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All Journal Indonesian Journal of Tropical and Infectious Disease JOURNAL OF COMMUNITY MEDICINE AND PUBLIC HEALTH RESEARCH CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL Jurnal Penyakit Dalam Indonesia
Ichwani, Jusri
Universitas Airlangga - Dr. Soetomo General Hospital
Biochemistry, Genetics & Molecular Biology Earth & Planetary Sciences Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Several Factors Associated With Nitrogen Balance In Elderly Patients Zurriyani Zurriyani; Jusri Ichwani; Novira Widajanti
Current Internal Medicine Research and Practice Surabaya Journal Vol. 1 No. 1 (2020): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE JOURNAL SURABAYA
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cimrj.v1i1.16828

Abstract

BackgroundNitrogen balance is the method used to assess the protein adequacy. A negative nitrogen balance means that the body suffers from protein energy malnutrition.ObjectiveTo determine the risk factors that associated with nitrogen balance in the elderly patients who were inpatient in IRNA Internal Medicine Dr.Soetomo Hospital.MethodsThe experimental design of the research used was analytic observational with the cross-sectional design. The study was conducted of 50 elderly patients. Risk factors measured were protein intake using food recall and nitrogen excretion that expressed in Urea Nitrogen Urine (gr / 24 h). The nitrogen balance was derived from the difference between nitrogen intake and nitrogen excretion in 24 hours. Bivariate data analysis using Chi square or exact fisher test, while multivariate data analysis using logistic regression test.ResultsIn bivariate analysis, risk factors significantly associated with negative nitrogen balance were decreased renal function (LFG <90 ml / min / 1.73 m2), prolonged bed rest> 7 days and malnutrition. Other risk factors not significantly associated with negative nitrogen balance were diabetes mellitus, random blood sugar> 180 mg / dl, hypoalbumin and CRP> 6 mg / dl. In multivariate analysis showed the decrease of renal function and duration of bed rest > 7 days was significant.ConclusionThe decreased renal function and bed rest for more than 7 days was a risk factor for protein malnutrition in elderly patients.
Association of Comprehensive Geriatric Assessments Component and Sarcopenia in Elderly Wardhana, Diar Meitha; Widajanti, Novira; Ichwani, Jusri
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 4
Publisher : UI Scholars Hub

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Abstract

Introduction. Sarcopenia is defined as a declined in skeletal muscle mass and strength along with its function may causes an increase in hospitalization, mortality, and health burden. Multi-factorial conditions of the aging process may cause sarcopenia. To assess those multi-factorial conditions in the elderly, a comprehensive geriatric assessment (CGA) method should be used, in which comprises of socio-demographic, medical, psychological, and functional domains. This research aims to analyze the components of CGA, including age, gender, nutritional status, mental status, and functional status as factors associated to sarcopenia in the elderly community in Surabaya. Methods. This community research was a cross sectional designed analytic observational study. The subjects were all elderly people visiting five chosen Posyandu, an integrated health service post, that meet the inclusion and exclusion criteria. A total of 308 data were collected and then bivariate and multivariate analyzes were performed to determine the components related to sarcopenia. Bivariate analysis was performed on components of age, sex, nutritional status, comorbidities, cognitive status, mental status, and functional status. Variables included in multivariate analysis were age, sex, nutritional status, comorbidities, cognitive status, and functional status. Results. The subjects were dominated by elderly females (74.7%). The median of age were 63 years (range 60-100 years). After performing multivariate analysis, three variables had the association to sarcopenia which were nutritional status assessed by MNA score ≤23.5 (OR 3.61, 95% CI 2.11–6.19), age ≥70 years old (OR 2.82, 95% CI 1.58–5.04), and male (OR 1,83, 95% CI 1,04–3,24). An area under curve (AUC) of 66.2% was obtained from the prediction model. Conclusion. The method of CGA has the power to predict sarcopenia of the elderly in the community as much as 66.2%
RELATIONSHIP BETWEEN LEVEL OF SERUM ADIPONECTIN AND FRAILTY IN ELDERLY PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE Marfiani, Erika; Ichwani, Jusri; Widajanti, Novira; Maranatha, Daniel; Amin, Muhammad
Indonesian Journal of Tropical and Infectious Disease Vol. 8 No. 2 (2020)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v8i2.16027

Abstract

Elderly are especially prone to the adverse health effects of chronic obstructive pulmonary disease (COPD). COPD is a typical aging disease which is found to be about 12% in the age group more than 64 years old. Frailty is an important geriatics syndrome, while adiponectin is an important adipokine that regulate homeostasis of energy. Adiponectin is affected by age, especially in males. Adiponectin levels increases as subcutaneous fat cells in older men decreases. Increased adiponectin can lead to muscle wasting which will further reduce body weight and body mass index (BMI), which indirectly also increases the degree of frailty. Until now the relationship between adiponectin with frailty degree in advanced COPD is still unknown.The aims of this study was to investigate the relationship between plasma adiponectin level and frailty in COPD elders. This was an observational analytic cross-sectional study. All anthropometric parameters, including weight, height, and body mass index (BMI), were measured. Adiponectin was measured by ELISA methods obtained from venous blood samples. Aged more than or equal to 60 years old, the patients underwent spirometry to determine the degree of airflow limitation and the degree of frailty defined by the Fried criteria. Statistic analysis used Rank Spearman. Thirty-eight male COPD patients became the subject of the study. The average age was 70-74 years, with a total of 13 robust, 12 prefrails and 13 frail patients. Level of adiponectin (mean and SD) in robust, prefrail, and frail were 6.84+ 2.66 , 6.58 + 4.27, and 11.62 + 4.90 respectively, p=0.015. Further analysis showed that level of adiponectin rose progresively with an increasing number of components of frailty. The degree of obstruction mostly with mild (42.1%), and no subjects with very severe. There were an increase in serum adiponectin levels in all subjects. In conclusion, level of adiponectin serum correlates positively with the degree of frailty.
TWO-YEAR MORTALITY PROFILE IN ELDERLY WITH FRAILTY : Observational Descriptive Study in Elderly Health Community in Surabaya, Indonesia Faizah, Ummi Ziyadatul; Widajanti, Novira; Ichwani, Jusri
Journal of Community Medicine and Public Health Research Vol. 3 No. 1 (2022): Journal of Community Medicine and Public Health Research
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (229.452 KB) | DOI: 10.20473/jcmphr.v3i1.30283

Abstract

Indonesia in the next few years will face problems related to the increasing population of the elderly. Frailty becomes one of the most common health problems in the elderly. The prevalence of frailty in the Indonesian elderly range from 17% to 36.5%. Frailty raises the risk of death and health care costs, as well as functional disability, hospitalization, and fall risk. This was an observational descriptive study conducted in the elderly health community in Surabaya. This study aimed to determine the proportion and describe the associated factors of 2-year mortality in the elderly with frailty, so it can help determine appropriate preventive and intervention ways to prevent mortality and increase the quality of life in the elderly. There were 113 subjects. Most of the subjects had elementary school grade, married, had an income of less than 1.5 million rupiah/month, financially dependent, regularly exercised, did not use walking aids, and had no history of falls in the last year. The mortality rate within 2 years was 8.8% with the characteristics of older than 70 years old, had sarcopenia, decreased functional status, were at risk of malnutrition, CIRS score > 5, moderate cognitive impairment, probably depression, and had components of exhaustion, slowness, and low physical activity based on the CHS Frailty
Co-Authors Faizah, Ummi Ziyadatul Maranatha, Daniel Marfiani, Erika Muhammad Amin Novira Widajanti, Novira Wardhana, Diar Meitha Zurriyani Zurriyani