Althea Medical Journal
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Patients Satisfaction with the Chronic Disease Management Program in Indonesia Using the Importance-Performance Matrix
Full text linkBackground: 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
Correlation of Platelet to Lymphocyte Ratio and C-Reactive Protein to Albumin Ratio with MEX-SLEDAI Scores in Patients with Systemic Lupus Erythematosus
Full text linkBackground: One of the methods used to assess systemic lupus erythematosus (SLE) disease activity is the Mexican systemic lupus erythematosus disease activity index (MEX-SLEDAI) score. Markers of SLE disease activity such as anti-dsDNA antibodies, complement, and anti C1q have limitations in terms of sensitivity and specificity. In rural areas where these markers are not available, simpler alternative markers are valuable. This study aimed to explore markers related to SLE disease activity based on the platelet to lymphocyte ratio (PLR) and C-reactive protein albumin ratio (CAR) using the MEX-SLEDAI score.Methods: This was a cross-sectional study using a correlational analytical design. Data collection was carried out retrospectively using secondary data taken from medical records of patients with SLE treated at Dr. Hasan Sadikin General Hospital Bandung, Indonesia in 2019–2021 and the Laboratory Information System (LIS). The data was analyzed using the Spearman rank correlation test.Results: Of the 51 participants, 92% were female with median MEX-SLEDAI scores of 9. The median value of PLR and CAR were 247.07 and 2.01, respectively. The CAR showed a moderate positive correlation (r=0.563, p0.05) with the MEX-SLEDAI score.Conclusions: MEX-SLEDAI scores has a moderate positive correlation with CAR, suggesting that CAR may be used as a marker in assessing disease activity in adult patients with SLE
Spatial Autocorrelation of Dengue and Its Relationship with Population Density in South Kalimantan, Indonesia
Full text linkBackground: Dengue is a viral infection transmitted to humans through the bite of Aedes aegypti and Ae. Albopictus mosquitoes. Demographic factors that may influence the development and prevalence of dengue cases include variations in population density, community characteristics, and economic and social demographics. This study aimed to determine the distribution, spatial autocorrelation, and relationship between population density and dengue.Methods: Secondary data analysis was conducted in Hulu Sungai Selatan District, South Kalimantan, Indonesia. Data on dengue cases, population density for each sub-district, and base maps were collected to and then be used as analysis material. Spatial autocorrelation was analyzed using the Moran's index and Local Spatial Autocorrelation Index (LISA), then the correlation of population density with dengue was carried out using linear regression.Result: Spatial Autocorrelation had positive autocorrelation and clustered spatial patterns in 2017 and 2018; whereas in 2019-2021 was negative and the spatial pattern was spread. There was a decrease in cases from high to low (HL) in Kandangan District in 2021, which was previously high to high (HH) in 2017-2019. There was a correlation between population density and dengue (R-value=0.448) with a moderate category.Conclusion: Dengue cases are more widespread in Kandangan. The spatial autocorrelation of dengue that occurs between sub-districts in Hulu Sunga Selatan District is due to sub-district location in the city center. There is a correlation between dengue and population density. Therefore, controlling dengue should be prioritized in the city center area first to break the chain of dengue transmission between sub-district in Hulu Sunga Selatan District.
Penile Length of Prepubertal Children in Surabaya
Full text linkBackground: Early recognition of phallic size abnormalities is essential to identify underlying endocrine and genetic disorders. Parents are concerned regarding their son’s penis length, especially obese and short-stature boys. This study aimed to investigate the factors of penile length in prepubertal boys aged 9-11 in Surabaya.Methods: A cross-sectional analytic observational study was conducted between October and November 2021 during the community services program of the Andrology Study Program, Universitas Airlangga. One hundred forty-eight healthy boys aged 9-11 years were enrolled in this study. Penile parameters and anthropometric measures were recorded. Data were analyzed with Spearman Rho’s formula to correlate the variables studied.Results: The average penile lengths and penile circumference of the penis were 6.3±1.4 and 5.2±1.0 cm, respectively. This study found two boys with micropenis (1.35%) with normal and overweight body mass index (BMI). The penile length was positively correlated with height but not with BMI.Conclusion: Androgen and growth hormones significantly influence penile length. Children with abnormal BMI tend to have smaller penile sizes, associated with increasing androgen aromatization
Correlation between Vertebral Slippage in Spondylolisthesis with Ligamentum Flavum Thickening in Dr. Soebandi Hospital, Jember, East Java, Indonesia
Full text linkBackground: Spondylolisthesis is a vertebral slip condition that compromises the body’s axial alignment and structures such as ligamentum flavum. The ligamentum flavum thickening may play a role in spondylolisthesis. The purpose of this study was to investigate the correlation between the slippage of vertebral body (spondylolisthesis) with ligamentum flavum thickening as a tissue response regarding increased mechanical stress.Methods: An analytical retrospective radiological observational was used a cross-sectional study from the results of MRI examination in Dr. Soebandi Hospital, Jember, Indonesia, collected from 2018-2021 using the simple random sampling method. Ligamentum flavum thickness and the degree of vertebral slip were measured using T2-weighted MR imaging and the correlation was analyzed using Fisher’s exact test. Results: Of 102 spondylolisthesis data records, 34 were taken, being female was the most prevalent cases in the age group above 60 years, with the most vertebral segment shift occurring at the L4–L5 level. There was a significant correlation. (p = 0.02; RR = 4.8) between ligamentum flavum thickening and vertebral slip in spondylolisthesis. Conclusion: The significant correlation between ligamentum flavum thickening and vertebral slip in spondylolisthesis suggest that mechanical stress has caused spondylolisthesis, by inducing chronic inflammation that results in hypertrophy of ligamentum flavum. Lumbar segmental instability due to spondylolisthesis is a factor contributing to the development of ligamentum flavum hypertrophy
Monitoring Obstacles of Toddlers Growth in Public Health Center Margahayu Raya Bandung City during the COVID-19 Pandemic: From Cadre Perspective
Full text linkBackground:Toddler growth monitoring is one of the specific nutritional interventions used to accelerate stunting reduction. The COVID-19 pandemic has reduced various ‘Minimum Service Standards‘coverages, including toddler growth monitoring. This study aimed to explore the obstacles of toddler growth monitoring at the Integrated Service Center (Pusat pelayanan terpadu, Posyandu) during the COVID-19 pandemic. Methods: This was a qualitative study with an interpretivism paradigm. The unit of analysis was Posyandu of Margahayu Raya Public Health Center, Bandung City, West Java. Primary data were obtained through in-depth interviews with 10 cadres from different Posyandu from September-December 2021. The data were collected using a semi-structured interview guide and a recorder, and analyzed using NVivo software.Results: During the COVID-19 pandemic, toddler weighing had been suspended for several months. Starting in August 2020, cadres and public health center officers worked to ensure that toddlers’ weight, body length, and height could be monitored despite the numerous obstacles.Conclusion: The obstacles to toddler growth monitoring are inadequate instruments of toddler body height measuring during home visits, minimum cadre skills, a lack of toddlers’ mother awareness to bring their toddlers to Posyandu, and a lack of public awareness to follow health protocols.
Patient Satisfaction with National Health Insurance and Public Health Center Accreditation: Lessons Learnt from Majalengka Regency, Indonesia
Full text linkBackground: Perceptions of patient satisfaction influence the quality of the public health center (Pusat Kesehatan Masyarakat, Puskesmas) services. This study aimed to determine the differences in the level of patient satisfaction with national health insurance and the accreditation status of Puskesmas.Methods: This quantitative analytical study using a cross-sectional method was conducted at four Puskesmas in Majalengka Regency from October to November 2021 using a purposive sampling technique. The instrument used was the community satisfaction instrument (IKM-29) questionnaire , with the variable measured being the level of satisfaction. Data was transformed into numerical form using Rasch modelling and analyzed using the Chi-Square, independent-t, and one-way ANOVA tests.Results: A total of 273 respondents consisted of insured (Jaminan Kesehatan Nasional, JKN) and non-insured (non-JKN) respondents, resulting in the satisfaction mean value between JKN and non-JKN patients of 2.50 and 2.51 (p-value= 0.926). Satisfaction at Puskesmas levels 1 (Dasar), 2 (Madya), 3 (Utama), and 4 (Paripurna) was 2.15, 2.23, 2.56, 3.03, respectively (p-value = 0.002), indicating an increase in the level of satisfaction at the Puskesmas accreditation level.Conclusion: There is no difference in satisfaction between respondents using JKN and non-JKN. However, there is an increase in satisfaction related to the Puskesmas accreditation level. It is recommended for each Puskesmas to maintain the same service to all patients and improve the quality of service, especially in service dimensions that are considered inferior. Additionally, it is necessary to review the minimum standard value for accreditation programs
Antioxidant Gel from Brown Algae (Ascophyllum nodosum) and Binahong Leaves for Diabetic Wound Healing
Full text linkBackground: Diabetic wounds are difficult to treat, causing persistent infections and often leading to limb amputation. One convenient way to manage diabetic wounds is by applying wound dressings. This study aimed to develop a wound dressing in form of a gel containing brown algae and binahong leaf extract for diabetic wound dressings.Methods: This study was an experimental study conducted in the Organic Chemistry Laboratory of Universitas Pendidikan Indonesia from June to September 2022. As many as 33 mice induced by alloxan were divided into 9 groups consisting of application of brown algae extract gel, binahong lead extract gel and a mixture of brown algae, and binahong leaf extract gel with the concentration of 2.5%, 5%, and 10% respectively. All treatments were given within 7 days. Laboratory data collected included phytochemical screening, total phenolic compound, antioxidant activity and organoleptic test.Results: Brown algae and binahong leaf extracts had a high total phenolic content of 331.25 mg GAE/g and 207.01 mg GAE/g, respectively with antioxidant activity of IC50 = 327.33 µg/mL and 209.30 µg/mL, respectively. It was found that brown algae and binahong leaf extracts could accelerate wound closure in a diabetic mouse model. Gel formulation with 10% w/w brown algae extracts presented 91.66% of wound closure, two times greater than treatment with commercial drugs.Conclusion: The developed gel containing brown algae and binahong leaf extracts can be a promising wound dressing for healing diabetic wounds