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Althea Medical Journal
Articles by issue : Vol 4, No 3 (2017)
30
Articles
Destructive Effect of Calcium Hypochlorite against Pseudomonas aeruginosa Biofilm

Arifani, Ilma, Pradini, Gita Widya, Desy Arya, Insi Farisa, Cahyadi, Adi Imam

Althea Medical Journal Vol 4, No 3 (2017)
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Abstract

Background: Pseudomonas aeruginosa is the most common bacteria contaminating the hemodialysis water and has high capability to form a biofilm. The presence of biofilm is hazardous because it becomes a constant source of bacterial and toxin release toward the hemodialysis patient’s blood. Calcium hypochlorite (Ca(OCl)2) is an easily obtained disinfectant. This study was aimed to detect the destructive effect of Ca(OCl)2 against P. aeruginosa biofilm and the optimal disinfectant concentration required to achieve significant effect.Methods: This experimental study was conducted in six replicates from September to October 2015 in Microbiology Laboratory of Faculty of Medicine Universitas Padjadjaran Bandung. A modified tissue culture plate method was performed to grow P. aeruginosa biofilms which were subsequently treated with Ca(OCl)2 in various chlorine concentrations, namely 20, 30, 40, and 500 parts per million (ppm). The data was analyzed using Welch Analysis of Variance (ANOVA) and Games-Howell post-hoc tests and presented in tables.Results: Data were obtained from 36 flat-bottomed polystyrene wells. There was a statistically significant mean difference between groups [F(4, 11.92)= 91.198, p<0.001)]. All of the tested chlorine concentrations caused significant decreases in biofilm optical densities (p = 0.027 for 20 ppm and p< 0.001 for 30, 40, and 500 ppm).Conclusions: Ca(OCl)2 with chlorine concentrations of 20, 30, 40, and 500 ppm have significant destructive effect against P. aeruginosa biofilm. The mean differences among treated groups were not significant. The most optimum concentration is 30 ppm.

Nasal Endoscopy Findings in Acute and Chronic Rhinosinusitis Patients

Dharmaputri, Stephanie, Lasminingrum, Lina, Sofiatin, Yulia

Althea Medical Journal Vol 4, No 3 (2017)
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Abstract

Background: According to European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) 2012, rhinosinusitis is diagnosed based on symptoms, nasal endoscopy, and CT scan. The CT scan is the gold standard to diagnose rhinosinusitis, but its high cost and lack of availability become the problems in Indonesia. Hence, nasal endoscopy is a choice to diagnose rhinosinusitis. This study was aimed to describe the findings of nasal endoscopyin in acute and chronic rhinosinusitis. Methods: This cross-sectional descriptive study was performed using medical record of acute and chronic rhinosinusitis patients. The samples were chosen with consecutive sampling. Inclusion criteria of this study were patients that underwent nasal endoscopy examination in Otorhinolaryngology–Head and Neck Surgery Clinic Dr. Hasan Sadikin General Hospital Bandung in 2014.The collected data were analyzed in the form of tables.Results: Among 138 patients, the number of female patients (55.1%) was higher than male patients. Majority of the patients (37.5%) were 25–44 years old. Majority of the chief complaint was nasal obstruction (48.6%). The patients with allergic history (48.6%) were higher than patients without allergic history (19.6%). According to nasal endoscopy results, nasal discharge and edema were found in most of the patients (68.8% and 63.0%), but nasal polyp was only found in 15.9% patients. Other findings, such as hypertrophy concha or nasal septum deviation, were also found on 87.7% patients. Conclusions: Most of the rhinosinusitis patients are found with at least one of the following results of nasal endoscopy, which are nasal discharge, edema, or nasal polyp. 

Health Related Quality of Life and Residual Symptoms in Prostatic Surgical Treatment at Bethesda Hospital Yogyakarta: a Retrospective Study

Krisna, Daniel Mahendra, Hariatmoko, Hariatmoko, Pinzon, Rizaldy Taslim

Althea Medical Journal Vol 4, No 3 (2017)
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Background: The incidence of Prostate Enlargement (PE) has been increasing over the years. The satisfaction towards the treatment result and life quality (QOL) improvement must be the key point of PE treatment. QOL is affected by many conditions, such as age, socioeconomic status, comorbid disease, and type of surgery. The objective of the study was to assess the QOL in PE patients post surgery, to explore the predictor factor, and to assess the satisfaction related to urinary functionality in the Indonesian context. Methods: A retrospective study was conducted and the subjects were all PE patients who underwent surgical treatment. EQ-5D-5L/EQ-VAS and Index Quality of Life (IQL) were used to assess the patient’s QOL & treatment satisfaction. The subjects were divided into several sub-groups based on age, type of surgery, comorbid condition, type of ward, funding source, histopathological result, and the year of treatment. The collected data wee analyzed using Mann-Whitney test, Kruskal Wallis test, or Chi-square test, Spearman’s rho test and multiple linear regression. Results: All the 149 subjects were at the average age of 69.09 years . There were no significant statistical differences in QOL between age, comorbid conditions, and histopathology result. Health insurance (HI) was significantly associated with QOL. There were improvements of IQL subjects. The most symptoms remaining was frequency (47.4%).Conclusions: Life improvement must be the major purpose of PE therapy. The association between HI with QOL suggests that a better HI in developing countries can ensure a better quality of life outcome.

Identification of Pathogen Protozoans (Cryptosporidium spp and Giardia lamblia) from Canteen’s Water-sources at Jatinangor, West Java, Indonesia

Murugesan, Komathi Nair, Agoes, Ridad, Sari, Sri Yusnita Irda

Althea Medical Journal Vol 4, No 3 (2017)
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Abstract

Background: The prevalence of intestinal protozoan infection caused by Cryptosporidium spp and Giardia lamblia has been rapidly increasing in developing countries. Contamination of water-sources by intestinal protozoans can spread infection to humans when it is consumed without any specific treatment. Jatinangor is an educational area where many universities are located and many students live in this area. This study aimed to identify the presence of intestinal protozoa (Cryptosporidium spp and Giardia lamblia) in water-sources used by canteens at Jatinangor area to detect the magnitude of protozoans intestinal infections.Methods: A descriptive cross sectional study was carried out from August to September 2014. Raw water samples from reservoir tanks, water containers and tapwater were taken from all canteens located along the main road of Jatinangor. Samples were centrifuged and divided into two portions; two drops from the first test tube was stained with Lugol solution and observed by 2 observers under a light microscope for Giardia lamblia, and sediments from the second test tube was stained using acid fast staining then observed for Cryptosporidium spp under the light microscope. Results: Out of 50 samples, 26 were positive for parasites, of which 22 (44%) were contaminated by Cryptosporidium spp and 4 (8%) were contaminated by Giardia lamblia.Conclusions: Half of the raw water-sources in Jatinangor are contaminated by Cryptosporidium spp and Giardia lamblia. Proper water treatment should be implemented by the owners of the canteens before it is consumed as drinking water. 

Geographical Factors in Diagnostic Delay among Multidrug Resistant Tuberculosis Patients

Nuraeni, Nunuy, Suryadinata, Hendarsyah, Lestari, Bony Wiem

Althea Medical Journal Vol 4, No 3 (2017)
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Background: Diagnostic delay is a  factor that can increase the high burden of multi-drug resistant tuberculosis (MDR-TB). Xpert Mycobacterium tuberculosis/Rifampicin known as Xpert is a rapid diagnostic test to detect MDR-TB. Diagnostic delay defined  the duration between a positive result of Acid Fast Bacilli (AFB) smear and positive result of MDR-TB by Xpert examination. This study aimed to compare the analysis of the geographical factors in the diagnostic delay of MDR-TB patients at Dr. Hasan Sadikin General Hospital as the top referral hospital in West Java Indonesia.Methods: This study was conducted in the period July−December 2016 using cross sectional design. A total of 152 MDR-TB patient data were collected from medical records of MDR-TB patients registered in MDR-TB clinic at Dr. Hasan Sadikin General Hospital in the period 2015−2016.  The socio-demographic characteristics were collected and analyzed descriptively The diagnostic delay among MDR-TB patients was analyzed by Mann Whitney test.Results: Diagnostic delay of MDR-TB patients was 15 days in median, with a minimal and maximal delay of 2−140 days. There was a significant difference of diagnostic delay between  patients from Bandung with a median of 9(2-135) days and patients from outside of Bandung with a median of 18(2-140) days, with p<0.01.Conclusions: MDR-TB patients from outside Bandung have a longer diagnostic delay than patient from Bandung . A further expansion of using Xpert as a rapid diagnostic test for MDR-TB patient is needed.

Three Years Data of Uterine Fibroids Patient Characteristics at West Java Top Referral Hospital

Azzahra, Mutiara, Gondodiputro, Sharon, Amarullah, Mulyanusa

Althea Medical Journal Vol 4, No 3 (2017)
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Background: Uterine fibroids are the most common benign tumor in female reproductive system and a major cause in declining their quality of live. Patient characteristics has high prevalence in black women, 40s, nulliparous, and early menarche. These characteristics are varied in some areas and considered in treatment decisions. The objectives of this study was to describe the uterine fibroid patient characteristics at Dr. Hasan Sadikin General Hospital, Bandung from 1 January 2013 to 31 December 2015.Methods: A descriptive study was conducted to 255 medical records of patients with uterine fibroids at Dr. Hasan Sadikin General Hosiptal, Bandung from 1 January 2013 to 31 December 2015. This study was conducted from September to November 2016. The variables were the year of treatment, age, education, occupation, married status, menarche, abortion, parity, type of uterine fibroids, and treatment. The collected data were analyzed and presented using frequency tables and percentages.Results: Most cases of uterine fibroids were discovered in 2014. The most characteristics with uterine fibroids were pre-menopausal age (41.18%), high school education (55.69%), housewife (63.14%), normal menarche (54.51%), married (92.16%), nulliparous (47.45%), no abortion (76.47%), multiple uterine fibroids (46.67%), and hysterectomy (58.04%).Conclusions: The most combination of characteristics of patients with uterine fibroids is nulliparrous women in reproductive and pre-menopausal age with normal menarche. 

Characteristics of Maxillofacial Fractures Resulting from Road Traffic Accidents at Dr. Hasan Sadikin General Hospital

Caesario, Oldi, Boesoirie, Shinta Fitri, Tahid, Alwin

Althea Medical Journal Vol 4, No 3 (2017)
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Background: Maxillofacial fracture is a serious injury in the head region which is frequently found in the emergency room. In Indonesia, the road traffic accident is the main etiology. Epidemiological assessments are important to assess trends and set the priorities for treatment and prevention of the injury. This study was conducted to identify the characteristics of maxillofacial fracture resulting from road traffic accidents. Methods: This descriptive retrospective study involved hospitalized patients with maxillofacial fracture resulting from road traffic accidents at Dr. Hasan Sadikin General Hospital in 2011–2013 using the total sampling technique. Data were collected in the period August–October 2014 which included patient demographics, detailed description of the accident and the fracture.Results: A total of 187 patients with male/female ratio of 5:1 and a mean age of 26.78 year. The majority of patients were motorcyclists (92%) with most of them were not wearing safety equipment. Most of the accidents took place in 2011 in Bandung. Mandible was the most common site of injury followed by the maxilla and nasal bone. Open reduction was performed in 69.52% patients).Conclusions: Maxillofacial fracture is more common in men with the mean age of 26.78 years. The majority of patients are motorcyclists. Most of them are not using safety equipment. Most of the accidents occurred in Bandung in 2011. Mandible is the most common site of fracture. Open reduction is the most commonly performed treatment

Effect of Short Term Cardiac Rehabilitation Program on Quality of Life in Patients with Coronary Artery Disease

Marita, Ina, Sastradimaja, Sunaryo B., Tiksnadi, Badai Bhatara

Althea Medical Journal Vol 4, No 3 (2017)
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Background: Cardiac rehabilitation (CR) programs are known to be one of the effective managements which aim to improve the quality of life (QoL) in coronary artery disease (CAD). However, there is still controversy about the effect on QoL dimension. The purpose of this study is to determine the effect of short term cardiac rehabilitation program on quality of life in patients with coronary artery disease.Methods: The study design used was a quasi experimental study with repeated measurements in consecutive sampling involving 11 subjects with CAD from September–November 2015 in Cardiorespiratory Clinic and Gymnasium of Physical Medicine and Rehabilitation and Cardiac Unit Services, Dr. Hasan Sadikin General Hospital Bandung. The cardiac rehabilitation program was performed for 4 weeks. The quality of life was scored using medical outcomes study short form 36 (SF-36) questionnaire before and after CR program. Statistics obtained in this study were analyzed using paired t-test and Wilcoxon test.Results: This study involved 11 male patients with CAD with an average age of 58 (11) years old with the diagnosis of CAD post CABG (n=6), CAD post PCI (n=4), and CAD unrevascularized (n=1). The average total score of quality of life questionnaire SF-36 demonstrated a significant increase (p<0.001) after CR program 87.27(8.5) as compared to before CR program 49.09(8.4). This improvement occurred in all QoL dimensions.Conclusions: Short term cardiac rehabilitation program can improve the quality of life in patients with coronary artery disease. 

Characteristics of Hypertension in Children at Dr. Hasan Sadikin General Hospital Bandung in January to December 2014

Meilani, Meilani, Sekarwana, Nanan, Pratiwi, Yuni Susanti

Althea Medical Journal Vol 4, No 3 (2017)
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Background: Hypertension is often found in children. It could cause serious complications and added risk of hypertension in adulthood. Hypertension in children is likely secondary type and some of them might be severe. The aim of this study was to determine the demographic and clinical characteristics of hypertension in children admitted to Dr. Hasan Sadikin General Hospital Bandung in January to December 2014.Methods: The study design used was a quantitative, descriptive cross-sectional study. Data were obtained from medical records retrospectively of inpatient children from the period January to December 2014. Data were collected from the period  September to November 2015 based on age and gender as a demographic characteristics and stage of hypertension, etiology of hypertension, and emerge of hypertensioncomplication as a clinical characteristics.Results: Ninety(1.9%)children with hypertension were found from 4,681 of total inpatient children consisting of 58 males and 32 females with median of age 8 (0−13) years old.The main stage of hypertension was hypertension stage 2 with 55 cases and nephrotic syndrome as the most common causes with 43 cases. The complications were present in hypertension stage 2 with 3 cases and hypertensive crisis with 2 cases.Conclusions: Children with hypertension are most commonly males and median of age was 8 years old. Hypertension is characterized by hypertension stage 2 and nephrotic syndrome as the most common etiology. Complications of hypertension appear in severe hypertension.

Treatment Seeking Patterns among Dengue Fever Patients: A Qualitative Study

Krisnian, Tharani, Alisjahbana, Bachti, Afriandi, Irvan

Althea Medical Journal Vol 4, No 3 (2017)
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Background: Incidence of dengue fever is increasing drastically and has become a major public health problem globally. The reason patients are late in seeking medical treatment should be identified in order to prevent complications which can be avoided to produce a good prognosis. This study was conducted to find the pattern of treatment seeking behaviour among dengue fever patients and their influencing factors using a health utilisation model. Methods: Data on health seeking behaviour were collected among the dengue fever patients who were admitted to Dr. Hasan Sadikin General Hospital Bandung from September–October 2014. The data were collected through in-depth interview with patients who were diagnosed with dengue fever and dengue haemorrhagic fever. All the interviews were recorded using an audio recorder. The recordings were transcribed and then translated into English and analyzed using thematic analysis.Results: Nine patients were interviewed. The age of the patients ranged between 17 to 46 years.  Altogether 7 patterns were identified with patients treatment seeking behavior. Most of them took longer steps to reach adequate care with blood examination. These longer steps, caused by lack of facilities to perform blood test in primary health care facilities, no bed for admission and also low skills of health care providers in diagnosing patients. The primary health care facility played an important role in the delay of patients acquiring definite care for their dengue fever.Conclusions: Health care seeking behavior is hampered by the inadequacy of primary health care facilities to provide adequate services to dengue patients.