eJournal Kedokteran Indonesia
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The Effect of Alpha Lipoic Acid in Preventing Atherosclerosis Lesion on the Abdominal Aorta of Diabetes Mellitus Type 2 Rats
No full textVarious studies have studied the clinical use of alpha-lipoic acid (ALA) for treating diabetic complications. The protective effect of lipoic acid in atherosclerosis induced by diabetes mellitus type 2 (DM type 2) still needs further study. This study was aimed to investigate the protective effect of ALA in atherosclerosis induced by DM type 2. Twenty one rats were divided into 3 groups: control, DM−treated and DM+ALA-treated group. Type-2 diabetes was induced by intraperitoneal injection of streptozotocin (50 mg/kg) followed by nicotinamide (110 mg/kg). ALA was administered orally at a dose of 60 mg/kg body weight/day throughout the feeding period for three weeks. This study was an experimental study with post-test only with control method which was conducted at Biochemistry laboratory, Faculty of Medicine Universitas Riau from June-October 2016. This study showed that DM+ALA treated group achieved lower atherosclerosis scores than DM-treated group and the difference between the two groups was statistically significant. In conclusion, alpha lipoic acid can prevent atherosclerosis lesions induced by diabetes
The Comparison of Survival, and Cost Effectiveness of Geriatric Patients Admitted in Dr. Cipto Mangunkusumo Hospital Before and During National Health Insurance Program Implementation
No full textComprehensive Geriatrics Assessment (CGA) has been proven to improve the overall outcome of geriatric patients care, and has been implemented in RSCM as the standard geriatric medical care. National Health Insurance Program (NHIP) was implemented in Indonesia in January 2014. It is unclear how NHI program will affect survival and cost effectiveness of geriatric patients receiving CGA. The aim of this study was to compare the survival and cost effectiveness between geriatric patients hospitalized during NHIP and before NHIP era in RSCM. This was a retrospective cohort study with historical control. The subjectswere geriatric inpatients aged ≥60 years old with one or more geriatric giants between July to December 2013 (non NHIP) and January to June 2014 (NHIP). A survival analysis and determination of incremental costeffectiveness ratio (ICER) was used to compare the survival and cost-effectiveness between the two groups. The clinical and demographic characteristics were relatively similar between the NHIP and non NHIP group. No difference in mortaliy rate during hospital care and 30 days survival rate between NHIP and non NHIP group (31.2% vs 28%, p=0.602; 65.2% vs 66.4%, p = 0.086, respectively). No significant difference was found in the survival curve between the two groups. Calculation of ICER showed that NHIP was associated with an increased cost of 1.4 million rupiah and 1.2 % higher mortality rate. Further research is needed to evaluate this result when NHI Program has been implemented for a longer duration
Head Position and Other Risk Factors Associated with Acute Neck Pain among Taxi Drivers
No full textNeck pain is a common musculoskeletal disorder which causes an increase in worker absenteeism and health expenses of companies. This study aimed to determine the relationship of the head position and other risk factors towards the incidence of acute neck pain among taxi drivers. The study was carried out on June to September 2015 using cross-sectional design with a sample of 113 respondents via consecutive sampling. Data were collected by interview, physical examination and photographic methods for measuring the head position while driving. The subject were taxi drivers in Jakarta. Exclusion criteria were driver with preexisting neck pain or neck discomfort at the initial time of the study, analgesic usage in the last 24 hours and the usage of neck pads while driving. Data was analyzed using multivariate logistic regression and cutoff point determination based on ROC curve. 46.7% of respondents were experiencing acute neck pain. The head position associated with acute neck pain was neck-horizontal angle (OR=14.72, 95% CI=5.08-42.6). Respondents with neck-horizontal angle ≤50º had 15 times greater risk of experiencing acute neck pain than neck-horizontal angle >50º. Risk factor of occupation associated with acute neck pain was duration of rest on duty (OR=7.61, 95% CI=2:51 to 23:13). Respondents with the duration of rest on duty ≤3 hours per day had 8 times greater risk of experiencing acute neck pain than respondents with longer rest >3 hours. There were no individual factors associated with acute neck pain
Association of FSH Level with Spermatogenic Histology Based on Johnson Criteria in Azoospermic Patients
No full textThe aims of this study is to know the association FSH level with spermatogenic histology on testical biopsy and to evaluate the use of FSH level as predictor of the succes of testical biopsy on azoospermic patient using Johnson criteria. This is a cross-sectional study, comparing two groups, i.e. spermatogenic histology pattern using Johnson criteria and FSH level (IU/L). Age, FSH level, spermatogenic histology pattern are collected from medical record. Population of this study were azoospermic patients in the Deparment of Urology Cipto Mangunkusumo hospital and Morula Clinic Bunda Hospital between 2011 – 2015. Descriptive study was calculate, followed by one way ANOVA comparative test with post-hoc test Duncan and ROC curve analysis to determined the AUC and cut-off value. The age of the patients were 21-51 years old and the most frequent were 31-40 years old (67%). The most frequent histology pattern and Johnson criteraia were maturation arrest (41%) and 5 (27.8%) respectively. Mean level of FSH was 15.83 IU/L with minimum level was 2.35 IU/L and maximaum 41.3 IU/L. There was association between FSH level and spermatogensis histology pattern using Johnsosn criteria, however the validity to predict the outcome of sperm in biopsy in azoospermic patients using FSH level was still low
Association between Sertoli Cell-Only Syndrome, Varicocele and FSH Level in Azoospermic Patients
No full textA varicocele is the most frequent causes of infertility because it causes damage to the testes that could increase the levels of FSH. The objectives of this study were to determine the relationship of varicocele history and the condition of Sertoli cell-only syndrome (SCOS) based on Johnson criteria from testicular biopsy and the relationship of SCOS with FSH levels or testicular volume in azoospermic patients. This cross-sectional study (110 samples) used data from testicular biopsy of azoospermic patients at the Biology Department FKUI and the medical records of Urology Department FKUI-RSCM in 2011-2015. Johnson’s criteria for most patients were 5 with a mean criteria of 4.42 (±1.997). The Johnson criteria of 2 in the biopsy results or SCOS is 21 (19.1%). In patients with a history of varicocele, there were only 10 (27.8%) patients with SCOS (p=0.378). There was no association between SCOS and the history of varicocele. Patients without SCOS have mean FSH levels of 14.1± 8.6IU/L and patients with SCOS have mean FSH of 21.3±7.5IU/L. There was significant difference mean of FSH level (paired t test, p<0,05), which is 7,247 in SCOS group and non-SCOS. There were 36 testes with the Johnson criteria of 2 and 157 testes having values above 2. The SCOS and non-SCOS group testicular volumes were significantly different (Mann-Whitney test, p=0.018). Varicocele could not be used as an indicator of SCOS, however high levels of FSH may indicate SCOS in azoospermic patients
Reverse-Transcriptase Characteristics of Hepatitis B Virus Polymerase Gene in Treatment-Naïve Asymptomatic Chronic Hepatitis B Individuals
No full textNucleos(t)ide analogues (NUCs) remain the main treatment for chronic hepatitis B (CHB). Long-term use of NUCs significantly reduces disease progression; however, it might lead to resistance-associated mutations. We studied characteristics of polymerase gene related to NUCs resistance in naïve hepatitis B surface antigen (HBsAg)-positive individuals. The research was done at Laboratory of Hepatitis, Eijkman Institute, Jakarta Thirty eight samples were obtained and submitted for HBV DNA detection. Identification of mutations was performed by PCR-sequencing, and analyzed to obtain NUCs resistance motifs. Genotype and subtype were determined based on HBsAg sequence. Mutation of rtQ238H/N was found in 37 (97.4%) samples. Of those, 23 (62.2%) showed rtQ238H mutation, 10 (27.0%) had rtQ238N mutation, and four (10.8%) with double mutations of rtA194T and rtQ238H. Genotype B was found in 26 (68.4%), C in 11 (28.9%), and D in one (2.6%) samples. Statistically, the mutation variant of rtQ238H was associated with genotype B (p<0.001), while rtQ238N with C (p<0.001). The ayw subtype was found in 25 (65.8%), adr in 11 (28.9%), and adw in two (5.3%) samples. No mutation associated with NUCs resistance was found in most samples. This emphasizes that NUCs are still a prospective treatment in naïve CHB patients. Mutation of rtQ238H was a variant found to be significantly associated with HBV genotype B and rtQ238N with genotype C
Implementation of Electronic Prescribing
No full textMedication errors often occur in general practice and in hospitals partly due to an error in the prescription or prescribing error because of incorrect medical decisions that affect patient safety and healthcare quality. Therefore, it is necessary to prevent and reduce such errors, among others, by writing an electronic prescribing (e-prescribing). This review will address the results of studies on the prevalence of prescription errors and the benefits of implementing e-prescriptions to avoid misinterpreting doctor’s handwriting on prescription papers and excessive drug prescribing, efficiency of drug preparation time at pharmacies, and the ability of e-prescribing manage databases that can analyze the history of drug allergy, proper dosage and potential drug interactions that harm patients. Moreover, it also discusses the implementation strategy, infrastructure support and government monitoring system (Food and Drug Supervisory Agency) regularly. Implementation of e-prescribing with appropriate strategies will have a positive impact on healthcare quality and patient safety
Study of Index Aedes Larvae in Salemba Campus Universitas Indonesia
No full textJakarta is one of urban areas in Indonesia that became endemic araea for DHF. In 2014 the Incidence Rate (IR) of DHF is 83.33 per 100,000 population. Salemba campus of Universitas Indonesia is one area in Central Jakarta is prone to the incidence of DHF. Salemba campus is the ground and building at Universitas Indonesia where all learning activities and administration activities on going. Salemba campus located in Central Jakarta is prone to the incidence of dengue. The aim of this study was to determine the density index of Aedes in the Salemba Campus Universitas Indonesia. This research is observational research with descriptive study approach. The research conducted in January 2015. The samples are 169 units buildings taken from 20 buildings were purposively selected. Index larva, obtained from mosquito larvae survey by single larvae method from 253 containers. Larval index determined from Container Index (CI), House index (HI), Bretau Index (BI) and Density Figure (DF), which can show the density and spread of larval Ae. aegypti in Salemba campus Universitas Indonesia. The Results showed CI 8.3%; HI 4.7%; BI 12.4% and DF 2-3 respevtively. The dominant container as larval breeding places is a bucket which is the not permanent container