E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Relationship between Knowledge and Compliance Using Anti-dyslipidemic Drugs among Hypertensive Patients with Dyslipidemia in Bandung, West Java, Indonesia
Get PDFBackground: Dyslipidemia occurs in 60% of hypertensive patients. Effective treatment of hypertensive patients with dyslipidemia can reduce the risk of cardiovascular disease by more than 50%. However, compliance with dyslipidemia medication in dyslipidemia patients is still low. Low compliance can be attributed to poor knowledge. This study aimed to analyze the relationship between knowledge and compliance using antidyslipidemic drugs in hypertensive patients with dyslipidemia.Methods: A cross-sectional analytical study was conducted from August to September 2022 at the Pasirkaliki Public Health Center (Pusat Kesehatan Masyarakat, Puskesmas), Bandung, Indonesia. The consecutive sampling method was used to collect 64 hypertensive patients with dyslipidemia who were taking anti-dyslipidemic drugs. Primary data on knowledge and compliance were obtained through valid and reliable questionnaires. The Chi-square test was used to determine the relationship between the two variables.Results: The study results showed that 95.3% of respondents had good knowledge. Respondent compliance showed obedience of 78.1%. Respondents with good knowledge had an obedience rate of 78.1%. There was a relationship between knowledge and compliance to using anti-dyslipidemic drugs in hypertensive patients with dyslipidemia (p=0.001).Conclusions: There is a relationship between knowledge and compliance with the use of anti-dyslipidemia drugs in hypertensive patients with dyslipidemia. Almost all patients have good knowledge. Continuous maintenance and improvement of patient knowledge is required, which can be achieved by conducting health education to better understand the relationship between diseases and the importance of taking medication
Tatalaksana Pasien Syok Sepsis dengan Peritonitis Diffusa ec. Abses Hepar Post Laparatomi Eksplorasi
Get PDFAbses hepar didefinisikan sebagai benjolan yang berisi pus pada hepar yang dapat berkembang dari cedera pada hepar atau infeksi intra-abdominal yang menyebar dari sirkulasi portal. Tingkat kejadian tahunan abses hepar adalah sekitar 2,3 kasus per 100.000 orang. Abses hepar dapat pecah yang menyebar sehingga menyebabkan peritonitis dan syok. Komplikasi penularan ke organ lain termasuk endoftalmitis atau emboli septik sistem saraf pusat yang berakibat fatal pada pasien yang dapat menyebabkan kematian. Laporan kasus ini menjelaskan pasien laki-laki 18 tahun dengan syok sepsis dan abses hepar. Prinsip tata laksana pasien abses hepar adalah insisi dan debridement. Pada kasus ini pasien sudah mengalami syok septik tata laksananya meliputi resusitasi cairan, optimalisasi penggunaan vasopresor-inotropik, pengendalian sumber infeksi (source control), dan pemberian antibiotik intravena dini, sebaiknya dalam waktu satu jam setelah diagnosis sepsis dan syok septik ditegakkan. Selain itu, perawatan pasien kritis di ICU juga merupakan tantangan tersendiri terutama pasien dengan syok septik. Manajemen cairan, nutrisi, serta pemberian analgesia dan sedasi sesuai dengan kebutuhan. Penatalaksanaan tepat pasien dengan syok sepsis karena abses hepar, luaran pasien yang baik dengan length of stay (LOS) yang singkat di ruangan ICU merupakan target dokter anestesi dan intensivis. Penatalaksanaan yang tepat akan memberikan prognosis pasien yang lebih baik; pada kasus ini pasien ditatalaksana dengan baik sehingga pasien mendapatkan perbaikan keadaan umum dan kesadaran pasien kompos mentis setelah diterapi.Abses hepar didefinisikan sebagai benjolan yang berisi pus pada hepar yang dapat berkembang dari cedera pada hepar atau infeksi intra abdominal yang menyebar dari sirkulasi portal. Tingkat kejadian tahunan abses hepar adalah sekitar 2,3 kasus per 100.000 orang. Abses hepar dapat pecah yang menyebar sehingga menyebabkan peritonitis dan syok. Komplikasi penularan ke organ lain termasuk endoftalmitis atau emboli septik sistem saraf pusat yang berakibat fatal pada pasien yang dapat menyebabkan kematian. Laporan kasus ini menjelaskan pasien laki-laki 18 tahun dengan syok sepsis dengan Abses Hepar. Penatalaksanaan tepat pasien dengan syok sepsis karena abses hepar, luaran pasien yang baik dengan Length Of Stay (LOS) yang singkat di ruangan ICU merupakan target dokter anestesi dan intensivis. Penatalaksanaan yang tepat akan memberikan prognosis yang lebih baik terhadap pasien
Effect of Cnidoscolus aconitifolius Leaf Extract in Lowering Triglyceride Levels and Body Weight of Wistar Rats with Metabolic Syndrome
Get PDFBackground: Cnidoscolus aconitifolius has the potential to be antidyslipidemic which has the effect of lowering triglyceride levels. This study aimed to explore the effect of Cnidoscolus aconitifolius leaf extract on triglyceride levels and body weight of Wistar rats with metabolic syndrome.Methods: This randomized controlled trial with a pre- and posttest design was conducted in 2021 at the Center for Food and Nutrition Studies, Yogyakarta, Indonesia. Male Wistar rats were subjected into metabolic syndrome state with a high-fat and high-fructose diet (HFHFD) for 21 days, then injected with Streptozotocin (STZ, 45 mg/kg) and Nicotinamide (NA, 110 mg/kg), and designated as positive control group. The intervention group was given 150 mg/kg, 300 mg/kg, and 450 mg/kg dose of leaf extract for 28 days. Triglyceride, glucose, high-density lipoprotein or HDL, and cholesterol were measured before and after intervention, using serum samples taken from the retro-orbital vein and analyzed using an enzymatic colorimetric method. The Wistar weight was measured every week. Data was analyzed by paired T-test and One-way ANOVA with Post-hoc Bonferroni and Games-Howell.Results: There was a significant decrease in triglyceride levels after the intervention (p< 0.005). Interestingly, there was also a significant increase in weight gain in all groups after the intervention (p=0.000), both were dose dependent.Conclusion: Cnidoscolus aconitifolius leaf extract is significantly lowering triglyceride levels in the Wistar rats model. In addition, weight gain has also been observed after intervention. Clinical studies are needed to further explore the potential of Cnidoscolus aconitifolius leaves as anti-dyslipidemia
Recombinant Tissue Plasminogen Activator (rtPA) Affects Extremity Motor Progress in Acute Ischemic Stroke Patients
Get PDFBackground: Decreased motor function is the most common disorder caused by stroke, leading to disability. Early recanalization is the potential therapy for acute ischemic stroke, by using recombinant tissue plasminogen activator (rtPA). This study aimed to analyze the effectiveness of rtPA therapy on the motor progression of extremities in acute ischemic stroke patients.Methods: This was a retrospective cohort study using secondary data from medical records of 45 patients with acute ischemic stroke who received rtPA therapy in Al Islam Bandung Hospital, Indonesia in 2022. The limb motor progress was designated as an increase in strength motoric function skills of the left and right arms, as well as the left and right legs which were influenced by the neuroplasticity process. Marginal homogeneity test was used with significance at p<0.05.Results: Therapy of rtPA improved affected limb motor progress in patients (p=0.000). Before the administration of rtPA, all patients experienced muscle weakness. After 24 hours of rtPA therapy, patients experienced a decrease in muscle strength (9.5%), a steady state (28.6%), and increased in muscle strength (61.9%). After 72 hours, it was found that patients experienced a decrease in muscle strength (9.5%), a steady state (16.7%), and increased in muscle strength (76.2%).Conclusion: Administration of rtPA significantly affects the progress of limb motor improvement in acute ischemic stroke patients. This study supports rtPA as a? primary therapeutic option for acute ischemic stroke patients and is expected to contribute to improving the management and recovery of stroke, a critical illness associated with aging
Perbandingan Antara Kombinasi Ibuprofen dan Parasetamol dengan Ketorolak dan Parasetamol Intravena Terhadap Derajat Nyeri dan Rasio Neutrofil Limfosit Pasca-Functional Endoscopic Sinus Surgery
Get PDFFunctional endoscopic sinus surgery (FESS) adalah metode gold-standard pada manajemen rinosinusitis kronik. Prosedur ini tetap menimbulkan rasa nyeri pascaoperasi, walaupun tindakan bersifat minimal invasif. Parasetamol yang dikombinasikan dengan obat anti-inflamasi non-steroid (OAINS) dapat digunakan untuk analgesik pascaoperasi. Hal lain yang perlu diperhatikan sebagai faktor prognostik adalah nilai rasio neutrofil limfosit (RNL). Penelitian ini mengamati penggunaan analgesia multimodal pada nyeri pascaoperasi serta apakah terdapat hubungan dengan RNL yang dilakukan di RSUlP Wahidin Suldirohulsodo dan rumah sakit jejaring antara bulan Agustus 2023 hingga Februari 2024. Desain penelitian adalah uji acak tersamar ganda yang membandingkan kelompok P1 (pemberian kombinasi parasetamol dan ibuprofen intravena [IV]) dengan kelompok P2 (kombinasi parasetamol dan ketorolak IV) pascaoperasi FESS. RNL dihitung perioperatif, jam ke-6 dan ke-24 pascaoperasi. Penilaian derajat nyeri dilakukan pada 6 jam, 12 jam, 24 jam dan 48 jam pascaoperasi. Total didapatkan 40 pasien yang dibagi ke dua kelompok. Tidak ditemukan perbedaan bermakna pada derajat nyeri antar kelompok (p>0,05) dan juga RNL (p>0,05). Kombinasi parasetamol baik dengan ibuprofen maupun ketorolak dapat menjadi pilihan sebagai multimodal analgesia pascaoperasi.Hingga saat ini, functional endoscopic sinus surgery (FESS) adalah metode gold-standard pada manajemen rinosinusitis kronik. Tindakan FESS, walaupun bersifat invasif minimal, tetap menimbulkan rasa nyeri pada pasien pascaoperasi. Asetaminofen atau parasetamol yang dikombinasikan dengan obat anti-inflamasi non-steroid (OAINS) seperti ibuprofen dan ketorolak dapat digunakan untuk analgesik pascaoperasi. Hal lain yang perlu diperhatikan sebagai faktor prognostik dalam suatu pembedahan adalah nilai rasio neutrofil limfosit (RNL). Studi ini mengamati penggunaan analgesia multimodal pada nyeri pascaoperasi serta apakah terdapat hubungan dengan RNL. Penelitian ini menggunakan desain penelitian uji acak tersamar ganda yang membandingkan kelompok P1 (pemberian kombinasi parasetamol dan ibuprofen intravena [IV]) dengan kelompok P2 (kombinasi parasetamol dan ketorolak IV) pascaoperasi FESS. Pasien dialokasikan ke masing-masing kelompok secara acak. RNL dihitung perioperatif, jam ke-6 dan ke-24 pascaoperasi. Penilaian derajat nyeri dilakukan pada 6 jam, 12 jam, 24 jam dan 48 jam pascaoperasi. Total didapatkan 40 pasien yang dibagi ke dua kelompok secara rata. Tidak ditemukan perbedaan bermakna pada derajat nyeri antar kelompok (p>0,05) dan juga RNL (p>0,05). Kombinasi parasetamol baik dengan ibuprofen maupun ketorolak dapat menjadi pilihan sebagai multimodal analgesia pascaoperasi
PERBANDINGAN NEBULISASI LIDOKAIN 2% DAN SPRAY LIDOKAIN 10% DALAM MENCEGAH REFLEKS BATUK PADA PASIEN BRONKOSKOPI DENGAN SEDASI DI RSUP HAJI ADAM MALIK MEDAN
No full textKeluhan batuk sering muncul pada pasien yang menjalani bronkoskopi akibat adanya trauma mekanik pada dinding saluran napas. Lidokain digunakan pada bronkoskopi untuk menekan refleks batuk. Penelitian ini bertujuan menilai efek lidokain yang diberikan secara nebulisasi dan spray terhadap refleks batuk pada pasien bronkoskopi. Desain penelitian randomized control trial dilaksanakan di RSUP Haji Adam Malik bulan Agustus sampai dengan September 2023 pada pasien bronkoskopi dengan sedasi. Sampel yang diperoleh 36 pasien yang dibagi menjadi 2 kelompok yaitu kelompok yang mendapat spray Lidokain 10% dan kelompok yang mendapatkan nebulisasi lidokain 2%. Variabel yang diteliti adalah derajat batuk. Analisis statistik yang digunakan adalah mann whitney. Berdasarkan penelitian yang dilakukan terdapat perbedaan derajat batuk yang bermakna pada pada menit ke-15, menit ke-30 dan postperlakuan (p<0,05). Pada kelompok nebulisasi Lidokain 2% derajat batuk lebih rendah dibanding dengan pada kelompok spray Lidokain 10%. Simpulan: Pemberian nebulisasi lidokain 2% lebih efektif menekan derajat batuk dibanding dengan spray lidokain 10% pada tindakan bronkoskopi dengan sedasi.Bronkoskopi adalah tindakan medis secara visual terhadap saluran pernapasan. Batuk yang muncul pada bronkoskopi akibat adanya trauma mekanik pada dinding saluran napas. Lidokain merupakan obat anestesi lokal yang digunakan pada bronkoskopi untuk menekan refleks batuk. Penelitian ini bertujuan menilai efek lidokain yang diberikan secara nebulisasi dan spray terhadap refleks batuk pada pasien bronkoskopi.Penelitian ini menggunakan metode desain Randomized Control Trial dilaksanakan di RSUP Haji Adam Malik Medan bulan Agustus dan September 2023. Subjek pasien Bronkoskopi dengan sedasi. Penelitian dengan dibagi menjadi 2 kelompok yaitu kelompok yang mendapat Spray Lidokain 10% dan Nebulisasi Lidokain 2%. Analisis statistik menggunakan SPSS.Penelitian terdiri dari 18 sampel yang dibagi menjadi 2 kelompok. Berdasarkan penelitian yang dilakukan terdapat perbedaan refleks batuk yang bermakna pada pada menit ke-15, menit ke-30 dan Post perlakuan (p<0,05). Dimana refleks batuk pada kelompok Nebulisasi Lidokain 2% lebih rendah dibandingkan pada kelompok Spray Lidokain 10%.Terdapat perbedaan refleks batuk yang signifikan pada pemberian Spray Lidokain 10% dan Nebulisasi Lidokain 2%. Nebulisasi Lidokain 2% lebih efektif menekan refleks batuk dibandingkan Spray Lidokain 10%
Nephroprotective Effects of Sunkist Peel Ethanol Extract on Diabetic Nephropathy
Get PDFThe most common long-term diabetic complication is diabetic nephropathy which, in most cases, falls into the End-Stage Kidney Disease. Numerous studies on the nephroprotective effects of citrus fruit have been conducted recently. This study was performed to investigate the phytochemical properties of Sunkist peel ethanol extract and their possible effects on improving diabetic nephropathy. To get the extract, the Sunkist peels were macerated and the extract was analyzed by GC-MS. An in vivo assay of five different groups of 25 male Wistar rats was then performed using the extracts. The groups included control, standard, 500 mg/kg extract, 750 mg/kg extract, and 1,500 mg/kg BW extract. All rats were sacrificed after 28 days of treatment and VEGF level serum and kidney histology analysis were performed. The VEGF data were first analyzed descriptively, followed by one-way ANOVA or Kruskal-Wallis test based on the data distribution. Meanwhile, the kidney histology was observed and narratively described. Results showed that the Sunkist peel ethanol extract has a potential effect to suppress the VEGF level (p-value < 0.05). The extract at the highest dose revealed the mildest pathology damage in the form of tubular structure degeneration without any glomerular damage. This study indicates that Sunkist peel extract has nephroprotective effects from its various phytochemical compounds that work as antioxidants and anti-inflammation
Awareness and Knowledge of Celiac Disease Among the General Population in Saudi Arabia
Get PDFCeliac disease (CD) is an immune-mediated systemic disorder affecting nutrient absorption triggered by both environmental (gluten) and genetic factors. This study aimed to determine the level of awareness and knowledge of CD among the general population of Saudi Arabia. A community-based online cross-sectional study was conducted between August and October 2022 to examine the awareness regarding signs, symptoms, complications, and treatment of celiac disease. Data were collected and analyzed from 1,675 participants distributed across the five regions in Saudi Arabia. Analysis shows that 65.1% of the participants were familiar with the symptoms of celiac disease, and 49.6% confirmed that symptoms, blood tests, and endoscopy are the best way to diagnose celiac disease. The mean awareness score for the study participants was 71.8 (SD 13.9), with 5.2% of the participants needed a better level of awareness. Having a family history of celiac disease was an important predictor of having a higher level of awareness of celiac disease (p<0.001). The general public in Saudi Arabia demonstrates a moderate to high level of awareness of CD, emphasizing the need for extensive efforts to maintain high awareness of CD among the general public
Knowledge on and Compliance with Standard Precautions among Medical Students in Jharkhand, India: A Cross-Sectional Study
Get PDFObjective: To assess the knowledge, attitude, and compliance with standard precautions among medical students in a tertiary care hospital in Jharkhand, India.Methods: A total of 280 medical students, including phase I and phase II MBBS students, participated in the study. Phase I comprised an introduction to standard precautions in four-hour classes while the Phase II comprised of 8 hours of theory and three skill assessments on standard precautions according to the CBME curriculum and pandemic module. A structured validated questionnaire was used to collect data on the student's knowledge, attitude, and practice related to standard precautions. The questionnaire included items assessing various aspects of standard precautions, and scoring criteria were used to evaluate student performance. The overall level of knowledge, attitude, and practice was classified as poor (<50% score), moderate (50–79% score), and good (≥80% score).Results: Among the phase I students, 32.8% got a good score. In contrast, in the phase II, 56.6% demonstrated good performance in adhering to standard precautions. The median total score was 68 (interquartile range 62-71) of 85, indicating a satisfactory level of understanding and compliance with standard precautions. However, areas such as needing to remove PPE before leaving the patient's environment and not recapping needles showed rooms for improvement.Conclusion: Students showed good knowledge and compliance with standard precautions. Phase II students demonstrated a better understanding of standard precautions compared to their phase I counterparts. This highlights the positive impact of practical hands-on training as particularly emphasized in the phase II curriculum
Correlation between Duration of Placement of Non-tunneled Hemodialysis Catheter and Positive Bacterial Culture Incidence in Hemodialysis Patients
Get PDFNon-tunneling hemodialysis catheter is one of the most convenient vascular accesses for hemodialysis in End Stage Kidney Disease (ESRD) patients. However, these catheters have the highest morbidity among all available accesses. Current guidelines recommend that non-tunneled hemodialysis catheters be placed for no more than 2 weeks to prevent bacterial contamination. This study was conducted in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, throughout January-December 2021. A correlation test with a prospective observational analysis design was applied to find the link between the duration of non-tunneled hemodialysis catheter placement and the incidence of positive bacterial culture on the catheter. Pearson correlation test was used to see the strength of the correlation, with a significance limit of 0.05. This study involved 28 subjects. The most common location for catheter placement was in the jugular vein, and laboratory examinations showed no correlation between leukocyte values and positive bacterial culture results. Hypertension and diabetes mellitus were not significant risk factors (p-value 0.887). At ≤14 days of catheter placement, only 1 (6.7%) of the subjects presented a positive culture result. Most of the positive bacterial culture results were found at a duration of 15-30 days of placement, (n=8; 53.3%). The results of the Pearson test showed a p-value of 0.036 and an r-value of 0.399, indicating a significant result with a strong correlation between the two variables. The duration of placement of hemodialysis catheters has a positive correlation with the incidence of positive bacterial cultures, which can increase the risk of systemic infection associated with hemodialysis catheters