (neuroprotection) and helps the formation of cell membranes in the brain (neurorepair). The benefits of citicoline in this patient are seen in motor and neurological improvements based on NIHSS assessments.
The Effect of Using a Dynamic Wrist Splint on Wrist Pain in Stroke Patients
Get PDFBackground: Hand movement function in hemiplegic stroke patients is impaired due to contractures and spasticity. Pain in the wrist joint often occurs when moved. This research aims to determine how dynamic wrist splints can reduce wrist pain in stroke patients.
Subjects and Method: This was a quasi-experimental study. The subjects were 20 hemiplegic stroke patients in Colomadu Karanganyar. The research was carried out in July – September 2023. The dependent variable was wrist pain. The independent variable was the use of a dynamic wrist splint. measurement the degree of pain using the Visual Analog Scale which is used to determine the level of pain felt by the sufferer. Data normality test using Shapiro-Wilk. The statistical test used in this research is wilxocon.
Results: The ages of subjects ranged from 30 to 62 years. Wrist pain was reduced after the use of a dynamic wrist splint compared to levels before its use.
Conclusion: There is an influence of dynamic wrist splints on wrist pain in stroke patients
Effect of Moringa Leaf Infusion (Moringa oleifera) on Reducing Blood Glucose and Total Cholesterol Levels in Mice (Mus musculus) with Diabetic Ulcers
Get PDFBackground: Diabetes mellitus is a chronic disease in the form of metabolic disorders, which is characterized by blood glucose levels (KGD) that exceed normal limits and are accompanied by impaired metabolism of carbohydrates, lipids, and proteins, as a result of abnormalities in insulin secretion. Diabetics are known to have slow wound healing. Moringa oleifera leaves or moringa plants contain flavonoid compounds, which can decrease glucose absorption. This study aims to determine the effect of moringa leaf infusion on blood sugar levels, glucose tolerance, cholesterol levels, body weight, and wound healing speed in mouse model animals.
Subject and Method: This study is experimental using a posttest only controlled group design, using 25 male mice (Mus musculus) divided into 5 groups. The study was conducted at the Phytochemistry and Animal House Laboratory, Faculty of Medicine, Methodist University Indonesia from March to May 2022. The bound variables were body weight measured using a scale, current blood glucose levels and blood glucose levels with glucose loading measured with strips and glucometers, total cholesterol levels measured using strips and cholesterol measuring devices, and the length of mice wounds measured using a ruler. The free variable is the variation in the dose of moringa leaf infusion. The data were analyzed using the Anova and Kruskal-Wallis tests.
Results: The administration of moringa leaf infusion had a significant effect on the reduction of the levels of each variable, namely a dose of 10% in body weight, a dose of 30% in KGD, 20% in KGD with glucose loading, 20% in cholesterol, and 20% in wound closure, which was proven based on the results of statistical tests.
Conclusion: Moringa leaf infusion can lower blood sugar levels, blood sugar levels by glucose depletion, cholesterol levels, body weight, and accelerate wound healing in sucrose-induced mice, high fat diet, and PTU