E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
Not a member yet
1208 research outputs found
Sort by
Family Support in Adherence to Oral Anti-Diabetic Medications among Patients with Type 2 Diabetes Mellitus
Full text linkBackground: Adherence to medication is an important aspect in type 2 diabetes mellitus management. One of the factors that determine medication adherence is family support. This study aimed to analyze the relationship between family support and adherence to oral anti-diabetic medications in patients with type 2 diabetes mellitus.Methods: This study was a quantitative, non-experimental correlational study with a cross-sectional method conducted in December 2022–January 2023 on patients with type 2 diabetes mellitus at the Pasirkaliki Public Health Center, Bandung City, Indonesia. The study used a minimal sampling method. Data collection analysis was performed using the SPSS program with the Chi-square test.Results: In total, 50 respondents were included, of whom the majority (n30; 60%) had good family support, whereas 17 (34%) had sufficient family support, and only 3 (6%) had poor family support. A good level of medication adherence was indicated by 39 (78%). There was a significant relationship between family support and adherence to oral anti-diabetic medications in type 2 diabetes mellitus (p=0.003).Conclusions: A good relationship between family support and adherence to oral anti-diabetic medications is crucial in enhancing quality of life and wellness among patients with type 2 diabetes mellitus. Research related to other factors that affect adherence to oral anti-diabetic medications warrant further studies
Neutrophil Lymphocyte Ratio and Mortality in Patients with Acute Limb Ischemia
Full text linkAcute Limb Ischemia (ALI) is a sudden decrease in limb perfusion with a potential of limb loss and is an indication for immediate vascular intervention. Apart from reducing the quality of life, the mortality rate in ALI is reported to be high, i.e., around 40%. Neutrophil Lymphocyte Ratio (NLR) can be used to reflect the inflammatory process in this condition. This study aimed to assess the correlation of NLR to mortality rate in ALI Rutherford Category III patients treated in Dr. Hasan Sadikin General Hospital Bandung, Indonesia. This was a cross-sectional analytical observative retrospective study on data collected from medical records of ALI Rutherford Category III patients treated in the hospital from 2019 to 2022. Sampling was performed consecutively and data were processed using the SPSS with univariate analysis and bivariate analysis using Kendall's tau b analysis test. Results demonstrated that of a total of 46 patients, the majority were female patients (n=31) and 28 patients died. The mean NLR levels in patients who survived was 5.8, in contrast with 9.7 observed among those who died. The statistical test results showed a significant correlation between the NLR and mortality rate of ALI Rutherford category III patients (
Factors Associated with Soil-Transmitted Helminths Infections in Children Aged 24-59 Months in Bandung District, Indonesia
No full textSoil-transmitted helminth (STH) infections remain a major public health concern in developing countries, particularly among lower- to middle-income populations with poor sanitation, limited access to healthcare, and inadequate clean water. Preschool-aged children are especially vulnerable due to their developing immune systems and increased nutritional needs. This study aimed to identify factors associated with STH infections among children aged 24–59 months in Bandung District, Indonesia. A case-control design was employed using secondary data from helminthiasis surveillance conducted between October 2019 and January 2023, involving a total of 261 children. The Kato-Katz technique was used to examine stool samples for the detection of STH species. Among them, 30 (11.49%) were infected with soil-transmitted helminths (STH), comprising ascariasis (11.11%), trichuriasis (0.38%), and hookworm infection (0.38%). Bivariate chi-square analysis revealed significant associations with fathers’ education level (p = 0.0003), BPJS-Healthcare participation (p = 0.015), water source (p = 0.015), distance from the water source to the latrine (p = 0.003), and nail hygiene (p = 0.018). Multivariate logistic regression confirmed that distance between water source and pit latrine (OR = 0.265; 95% CI: 0.76–0.92), nail hygiene (OR = 0.318; 95% CI: 0.13–0.76), and participation in BPJS-healthcare program (OR = 0.364; 95% CI: 0.15–0.91) were key determinants of STH infection. These findings highlight the importance of addressing environmental and behavioral factors through public health interventions, including improving access to clean water, promoting personal hygiene, and enhancing parental, particularly paternal education, as essential strategies for reducing the risk of STH in children
Acid-Base and Electrolytes Profile in Critically Ill Pediatric Patients Admitted to Pediatric Intensive Care Unit (PICU)
Full text linkCritically ill pediatric patients are known to experience more frequent episodes of acid-base and electrolyte imbalances when compared to adults, which can significantly impact morbidity and mortality with higher mortality rates and longer hospital stays. Data on the profile of acid-base and electrolyte imbalances in critically ill pediatric patients is very limited in Indonesia. This study was conducted to describe the electrolytes and acid-base profile of critically ill pediatric patients admitted to the Pediatric Intensive Care Unit (PICU). This was a cross-sectional study using secondary data from medical records of critically ill pediatric patients aged 1 month to 18 years admitted to the PICU of Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, from January 1 to December 31, 2021. Results indicated that 131 (50.8%) of 258 patients experienced electrolytes and acid-base imbalances. The majority of patients were boys (53.0%) and infants (32.8%). The most common primary diagnosis was respiratory (28.2%), central nervous system (19.8%), and gastrointestinal disorders (15.3%). A total of 366 electrolyte imbalance events and 111 acid-base imbalance events were recorded. The most common electrolyte imbalance events were hyponatremia (75.6%), hypocalcemia (48.9%), and hypokalemia (42.7%), respectively, while the most frequent acid-base imbalance events were respiratory alkalosis (33.6%) and metabolic acidosis (21.4%). Electrolyte and acid-base imbalances are common among critically ill pediatric patients in PICU. Thus, early evaluation and recognition of acid-base and electrolyte imbalances are crucial in order to prevent poor outcomes in these patients
HER2 Reactivity Pattern and Association with Various Tumor Factors in Breast Cancer Patients
Full text linkBackground: Breast cancer prognosis and therapeutic strategies are strongly influenced by biomarker profiles, particularly HER2 reactivity, which impacts treatment selection and disease progression.Objective: To study the HER2 reactivity pattern and identify the association of HER2 pattern with various tumor factors in patients with breast cancer.Methods: This prospective study comprised of 150 surgically operated female cases of breast cancer admitted to the Department of Pathology for ER, PR, and HER2 testing between December 2015 and October 2017.Results: Of 150 cases, the mean age was 52 years (IQR, 41-63 years). This study showed that majority of tumors were IDC-NOS, grade 2, tumor size T2, and had negative lymph node status. HER2 negative cases were in the majority, as well as the ER/PR+ cases. Triple-negative cases were slightly higher (49 cases). When HER2 was correlated with tumor characteristics, younger patients with HER2-positive were in the majority, with the higher the tumor size is, the greater the chance for HER2 negativity. The majority of IDC cases and all ILC cases showed HER2 negativity. Both medullary cases showed HER2 positive, and one case of mucinous showed HER2 negativity with ER/PR positivity. Irrespective of ER/PR status, the majority of tumors had HER2 negativity.Conclusion: HER2/neu positively correlates with increasing age, menstrual status, tumor size, and tumor grade. No association is found between histological type, lymph node status, and ER/PR. This study also reveals that patient with higher levels of HER2/NEU-overexpression had statistically significant lower levels of ER/PR-positive tumors. In addition, when Her2 neu is positive in tumors, along with ER and PR, it is mostly high-grade
Eribulin in Heavily Pre-Treated Metastatic Breast Cancer: A Case Series
Full text linkBackground: Treatment options are limited for heavily pre-treated metastatic breast cancer patients, with Eribulin showing promise in improving survival outcomes.Objective: To evaluate Eribulin outcomes in patients with MBC. Metastatic or incurable diseases are observed in 4% to 10% of women despite advances in breast cancer treatment. To address this problem, EMBRACE, an important randomized phase III clinical trial was carried out by comparing eribulin to the treatment selected by physicians for individuals with previously treated locally recurrent or metastatic breast cancer (MBC). The results showed a significant and prolonged increase in median overall survival among patients treated with eribulin, compared to those who received the physician's selected treatment.Case Series: This study presents three patients who showed favorable outcomes after treatment with eribulin, despite multiple lines of previous therapy. Patient 1 was diagnosed with triple-negative breast cancer and initially achieved remission before experiencing a recurrence involving a chest lesion and enlarged lymph nodes. After two cycles of eribulin, the patient showed significant improvement. Patient 2 developed brain and liver metastases following the completion of hormonal therapy, prompting the initiation of eribulin as the next line of treatment. Patient 3 had disease progression despite undergoing multiple lines of hormonal and chemotherapy. Eribulin was administered and patient remained stable.Conclusion: Patients with MBC tend to have substantially favorable outcomes with eribulin chemotherapy even after extensive previous treatment
Role Of High-Resolution CT Thorax in Interstitial Lung Disease Evaluation
Full text linkBackground: High-Resolution Computed Tomography (HRCT) plays a crucial role in the evaluation of interstitial lung diseases, offering detailed imaging for accurate diagnosis.Objective: To evaluate diagnostic precision and clinical relevance of High-Resolution Computed Tomography (HRCT) in evaluating Interstitial Lung Diseases (ILDs).Methods: This observational study analyzed HRCT images from 30 patients using a multi-detector CT scanner. The study was conducted at the Department of Radiodiagnosis of Gian Sagar Medical College and Hospital, India, in a period of one year (January 2024 to December 2024). Images were reviewed by two radiologists for various features, including ground-glass opacities, reticulations, honeycombing, and traction bronchiectasis. The patterns were classified as definite UIP, probable UIP, or suggestive of chronic HP or NSIP.Results: Eighteen patients (60%) showed basal-predominant honeycombing, reticulations, and traction bronchiectasis consistent with definite UIP. Six of these also exhibited upper lobar emphysema, categorized as Combined Pulmonary Emphysema and Fibrosis (CPFE). Another six patients with NSIP displayed subpleural curvilinear opacities, fine reticulations, and ground-glass abnormalities. Six (20%) patients with chronic HP showed diffuse ground-glass opacities and traction bronchiectasis, primarily in the upper lobes with air trapping on expiratory scans.Conclusion: This case series demonstrates the diverse HRCT findings in ILD, underscoring the importance of HRCT in diagnosis and prognosis. Larger studies with histopathological confirmations are needed to refine these diagnostic insights
Effectiveness of Cadaver Compared to Plastination as Anatomy Learning Media: Medical Student Perspective
No full textBackground: Anatomy is a fundamental component of medical education, playing a pivotal role in understanding the structure and function of the human body. Cadaver-based anatomy learning remains widely used in many medical faculties; meanwhile, plastination as an alternative method, offering efficiency and practicality. This study aimed to evaluate the effectiveness of cadaver and plastination learning media in improving anatomical understanding among first-year medical students.Methods: This was a cross-sectional quantitative study with a pretest-posttest control group design conducted in November-December 2023. The study included 69 first-semester medical students from the Universitas Pertahanan, Republic of Indonesia who had not previously received musculoskeletal anatomy lectures. Participants were divided into cadaver and plastination groups. A questionnaire was distributed before and after the anatomy class. Data were analyzed with the Mann-Whitney, Wilcoxon, and paired sample t-test.Results: Both cadaver and plastination groups showed a significant increase in post-test scores (p<0.05), indicating that each method effectively improved students’ anatomical understanding. However, there was no significant difference between the two groups (p-value=0.253), suggesting comparable effectiveness between cadaveric and plastinated teaching media.Conclusions: Cadaveric and plastinated learning media are equally effective in improving anatomical knowledge among first-semester medical students. A thorough understanding of human anatomy is essential not only for clinical competency but also for advancing knowledge related to wellness, healthy aging, and the management of degenerative diseases.
Enhancing Care Quality and Wellness for Older Adults: Empathy Training in Nursing
No full textBackground: Empathy plays an essential role in older adult care and patient wellness, by strengthening healthcare quality and the nurse-patient relationship. This study evaluated the effectiveness of Carl Rogers-based empathy training in improving the capacity of empathy among nurses, particularly in caring for older adult patients and wellness. Methods: A quasi-experimental pre- and post-test design was conducted in October 2024 at Bekasi Regency Hospital, Indonesia. Nurses from inpatient and outpatient units were selected through purposive sampling. Empathy was assessed using the Interpersonal Reactivity Index (IRI) before and after a three-day training program. The analysis included overall empathy scores and four subdimensions: Empathic Concern (EC), Perspective Taking (PT), Fantasy Scale (FS), and Personal Distress (PD). Data were analyzed using the Wilcoxon signed-rank test and effect size calculations.Results: The mean total empathy score slightly decreased from 47.91±7.4 to 46.14±2.6 (p=0.190, r=0.22). However, significant improvements were observed in EC (p=0.004, r=0.51) and FS (p=0.007, r=0.42), whereas PD decreased significantly (p=0.001, r=0.61). No significant change was found in PT (p=0.457, r=0.12). Conclusion: Short-term empathy training effectively enhances emotional dimensions of empathy, such as empathic concern and fantasy scale, while reducing personal distress. However, it does not significantly improve overall empathy scores. Long-term training, reinforcement strategies, and cognitive-based interventions may be needed to support sustained empathy developments in nursing care for older adults and patient wellness
Comparison of Sensitivity and Specificity between B.I.L.E. Criteria and Tokyo Guidelines 2018 (TG18) for Diagnosing Acute Cholangitis
Full text linkAcute cholangitis is an inflammatory condition of the biliary system due to bacterial infection associated with biliary stasis or obstruction. Diagnosis is made using the Tokyo Guidelines 2018 (TG18) criteria. The biliary imaging abnormality, inflammatory test abnormality, liver test abnormality, and exclusion of cholecystitis/pancreatitis (B.I.L.E.) criteria are relatively new, with limited studies evaluating their sensitivity, specificity, and validation. This study aimed to compare the sensitivity and specificity of B.I.L.E. and TG18 criteria for the diagnosis of acute cholangitis. This is an observational analytic study with prospective cohort design during May 2023–May 2024. Data were obtained from patients who came to the Emergency Department of Dr. Hasan Sadikin General Hospital Bandung, Indonesia, with clinical symptoms of fever and jaundice, suspected of acute cholangitis. There were 95 subjects in this study. Based on B.I.L.E. criteria, 57 (60%) patients were categorized as high probability and 38 (40%) patients were categorized as unlikely acute cholangitis, while the TG18 criteria resulted in 61 (64.2%) patients classified as definite and 34 (35.8%) patients classified as suspected acute cholangitis. The sensitivity of the B.I.L.E. criteria was 92.1%, with a specificity of 94.73%. Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of B.I.L.E. criteria were 92.1% and 94.73%, respectively. In contrast, the sensitivity and specificity of TG18 criteria in this study were 82.35% and 83.6%, respectively. The PPV of TG18 reached 73.68% while the NPV of TG18 reached 89.47%. In conclusion, B.I.L.E. criteria have higher sensitivity and specificity than TG18 criteria in diagnosing acute cholangitis patients