Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya

EFFECT of ADMINISTRATION of BAY LEAF EXTRACT (Eugenia polyantha) ON TOTAL CHOLESTEROL and TRIGLYCERIDE LEVEL S IN PATIENTS WITH HYPERTENSION and TYPE 2 DIABETES MELLITUS AT IMAN CLINIC MEDAN

Frisca Indriani Putri — 2024-09-30

Cholesterol is a fat component that stabilizes cell membranes and is a precursor of bile salts and steroid hormones. The HMG-CoA reductase enzyme has an important role in the cholesterol synthesis process. Triglycerides are the primary fats found in food that undergo emulsification in the small intestine by bile salts and are digested by lipase. The flavonoids in bay leaves will react with the hydroxyl groups in cholesterol. Saponins will increase the binding of cholesterol to fiber. Tannins can inhibit fat absorption in the intestine. This study examined the effect of administering bay leaf extract (Eugenia polyantha) on total cholesterol and triglyceride levels in patients with hypertension and Diabetes mellitus type 2 in Clinic Iman Medan. This research is a Quasi-experimental design using 32 samples consisting of 16 samples from the control group and 16 from the experimental group. This study used bay leaf extract in 200 mg bay leaf capsules with 3 doses given to each group. Based on the results of the hypothesis test using the Paired T-test and Wilcoxon test, giving bay leaf extract had no effect on total cholesterol and triglyceride levels with a P-value < 0.05. There was no effect of giving bay leaf extract (Eugenia polyantha) on total cholesterol and triglyceride levels in patients with hypertension and DM type 2

THE RELATIONSHIP BETWEEN AIR POLLUTION AND CORONARY ARTERY DISEASE: A SYSTEMATIC REVIEW

Balqis Ufairah Rioza — 2024-09-30

Several previous research studies have shown that air pollution has broad impacts on human health, particularly in the cardiovascular field. Exposure to air pollution entering the respiratory system can trigger inflammatory responses and increase the risk of cardiovascular diseases such as coronary artery disease. This systematic review aim to determine the relationship between air pollution and the occurrence of Coronary Artery Disease (CAD). Journal searches were conducted on five electronic databases, namely Pubmed, Science Direct, Europe PMC, Wiley Online Library, and Cochrane, following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) method. The search results get six original articles that meet the inclusion and exclusion criteria for analysis. Based on the results of the analysis shows that there is a significant relationship between air pollution in the form of gas components or particulate matter with the incidence of coronary artery disease. High levels of air pollution in an area can also increase the risk of CAD higher than areas with lower levels of air pollution.

OCTREOTIDE FOR TREATMENT RECURRENT HYPOGLYCEMIA INDUCED BY SULFONYLUREA: A CASE REPORT AND LITERATURE REVIEW

Yuddy Imowanto — 2024-09-30

Overdose can cause hypoglycemia, which is unresponsive to dextrose treatment alone. Octreotide, though not universally used, is an antidote for sulfonylurea overdose. We present a case report of a 62-year-old male who mistakenly consumed six tablets of sulfonylurea (Glibenclamide®), thinking they were loperamide for diarrhea. He developed dizziness, diaphoresis, vomiting, and unconsciousness. Physical examination revealed a GCS of 225, blood pressure of 188/79 mmHg, heart rate of 85 bpm, respiratory rate of 24/min, and oxygen saturation of 99%. Blood results showed RBS at 13 mg/dl, normal CBC, unremarkable blood gas analysis, hypokalemia at 2.87 mmol/l, and normal RFT and LFT. The patient was treated with bolus Dextrose 40%, maintenance Dextrose 10%, and hydrocortisone 100 mg, but blood sugar remained refractory for 1 hour despite increasing glucose infusion. After 5 hours without satisfactory results, we administered the first dose of octreotide (50 IU IV), resulting in a hypoglycemic interval lasting 2.5 hours. After a second dose of 50 IU octreotide, hypoglycemia was resolved. The patient was moved to the general ward and survived. In this case, octreotide extended the interval of hypoglycemia and reduced the need for dextrose. Using octreotide for conditions other than sulfonylurea overdose is not recommended.

ALPHA-MANGOSTIN POTENCY TO IMPROVE RENAL FUNCTION AND HISTOPATHOLOGICAL IMAGES IN HIGH-FAT DIET RATS

Laela Kinghua Liana — 2024-09-30

This study aimed to study whether alpha-mangostin could protect the kidneys of high-fat diet rats using the creatinine serum level and histopathological changes as parameters. The in vivo experimental study with a completely randomized design used 30 male Sprague Dawley rats. After 7 days of adaptation, they were randomly divided into six treatment groups, each with five replications. The study was done for four weeks: NC group (given standard pellet without treatment for four weeks), five other groups were given a high-fat diet for four weeks, and at the last two weeks were added with aquadest, corn oil, alpha-mangostin dose-1, alpha-mangostin dose-2, and simvastatin, namely PTL, CO, D1, D2, and Sim group. Creatinine level was examined at the end of week 2 and week 4; the difference percentage was analyzed using ANOVA/Kruskal Wallis (α=0.05) and continued with Duncan/Mann Whitney. It was shown that creatinine level decreased in D1/D2 = PTL mice (p>0,05); kidney histopathological image in D1 was better than PTL (p<0,05). It was concluded that the alpha-mangostin kidney protection effect was not yet visible according to creatinine level, but it was visible according to histopathological image; further studies are needed.

RISK FACTORS INFLUENCING THE INCIDENCE OF PREDIABETES BASED ON SCREENING ACTIVITIES AT THE INTEGRATED NON-COMMUNICABLE DISEASES DEVELOPMENT POST (POSBINDU PTM) IN MEDAN KOTA DISTRICT HEALTH CENTER

Dita Purnama Sari Tarigan — 2024-09-30

The risk factors for prediabetes are the same as those for T2DM, such as a family history of Diabetes, female gender, obesity, and so on. Early detection of prediabetes can open the door for T2DM prevention interventions. This type of research is descriptive-analytic with a cross-sectional design. Data collection methods include medical records and field observation. Based on the results of the Spearman test, it was found that there was no significant relationship between gender (p-value=0.609, Correlation Coefficient=-0.079, opposite relationship), hereditary history of Diabetes (p-value=0.298, Correlation Coefficient=0.160, unidirectional relationship), and obesity (p-value=0.382, Correlation Coefficient=-0.135, opposite relationship) with the incidence of prediabetes based on screening at Posbindu PTM activities at Simpang Limun Health Center and Teladan Health Center. There is no significant relationship between gender, family history of Diabetes, and obesity with the incidence of prediabetes based on screening at Posbindu PTM activities at the Simpang Limun Health Center and Teladan Health Center.

A CASE-CONTROL STUDY OF HEMATOLOGICAL ANALYSIS ON DIABETES AND COVID-19 SEVERITY

Ahmad Ghiffari — 2024-09-30

This study investigates the relationship between diabetes comorbidity and COVID-19 severity in Muhammadiyah Palembang Hospital, focusing on hematological parameters as potential predictors of disease progression. Utilizing a case-control design with 61 respondents, demographic data, COVID-19 severity classifications, and hematological profiles were analyzed. Results reveal a prevalence rate of diabetes mellitus among COVID-19 patients at 32.8%, with diabetic individuals experiencing higher rates of moderate clinical complications. Hematological analysis demonstrates variations in parameters such as hemoglobin levels, platelet counts, and neutrophil-to-lymphocyte ratio between diabetic and non-diabetic COVID-19 patients. These findings underscore the importance of tailored interventions for diabetic individuals infected with COVID-19 and highlight the potential of hematological parameters in predicting disease severity. The study suggests the need for larger-scale, multicenter research to validate findings and inform evidence-based clinical practice in managing COVID-19 patients with comorbid diabetes mellitus.

SAFETY EVALUATION ON THE USE OF HIGH ALERT DRUGS IN RSUD ARIFIN ACHMAD RIAU PROVINCE

Najwa Khairunnisa — 2024-09-30

High alert drugs are drugs that have a high percentage of causing risk of harm to patients. To avoid errors, high alert drugs must be used properly, including storage and marking. The objective of this study was determine the safe use of high alert drugs at Arifin Achmad Hospital in Riau Province. This was a descriptive study that included 68 pharmacy officers. A questionnaire was used to collect data, which was the univariately analysed on a computer system. The result showed that the accuracy of the use of high alert drugs based on the 5 principles was in the good category. As many as 65 people (95.6%) were good at the right patient, 67 people (98.5%) were good at the right drug, 66 people (97.1%) were good at the right time of administration, 65 people (95.6%) were good at the right dose, and 66 people (97.1%) were good at the right route of administration. As many as 67 (98.5%) rated the storage safety and labelling of high alert drugs as good. The conclusion of this study is that the implementation of the five rights principle of medication, storage safety and labelling of high alert drugs at Arifin Achmad Hospital in Riau Province has reached a good level.

ANALYSIS BETWEEN KNOWLEDGE AND ATTITUDES OF PARENTS REGARDING PROVIDING DOUBLE IMMUNIZATION AT THE MINASA UPA COMMUNITY HEALTH CENTER

Nur Azizah Zabir — 2024-09-30

Immunization is the act of providing immunity against a disease by introducing specific substances into the body. The completeness of immunization can be influenced by several factors such as knowledge, attitudes, number of children, health worker attitudes, family support, distance from home, education, socio-cultural factors, and community trust. This study aims to determine the relationship between parental knowledge and attitudes toward administering double immunization in infants conducted at the Minasa Upa Community Health Center. The research method used was quantitative research with an observational analytic design with a cross-sectional approach and a non-probability sampling method with a purposive sampling technique, resulting in 85 samples. The study results found that most respondents had good levels of knowledge, with 46 respondents or 54.1%, and exhibited positive attitudes, with 43 respondents or 50.6%. The highest number of respondents who administered double immunization to infants were found to have good knowledge, accounting for 67.4%, with a P-value of 0.003. Meanwhile, the number of respondents who administered double immunization and had positive attitudes was 69.8%, with a P-value of 0.001. Based on this research, it can be concluded that there is a significant relationship between parental knowledge and attitudes towards the administration of double immunization in infants.

CORRELATION OF T-CELL LYMPHOMA SUBTYPES WITH ANEMIA AT DR MOHAMMAD HOESIN HOSPITAL PALEMBANG 2018-2022

Krisna Murti — 2024-09-30

Lymphoma is divided into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Among NHL T-cell lymphoma is a rare malignancy of T cells, accounts for 12% of all NHL cases, it is further classified into 53 subtypes by WHO. T-cell lymphoma generally have worse prognosis than those B cells. In 2020 there were 16.125 new cases in Indonesia with 9.024 deaths for all ages and genders. Anemia occurs in some cases of lymphoma, which will make the prognosis of lymphoma worse. This study aims to determine the relationship between T-cell lymphoma subtype and anemia. This observational analytic study utilized a cross-sectional design conducted at the Department of Anatomic Pathology Faculty of Medicine Sriwiaya University/Dr. Mohammad Hoesin Palembang Hospital (RSMH) and the central laboratory of RSMH. The samples from this study were all patients who were diagnosed histopathologically and immunohistochemically as T cell lymphoma at RSMH Palembang from 2018 to 2022. Among 38 samples, T-cell lymphoma predominated in the age group <55 years (73,7%), male gender (73,7%), extranodal location (73,7%), and ENKTCL, nasal subtype (55,3%). Anemia occurred in 60,5% cases and most often it is mild anemia (60,9%). There was no significant correlation between T-cell lymphoma subtype and anemia status (*p = 0.178) and T-cell lymphoma subtype and anemia degree (*p = 0.342). It can be concluded that there is no significant correlation between the T-cell lymphoma subtype and anemia.

USE OF PROPHYLACTIC ANTIBIOTICS IN PATIENTS UNDERGOING CAESAREAN SECTION AT CUT MEUTIA GENERAL HOSPITAL, NORTH ACEH 2021-2022

Yuziani — 2024-09-30

Caesarean section is a surgical procedure to remove the fetus through an incision in the lining of the abdomen and uterus. Cesarean delivery is performed by considering clinical signs of the mother and fetus, such as placenta previa, abnormal location of the fetus, as well as different signs that may endanger the existence of the mother or embryo. According to the World Health Organization (WHO), the number of cesarean deliveries has increased, which is directly relative to the increase in the contamination rate of surgical wound infection (ILO). Prophylactic antibiotics are one of the prevention of surgical wound infection. The research method used is retrospective descriptive. The sampling technique in this research uses non-probability sampling, namely total sampling. The aftereffects of this review show that the use of prophylactic antibiotics in caesarean section patients, namely ceftriaxone 51.2% and cefotaxime 48.8%, the use of prophylactic antibiotics at the Cut Meutia Aceh General Hospital based on ASHP, the use of antibiotics ceftriaxone, cefotaxime, and reponem is 100% inappropriate and based on PPRA RSU Cut Meutia which is 100% compliant. The aftereffects of this study presumed that the utilization of anti-toxins based on ASHP is not appropriate and based on PPRA Cut Meutia Hospital is appropriate.

COGNITIVE FUNCTION OF THE ELDERLY IN PALEMBANG CITY NURSING HOMES: AN EPIDEMIOLOGICAL STUDY

Rini Nindela — 2024-09-30

Elderly refers to individuals who have reached the final stage of life, namely 60 years old and above. Physiologically, the elderly will experience various declines in body functions. The decline in cognitive function is among the most common in the elderly. The incidence of cognitive decline in the elderly in Indonesia is relatively high, which is as much as 32.4%, and is most vulnerable at the age of 65 years. Cognitive impairment can cause older adults to have difficulty in doing daily activities (bathing, dressing, washing, cooking), managing finances, getting lost on the road, and other disturbances that make the elderly less independent and confident, then tend to withdraw from social activities. The disturbances can also lead to anxiety disorders and depression. This study aims to determine the profile of cognitive function in the elderly at Palembang Nursing Homes. This cross-sectional study involves all elderly individuals in Palembang City Nursing Homes who meet the inclusion-exclusion criteria. The Indonesian version of the Montreal Cognitive Assessment (MoCA-Ina) was used to assess cognitive function. In this study, as many as 69 elderly (87.34%) had experienced a decline in cognitive function. Then, the dominant characteristics in the group that experienced a decrease in cognitive function were >90 years old (100%), women (91.38%), college graduates (100%), never worked (100%), had a history of stroke (92.86%), did not remember or did not know about cognitive impairment history in the family (93.33%). Delayed recall was the aspect that experienced the most disruption (96.2%). This study has revealed that the prevalence of cognitive impairment in Palembang Nursing Homes is exceptionally high. Therefore, it is imperative to implement routine screenings to identify early cognitive impairment in the elderly to provide immediate treatment.

ANALYSIS OF RISK FACTORS FOR DELAYED DIAGNOSIS IN PULMONARY TUBERCULOSIS CASES IN BENGKULU CITY

Marissa Aurelya Putri — 2024-09-30

This study aims to analyse the factors associated with delayed diagnosis of Pulmonary Tuberculosis and the frequency distribution of TB patients. The research method was analytic-observational with cross sectional approach. The research sample was patients in Bengkulu City total of 64 respondents. The results of the analysis showed that the majority of TB patients were male, age group 16-25 years, people who had jobs, and secondary education, had initial symptoms of cough, lived in the central area of the city, the distance from home to the nearest health facility was 1 < 2 km, had a good level of knowledge, the majority had low stigma towards TB disease. There was no significant association between delay in diagnosis and gender, age, education, income, occupation, distance from home to health centre, location of residence, initial symptoms, first action of health centre, first health service visited. There was a significant association between the time between initial symptoms and seeking treatment and the incidence of delayed diagnosis. However, there was no significant association between delayed diagnosis, patient stigma about TB disease and knowledge.

MANAGEMENT OF GESTATIONAL HYPERTENSION THROUGH FAMILY MEDICINE APPROACH: CASE REPORT

Silvi Ayu Pratiwi — 2024-09-30

Several factors contribute to the incidence of hypertension during pregnancy, including a familial history of hypertension, obesity, and unhealthy dietary habits. Family habits can have a substantial impact on lifestyle, especially nutritional choices. This report presents a case of gestational hypertension in Mrs. DK, a 20-year-old pregnant woman with obesity, who was managed utilizing a family medicine approach. The identified root cause of her problem as an inherited genetic susceptibility to hypertension, exacerbated by poor dietary habit within the family. Mrs. DK and her family was given comprehensive intervention to ensure a healthy pregnancy. This strategy provided her with results in the form of controlled blood pressure and enhanced understanding of her condition and nutritional requirements, as well as strategies to fulfill them. Ongoing surveillance is necessary to guarantee that goals are being met.

REASON FOR HOSPITAL ADMISSION IN PEDIATRIC WARD OF AN INDONESIAN RURAL HOSPITAL IN 2023

Siti Rofiqoh — 2024-09-30

This study aims to determine the number of pediatric patients hospitalized at one rural hospital in Pekalongan Regency, Central Java, during 2023. This research design uses a descriptive cohort study with a cross-sectional approach. The research data was obtained from the hospital's Electronic Medical Records or E-RM. This study's results show that 2,731 children were being treated at Kajen Regional Hospital during 2023, with length of stay varying from 1 to 20 days. The most common reasons for hospitalization were fever, nausea, vomiting, cough and cold, febrile seizures, diarrhea, and shortness of breath. During 2023, there were 57 cases of death, and the three highest causes of death were fever: 23(40%) cases, seizures: 13(23%) cases, and shortness of breath and cough: 13(23%) cases. The results of this research can be used to determine priorities for preventive health programs to reduce hospitalization and child mortality rates. The plausible actions to respond to this situation are improving the vaccination program uptake, sanitation, and nutrition education by involving local leaders and community organizations to reduce the detrimental effect of fever, seizure, and respiratory disease on children.

PHARMACODYNAMIC OF METFORMIN IN TYPE 2 DIABETES MELLITUS PATIENTS: REVIEW OF THE PRKAA2 AND SLC22A3 GENES

Sakura Muhammad Tola — 2024-09-30

Type 2 diabetes mellitus (type 2 DM) is a disease including on metabolic disorder that characterized by an increase in glucose levels above normal. This glucose increase is caused by reduced insulin function which can be in the form of abnormalities in insulin secretion, impaired insulin action in peripheral tissues, or both. Metformin is one of the recommended therapies for type 2 DM. AMPK is the main pathway of metformin's mechanism. AMPKa2 encoded by PRKAA2 gene is an AMPK subunit that plays an important role in AMPK activation. OCT3 encoded by SLC22A3 plays a role in the metformin transport mechanism. OCT3 is needed in the metformin pharmacokinetic like absorption and elimination, this process determines metformin bioavailability, clearance, and its pharmacological effects. Mutations in PRKAA2 and SLC22A3 cause variations in the pharmacodynamic effects and pharmacokinetic of metformin in individuals directly. These changes will ultimately affect the effectiveness of metformin in type 2 DM patients.