Journal of Agromedicine and Medical Sciences
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The Relationship Between Antihypertensive Drug Compliance and the Incidence of Intradialyctic Hypertension in Hemodialysis Patients at RSD dr. Soebandi Jember
No full textChronic renal failure is a global health problem with the number of sufferers increasing every year. This disease is classified into five stages based on glomerular filtration rate values with or without evidence of kidney damage. In the end stage of chronic renal failure, patients require renal replacement therapy, namely kidney transplantation or hemodialysis. Having hemodialysis therapy is capable cause various complication, one of them is intradialytic hypertension. One of the important thing to do to prevent intradialytic hypertension in hemodialysis patent is consuming antihypertensive drug. Antihypertensive drug is capable to control blood pressure, but the usage must be accompanied by patient compliance in consuming drug in order to provide long-term treatment effect. If the patient does not obey on consuming the drug and their blood pressure cannot be controlled the complication will exist, such as the organ damage. Therefore, the aim of this study is to determine the relationship between adherence to consuming antihypertensive drugs and intradialytic hypertension in hemodialysis patients. This study used an analytic observational method with a cross sectional approach. The sample in this study used 88 eligible respondents. The level of drug compliance was measured by using the MMAS-8 (Modified Morisky Adherence Scale) questionnaire, while the blood pressure was measured by using a tensimeter from pre-dialysis to post-dialysis. The data will be processed and analyzed by using chi-square test. Based on the result of the study obtained a p-value is <0.05 (p-value = <0.001), it can be concluded that there is a relationship between compliance with antihypertensive drug consumption with intradialytic hypertension in hemodialysis patients.
Keywords: intradialytic hypertension, medication adherence, MMAS-8 questionnaire
The Phytochemical Identification And Antibacterial Activity Test Of Leucas Lavandulifolia Against Escherichia Coli
No full textDiarrhea is defined as a condition where the stool changes or becomes softer or more liquid with a frequency of 3 or 4 times a day. Based on its etiology, diarrhea is caused by several microorganisms, one of which is bacteria. The bacteria that causes diarrhea most often found in Indonesia is Escherichia coli. One type of plant that has the potential as an antibacterial is the Leucas lavandulifolia or Lenglengan plant. Based on ethnopharmaceutical studies, lenglengan leaves are commonly used to treat insomnia, pinworms, coughs with phlegm, epilepsy and digestive disorders. This research was carried out using lenglengan leaf ethanol extract with concentrations of 2.5%, 5%, 10%, 20% and 40%. In this study, phytochemical screening was also carried out using the TLC method. Antibacterial testing was carried out using the well diffusion method. The results obtained were the formation of a clear zone around the well, which indicated activity inhibiting bacterial growth. The results of testing antibacterial activity against E.coli showed that the ethanol extract of langlengan leaves at concentrations of 2.5%, 5%, 10%, 20% and 40% had antibacterial activity with clear zone results of 1.04 ± 0.33 , 12.71 ± 0.34, 13.90 ± 0.60, 15.23 ± 0.36, and 19.32 ± 0.79 mm. The results of the phytochemical screening showed that ethanol extract of lenglengan leaves contained alkaloids, saponins, flavonoids, terpenoids/steroids and polyphenols. It can be concluded, the ethanol extract of lenglengan leaves has antibacterial activity against E.coli where the greater sample concentration, the greater activity
Evaluating the Effect of Outpatient Registration Systems on Patient Recommendations Using Value Stream Mapping and Path Analysis
No full textDigital transformation in healthcare requires hospitals to adopt efficient and integrated information systems. This research aims to analyze the influence of outpatient registration information system types—conventional, Hospital Management Information System (HMIS), and Mobile JKN—on recommendations to others using Value Stream Mapping (VSM) and path analysis with SmartPLS. The study was conducted at Citra Husada Hospital Jember with 98 respondents selected through convenience sampling. The VSM results indicate that Mobile JKN has the shortest total service time (1 hour 32 minutes) and the highest efficiency value (8.6%). Statistical analysis shows that interaction with medical personnel, ease of access, ease of use, and data security significantly influence patient satisfaction. Medical information satisfaction and overall service quality are proven to be the main factors driving patient recommendations. Consequently, Mobile JKN is the most efficient registration system alternative and has the potential to improve hospital service quality. Optimization of system integration and user education is recommended to support digital-based healthcare service transformation
A Rare Case of Complete Atrioventricular Block caused by Acute Rheumatic Fever in Young Adult: A Case Report
No full textAcute Rheumatic Fever (ARF) causes inflammatory process that can affect multiple organs including the heart conduction system. The most common rhythm issue is first-degree atrioventricular (AV) block, complete AV block, and another kind of aberrant conduction. The occurrence of second and third-degree AV block are less common in ARF. Modified major and minor of Jones criteria is used to diagnose ARF, other supportive laboratory examinations are helpful to confirm the diagnosis. We reported a 25 years old man came to emergency unit with fever and chest pain. A complete AV block was found using electrocardiogram along with high Anti-Streptolysin (ASO) titers and troponin as a proof of inflammatory process, especially on heart conduction. The patient is completely recovered with corticosteroid without any single residual symptom. Despite the rarity of its occurrence, adult-onset ARF may be one of the causes of complete AV block. Early investigation and treatment will prevent further complication on cardiovascular system.
Keywords: rheumatic fever, atrioventricular bloc
Children Under Five Years of Age: Factor Analysis of Tuberculosis Preventive Therapy's Success in Controlling Childhood Tuberculosis
No full textJember Regency is the 2nd Regency after Surabaya City in finding the highest number of TB cases in East Java Province, with 5,244 adult cases and 478 pediatric TB cases found. Finding TB cases in children is an important component in controlling TB because the number of children aged less than 14 years constitutes 12% of the population. The government's efforts to control childhood TB by providing TPT (TPT) as an effort to strengthen the management of latent tuberculosis infection (ILTB) are still low. Toddlers in close contact with Drug Sensitive Tuberculosis (TB SO) are a group at risk of being infected with TB so they need to get TPT. This study aims to determine and analyze the driving factors, enabling factors, reinforcing factors and the role of the Medication Supervisor (PMO) on medication adherence in the TPT program for toddlers in close contact with TB in Jember Regency. The method in this research uses the Explanatory Research type, which is a type of research that aims to analyze the relationship or influence between variables through hypothesis testing. The results of this research indicate that the success factors of the TPT administration program, namely driving factors, enabling factors, reinforcing factors and the role of the Medication Supervisor (PMO) are proven to influence medication adherence in the TPT administration program for toddlers in close contact. It’s known that the factors contributed mainly to the successness of Tuberculosis Prevention Therapy are family’s support and the rile of the the Medication Supervisor (PMO)
Computational Insights into Leucaena leucocephala Extract Shampoo as a Malassezia furfur Anti-Dandruff Agent
No full textDandruff is a scalp condition characterized by excessive flaking resulting from colonization by the fungus Malassezia furfur. Chemical-based anti-dandruff shampoos frequently result in side effects, including irritation, resistance, and hair discoloration. This study investigates the efficacy of Leucaena leucocephala leaf extract as a natural treatment for dandruff using an in-silico methodology. This research employed molecular modeling and docking assays targeting the 14-alpha lanosterol demethylase enzyme (CYP51), the primary antifungal target in Malassezia furfur. The docking results indicated that the active compounds in Leucaena leucocephala leaves, namely squalene and lupeol, exhibit a competitive binding affinity for CYP51, similar to the mechanism of action of ketoconazole. Squalene engages in polar interactions akin to the natural ligands of CYP51, whereas lupeol demonstrates robust hydrophobic interactions, suggesting its potential as an enzyme inhibitor. The findings indicate that herbal compounds derived from Leucaena leucocephala may serve as a natural alternative for dandruff treatment, presenting a reduced risk of side effects relative to synthetic chemicals. Further in vivo studies are necessary to validate the effectiveness and safety of anti-dandruff topical formulations.
Keywords: CYP51, Dandruff, Leucaena leucocephala, Malassezia furfur, Natural antifunga
The Relationship of Work Duration and The Symptom of Carpal Tunnel Syndrome (CTS) in Rujak Sellers in Glenmore District Banyuwangi Regency
No full textCarpal Tunnel Syndrome (CTS) is a neuromuscular disease characterized by tingling, pain and sensory disturbances in the palms and fingers due to compression of the median nerve which is in the carpal tunnel. One of the risk factors for CTS is that repetaed wrist flexion-extension movements over a long period of time can trigger mechanical trauma or ischemia to the median nerve. Rujak seller is one of the jobs that is at risk of experiencing CTS. This research was conducted to determine the relationship between duration and frequency of work and symptoms and severity of CTS in rujak sellers in Glenmore District, Banyuwangi Regency. This cross-sectional analytical observational study was conducted from April to June 2024 and involved 59 respondents. Data was collected through interviews using questionnaires on work duration, work frequency, CTS symptoms and the Indonesian version of the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ). The results of the Spearman analysis show a significant relationship between work duration and CTS symptoms (p=0.005) with a correlation coefficient of 0.361. The results of data analysis also show a significant relationship between work frequency and CTS symptoms (p=0.000) with a correlation coefficient of 0.595. This research concluded that the duration and frequency of work had a significant positive relationship with the symptoms and severity of CTS. The longer the duration of work and the more frequent the frequency of work, it can increase the risk of CTS and increase the severity of CTS.
Keywords: Carpal Tunnel Syndrome; CTS Symptoms; Duration of Work; Frequency of Wor
Drug Inventory Management with A System Approach to Overcome Drug Inventory Inefficiencies in Hospital Pharmacy Installations
No full textHospital is a health service institution that provides complete individual health services, providing inpatient, outpatient and emergency services. One of the non-medical services that plays an important role in medical support is pharmaceutical services. Pharmaceutical services are very important for hospitals because they are supporting services that become cost centers and revenue centers. Pharmacy installations require good drug management so they can provide effective and efficient services. Management efforts that can be taken are to carry out pharmaceutical logistics management using a systems approach. The aim of the research is to examine drug management in hospital pharmacy installations using a systems approach. This research is qualitative research with a case study approach. The results show that the input components that hinder the drug inventory management process at Hospital X include human elements (lack of pharmacists and knowledge of health workers), money (delays in drug payments waiting for the budget to come down), material (lack of facilities and infrastructure, non-ergonomic room layout), method (non-compliance of officers with SOP), machine (incomplete SIMRS features and random errors), and market (complaints from patients who do not get drugs at Hospital X). Meanwhile, waste in the drug inventory management process consists of defects (miscalculation of supplies and needs, non-ergonomic room layout, and mismatch between real stock, manual stock opname, and SIMRS stock opname), overproduction (there are repeated checks at the depot due to inconsistencies with SIMRS), waiting (the process of waiting for drugs from the distributor and there is a waiting time for the BLUD budget to decrease), transportation (the capacity of facilities and infrastructure is inadequate so that the distribution process is repeated), inventory (manual stock opname results in waste of paper and stationery and storage of used and unused drugs in one room), motion (the hospital must purchase drugs from partner pharmacies if there is an empty stock), extra-processing (the use of SIMRS for stock opname is less than optimal because it is still semi-conventional with manual stock opname).
Keywords: drug management, pharmaceutical installation, hospital, system
