E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Characteristics of the Mothers on Stunting Toddlers 12-36 Months West Bandung Regency, Indonesia
Get PDFObjective: To determine the characteristics of respondents with stunted toddlers aged 12-36 months in the Batujajar and Cihampelas districts of West Bandung District.Methods: A case-control study with a pretest-posttest design was conducted from May to August 2022 in West Bandung Regency, Indonesia. The study included 124 mothers with stunted toddlers, who were divided into two groups - control and treatment - with 62 toddlers each, using simple random sampling.Result: The majority of children under the age of five in this study were female. In the case group, the majority of mothers were in the 20-29 age range (40.3%), while in the control group, the majority were in the 30-39 age range (38.7%). Most mothers in both the control and case groups had a high school education (41.8%). The majority of participating mothers were housewives (85.5%). Childcare was primarily provided by mothers, and most of the resource persons were also mothers.Conclusion: Based on the characteristics observed in this study, the majority of children under the age of five were female in both the case and treatment groups. Most mothers in both groups had a high school education, and the majority of participating mothers were housewives. Childcare was primarily handled by mothers, and most of the resource persons were also mothers
Patients Satisfaction with the Chronic Disease Management Program in Indonesia Using the Importance-Performance Matrix
Get PDFBackground: Indonesia still has a high prevalence of hypertension and diabetes mellitus. On the other hand, essential health services were disrupted during the COVID-19 pandemic. Hence, the quality of service still needs to be prioritized. The government also obliges the government-owned primary healthcare facilities (Pusat Kesehatan Masyarakat, Puskesmas) to conduct customer satisfaction surveys to evaluate service quality. This study was conducted to analyze patients’ satisfaction with the chronic disease management program (Program Pengelolaan Penyakit Kronis, Prolanis) provided by Puskesmas in Bogor City.Methods: Quantitative research with a survey approach using the CSI-29 questionnaire was conducted from October to November 2021 on 104 Prolanis participants from 6 Puskesmas in Bogor City, West Java, Indonesia. The variables were 9 dimensions of satisfaction based on the CSI-29 questionnaire. Data was transformed using the Rasch model and analyzed using the Importance-Performance Matrix (IPM).Results: Of the 104 participants, there were 78 (75%) were satisfied with the Prolanis services provided by the Puskesmas. The IPM analysis showed that the dimensions of requirements, procedures, costs, type of service products, and attitudes of health workers had low expectations and perceived performance level.Conclusions: Most of the Prolanis participants were satisfied with the Prolanis services provided by the Puskesmas in Bogor City
Efektivitas Retrograde Autologous Priming dalam Menurunkan Volume Kebutuhan Transfusi Sel Darah Merah Selama Operasi pada Bedah Jantung Koroner dengan Mesin Pintas Jantung Paru: A Randomized Controlled Trial
Get PDFPemakaian mesin pintas jantung paru (PJP) dalam operasi coronary artery bypass graft (CABG) dapat meningkatkan kebutuhan transfusi darah. Tujuan penelitian ini untuk mengetahui efektivitas retrograde autologous priming (RAP) dalam menurunkan volume transfusi sel darah merah/packed red cell (PRC) pada pasien bedah jantung koroner dengan mesin PJP. Penelitian ini melibatkan 52 pasien yang dijadwalkan menjalani operasi coronary artery bypass graft (CABG). RAP dimulai selama bypass dalam satu kelompok dengan mengalirkan larutan kristaloid dari jalur arteri dan vena ke dalam kantong penampung dengan volume penarikan RAP yang dimaksudkan dan disesuaikan untuk setiap pasien. Non-RAP menggunakan teknik konvensional PJP. 52 pasien (RAP = 26; kontrol = 26) dilibatkan dalam analisis. Pasien dalam kelompok RAP menerima volume transfusi PRC intraoperatif yang jauh lebih rendah dibanding dengan pasien pada kelompok non-RAP (median, 0 mL vs 205 mL, p=0,014). Analisis regresi linier berganda menunjukkan bahwa prosedur RAP mempengaruhi secara signifikan (p<0,05) volume PRC yang dibutuhkan dalam transfusi intraoperatif. RAP selama operasi bedah jantung koroner dengan mesin PJP adalah prosedur yang aman dan efektif yang secara signifikan mengurangi kebutuhan transfusi volume PRC. Pemakaian mesin pintas jantung paru (PJP) dalam operasi coronary artery bypass graft (CABG) dapat meningkatkan kebutuhan transfusi darah.Tujuan penelitian ini untuk mengetahui efektivitas retrograde autologous priming (RAP) dalam menurunkan volume transfusi sel darah merah/packed red cell (PRC) pada pasien bedah jantung koroner dengan mesin PJP. Penelitian ini melibatkan 52 pasien yang dijadwalkan menjalani operasi coronary artery bypass graft (CABG). RAP dimulai selama bypass dalam satu kelompok dengan mengalirkan larutan kristaloid dari jalur arteri dan vena ke dalam kantong penampung dengan volume penarikan RAP yang dimaksudkan dan disesuaikan untuk setiap pasien. Non-RAP menggunakan teknik konvensional PJP. 52 pasien (RAP = 26; kontrol = 26) dilibatkan dalam analisis. Pasien dalam kelompok RAP menerima volume transfusi PRC intraoperatif yang jauh lebih rendah dibandingkan pasien pada kelompok non-RAP (median, 0 mL vs 205 mL, p=0,014). Analisis regresi linier berganda menunjukkan bahwa prosedur RAP mempengaruhi secara signifikan (p <0,05) volume PRC yang dibutuhkan dalam transfusi intraoperatif.RAP selama operasi bedah jantung koroner dengan mesin PJP adalah prosedur yang aman dan efektif yang secara signifikan mengurangi kebutuhan transfusi volume PRC
Risk Factors for Extended Spectrum Beta-Lactamase Producing Klebsiella pneumoniae in Arifin Achmad Hospital Riau, Indonesia
Get PDFMultidrug-Resistant (MDR) bacteria that produce Extended-Spectrum Beta-Lactamase (ESBL) isolates pose a global threat to human health, including in Indonesia. The availability of therapeutic options for ESBL-producing Klebsiella pneumoniae (ESBL-KP) is limited, making early recognition of patients with ESBL crucial to preventing the spread of these bacteria within the hospital. This study aimed to examine the risk factors associated with ESBL-KP in the Arifin Achmad General Hospital Riau, Indonesia. This prospective case-control study was performed from January to March 2018, with the diagnosis of ESBL established using the Vitek 2 compact automated tool. The risk factors examined were gender, age, specimen type, ward of origin, hospitalization exceeding seven days, history of antibiotic usage, presence of diabetes mellitus, chronic kidney disease, immunocompromised status, ICU care, and hospitalization within the past month. Patients hospitalized for more than seven days were 4.75 times more likely to develop ESBL-KP, while immunocompromised patients were 2.92 times more likely to develop ESBL-KP. However, the history of antibiotic use, diabetes mellitus, chronic kidney disease, ICU care, and hospitalization within the past month did not exhibit statistically significant associations with ESBL-KP infection. Therefore, ESBL-KP infection should be anticipated in patients hospitalized for more than seven days and those who are immunocompromised. It is crucial to implement infection prevention and control measures, as well as selecting appropriate antibiotic therapy
Histopathological Aspects as Predictor of Recurrency of Locally Advanced Breast Cancer
Get PDFThe histopathological aspect of breast cancer has been established as one of the important prognostic factors of recurrence. This study aimed to determine whether histopathological examination can be used as a predictor of the incidence of recurrence in locally advanced breast cancer patients. This was a cohort retrospective observational study with a correlative analytical approach. Subjects of this study were breast cancer patients who have undergone mastectomy and/or received additional therapy at Dr. Hasan Sadikin General Hospital Bandung, Indonesia, between January 2017 and September 2019. Data were collected through medical records and anatomical histopathology data. Subjects were divided based on their recurrency status. A total of 62 breast cancer patients were included in the study with 31 recurrent patients and 31 non-recurrent patients. A total of 29 patients in the recurrent group (93.5%) had lymphovascular invasion. Histopathology grading showed a difference in both groups, in which recurrent group patients were mostly (74.2%) in the high histopathological grade while 51.6% of samples in non-recurrent group were categorized as moderate histopathological grade. Complete histopathological margins were found in both recurrent and non-recurrent groups for 54.8% and 87.1% respectively. There is a correlation between histopathologic grading, lymphovascular invasion, and incision margin with the recurrence of a locally advanced stage breast cancer. It can be concluded that some histopathological aspects can be used as a predictor of recurrence in locally advanced breast cancer
A Case Study on Neurological Outcome in Persistent Neonatal Hypoglycemia in Upper Middle-Income Country
Get PDFIn Indonesia, comprehensive management and monitoring of persistent neonatal hypoglycemia, is rarely reported. Despite the fact that there are studies highlighting the risk of neurodevelopmental disorders in neonates with hypoglycemia, there seems to be limited comprehensive case reports detailing both the early diagnosis and the long-term growth and development monitoring in these neonates. A unique case report of a 10-day-old male baby, born at a term weeks gestation via caesarean section, diagnosed with persistent hypoglycemia and suspect of hyperinsulinemia is presented in this study. At birth, the neonate exhibited hypoglycemia with a blood glucose level of 25 mg/dL, accompanied by a one-minute seizure characterized by upward gaze and stiffening of the extremities. The neonate cried after seizure and there was no loss of consciousness and was admitted to the NICU due to worsening respiratory distress. Based on the thoracic X-ray examination, he was diagnosed with transient tachypnea of newborn (TTN). Blood glucose levels were monitored every four hours, and tests for cortisol, thyroid and growth hormone and routine urinalysis were planned. Total parenteral nutrition (TPN) were given with intravenous antibiotics. At 6months of age, the infant was diagnosed with intellectual disability by the growth and development social pediatric unit. At 7 months, the infant began undergoing physiotherapy. This case was followed for 7 months in total and the findings highlight the challenges in managing neonatal persistent hypoglycemia and the potential long-term developmental implications in neonates with early-life hypoglycemia, emphasizing the need for continual growth and development monitoring
Tacrolimus Therapy Among Steroid-Resistant Nephrotic Syndrome Children: A Preliminary Study in West Java, Indonesia
Get PDFObjective: To explore the outcomes of Tac therapy for Steroid-Resistant Nephrotic Syndrome (SRNS) and its implication in reducing the number of CKD events.Methods: An open, prospective, cohort study was conducted at a tertiary hospital in Bandung, West Java, Indonesia. Children (age 1–18 years old) with steroid and cyclophosphamide resistant nephrotic syndrome were enrolled in this study. Blood pressure, urinary protein, serum ureum, and creatinine levels were measured every month, Tac and soluble urokinase plasminogen activator receptor (supaR) levels were assessed at the 0, third, and sixth months.Results: Ten of fifteen subjects enrolled in this study got better within 3–6 months with a trend of decreasing suPAR level and proteinuria, as well as stable blood pressure and serum creatinine and ureum level. During treatment, no side effects of the subjects were found with the Tac level maintain safely.Conclusion: Tac is an effective and safe agent in treating SRNS, especially for those do not respond well to an alkylating agent
Risk Factors for Treatment Drop Out Among Pulmonary Tuberculosis Patients at the UPT Public Health Center in Medan Sunggal
Get PDFAbstractObjective: To determine the factors contributing to treatment dropout in tuberculosis (TB) patients.Methods: This study utilized a case-control design with a sample size of 81 participants. Univariate, bivariate, and multivariate analyses were conducted, and an accidental sampling technique was employed. The study was conducted at the Public Health Center/Puskesmas Medan Sunggal, in the Medan Sunggal District, City of Medan, and North Sumatra Province. The research took place from February to April 2023.Results: The research analysis revealed a significant relationship between knowledge and family support (p0.05). This lack of significance may be attributed to the consistent occurrence of side effects throughout the different stages of treatment.Conclusion: In conclusion, this research demonstrates a significant correlation between patients’ knowledge, family support, and treatment dropout (p0.05).Keywords: Drug side effect, pulmonary TB, TB treatment drop ou
Internet Usage and Its Utilization for Outpatient Treatment among Older Adults in Indonesia: Evidence from the 2020 National Socioeconomic Survey
Get PDFBackground: Health insurance is essential for older adults to get healthcare services. Interestingly, only around half of older adults in Indonesia had used the health insurance for outpatient care. Recently, internet usage has increased and is considered a predisposing factor for seeking therapy. This study aimed to explore the internet use among older adults for outpatient therapy.Methods: The National Socioeconomic Survey (SUSENAS)-core 2020 had included 29,905 older adults who had poor self-rated health and were unable to work or carried out other daily activities. Regression analysis was performed to determine the factors that influence the outpatient treatment.Results: Outpatient treatment utilization was highly associated with all predisposing factors such as age, gender, marital status, and education (p<0.05). Older adults who did not use the internet were 1.4 times more likely not obtain outpatient care (OR 1.362; 95% CI (1.207–1.537)). Those without health insurance had a higher probability of not seeking outpatient care (OR 1.643; 95% CI (1.551–1.741)) than those who had health insurance. Enabling factors, such as household wealth and living arrangements, were significantly associated with outpatient treatment utilization (p<0.05).Conclusions: Although health insurance remains the most significant factor, internet use is emerging as a way to increase coverage of outpatient treatment for the older adults
PERBANDINGAN NEBULISASI PREOPERASI LIDOKAIN DENGAN KOMBINASI LIDOKAIN DAN BUDESONID TERHADAP SKALA NYERI TENGGOROK PASCAOPERASI AKIBAT INTUBASI ENDOTRAKEAL PADA PASIEN YANG DILAKUKAN ANESTESI UMUM
No full textKomplikasi intubasi dengan pipa endotrakeal (ETT) yang paling sering adalah nyeri tenggorok pascaoperasi/postoperative sore throat (POST). Insidensi POST berkisar 14,4%−50%. Penggunaan metode farmakologi terbukti menurunkan angka kejadian POST melalui efek analgesia dan anti-inflamasi. Salah satu obat yang sering digunakan untuk pencegahan POST adalah nebulisasi lidokain. Nebulisasi steroid juga efektif karena dapat mengurangi inflamasi, edema, transudasi cairan, dan juga derajat nyeri. Penelitian ini membandingkan antara nebulisasi preoperasi dengan lidokain dan nebulisasi preoperasi dengan lidokain dengan budesonide. Penelitian dilakukan di RSUP Dr. Hasan Sadikin Bandung antara bulan Oktober–Desember 2023 yang menggunakan analitik komparatif eksperimental, dengan rancangan double blind randomized controlled trial terhadap dua kelompok penelitian. pengambilan sampel penelitian dilakukan dengan cara consecutive sampling. Data dianalisis menggunakan uji Mann Whitney dan normalitas data menggunakan Uji Shapiro wilk. Hasil penelitian karakteristik umum subjek penelitian didapatkan data terdistribusi normal. Pada Jam ke-1, 2, 4 didapatkan skala nyeri tenggorokan antara kelompok lidokain dan lidokain+budesonide p>0,05 atau tidak signifikan, pada jam ke-6, 12, 24 skala nyeri tenggorokan antara kelompok lidokain dan lidokain+budesonide p0,05 data terdistribusi normal. Pada Jam ke 1, 2, 4 didapatkan skala nyeri tenggorokan antara kelompok lidokain dan lidokain+budesonide p>0,05 atau tidak signifikan, pada jam ke 6, 12, 24 skala nyeri tenggorokan antara kelompok lidokain dan lidokain+budesonide p<0,05 atau signifikan. Kesimpulan yang didapatkan adalah skala nyeri tenggorok pascaoperasi pada pemberian nebulisasi lidokain dan budesonid preoperasi lebih kecil dibandingkan dengan nebulisasi lidokain saja