141 research outputs found
Validity and reliability testing of the Shatri Sinulingga psychosomatic test (SSPT) questionnaire as a screening instrument for psychosomatic disorders in Indonesia
Get PDFThe incidence of psychosomatic disorders is increasing in Indonesia, and therefore screening instruments that are culturally appropriate for the Indonesian population are needed. The aim of this study was to assess the validity and reliability of the Shatri Sinulingga psychosomatic test (SSPT) questionnaire as a screening instrument for psychosomatic disorders in Indonesia. An analytic descriptive cross-sectional study divided into two stages (questionnaire formulation and distribution through the Psikosom.id application) was conducted in 2023. The validity test was carried out using the product moment technique, and Cronbach's alpha assessment was carried out to evaluate the reliability of the questionnaire. A total of 372 participants were included, with a mean age of 39.24 years old. The SSPT questionnaire scores had strong correlations with the scores of hospital anxiety and depression scale (HADS) (r=0.668; p<0.001) and the Symptom Checklist-90 (SCL-90) (r=0.674; p<0.001); and moderately correlated with the score of fatigue severity scale (FSS) (r=0.505; p<0.001) and Pittsburgh Sleep Quality Index (PSQI) (r=0.492; p<0.001). The correlation coefficient (r) value of each SSPT question ranged from 0.389–0.726, and all r higher than r table with an overall Cronbach’s alpha of 0.744. The SSPT questionnaire's strong predictive performance: had a sensitivity of 75.6% and specificity of 71.4% with an area under the curve (AUC) of 81% (95%CI: 76.6–85.4%; p<0.001) to HADS; sensitivity of 80% and specificity of 58.6% with an AUC of 75.1% (95%CI: 70–80.2%; p<0.001) to FSS; sensitivity of 64% and specificity of 67.5% with an AUC of 71.2% (95%CI: 65.4–77%; p<0.001) to PSQI; and had sensitivity of 78% and specificity of 67.4% with an AUC of 80.9% (95%CI: 76.6–85.3%; p<0.001) to SCL-90. The study highlights that the SSPT questionnaire is valid and reliable to be used as a screening instrument for psychosomatic disorders in Indonesia
Success Rate of Liver Stiffness Measurement Using Transient Elastography in Non-alcoholic Fatty Liver Disease Patients with Obesity and Its Influencing Factors
Get PDFBackground: Percentage of patients who had liver stiffness measurement failure using transient elastography varied between 2-10%; mainly caused by obesity. XL probe is expected to increase the success rate of liver stiffness measurement in patients with obesity. The objective of this study is to evaluate the success of liver stiffness measurement using M and XL probes and its influencing factors.Method: Patients who fulfilled the inclusion criteria were included in this study. Examination results were then analysed using statistical analysis unpaired t-test or Mann-Whitney and McNemar statistical tests.Results: From 92 NAFLD patients with obesity who were studied, the proportion of success in measuring liver stiffness using M probe was 57.6%, while that of XL probe was 88.0%. This difference was statistically significant (p 0.001). BMI, SCD, and thoracic circumference were associated with success in measuring liver stiffness using M probe, with p value of 0.007, 0.001, and 0.001 respectively. The results of Mann-Whitney statistical test revealed median value of BMI and SCD of patients who had liver stiffness measurement failure using M probe were 32.7 kg/m2 and 2.6 cm respectively. T-test results showed that the mean value of thoracic circumference of patients who had liver stiffness measurement failure using M probe was 97.8 cm.Conclusion: Proportion of success in measuring liver stiffness in NAFLD patients with obesity using XL probe was better compared to the M probe. BMI, SCD, and thoracic circumference were associated with the success of measuring liver stiffness using M probe. The same variables were not associated with XL probe.</jats:p
Perubahan Status Fungsi Hati, Status Nutrisi, Kadar 3-β-Hidroksi Butiran Darah, dan Keseimbangan Nitrogen pada Pasien Sirosis Hari yang Menjalankan Puasa Ramadhan
Get PDFPendahuluan. Prevalensi sirosis cukup tinggi di Indonesia yang mayoritas populasinya adalah muslim. Pada saat menjalani puasa Ramadhan yang merupakan kewajiban umat muslim terjadi berbagai proses metabolik seperti penurunan glikokogenesis, peningkatan glukoneogenesis dan ketogenesis, dapat mempengaruhi keadaan klinis, nutrisi dan bokimiawi pasien sirosis hati yang juga mengalami proses hiperkatabolik. Penelitian tentang pengaruh puasa Ramadhan pada pasien sirosis hati di Indonesia belum pernah dilakukan. Berdasarkan kenyataan diatas perlu diteliti bagaimana perubahan terhadap status nutrisi, status fungsi hati, pembentukan badan keton dan keseimbangan nitrogen pada pasien sirosis hati yang menjalankan puasa Ramadhan.
Metode. Penelitian ini merupakan studi pre dan post, yang menilai perubahan pada pasien sirosis hati yang berpuasa Ramadhan: saat Ramadhan dan pasca Ramadhan. Pada subjek penelitian dilakukan pengambilan data-data dasar, anamnesis dasar. Pada minggu ke 4 saat puasa Ramadhan dilakukan pengukuran antropometrik, yaitu timbang berat badan, indeks massa tubuh (IMT), ketebalan triceps skinfold (TSF), dan mid-upper arm circumference (MUAC). Pada subjek juga dilakukan pengambilan darah vena untuk pemeriksaan laboratorium dan pengukuran ekskresi nitrogen urin yang ditampung dalam 24 jam. Pada minggu ke empat pasca Ramadhan subyek dievaluasi kembali dengan prosedur yang sama seperti saat Ramadhan.
Hasil. Rerata (SD) indeks massa tubuh saat puasa Ramadhan adalah 25,112 (4,05) kg/m2 dan pasca Ramadhan 25,25 (4,01) kg/m2 (p = 0,438). Didapatkan rerata (SD) midarm muscle circumference (MAMC) saat Ramadhan 25,77 (3,077) cm dan rerata (SD) pasca Ramadhan 25,96 (3,42) cm (p=0,228). Tidak ada perbedaan bermakna secara statistik antara kadar 3-β-hidroksi butiran darah saat puasa Ramadhan dan 4 minggu pasca Ramadhan. Rerata (SD) saat puasa Ramadhan 2,44 (2,93) gram/24 jam, sedangkan rerata (SD) keseimbangan nitrogen pasca Ramadhan 0,51 (3,16) gram/24 jam (p=0,037).
Simpulan. Tidak ada perubahan status fungsi hati yang dinilai dengan Skor Child Pugh saat puasa Ramadhan dan pasca Ramadhan. Indeks massa tubuh dan ketebalan TSF membaik pasca Ramadhan. Tidak ada perbedaan kadar 3-β-hidroksi butirat darah saat puasa Ramadhan dan pasca Ramadhan. Terdapat keseimbangan nitrogen yang lebih positif saat puasa Ramadhan dibandingkan pasca Ramadhan
Factors Associated with Late Referral in End Stage Renal Disease Patients at Dr. Cipto Mangunkusumo Hospital
Get PDFIntroduction. Timely referral to nephrologist is important in Chronic Kidney Disease (CKD) patients. Late referral has been proven increasing the morbidity and mortality rate. Factors affecting late referral are well known in western population. As a tertiary referral hospital where all patients are served by consultants, Dr. Cipto Mangunkusumo General Hospital (RSCM) do not have data regarding late referral of CKD patients. This study aimed to determine the proportion of late referral to nephrologist of CKD-End Stage Renal Disease (ESRD) patients in RSCM and its related factors.
Methods. A cross-sectional study of 210 CKD-ESRD patients who started dialysis initiation in dialysis unit of Cipto Mangunkusumo General Hospital from April 2017 to January 2019. Late referral were defined as patients who were referred to nephrologist more than 6 months prior to dialysis. Independent variables consist of age, gender, education, income status, ambulation status, risk of comorbid disease, compliance and underlying of kidney disease. From the dialysis registry and medical record, then continued with follow up the subjects. Living subjects was given informed consent to perform a structured interview. The subjects who died and hard to contact, data were collect from medical record. Bivariate analysis was done using Chi-square methods, Fisher method is used as alternative. Significant variables will be further analyzed with logistic regression test.
Results. From 210 subjects who undergo dialysis at the first time in Cipto Mangunkusumo Hospital, 189 patients were referred late (proportion 90%; 95% CI 86.2-93.7). From multivariate analysis, two main factors related to later referral were the assisted-ambulatory status (p=0.002; OR 6.71; 95% CI 2.02-22,32) and non-compliance (p=0.001; OR 7.42; IK 95% 2.33-23.62).
Conclusions. The proportion of late referral of CKD-ESRD patients at Dr.Cipto Mangunkusumo General Hospital is 90%. Assisted-ambulatory status and non-compliance are related to late referral of CKD-ESRD patients. Further study is needed to know the role of other factors such as health care system and its implementation by physician
Validity and Reability Test of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Breast23 in Breast Cancer Patient on Treatment
Get PDFIntroduction. Improved survival of breast cancer patients are not necessarily followed by improvement of quality of life. European Organization for Research and Treatment of Cancer (EORTC) emphasize the importance of assessing the quality of life in cancer patients. Currently, in Indonesia, there has been no reliable and valid questionnaire to assess quality of life of breast cancer patients accurately. This study aims to prove that the EORTC QLQ-BR23 is valid and reliable measuring instrument used in Indonesia.
Methods. This is a cross-sectional study. The study began with the EORTC QLQBR23 translated into Indonesian and then tested on 10 respondents. After that, The Indonesian version of EORTC QLQ-BR23 is used in the main study with a larger sample size. Test-retest was assessed with intraclass correlation coefficient (ICC). Internal consistency was assessed by Cronbach alpha. Construct validity was assessed by multi-trait scaling analysis. The criteria validity assessed by looking at the correlation between domains European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Cancer 30 (EORTC QLQC30) and EORTC QLQ-BR23 with Short Form 36 (SF36).
Results. Data collection were done on 100 breast cancer patients on treatment from September to October 2015. ICC value (1 hour interval) in all domains of EORTC QLQ-BR23 is very good (ICC> 0.8). There is a decline in the value of ICC (30 days interval) in all domains of EORTC QLQ-BR23. Cronbach alpha values > 0.7 in almost all domains of EORTC QLQ-BR23 domain unless symptoms arm domain (Cronbach's Alpha: 0.643). Multi-trait scaling analysis showed a fairly high correlation between the scores of the questions with a score of his own domain. While the relationship of the questions with different domains always have a lower correlation than the domain itself. In criteria validity test, obtained 19 correlation with r > 0,3 between domains EORTC QLQ-C30 and EORTC QLQ-BR23 with SF36.
Conclusion. EORTC QLQ-BR23 is a valid and reliable instrument for assessing quality of life of breast cancer patients in Indonesi
COMBINATION EFFECT OF LISINOPRIL AND DILTIAZEM AS ANTI FIBROSIS IN PERITONEUM OF RATS
Get PDF Objective: The objective of this research was to evaluate the effect of combination between lisinopril and diltiazem in reducing expression of transforming growth factor-β (TGF-β) and fibrosis peritoneum in a male rat treated with continuous ambulatory peritoneal dialysis (CAPD).Method: This was an experimental study, post-test only control group design. Thirsty Dawley Sprague rats are divided into five groups: Control group (Group 1), CAPD liquid 4,25% (Group 2), lisinopril 1.44 mg oral and CAPD (Group 3), and diltiazem CD 6.48 mg oral and CAPD (Group 4), lisinopril 1.44 mg+diltiazem CD 6.48 mg oral and CAPD (Group 5). After 4 weeks, rats sacrificed expression of TGF-β and peritoneal fibrosis are conducted by histopathology with hematoxylin-eosin staining and immunology with anti-human-TGF-β.Result: Twenty peritoneal of rats can be examined. Mean score of TGF-β in control group is 1, 8, in CAPD group is 2, in lisinopril and CAPD group is 1, 8, in diltiazem CD and CAPD group is 1, 8, in lisinopril and diltiazem CD and CAPD group is 1, 7 (p=0.959). Mean score of peritoneal fibrosis in control group is 1, 1, in CAPD group is 2, 6, in lisinopril and CAPD group is 1, 2, in diltiazem CD and CAPD group is 1, 3, in lisinopril and diltiazem CD, and CAPD group is 1, 5 (p=0,268).Conclusion: Combination of lisinopril and diltiazem lower the expression of TGF-β and peritoneum fibrosis better than lisinopril or diltiazem but statistically not significant. Combination of lisinopril and diltiazem lower the peritoneal fibrosis but statistically not significant, and it does not better than lisinopril or diltiazem.</jats:p
Effectivity of Opioid Rotation Compared to Opioid Combination for Cancer Pain: An Evidence Case Report
Get PDFPain is the main symptom in cancer patients that needs to be addressed immediately because it can reduce the quality of life. Concern or the ineffectiveness of using one type of opioid makes it necessary for clinicians to understand how to rotate opioids. Therefore, this evidence-based case report was conducted to identify the effectiveness of opioid rotation and combined opioids for the cancer pain management through a literature search on three databases. Literature searching was performed by using Pubmed, Cochrane library, and EBSCO according to clinical inquiries. Of the 24 studies obtained, only one study met the criteria and was then critically assessed. The study found that pain score in both opioid rotation group (fentanyl transdermal) and combined opioids group (oral oxycodone and fentanyl transdermal) was decreased from 2.9 to 2.0 (p=0.22) and 3.0 to 1.8 (p<0.06), respectively. In addition, therapeutic success was achieved in 11 patients in the opioid rotation group and 12 patients in the combined opioids group (p=0.98). Based on the study, it can be concluded that opioid rotation is as effective as combined opioids in managing pain in cancer patients
Kepatuhan Berobat pada Pasien Asma Tidak Terkontrol dan Faktor-Faktor yang Berhubungan
Get PDFPendahuluan. Mencapai kontrol asma masih merupakan tujuan yang sulit dicapai sebagian besar pasien meskipun telah tersedia pedoman manajemen asma internasional dan terapi yang terbukti efektif. Tingkat kontrol asma yang rendah diantaranya disebabkan kepatuhan terhadap pengobatan yang rendah. Hingga saat ini faktor-faktor yang berhubungan dengan kepatuhan berobat pasien asma tidak terkontrol masih sedikit diteliti. Penelitian ini bertujuan mengetahui profil kepatuhan berobat pada pasien asma tidak terkontrol dan hubungan antara faktor terkait pasien, faktor terkait penyakit, faktor terkait pengobatan, faktor terkait sosial ekonomi dan faktor terkait sistem pelayanan kesehatan terhadap kepatuhan berobat pasien asma tidak terkontrol
Metode. Penelitian potong lintang terhadap pasien asma tidak terkontrol yang datang ke poliklinik alergi dan imunologi RSCM dari bulan Februari 2012 hingga Mei 2012. Semua pasien asma yang memenuhi kriteria dilakukan anamnesis, pemeriksaan fisis lengkap, pengisian kuesioner, tes kontrol asma, tes Beck Depression Inventory dan Asthma General Knowledge Questionnaire. Analisis awal hubungan kepatuhan dengan faktor-faktor yang diteliti menggunakan uji Chi-square. Kemudian dilanjutkan dengan regresi logistik untuk setiap variabel yang bermakna.
Hasil. Dari 125 pasien asma tidak terkontrol didapatkan kepatuhan rendah sebesar 56 %. Dilakukan analisis bivariat terhadap faktor-faktor yang berhubungan dengan kepatuhan yaitu usia, pendidikan, pengetahuan asma, penghasilan, depresi, sediaan obat yang digunakan, keyakinan pasien terhadap dokter, asuransi kesehatan dan hubungan keluarga dan didapatkan pengetahuan bermakna dengan p=0,001 (IK 1,939-24,789). Kemudian dilakukan regresi logistik didapatkan pengetahuan paling berpengaruh terhadap kepatuhan (p=0,003) dengan OR 6,933 (IK 1,939-24,789)
Simpulan. Kepatuhan berobat pada pasien asma tidak terkontrol masih rendah dengan pengetahuan merupakan faktor yang berhubungan dengan kepatuhan
Fecal Calprotectin Level as Diagnostic Marker for Intestinal Inflammation in Inflammatory Bowel Disease Patients
Get PDFBackground: Inflammatory bowel disease diagnosis was still based on invasive examination, such as endoscopy and histopathology. Fecal calprotectin was a non-invasive intestinal inflammation marker, but several study give a different result in its diagnostic value and correlation to inflammatory bowel disease. This research was aimed to prove that fecal calprotectin examination has a high diagnostic value in diagnosing inflammatory bowel disease, and also correlate to its clinical stages.
Method: This is a cross sectional study to do a diagnostic test in several hospital in Jakarta, from September 2014 to February 2015. Receiver operating characteristic (ROC) curve was made to get fecal calprotectin diagnostic level and Krusskal Wallis test was performed to identify fecal calprotectin difference among each inflammatory bowel disease clinical stages.
Results: A total of 71 patients with inflammatory bowel disease was invoved in this research, based on colonoscopic examination result. Among them, 57 patients was confirmed to have intestinal inflammation based on histopathology result. Fecal calprotectin level was found to be higher in patients with inflammatory bowel disease than patients without intestinal inflammation (553,8 µg/g vs. 76,95 µg/g, p < 0,001). A cut off point of 179,3 µg/g was gathered, with 96% sensitivity (95% CI: 0,88-0,99), 93% specificity (95% CI: 0,69-0,99), and 99,5% area under curve (AUC) 99,5% (95% CI: 0,98-1,00). A significant difference was found between fecal calprotectin in each inflammatory bowel disease clinical stages (p < 0,001).
Conclusion: Fecal calprotectin has a high diagnostic value for inflammatory bowel disease (IBD) and strongly correlate to its disease clinical stages
Use of Clinical Parameters and Strain Echocardiography to Predict Stenosis Severity based on Gensini’s Score in Stable Coronary Artery Disease
Get PDFIntroduction. In patient with stable coronary artery disease (CAD), severity of stenosis is closely related to prognosis. It is known that several clinical parameters and recently-developed strain echocardiography can predict severity of stenosis. Assessment of clinical parameters, altogether with strain echocardiography is expected to make better prediction. This study aim to determine whether clinical factors, i.e. age, sex, diabetes, typical angina, and history of myocardial infarction, and strain echocardiography parameter, i.e. global longitudinal strain (GLS), can predict severity of coronary artery stenosis measured with Gensini score,and to further develop a prediction model based on significant parameters.
Methods. This is a cross-sectional study taken at Dr. Cipto Mangunkusumo National Central General Hospital during period March – May 2019. Patient with stable CAD scheduled to undergo coronary angiography is recruited consecutively. Bivariate analysis using chi-square is performed to each predictor. Significant predictors are further analysed using backward stepwise logistic regression. A prediction model is then developed based on significant predictors by multivariate analysis.
Results. The study group include 93 subjects. Significant predictors on bivariate analysis include diabetes melitus (OR 2.79; CI95%:1.08-7.23), history of myocardial infartion (OR 4.04; CI95%:1.51-10.80), typical angina (OR 5.01; CI95%:1.91-13.14), and GLS ≥-18.8 (OR 30.51; CI95%:10.38-89.72). Significant predictors on multivariate analysis are typical angina (OR 4.48; CI95%:1.39-14.47) and GLS ≥18.8 (OR 17.30; CI95%:5.38-55.66). Predicton model is not developed because there are only two significant predictors.
Conclusions: Typical angina and GLS are predictors of stenosis severity in patient with stable CAD. Age, sex, diabetes, and history of myocardial infarction are not significant predictors. A prediction model can not developed because there are only 2 significant predictors
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