RESUMEN
The purpose of this study was to determine whether there were any TB clusters in Aceh Province, Indonesia and their temporal distribution during the period of 2019-2021. A spatial geo-reference was conducted to 290 sub-districts coordinates by geocoding each sub-district's offices. By using SaTScan TM v9.4.4, a retrospective space-time scan statistics analysis based on population data and annual TB incidence was carried out. To determine the regions at high risk of TB, data from 1 January 2019 to 31 December 2021 were evaluated using the Poisson model. The likelihood ratio (LLR) value was utilized to locate the TB clusters based on a total of 999 permutations were performed. A Moran's I analysis (using GeoDa) was chosen for a study of both local and global spatial autocorrelation. The threshold for significance was fixed at 0.05. At the sub-district level, the spatial distribution of TB in Aceh Province from 2019-2021 showed 19 clusters (three most likely and 16 secondary ones), and there was a spatial autocorrelation of TB. The findings can be used to provide thorough knowledge on the spatial pattern of TB occurrence, which is important for designing effective TB interventions.
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Análisis Espacial , Tuberculosis , Indonesia/epidemiología , Humanos , Tuberculosis/epidemiología , Estudios Retrospectivos , Incidencia , Análisis Espacio-Temporal , Análisis por ConglomeradosRESUMEN
Adolescent hypertension is emerging as a significant health challenge. Peer-led interventions utilizing engaging multimedia platforms have demonstrated the potential to enhance prevention behaviors among adolescents. However, there remains a gap in the literature comparing the effectiveness of multimedia intervention with traditional lecture-based approach in adolescent hypertension prevention in Indonesia. The aim of this study was to compare the traditional lecture-based approach and interactive multimedia intervention (e-module, animated videos, and infographics) on adolescents' knowledge, attitudes, and practices regarding adolescent hypertension prevention. A quasi-experimental study with pre-test and post-test control group study was conducted from June to December 2023 in two senior high schools in districts of Pedurungan and Kedungmundu, Semarang, Central Java, Indonesia. To prepare the multimedia model, the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) framework and mapping intervention approach were employed to ensure effective decision-making at each step. A total of 100 high school students were involved, with 50 assigned to the intervention group and 50 to the control group. The intervention group received a multimedia model from the peer educators, while the control group received a traditional PowerPoint-based presentation from the community healthcare workers. The hypertension prevention knowledge, attitude, and practice were assessed using validated questionnaires with 20, 15, and 15 items, respectively. This study found that, after model implementation, significant improvements were observed in students' knowledge, attitudes, and practices regarding hypertension prevention (all had p<0.001). Specifically, knowledge scores increased by 4.78 points, attitude scores by 10.64 points, and practice scores by 2.9 points. This study highlights that multimedia interventions could significantly improve hypertension prevention behaviors among adolescents by enhancing their knowledge, attitudes, and practices through engaging and interactive multimedia materials.
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Conocimientos, Actitudes y Práctica en Salud , Hipertensión , Multimedia , Humanos , Indonesia , Hipertensión/prevención & control , Adolescente , Masculino , Femenino , Encuestas y Cuestionarios , Educación en Salud/métodos , Grupo ParitarioRESUMEN
Neutrophil-to-lymphocyte ratio (NLR) as a predictor in determining low cardiac output syndrome (LCOS) has not been widely reported. The aim of this study was to explore the role of pre-surgery, 0-, 4-, and 8-hour post-surgery NLR as predictors of LCOS incidence after open heart surgery in children with congenital heart disease (CHD). This study used a prognostic test with a prospective cohort design and was conducted from December 2020 until June 2021 at the cardiac intensive care unit (CICU) of Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. The subject consisted of children aged one month to 18 years who underwent open heart surgery using a cardiopulmonary bypass (CPB) machine. A receiver operating characteristic curve was applied to identify the predictive performance of NLR for poor outcomes (LCOS incidence). Out of 90 patients included in the study, 25 (27.8%) of them developed LCOS between 3 to 53 hours post-surgery. All NLR values (pre-surgery and 0-, 4-, and 8-hours post-surgery) were associated with the incidence of LCOS. Pre-surgery NLR (cut-off value ≥0.88) had a fair predictive value (area under curve (AUC) 70; 95%CI: 57-83) for predicting LCOS incidence with sensitivity and specificity of 64% and 64.62%, respectively. NLR 0-hour post-surgery (cut-off value ≥4.73) had a good predictive value (AUC 81; 95%CI: 69-94) for predicting LCOS incidence, with 80% sensitivity and 80% specificity. NLR 4- and 8-hours post-surgery had very good predictive values (AUC 97%; 95%CI: 92-100 and 98; 95%CI: 94-100, respectively), with cut-off values ≥6.19 and ≥6.78, had the same 92% sensitivity and the same 96% sensitivity. The presence of LCOS was associated with mortality (odds ratio of 5.11 with 95%CI: 3.09-8.46). This study highlights that pre-surgery, 0-, 4-, and 8-hours post-surgery NLR can be predictors of LCOS after open heart surgery in children with CHD.
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Gasto Cardíaco Bajo , Procedimientos Quirúrgicos Cardíacos , Cardiopatías Congénitas , Linfocitos , Neutrófilos , Humanos , Masculino , Femenino , Cardiopatías Congénitas/cirugía , Lactante , Preescolar , Estudios Prospectivos , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Gasto Cardíaco Bajo/sangre , Gasto Cardíaco Bajo/etiología , Niño , Indonesia/epidemiología , Adolescente , Complicaciones Posoperatorias/sangre , Complicaciones Posoperatorias/etiología , Valor Predictivo de las Pruebas , Pronóstico , Curva ROCRESUMEN
Clinical manifestations of neonatal sepsis are often unspecified. Therefore, sepsis biomarkers could be used to support diagnosis while waiting for blood culture results, such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). The aim of this study was to evaluate the role of NLR and PLR as diagnostic markers in neonatal sepsis. A cross-sectional study was conducted at Haji Adam Malik General Hospital, Medan, Indonesia, from April to October 2019. This study included neonates aged less than 28 days, diagnosed with suspected sepsis, and had no previous history of antibiotics administration. Patients underwent clinical assessment, laboratory examination, and blood culture. Patients were grouped into sepsis and non-sepsis based on the blood culture results. The median hematological examination and the range of NLR and PLR in both the sepsis and non-sepsis groups were subjected to analysis using the Mann-Whitney U test to assess differences. NLR and PLR optimal cut-off values were determined using a receiver operator curve (ROC) with a confidence interval of 95%. A total of 137 neonates were enrolled, of which 49 were classified as sepsis and 89 as non-sepsis based on blood culture results. The optimal cutoff values for NLR and PLR were 2.75 and 11.73. Using those cutoff values, NLR and PLR could predict neonatal sepsis with sensitivities of 52.1% and 47.9%, specificities of 50.6% and 47.2%, area under the curve (AUC) of 0.46 and 0.47, with p=0.525 and p=0.662, respectively. Further investigation is warranted to refine the NLR and PLR utility and enhance diagnostic accuracy in clinical practices.
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Sepsis Neonatal , Neutrófilos , Humanos , Sepsis Neonatal/diagnóstico , Sepsis Neonatal/sangre , Recién Nacido , Estudios Transversales , Masculino , Femenino , Indonesia , Linfocitos , Plaquetas , Recuento de Plaquetas , Biomarcadores/sangre , Recuento de Linfocitos , Curva ROCRESUMEN
Preeclampsia (PE), a serious medical condition with substantial maternal and perinatal implications, poses a significant challenge, particularly in high-incidence countries like Indonesia. Red blood cell (RBC) indices, neutrophil-to-lymphocyte ratio (NLR), and microalbuminuria (albumin-to-creatinine ratio (ACR)) may signal systemic inflammation and endothelial dysfunction, recently recognized as potential indicators for diagnosing and predicting disease severity. The aim of this study was to analyze RBC indices, NLR, and ACR changes in women with PE and their potential for predicting disease severity. A cross-sectional study was conducted at multi-center hospitals across Medan, Indonesia, from June 2022 to June 2023. The patients were grouped into PE cases with and without severe features. Demographic characteristics and complications were recorded while blood and urine were tested. The Chi-squared test, Fisher's exact test and Mann-Whitney test were used to determine biomarkers associated with severe PE. A total of 208 PE patients were included in the study (104 patients for each PE with and without severe features). Our data indicated that PE patients with severe features had higher red cell distribution width (18.5% vs 13.7%; p<0.001), NLR (5.66% vs 4.1%; p<0.001), and ACR (755.97 mg/dL vs 468.63 mg/dL; p<0.001) compared to those without severe features. In contrast, the platelet count was lower in severe features than those without (21.9 × 106/µL vs 27.0 × 106/µL; p=0.002). This study highlighted that PE patients with severe features predominantly had higher levels of RDW, NLR, and ACR and lower platelet counts compared to those without severe features. Therefore, basic tests such as complete blood count and urinalysis, which are inexpensive and feasible in primary care settings with limited resources, offer hope as valuable diagnostic biomarkers for pregnant women diagnosed with PE in a low resource setting.
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Biomarcadores , Creatinina , Índices de Eritrocitos , Preeclampsia , Índice de Severidad de la Enfermedad , Humanos , Femenino , Preeclampsia/sangre , Preeclampsia/diagnóstico , Preeclampsia/orina , Embarazo , Estudios Transversales , Adulto , Biomarcadores/sangre , Biomarcadores/orina , Indonesia , Creatinina/sangre , Creatinina/orina , Neutrófilos/metabolismo , Valor Predictivo de las Pruebas , Linfocitos/metabolismo , Albuminuria/diagnóstico , Albuminuria/sangre , Configuración de Recursos LimitadosRESUMEN
Heart failure is a pediatric emergency caused by the heart's inability to adequately meet the body metabolic needs and the most common cause is congenital heart disease (CHD). The G protein is the most prominent family of membrane-bound protein known to act in major regulatory events of the cardiovascular system, one of which is heart failure. The aim of this study was to determine the level of G protein and its relationship with left ventricular systolic function in children with acyanotic CHD. A cross-sectional study was conducted in Dr. Zaionel Abidin Hospital, Banda Aceh, Indonesia. The patients aged 0 to 18 years and had acyanotic CHD diagnosis by echocardiography were included. Anthropometry measurement was performed according to standard WHO procedures and G protein level was measured using the ELISA method. The Chi-squared test was used to measure the relationship between G protein level and left ventricular systolic function. Out of a total of 38 children with acyanotic CHD, the mean level of G protein was 36.25 ng/mL and the mean of left ventricular systolic function was 73.1%. There was no relationship between G protein and left ventricular systolic function in children with acyanotic CHD. However, further study with a larger sample size and considering other variables are needed to confirm this finding.
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Cardiopatías Congénitas , Función Ventricular Izquierda , Humanos , Estudios Transversales , Preescolar , Masculino , Femenino , Lactante , Niño , Función Ventricular Izquierda/fisiología , Cardiopatías Congénitas/complicaciones , Cardiopatías Congénitas/fisiopatología , Adolescente , Ecocardiografía , Recién Nacido , Indonesia/epidemiología , SístoleRESUMEN
Butterfly pea flower (Clitoria ternatea) may serve as an alternative anti-dandruff treatment; however, its effects on Malassezia spp. remain unexplored. The aim of this study was to explore the effects of C. ternatea as an herbal-based anti-dandruff treatment on Malassezia spp. DNA expression, plakoglobin levels, IL-8 levels, sebum levels, dandruff severity scores, adverse effects, and patient satisfaction. An experimental study with a pretest-posttest control design was conducted at the Outpatient Clinic of Dermatology and Venereology, Arifin Achmad Hospital, Pekanbaru, Indonesia, from November 2023 to January 2024. The flower of C. ternatea was used to formulate the shampoo. The study involved 70 female patients aged 18-25 with dandruff, who were divided into two groups: (a) experimental group using 20% C. ternatea shampoo and (b) control group using 2% ketoconazole shampoo. The present study found that 2% ketoconazole shampoo significantly reduced Malassezia spp. DNA expression compared to 20% C. ternatea shampooo (Clitoria ternatea: ΔCq=1.76±3.18; ketoconazole: ΔCq=3.77±2.90; p=0.008). No significant difference was observed in plakoglobin levels (C. ternatea: ΔCq=1.98±3.63; ketoconazole: ΔCq=2.50±2.36; p=0.427) or IL-8 levels (C. ternatea: ΔCq=3.46±4.00; ketoconazole: ΔCq=4.16 ± 3.62; p=0.459). C. ternatea significantly reduced sebum levels more than ketoconazole (C. ternatea: 1.16±0.98%; ketoconazole: 0.22±0.38%; p<0.001). Dandruff scores and patient satisfaction were similar for both shampoos (p=0.115 and p=0.336, respectively). Adverse effects were more common in the 2% ketoconazole shampoo group, affecting 21.2% of the patients. In conclusion, 2% ketoconazole shampoo is more effective in reducing Malassezia spp. DNA expression, while 20% C. ternatea shampoo offers better sebum control. Both shampoos are similarly effective in ameliorating dandruff severity and are well-tolerated, with fewer adverse effects reported for C. ternatea.
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Caspa , Malassezia , Humanos , Femenino , Adulto , Caspa/tratamiento farmacológico , Caspa/microbiología , Malassezia/efectos de los fármacos , Preparaciones para el Cabello/farmacología , Adolescente , Adulto Joven , Cetoconazol/farmacología , Indonesia , Flores , Clitoria/química , Antifúngicos/farmacología , Satisfacción del PacienteRESUMEN
Severe acute malnutrition (SAM) is a global health concern that affects children and leads to delayed growth. The aim of this study was to compare the impact of F100 milk and Bregas Nutriroll, a local ready-to-use therapeutic food (RUTF), on SAM children. An unmasked, non-blinded, two-group, and simple randomized controlled trial was conducted. Indonesian children aged 12-59 months with SAM were randomly assigned to receive either F100 milk or Bregas Nutriroll. After eight weeks, the increase in the mean weight gain in both groups was assessed. The Bregas Nutriroll group (n=19) had a mean weight gain of 1.07±0.09 kg, while the F100 group (n=17) had a mean weight gain of 1.05±0.11 kg. The Bregas Nutriroll group had a slightly higher gain of mid-upper arm circumference (MUAC) than the F100 group (0.62±0.34 cm vs 0.50±0.37 cm). The gain of children's height of the Bregas Nutriroll group was 0.96±0.42 cm, while the F100 group was shorter at a mean of 0.81±0.44 cm. Statistically significant differences (p<0.001) in nutritional status were observed based on weight, MUAC, and height/length after F100 and Bregas Nutriroll interventions. The intervention with F100 increased hemoglobin (Hb) levels of 0.71±1.25 mg/dL, while the Bregas Nutriroll intervention led to an increase of 0.11±1.39 mg/dL. In conclusion, our study showed that community-based treatment with F100 milk or Bregas Nutriroll resulted in nutritional status in children with SAM. These findings suggested that both treatments could be effective in treating SAM in improving nutritional status and child health outcomes.
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Desnutrición Aguda Severa , Aumento de Peso , Humanos , Lactante , Indonesia/epidemiología , Desnutrición Aguda Severa/dietoterapia , Femenino , Preescolar , Masculino , Aumento de Peso/efectos de los fármacos , Animales , Leche , Fórmulas Infantiles , Comida RápidaRESUMEN
Due to the persisting development of SARS-CoV-2 variants, studies on the kinetics, duration, and function of antibodies are essential for vaccine development and long-term immunity prediction. This longitudinal study examined post-vaccination antibody responses in people after receiving CoronaVac or ChAdOx1 vaccines with or without a history of SARS-CoV-2 infection. Conducted in Indonesia between August 2021 and May 2023, this study involved 121 participants divided into two groups based on the received vaccine types and monitored for 18 months post-second dose vaccination by assessing the binding antibody (BAb) level and neutralizing antibody (NAb) inhibition rate at six time points. The study also documented the participants' age, gender, and body mass index (BMI). Before the first dose vaccination, 85 (70.2%) participants were reactive BAb (defined by BAb level ≥50 AU/mL) indicating a history of infection. In the CoronaVac group, only 53.1% were reactive BAb. However, 100% of participants were positive NAb (defined by NAb inhibition rate ≥30%), which indicates a past history of infection with low initial or rapidly decreasing BAb levels. In the ChAdOx1 group, 81.9% of participants were reactive, while only 54.2% were positive NAb, suggesting a recent infection with a high BAb level but a relatively low NAb inhibition rate. During the 18 months post-second dose vaccination, the BAb levels fluctuated. However, 100% of participants were positive NAb. No significant difference in antibody response was documented among participants with or without infection history. Also, no significant impact was presented by the factors of sex, age, and BMI. The findings highlight the crucial of the vaccine in public health and how vaccination strategies could be optimized effectively during and after the post-pandemic.
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Anticuerpos Neutralizantes , Anticuerpos Antivirales , Vacunas contra la COVID-19 , COVID-19 , SARS-CoV-2 , Humanos , Indonesia/epidemiología , Masculino , Estudios Longitudinales , Anticuerpos Neutralizantes/sangre , Anticuerpos Neutralizantes/inmunología , Femenino , COVID-19/prevención & control , COVID-19/inmunología , COVID-19/epidemiología , Adulto , Vacunas contra la COVID-19/inmunología , Vacunas contra la COVID-19/administración & dosificación , Persona de Mediana Edad , Anticuerpos Antivirales/inmunología , Anticuerpos Antivirales/sangre , SARS-CoV-2/inmunología , ChAdOx1 nCoV-19 , Adulto Joven , VacunaciónRESUMEN
This study investigated indicators of the severity and mortality of COVID-19 in children in Medan, Sumatera Utara Province, Indonesia. The aim of this study was to identify determinants of severity and outcome of children with COVID-19 as the lesson learned from the COVID-19 pandemic, particularly the limited health facilities in Indonesia. This retrospective cohort study was conducted in 2020, 2021, and 2022 at multiple centers. Inpatient and outpatient children confirmed to be SARS-CoV-2 positive were randomly recruited in the selected hospitals. Baseline data (demographic, clinical, laboratory and radiological data) were collected, and outcomes were classified as recovered/deceased (for the inpatient group) or returned to the hospital (for the outpatient group). Severity status was identified based on the Indonesia COVID-19 guidelines. The laboratory data were categorized according to international standards and data were analyzed using univariate analyzes followed by multivariate logistic regression. A total of 303 inpatient and 114 outpatient children were included in the analysis. Out of the total inpatient cases, nine patients died, with 2.9 mortality rate. Our final multivariate indicated that the presence of shortness of breath (SOB), anemia, and abnormal C-reactive protein (CRP) levels were significantly associated with the severity or the presence of emergency signs, while the presence of SOB and comorbidities were significantly associated with mortality in inpatient children with COVID-19. The presence of fever, cough, SOB, muscle ache and diarrhea were the reasons why the children were returned to the hospital from self-isolation at home among outpatient COVID-19 cases; however, the cough was the only significant factor in the final multivariate mode. This study highlights important determinants of COVID-19 severity and mortality in children, which should be considered during clinical decision-making in low-resource settings of healthcare centers in Indonesia.
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COVID-19 , Índice de Severidad de la Enfermedad , Humanos , COVID-19/mortalidad , COVID-19/epidemiología , Indonesia/epidemiología , Estudios Retrospectivos , Femenino , Masculino , Niño , Preescolar , Lactante , Adolescente , SARS-CoV-2RESUMEN
Health promoting university is a holistic approach to health that uses higher education settings to create a learning environment that improves the health and well-being of the campus community in a sustainable manner. The utilization of technology such as artificial intelligence (AI) could be one of the main success factors in the implementation of health-promoting universities to increase the effectiveness and efficiency of all stages of activities carried out in health promotion and prevention efforts. Integrated monitoring with the utilization of AI in this program is conducted to evaluate the health status of the students. The Syiah Kuala Integrated Medical Monitoring (SKIMM) has three components of continuous health status evaluation: vital signs, nutritional status, and burnout status. Health status monitoring was conducted continuously for three months among medical students at the Faculty of Medicine Universitas Syiah Kuala, Banda Aceh, Indonesia. This system uses the WhatsApp application as a platform to monitor health status. Student health monitoring in this program consists of two main activities: the health measurement phase and the health monitoring phase. The use of the SKIMM system to monitor students' vital signs, nutritional status and burnout status through the use of AI significantly raises students' awareness to conduct timely self-examination and enables sustainable healthy lifestyle behavior change. The adoption of AI technology allows for continuous health promotion to the entire academic community, including students in implementing the health promoting university.
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Inteligencia Artificial , Estudiantes de Medicina , Humanos , Estudiantes de Medicina/psicología , Indonesia , Promoción de la Salud/métodos , Estado de Salud , Femenino , Masculino , Universidades , Estado Nutricional , Signos VitalesRESUMEN
Coal plays a crucial role in Indonesia's foreign exchange and East Kalimantan's revenue sharing, yet its environmental impacts, including soil acidification, raises concerns. Reclamation measures involve revegetation with pioneer plants such as Macaranga sp., known for their medicinal properties. However, the pharmacological properties of these plants are influenced by secondary metabolites, which depend on soil parameters such as pH and nutrient levels. The aim of this study was to evaluate the acute toxicity, secondary metabolites, and antioxidant activities of Macaranga tanarius leaf extracts from post-coal mining area (MTPCMA) and non-mining area (MTNMA) alongside soil parameters. Acute toxicity of M. tanarius leaf extracts and soils were assessed using the brine shrimp lethality test (BSLT). Phytochemical screening was done using thin-layer chromatography (TLC), determining total phenolic (TPC) and flavonoid content (TFC). The DPPH radical scavenging assay was used to assess the antioxidant activity. A comparative analysis between MTPCMA and MTNMA was conducted using Student t-test. The data showed no significant difference in toxicity between MTPCMA and MTNMA leaf extracts (LC50 of 100-1000 µg/mL) (p=0.062), and soils from both areas were non-toxic (LC50 of >1000 µg/mL). Although heavy metal concentrations were higher in PCMA than in NMA soil (p<0.001), secondary metabolite compounds and TFC in both extracts were not significantly different (p=0.076). Both extracts contained flavonoids and polyphenols with antioxidant activity and terpenoids without antioxidant activities. The DPPH radical scavenging test suggested insignificant antioxidant activity between MTPCMA and MTNMA extracts (p=0.237). In conclusion, non-toxic soils in post-mining land and insignificant differences between MTPCMA and MTNMA extracts suggest good soil nutrient availability, highlighting the success of land recovery after 10 years of revegetation with M. tanarius.
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Antioxidantes , Artemia , Extractos Vegetales , Indonesia , Antioxidantes/metabolismo , Animales , Extractos Vegetales/química , Extractos Vegetales/toxicidad , Extractos Vegetales/farmacología , Artemia/efectos de los fármacos , Hojas de la Planta/química , Minas de Carbón , Suelo/química , Pruebas de Toxicidad Aguda , Fitoquímicos/análisis , Fitoquímicos/toxicidad , Flavonoides/análisis , Flavonoides/metabolismo , Metabolismo SecundarioRESUMEN
Lantana camara Linn contains a diverse array of metabolites that exhibit therapeutic potential. The aim of this study was to evaluate the potential of L. camara leaves, which were collected at the Ie-Seu'um geothermal area in Aceh, Indonesia, as an anti-inflammatory through network pharmacology and in vitro analysis. The ethanolic extract derived from L. camara underwent identification utilizing gas chromatography-mass spectrometry (GC-MS) to verify chemical constituents for drug-likeness properties. The evaluation of anti-inflammatory activity included network pharmacology and a series of in vitro investigations using two methods: protein inhibition and albumin denaturation assays. The findings revealed that the extract contained a domination of terpenoids and fatty acids class, which met the evaluation criteria of drug-likeness. Network pharmacology analysis identified the top five key proteins (peroxisome proliferator-activated receptor gamma, prostaglandin G/H synthase 2, epidermal growth factor receptor, hypoxia-inducible factor 1-alpha, and tyrosine protein kinase-Janus kinase 2) involved in inflammation-related protein-protein interactions. Gene ontology enrichment highlighted the predominance of inflammatory responses in biological processes (BP), cytoplasm in cellular components (CC), and oxidoreductase activity in molecular functions (MF). In vitro analysis showed that the extract inhibited protein activity and protein denaturation with inhibitory concentration (IC50) values of 202.27 and 223.85 ppm, respectively. Additionally, the extract had antioxidant activity with DPPH- and ABTS-scavenging IC50 values of 140 ppm and 163 ppm, respectively. Toxicological assessment by brine shrimp lethality assay (BSLA), yielding a lethal concentration (LC50) value of 574 ppm (essentially non-toxic) and its prediction via ProTox 3.0 that indicated non-active in hepatotoxicity, carcinogenicity, immunotoxicity, mutagenicity, and cytotoxicity. These results suggested that L. camara holds noteworthy effectiveness as a potential candidate for complementary medicine in the realm of inflammatory agents, warranting further investigation in clinical settings.
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Antiinflamatorios , Lantana , Farmacología en Red , Extractos Vegetales , Lantana/química , Antiinflamatorios/farmacología , Antiinflamatorios/química , Extractos Vegetales/farmacología , Extractos Vegetales/química , Animales , Hojas de la Planta/química , Cromatografía de Gases y Espectrometría de Masas , IndonesiaRESUMEN
Coronavirus disease 2019 (COVID-19) is characterized by an acute respiratory infection with multisystem involvement and the association of its severity to liver function abnormalities is not well characterized. The aim of this study was to assess the association between the severity of COVID-19 patients and liver function abnormalities. This retrospective study included adult patients with confirmed COVID-19, which were classified as non-severe or severe according to World Health Organization guidelines. Liver function test results were compared between the severity groups. A total of 339 patients were included of which 150 (44.25%) were severe cases. The male-to-female ratio was 0.9:1 and 3:2 in the non-severe and severe groups, respectively (p=0.031). Aspartate aminotransferase (AST), alanine transaminase (ALT), and total bilirubin levels and acute liver injury (ALI) incidence were significantly higher in the severe group compared to non-severe group (p<0.001, p<0.001, p=0.025, p=0.014, respectively). In contrast, albumin levels were significantly lower (p=0.001). Multivariate analysis showed that ALI was significantly associated with human immunodeficiency virus (HIV) infection (odds ratio (OR): 5.275; 95% confidence interval (CI): 1.165-23.890, p=0.031), hemoglobin level (OR: 1.214; 95%CI: 1.083-1.361, p=0.001), and hypoalbuminemia (OR: 2.627; 95%CI: 1.283-5.379, p=0.008). Pre-existing liver diseases were present in 6.5% of patients. No significant differences were observed between the groups based on COVID-19 severity and ALI presence. Liver function test abnormalities, including ALI, are more prevalent in patients with severe COVID-19 infection. HIV infection, high hemoglobin levels, and hypoalbuminemia may be potential risk factors for ALI.
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COVID-19 , Pruebas de Función Hepática , Índice de Severidad de la Enfermedad , Humanos , COVID-19/epidemiología , COVID-19/sangre , COVID-19/complicaciones , Masculino , Femenino , Estudios Retrospectivos , Indonesia/epidemiología , Persona de Mediana Edad , Adulto , Hepatopatías/epidemiología , SARS-CoV-2 , Infecciones por VIH/epidemiología , Factores de RiesgoRESUMEN
Previous studies have associated tumor size with metastasis and prognosis in lung carcinoma; however, a precise cut-off for predicting distant metastasis in lung adenocarcinoma remains unclear. The aim of this study was to determine the cut-off point for predicting distant metastasis in lung adenocarcinoma. A cross-sectional study was conducted at Dr. Moewardi Hospital, Surakarta, Indonesia, from January 2022 to September 2023. Total sampling was employed, involving patients over 18 years old with a confirmed diagnosis of lung adenocarcinoma based on lung computed tomography (CT) scan findings, who had not yet received chemotherapy and had confirmed metastasis outside the lung. The study's dependent variable was the incidence of distant metastasis, while the independent variable was lung adenocarcinoma size. Two experienced thoracic radiologists measured lung adenocarcinoma size by assessing the longest axis using chest multi-slice computed tomography (MSCT) in the lung window setting. Receiver operating characteristic (ROC) curve analysis determined the optimal tumor size cut-off for predicting distant metastasis. Of 956 thoracic cancer patients, 108 were diagnosed with lung adenocarcinoma. After applying the inclusion and exclusion criteria, 89 patients were eligible. In the present study, tumor size predicted 68.1% of distant metastasis cases, with a cut-off point of 7.25 cm, yielding a sensitivity of 61.9% and a specificity of 61.5%. Tumors >7.25 cm had a 2.60-fold higher risk of distant metastasis compared to smaller tumors, with larger tumors more likely to spread to various sites. In conclusion, lung adenocarcinomas larger than 7.25 cm have a 2.60-fold increased risk of distant metastasis, making tumor size a crucial predictive factor. The study provides valuable insights for radiologists and can improve diagnosis accuracy and treatment planning by emphasizing tumor size as a key factor in managing lung adenocarcinoma.
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Adenocarcinoma del Pulmón , Neoplasias Pulmonares , Tomografía Computarizada por Rayos X , Humanos , Masculino , Femenino , Adenocarcinoma del Pulmón/diagnóstico por imagen , Adenocarcinoma del Pulmón/patología , Adenocarcinoma del Pulmón/secundario , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/diagnóstico por imagen , Persona de Mediana Edad , Estudios Transversales , Indonesia/epidemiología , Anciano , Metástasis de la Neoplasia , Pronóstico , Adulto , Curva ROC , Valor Predictivo de las PruebasRESUMEN
Asthma is a chronic inflammatory airway disorder and is among the top ten causes of morbidity and mortality in Indonesia, highlighting the need for effective management strategies. This study aimed to evaluate changes in asthma knowledge levels before and after using the "Paru Sehat" smartphone application for digital education. A quasi-experimental study using a pre- and post-test design was conducted over three months at the outpatient clinic of Universitas Sumatera Utara Hospital, Medan, Indonesia, among asthma patients aged over 18 years. The patients completed the Patient Asthma Knowledge Questionnaire (PAKQ) before installing the "Paru Sehat" application to establish baseline knowledge. Once a week, patients received reminders to access materials covering an asthma overview, peak flow meter use, medication differences, and management techniques. After four weeks of intervention, the participants' knowledge was reassessed using the PAKQ. Data were analyzed using either paired Student's t-test or Wilcoxon test to assess the improvement in knowledge. The results showed increases in knowledge about asthma in general, asthma triggers, and asthma diagnosis domains, with the median score in each domain rising by one point (p=0.003, p=0.001, and p=0.002, respectively). The asthma management domain exhibited the largest change, with a median increase of two points (p<0.001). The total scores increased by an average of five points (p<0.001), indicating an overall improvement in patient knowledge about asthma. The "Paru Sehat" application demonstrated significant potential in enhancing asthma knowledge across multiple domains. Further research is warranted to explore the long-term effectiveness of the application in diverse populations and settings, ultimately contributing to improved asthma management and patient outcomes.
Asunto(s)
Asma , Conocimientos, Actitudes y Práctica en Salud , Educación del Paciente como Asunto , Teléfono Inteligente , Humanos , Asma/terapia , Femenino , Masculino , Adulto , Educación del Paciente como Asunto/métodos , Indonesia , Encuestas y Cuestionarios , Persona de Mediana Edad , Aplicaciones MóvilesRESUMEN
A positive community perception of the coronavirus disease 2019 (COVID-19) vaccination program is crucial for increasing vaccination coverage and achieving herd immunity. This study aimed to identify factors influencing the acceptance of a COVID-19 booster vaccine in Indonesia. It was conducted as a cross-sectional, multicenter study using a validated questionnaire distributed online to Indonesian participants aged 18 years and older. The questionnaire covered sociodemographic characteristics, clinical conditions of both the participants and their closest contacts, the Health Belief Model (HBM) domain, and preferences for the location of receiving a booster vaccine, as well as reasons for declining a booster vaccine. Of 1550 respondents, 78.6% had received the first COVID-19 booster dose. Sociodemographic factors influencing first booster vaccine acceptance in Indonesia included age (OR36-45 vs 18-25 years: 2.43; 95%CI: 1.13-5.24; OR>45 vs 18-25 years: 3.58, 95%CI: 1.96-6.52), length of education (OR13-16 vs <12 years: 1.34; 95%CI: 1.00-1.80; OR>16 vs <12 years: 4.15, 95%CI: 2.12-8.09), monthly income (ORIDR3,500,000 vs 1,500,000: 1.72; 95%CI: 1.19- 2.49), and occupation (ORHealth workers vs not-working: 1.81; 95%CI: 1.00-3.29). Clinical aspects and HBM domains associated with booster vaccine acceptance were the presence of chronic disease (OR: 1.94; 95%CI: 1.03-3.66), previously tested positive for COVID-19 (OR: 1.90; 95%CI: 1.24-2.89), having a family member or friend who was hospitalized due to COVID-19 (OR: 1.86; 95%CI: 1.32-2.62), perceived susceptibility (OR: 1.20; 95%CI: 1.02-1.41), perceived access barriers to COVID-19 vaccination (OR: 0.52; 95%CI: 0.44-0.61), and perceived benefits of COVID-19 vaccination (OR: 1.67; 95%CI: 1.41-1.97). In conclusion, factors influencing the first COVID-19 booster vaccine acceptance in Indonesia ranged from demographic and clinical characteristics as well as HBM domains. Effective strategies to expand COVID-19 booster vaccine coverage should consider these factors to encourage participation in the vaccination program.
Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Inmunización Secundaria , Humanos , Indonesia/epidemiología , Estudios Transversales , Masculino , Adulto , Femenino , Vacunas contra la COVID-19/administración & dosificación , COVID-19/prevención & control , COVID-19/epidemiología , Persona de Mediana Edad , Adolescente , Encuestas y Cuestionarios , Adulto Joven , Aceptación de la Atención de Salud/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , SARS-CoV-2/inmunologíaRESUMEN
The amputation rate resulting from electrical burn injuries remains high, yet no study has investigated whether early fasciotomy may reduce the amputation rate. The aim of this study was to analyze the success rate of fasciotomy in preventing amputation and determine the optimal timing for fasciotomy in electrical burn injuries. This study was conducted at Dr. Soetomo Hospital from January 2020 to July 2023. Total sampling was employed to recruit the patients. Clinical data, voltage characteristics, burn location, affected total body surface area, burn depth, hospital arrival time, and time interval from incident to fasciotomy were assessed. Chi-squared test was used to assess factors associated with the fasciotomy incidence and factors associated with amputation after fasciotomy. A total of 45 patients were included, of which 97.8% were male, with a mean age of 37.60 years old. Approximately 73% of patients had full-thickness burn injuries, with the left upper extremity being the most affected (80%). There are seven patients (15.6%) had fasciotomy and five (11.1%) patients had an amputation. Our data indicated a significant association between voltage characteristics and fasciotomy incidence (p=0.034). Additionally, our data indicated that earlier arrival to the hospital (p=0.002) and timely fasciotomy conducted upon arrival (p<0.001) were associated with a reduced rate of amputation. This study highlights that prompt arrival to the hospital and early fasciotomy may prevent amputation in patients with electrical burn injuries.
Asunto(s)
Amputación Quirúrgica , Quemaduras por Electricidad , Fasciotomía , Humanos , Masculino , Quemaduras por Electricidad/cirugía , Quemaduras por Electricidad/epidemiología , Indonesia/epidemiología , Femenino , Adulto , Estudios Transversales , Amputación Quirúrgica/estadística & datos numéricos , Amputación Quirúrgica/efectos adversos , Persona de Mediana EdadRESUMEN
Heart failure is a complex clinical manifestation due to diastolic dysfunction and systolic dysfunction of the left ventricle (LV). Diastolic dysfunction of the LV plays an important role in worsening the quality of life (QoL) in heart failure patients. The aim of this study was to assess the relationship between the severity or grade of LV diastolic dysfunction and QoL in heart failure with reduced ejection fraction (HFrEF) patients. A retrospective cohort study was conducted at the Cardiac Center of H. Adam Malik Hospital, Medan, Indonesia, from January 2022 to December 2022. This study included inpatients and outpatients aged above 18 years who were diagnosed with HFrEF, identified by echocardiography with an ejection fraction of ≤40%. Echocardiography was performed to evaluate left ventricular diastolic dysfunction, and QoL was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ) 6-12 months after the severity of LV diastolic dysfunction was confirmed. The MLHFQ was classified into good and poor QoL. The severity of LV diastolic function was measured using the E/A ratio, mean E/e' ratio, tricuspid regurgitation velocity (TR Vmax), and left atrial volume index (LAVI), and was classified into grades I, II, and III. The relationships between the severity of diastolic dysfunction and other factors with QoL were measured using Chi-squared, Fisher's exact test, or Mann-Whitney test, as appropriate. A total of 96 patients were included in the study, of which 56 (58.3%) patients had grade I, 12 (12.5%) had grade II, and 28 (29.2%) patients had grade III of LV diastolic dysfunction. There were 77 (80.2%) and 19 (19.8%) patients with good and poor QoL, respectively. This study revealed a significant relationship between the severity of LV diastolic dysfunction and QoL in HFrEF patients with p=0.040. In conclusion, the degree of LV diastolic dysfunction is related to the QoL of HFrEF patients and therefore better comprehensive management strategies should be considered in HFrEF cases to address the impact of LV diastolic dysfunction on QoL.
Asunto(s)
Ecocardiografía , Insuficiencia Cardíaca , Calidad de Vida , Volumen Sistólico , Disfunción Ventricular Izquierda , Humanos , Masculino , Calidad de Vida/psicología , Femenino , Disfunción Ventricular Izquierda/fisiopatología , Disfunción Ventricular Izquierda/diagnóstico por imagen , Persona de Mediana Edad , Estudios Retrospectivos , Volumen Sistólico/fisiología , Insuficiencia Cardíaca/fisiopatología , Insuficiencia Cardíaca/psicología , Insuficiencia Cardíaca/complicaciones , Anciano , Indonesia/epidemiología , Encuestas y Cuestionarios , Adulto , Índice de Severidad de la Enfermedad , Diástole/fisiologíaRESUMEN
In pharmaceutical care, patients' perceptions of drug information provided by pharmacists are vital for assessing pharmaceutical services at community health centers (in Indonesian known as Puskesmas). The aim of this study was to determine the alignment between patients' expectations and experiences of drug information services by pharmacists at Puskesmas in Indonesia. This multicenter cross-sectional study utilized a validated questionnaire among outpatient patients aged 18 years and above across all 47 Puskesmas in Makassar, Indonesia. A total of 622 respondents were interviewed between September to December 2023. Significant gaps were observed between patients' expectations and experiences regarding all the drug information aspects such as quantity (median: 4 vs 3, p<0.001), drug effects (median: 4 vs 3, p<0.001), dosage form (median: 3 vs 3, p<0.001), proper administration (median: 4 vs 4, p<0.001), side effects (median: 4 vs 2, p<0.001), storage (median: 3 vs 2, p<0.001), drug-drug interactions (median: 4 vs 2, p<0.001), drug-food interactions (median: 4 vs 2, p<0.001), handling missed dose (median: 3 vs 2, p<0.001), managing accidental overdoses (median: 4 vs 2, p<0.001), history of drug use (median: 3 vs 2, p<0.001), co-medications (median: 3 vs 2, p<0.001), and previous drug allergies (median: 3 vs 2, p<0.001). Sociodemographic factors influencing patients' need for drug information services encompass age, sex, educational attainment, comorbidities, family size, number of visits, monthly income, and occupation. The quality of drug information services at Puskesmas in Indonesia still requires optimization and customization to meet the specific needs of patients, taking into account their sociodemographic characteristics.