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Althea Medical Journal
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Effect of Antihyperglycemic Agents on Hemoglobin A1c Level in Type 2 Diabetes Mellitus Patients

Kamila, Tasya, Dewi, Vycke Yunivita Kusumah, Miftahurachman, Miftahurachman

Althea Medical Journal Vol 5, No 2 (2018)
Publisher : Althea Medical Journal

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Abstract

Background: Type 2 diabetes mellitus (T2DM) patients require continuous lifelong attention to pharmacotherapy to achieve and maintain optimal glucose control, which can be monitored through measuring HbA1c. This study aimed to see the comparrison of HbA1c levels before and after a minimum of two months use of antihyperglycemic agents in patients with T2DM.Methods: This analytical cross-sectional  study used medical records of patients with T2DM in the center of outpatient medical records at the Department of Clinical Pathology, Dr. Hasan Sadikin General Hospital, in  2013. Sampling was conducted using consecutive sampling technique. The data analysis used the paired t-test and Wilcoxon test for not normal data distribution.Results: Before and after a minimum of two months use  of antihyperglycemic agents, HbA1c concentration was 7.15% (6.1–12.2) and 7.3% (5.9–11.9) respectively. Statistically, the difference of HbA1c concentration of T2DM patients between those period  was not significant (0.15%; p=0,812). Mean HbA1c concentration was found with greatest decrease in patients treated with sulfonylurea (2.25%), followed by insulin (0.1%). There were increases in mean HbA1c concentration in patients treated with metformin (0.05%), metformin+insulin (1.1%), sulfonylurea +metformin (0.6%), sulfonylurea+alpha-glucosidase inhibitor (1.1%), and sulfonylurea + metformin + alpha-glucosidase inhibitor (0.05%).Conclusions: There is no significant difference of HbA1c levels before and after two months to two years use of antihyperglycemic agents in T2DM patients. This result showed the importance of comprehensiveness in T2DM therapy. The therapy should not merely consist of antihyperglycemic medication alone, but also physical exercise, lifestyle modification, and diet control.

Visual Inspection Test with Acetic Acid for Cervical Cancer Screening: Willingness and Acceptability among Reproductive Age and Married Women

Hassan, Rozaliamisah Binti, Armawan, Edwin, Arya, Insi Farisa Desy

Althea Medical Journal Vol 5, No 2 (2018)
Publisher : Althea Medical Journal

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Abstract

Background: Cervical cancer is a preventable disease, thus early screening test should be performed for early cervical cancer prevention. Previous studies showed that among all of the screening techniques, visual inspection with acetic acid is an alternative, simple safe cervical cancer prevention technique. This study aimed to identify the willingness and acceptability of visual inspection with acetic acid among reproductive age and married women as cervical cancer prevention.Methods: A descriptive cross-sectional study was conducted among 100 reproductive age and married women in Jatinangor subdistrict West Java in 2014. A validated questionnaire was used to obtain information about the respondents’s characteristics, risk factors of cervical cancer, willingness and acceptability of Visual Inspection using Acetic Acid Test (VIA). The collected data were presented using tables.Results: Out of 100 respondents, 93% ever heard of cervical cancer, however 79% were aware of cervical cancer. As high as 96% were aware of the importance of cervical cancer screening, however 36% were aware of cervical cancer screening, and 19% were aware of VIA test. While 83% never had previous education on cervical cancer, 91% reported willingness to take part on cervical cancer education and 83% willingness of cervical cancer screening. Noted 17% were non-acceptance of VIA test for future cervical cancer screening due to their busy life and afraid of the outcome result.Conclusions: The majority of reproductive age and married women  are willing and accept VIA test for cervical cancer screening. 

Susceptibility to Community Associated Methicillin Resistant Staphylococcus Aureus: A Preliminary Study

Xian, Gan Ee, Megantara, Imam, Gondodiputro, Sharon

Althea Medical Journal Vol 5, No 2 (2018)
Publisher : Althea Medical Journal

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Abstract

Background: The Staphylococcus aureus infection is a leading cause of infection around the world. Due to the introduction of antibiotics, a strain called Methicillin-resistant S. aureus (MRSA) has emerged and occured in hospitalized patients worldwide. However around 1990, this infection had been detected among healthy people in the community without previous health care contact, known as community associated MRSA (CA-MRSA). The objectives of this study was to identify the susceptibility to CA-MRSA among people who came to Puskesmas Jatinangor, West Java, Indonesia.Methods: A descriptive study using purposive sampling was carried out from September to October 2014 with data obtained through anterior nasal swab of 65 patients from Puskesmas Jatinangor who fulfilled the exclusion and inclusion criteria. Samples were transported to the microbiology lab of Faculty of Medicine Universitas Padjadjaran and planted on blood agar for culturing, then identified through gram staining, catalase and coagulase tests. Lastly tested for antibiotic resistance and the zone of inhibition measuring ≤21mm were classified as positive MRSA. The collected data were presented using tables.Results: Out of 65 samples that were collected and tested, 17 samples (26%) were Staphylococcus aureus (S. aureus) carriers; 6 samples (9%) were positive with MRSA isolates; 6/17 of the S. aureus are MRSA.Conclusions: People who come to Puskesmas Jatinangor show a significantly high proportion of susceptibility to CA-MRS.

Young to Middle-Aged Adults and Low Education: Risk Factors of Spondylitis Tuberculosis with Neurological Deficit and Deformity at Dr. Hasan Sadikin General Hospital

Ismiarto, Adrian F., Tiksnadi, Bambang, Soenggono, Arifin

Althea Medical Journal Vol 5, No 2 (2018)
Publisher : Althea Medical Journal

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Abstract

Background: Incidence of tuberculosis has risen again, including extrapulmonary tuberculosis. Spondilitis tuberculosis is one the most commonly encountered which can cause disability and even death. The aim of this study was to evaluate characteristics of spondilitis tuberculosis patients and probable risk factors.Methods: This was a descriptive, cross sectional study from all medical records of spondylitis tuberculosis patients at Dr. Hasan Sadikin General Hospital from January 2012 to December 2013. Variables evaluated were demographic data, history related to tuberculosis, nutrinutional status, patient’s characteristics, and treatments received.Results: Spondylitis tuberculosis represented 65.6% of bone and joints tuberculosis.  From 78 cases, the male to female ratio was 1.2:1, and mostly found in young and middle-aged adults (79.6%) between 20−64 years old.  Patients’ level of education were mostly elementary school (30.8%) and unemployed.  Clinical symptoms were mostly neurological disorders, deformity (kyphotic/gibbus), and tenderness. Predilections sites were thoracal and lumbal vertebrae. Forty eight percents of cases were also sufferring from TB in other organs.  Treatments given for these cases were anti tuberculosis drugs (80.8%) and operative procedures (62.8%).Conclusions: Most common clinical manifestations are neurologial deficit, deformity, and tenderness; mostly have pulmonary tuberculosis as a comorbid disease; probable risk factors are young and middle-aged adults, low education level, and unemployment.

Emotional Mental Problems among Adolescents: Urban and Semi-Urban Settings

Dhamayanti, Meita, Peryoga, Stanza Uga, Firmansyah, Mohamad Rizqy

Althea Medical Journal Vol 5, No 2 (2018)
Publisher : Althea Medical Journal

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Abstract

Background: Emotional mental problems refer to something that complicates someone in an attempt to conform to the environment and experiences. In Indonesia the prevalence of emotional mental problems is 6.0%. In West Java province as the most populous region in Indonesia, the number of prevalence is above the national average of 9.3%. West Java province was selected for this study because in addition to being the most densely populated region, it also has urban and semi-urban areas. The purpose of this study was  to identify the difference in the prevalence of emotional mental problems of adolescent in urban and semi-urban areas.Methods: This study used the cross sectional approach method. Inclusion criteria were adolescents aged 14-16 years who attended several Junior High and Senior High Schools in Cirebon City as an urban area and Sumedang Regency as a semi-urban area. Exclusion criteria were adolescents who filled out  the questionnaire incompletely. The study variables consisted of adolescents, urban and semi-urban areas, and emotional mental problems. Data were analyzed by using chi square (x2) test.Results: Out of 1039 respondents, 816 met the inclusion criteria. There were significant differences in emotional mental problems on the aspects of emotional symptoms, behavior, hyperactivity, interpersonal relationships, social behavior, and total value of emotional mental problems with p value <0.05.Conclusions: There is a difference in emotional mental problems of adolescents in urban and semi-urban areas. Adolescents in urban regions have higher mental-emotional problems than in semi-urban regions. 

Cognitive and Functional Outcome of Patients with Ischemic Stroke at Dr. Hasan Sadikin Hospital Bandung

Nahrowi, Najmia Shabrina, Ong, Paulus Anam, Adam, Achmad

Althea Medical Journal Vol 5, No 2 (2018)
Publisher : Althea Medical Journal

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Abstract

Background: Stroke is the second leading cause of death and adult disability throughout the world in which the risk of cognitive impairment tripled after stroke. Approximately 30% of the patients experience residual disabilities and over half of patients remain physically dependent following a stroke. This study aimed to describe cognitive and functional outcome of patients with ischemic stroke at Dr. Hasan Sadikin Hospital Bandung.Methods: This retrospective descriptive study used secondary data from medical records  (January-December 2013) of patients with ischemic stroke at Dr. Hasan Sadikin Hospital, Bandung, and was conducted from June–September 2017. Cognitive outcome was determined by the final score of the Indonesia version of MoCA (MoCA-INA), classified into impaired if the score was <26 and normal if the score was >26.Whereas functional outcome was determined by degradation of Barthel Index (BI), from complete dependence to independence.  Data were analyzed, presented in the form of tables.Results: Out of a total of 91 subjects consisting of 46 female (50.55%) and 45 male (49.45%), the result showed 55 subjects (60.44%) had cognitive impairment with memory (75.82%) as the highest prevalence of impaired cognitive domain. The functional outcome was 34 patients (37.37%) had moderate to complete dependence whereas only 13 patients (14.29%) were independent.Conclusions: Cognitive impairment occurs in more than 75% ischemic stroke patients with memory as the most commonly impaired domain and more than one third of ischemic stroke patients still have moderate to complete dependence in activities of daily living (ADL). 

Factors Influencing Outcomes of Children Hospitalized with Acute Severe Malnutrition

Rusmil, Viramitha Kusnandi, Wiramihardja, Siska, AP, Adhitya, Gurnida, Dida A

Althea Medical Journal Vol 5, No 2 (2018)
Publisher : Althea Medical Journal

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Abstract

Background: Nutrition is still a global health issue, and improving nutrition is among the targets of the Sustainable Developmental Goals (SDGs). One of Indonesia’s SDGs indicators is to reduce prevalence of malnutrition in children. Indonesia, as a developing country, implements a comprehensive malnutrition treatment program for children, including various aspects related to management of children with acute malnutrition. The purpose of this study was to identify factors associated with the outcome of children hospitalized with acute severe malnutrition. Methods: This cross sectional study enrolled 195 children with severe acute malnutrition, admitted to hospital from November 2016 to August 2017. Statistical Analysis was conducted using multivariable logistic regression to identify factors associated with the outcome. Adjusted Ratio with Confident Interval 95% and the value of P <0 .05 was considered significant. Result: A total of 195 children were diagnosed havings acute severe malnutrition. A history of complete immunization status (p value <0.001) was proved to be directly proportional to the recovery rate of patients with acute severe malnutrition. Provision of other types of antibiotic (p value 0.001) showed to increase recovery rates of patients with acute severe malnutrition. Several comorbid diseases reduced recovery rates such as pneumonia (Crude OR 0.619) tuberculosis (Crude OR 0.606) and HIV (p value 0.08).Conclusions: This study shows that although the provided treatments are appropriate with the standard treatment for severe malnutrition, they still encounter high levels of morbidity. Further large-scale studies should be conducted to develop better interventions and management of acute severe malnutrition, in order to achieve better outcome. 

Elderly Profile of Quality of Life Using WHOQOL-BREF Indonesian Version: A Community-Dwelling

Hidayati, Aghnia Rizki, Gondodiputro, Sharon, Rahmiati, Lina

Althea Medical Journal Vol 5, No 2 (2018)
Publisher : Althea Medical Journal

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Abstract

Background: Indonesia as one of the developing countries is facing a demographic transition. The proportion of under-five children is decreasing while the proportion of elderly is rising. This situation is followed by the increase of noncommunicable/degenerative diseases. However, this situation is not a constraint for the elderly to have a better life. The WHOQOL Group had developed a questionnaire to measure the elderly’s quality of life. The aim of this study was to describe the quality of life (QoL) of a community-dwelling elderly by using the WHOQOL-BREF questionnaire Indonesian version.Methods: Eighty eight elderly from 6 villages in Jatinangor, West Java, Indonesia were involved in a descriptive study relating to QoL by using the WHOQOL-BREF questionnaire Indonesian version.  The inclusion criteria were men and women, aged ≥60 years, could communicate effectively, and had Mini Mental State Examination score ≥>23. The variables in the study were physical, psychological, social and environmental domains and facets in the QoL questionnaire. The collected data in the study were analyzed using the central tendency items.Results: Most respondents had low QoL scores (≤60). This study discovered that some facets of every domain in the WHOQOL-BREF had low scores, namely adequate energy, ability to perform daily living activities, satisfaction with work capacity, ability to concentrate, acceptance of physical appearance, satisfaction of sex life, financial fulfillment, availibility of information, opportunity for leisure activities and transport.Conclusions: Most of the elderly have low QoL scores in some facets of every domain in the WHOQOL-BREF questionnaire.  

Knowledge and Attitude of Women in Reproductive Age toward Clubfoot in Cikeruh Village, Jatinangor Sub−district in 2014

Fitraendi, F. M. Dicky, Fathurachman, Fathurachman, Susanto, Nugroho Harry

Althea Medical Journal Vol 5, No 2 (2018)
Publisher : Althea Medical Journal

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Abstract

Background: Clubfoot is a congenital anomaly which the ankle is twisted outward from the normal position. Clubfoot is the most common birth defect that can cause disability in the world. 150.000 – 200.000 babies are born with clubfoot every years. Clubfoot is a neglected disease. Immediate intervention is needed to treat the patient with Clubfoot. One of the most common barrier of the treatment is the knowledge and attitude of the society about Clubfoot. This study aimed to know the knowledge and attitude of the society especially women with reproductive age toward clubfoot in Cikeruh village Jatinangor sub−district in 2014.Methods: This research was conducted to 100 women with reproductive age with age interval 15−49 years old which live in Cikeruh village Jatinangor in 2014 with purposive sampling method. A questionnaire was used as instrument to collecting data which is later categorized by good, fair, and low for the knowledge and positive and negative for attitude.Results: From 100 sample women of reproductive age in Cikeruh village at 2014 who were asked about clubfoot, 39% had a good knowledge and 61% had a fair knowledge. There were 42% of respondent who had a negative attitude toward clubfoot and 58% had positive attitude.Conclusion: Majority sample women of reproductive age in Cikeruh village at 2014 have a fair knowledge about clubfoot. The ratio between positive and negative attitude toward clubfoot is almost 1:1 because of the minimal differences. 

Foot Anthropometric Profile of High School Students in Bandung

Abdurrahman, Imam Ramdhani, Tahid, Alwin, Fathurachman, Fathurachman

Althea Medical Journal Vol 5, No 2 (2018)
Publisher : Althea Medical Journal

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Abstract

Background: During the process of walking, the foot plays a role in supporting the body weight. Due to continously with stand weight, a person will experience foot pain aggravated by the use of improper shoe size. Foot anthropometric data acts as reference in the manufacture of orthotics and shoes with appropriate size, while Indonesia still does not have foot anthropometric data. The purpose of this study was to describe foot anthropometric data of high school students in Bandung in order to obtain good fitting shoes.Methods: The study was performed using observational descriptive method on 81 students aged 16–18 years from three different senior high schools in different regions of Bandung in November 2014.Results: The mean of foot and ankle anthropometry of senior high school students were 25.75 cm for Foot Length, 18.82 cm for Ball of Foot Length, 21.57 cm for Outside Ball of Foot Length, 9.70 cm for Foot Breadth Diagonal, 5.43 for Heel Breadth, 6.00 cm Navicular Height, 6.62 cm for Instep Height and 5.06 for Heel to Lateral Malleolus.Conclusions: The anthropometric data help the footwear industry to determine the design and size for shoes in Indonesia.