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EVALUASI KUALITAS HIDUP DAN SKALA NYERI PADA LANJUT USIA PENYINTAS COVID-19 PASCA RAWAT INAP Soenarti, Sri; Sutanto, Heri; Indiastari, Dewi; Budiarti, Niniek; Hermanto, Djoko Heri; Susanto, Jefri Pratama
Majalah Kesehatan Vol. 10 No. 2 (2023): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/majalahkesehatan.2022.010.02.5

COVID-19 menyebabkan banyaknya kematian pada populasi lanjut usia (lansia). Di Indonesia, hingga akhir Mei 2021 terdapat 49% kematian akibat COVID-19 dan pada pasien di atas 60 tahun (lansia) hanya didapatkan 10% kasus sembuh. Lansia dikategorikan sebagai kelompok berisiko terinfeksi virus Corona. Wabah penyakit ini tidak hanya berdampak pada kesehatan fisik tetapi juga kesehatan mental. Pada saat pandemi, memahami kualitas hidup lansia yang sembuh dari COVID-19 pasca perawatan di rumah sakit adalah tantangan global yang baru. Penelitian ini dilakukan dengan mengambil data lansia yang selamat dari COVID-19 pasca rawat inap untuk dinilai kualitas hidupnya dan kesehatan diri. Penilaian dengan wawancara melalui telepon. Data demografi, sosial ekonomi, status kesehatan diambil dari rekam medis pasien. Responden memperoleh rerata skor kualitas hidup (EQ-5D) 0,911 dan rerata skor VAS 89,6. Nyeri sendi memiliki korelasi yang signifikan secara statistik dengan ketidaknyamanan (p < 0,000). Lama rawat inap kurang dari 14 hari memiliki hubungan yang bermakna dengan ketidaknyamanan (p < 0,05). Sedangkan dimensi lain seperti mobilitas, perawatan diri, aktivitas sehari-hari dan kecemasan/depresi tidak berkorelasi dengan ketidaknyamanan secara signifikan. Kesimpulannya, kualitas hidup dan kesehatan diri yang dilaporkan oleh lansia penyintas COVID-19 relatif bagus. Adanya keluhan nyeri sendi dikaitkan dengan kualitas hidup yang lebih buruk (dimensi ketidaknyamanan), sementara risiko ketidaknyamanan meningkat secara signifikan dengan lama rawat yang lebih singkat.

PRIA 50 TAHUN DENGAN MORBUS HANSEN DENGAN MANIFESTASI THROMBOSIS VENA DALAM Baeha, Ferdinando Motuho; budiarti, niniek; Maharani, Tri Dita
Jurnal Ilmiah Kesehatan Media Husada Vol 12 No 2 (2023): November
Publisher : LPPMK STIKES Widyagama Husada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33475/jikmh.v12i2.337

Kusta adalah penyakit yang terutama mempengaruhi kulit dan saraf tepi, mengakibatkan neuropati dan konsekuensi jangka panjang yang terkait, termasuk kelainan bentuk dan kecacatan. Penyakit ini dikaitkan dengan stigma, terutama bila ada kelainan bentuk. Gangguan hemostatik sering dikaitkan dengan infeksi akut dan kronis karena fungsi trombosit, pembekuan darah, dan fibrinolisis terkait erat dengan sistem kekebalan tubuh. Kejadian DVT (Deep Vein Thrombosis) pada pasien koinfeksi morbus Hansen tidak banyak dilaporkan, sehingga kita harus lebih waspada bahwa DVT dapat muncul sebagai manifestasi lanjutan pada pasien dengan infeksi kronis.

Increasing Adolescents' Knowledge in Indonesia of HIV and STD in Leading-Up Three Zero HIV/AIDS 2030 Indiastari, Dewi; Setyowati, Lita; Sutanto, Heri; Budiarti, Niniek; Rosandi, Millanitalia; Dwitarahma, Marshandyar
Clinical and Research Journal in Internal Medicine Vol. 5 No. 1 (2024): Volume 5 No 1, May 2024
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2024.005.01.06

During the transition period of puberty, adolescents experience physical, psychological, and ways of thinking, which social and environmental changes will have a significant impact on adolescents. Improper self-control becomes a threat that can damage the morale and future of adolescents, including choosing the wrong environment resulting in drug abuse, unwanted pregnancies, abortions, sexually transmitted infections, HIV, and AIDS. This community service activity aims to increase the knowledge and importance of youth awareness in Malang about HIV and STIs. This activity is an online lecture-based activity (webinar) and live event assisting teenagers in Malang area. It is held for seven weeks by providing education about what HIV is, why it must be avoided—the dangers of sexually transmitted infections online followed by a discussion session. The activity was attended by 763 participants aged 10-20 years and 114 guardians of students and laypeople. The results obtained during the activity showed an increase in the post-test scores compared to the values before getting the webinar. A long-term evaluation still needs to be carried out to assess the absorption rate of the material that has been carried out on the quality of life of webinar participants. The conclusion obtained from this activity is that the knowledge of webinar participants, especially teenagers, about HIV/AIDS has increased, and knowledge is a fundamental thing that must be instilled in adolescents as early as possible to prevent HIV transmission in adolescents.

Association of Sociodemographic Factors in Affecting the Knowledge, Attitude, and Behaviour of Tuberculosis and HIV in Malang: A Community-Based Study in Rural Area Rosandy, Milanitalia; Candradikusuma, Didi; Indiastari, Dewi; Fatma, Endah; Budiarti, Niniek; Sutanto, Heri; Abellia, Gaby
Clinical and Research Journal in Internal Medicine Vol. 5 No. 1 (2024): Volume 5 No 1, May 2024
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2024.005.01.07

Background: Tuberculosis is the leading cause of death among people with HIV. In Indonesia, the Tuberculosis prevalence in 2021 stood at 969,000 cases with an average of 354 cases per 100,000 people. Nevertheless, tuberculosis is often neglected by many people, whereas in fact, it is a preventable and curable disease. This study aims to assess the knowledge, perception, behaviour, and screening for tuberculosis and their association with sociodemographic factors in a rural area of Malang, Indonesia. Method: A cross-sectional community-based study was conducted. The subjects of this study were adults (≥18 years old) who could comprehend the Indonesian language. We included 462 individuals who were chosen randomly by a multistage stratified sampling technique in rural areas of Malang, Indonesia. A validated questionnaire was asked to be filled in by participants, which were selected randomly using a multistage stratified sampling technique. Collected data were analyzed on SPSS for Windows version 25.0 Results: This study found that most (59.77%) of adults from the study area are still unaware of tuberculosis infection, transmission, prevention, and its risk factors. Only 1.2% were aware of the importance of screening if they had contact with positive tuberculosis patients. Participants in the age groups of 61 to 70 and over 70 years old were 5.5 and 4.0 times more likely to exhibit unsatisfactory behaviour compared to those in the 27 to 30 age group. Conclusion: This study shows that knowledge, perceptions, behaviours and tuberculosis screening toward tuberculosis are still lacking in rural communities in Malang and showed that participant on younger age and higher educational subjects has better knowledge, behaviour, perception and screening towards Tuberculosis and HIV.

Treatment challenges of nevirapine-induced Stevens-Johnson syndrome: a case report Rosandy, Milanitalia Gadys; Indiastari, Dewi; Candradikusuma, Didi; Budiarti, Niniek; Sutanto, Heri; Amalia, Dinda
Indonesian Journal of Biomedicine and Clinical Sciences Vol 56 No 4 (2024)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v56i4.13026

Nevirapine, a non-nucleoside reverse transcriptase inhibitor (NNRTI), is a crucial component of antiretroviral therapy (ART) in HIV management. However, nevirapine carries a rare but potentially life-threatening risk of Stevens-Johnson syndrome (SJS). We reported a case of severe cutaneous manifestations of extensive necrolysis in an HIV-positive patient on the ARV nevirapine. This case highlights the importance of recognizing nevirapine-induced SJS, particularly in the early stages, to ensure prompt discontinuation of the drug and initiation of appropriate supportive care. Clinicians managing HIV patients on nevirapine-based ART should remain vigilant for early signs of SJS and maintain a high index of suspicion.

Hubungan Antara Kepatuhan Terapi Antiretroviral terhadap Terjadinya Kondisi Underweight, Lingkar Betis, Handgrip Strength, dan Skinfold Triceps pada Pasien HIV/AIDS di RSSA Malang Budiarti, Niniek; Kurniawan, Fitto; Soenarti, Sri
Jurnal Klinik dan Riset Kesehatan Vol 4 No 1 (2024): Edisi Oktober
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.04.1.4

Background: Human Immunodeficiency Virus or commonly known as HIV is a virus that infects CD4 cells thereby impaired the human immune system. The number of new HIV cases in Indonesia in 2019 was reported to have reached 50,282 cases and tends to increase from year to year. What often happens in people with HIV/AIDS (PLWHA) tends to experience weight loss accompanied by opportunistic infections that do not occur in normal people. Adherence to therapy is the main factor that must be emphasized by PLWHA in order to achieve treatment success. However, ARV therapy adherence rates are reported to be <80%. This number can be a predictor of therapy failure. One indicator of the success of therapy is when there is clinical improvement in the patient's condition, such as no opportunistic infections or weight gain. Aim: The aim of this study was to determine whether there is a relationship between adherence to antiretroviral therapy and underweight conditions in HIV/AIDS patients. Methods: This study used a cross sectional design with an analytical observational nature and the research subjects were patients at RSSA Malang who visited from June to August 2023. Results: The results of the study showed that there was a significant relationship between adherence to taking ARVs and being underweight (p=0.018) and there was no significant relationship between adherence to taking ARVs with calf circumference, handgrip strength, and triceps skinfold. Conclusion: The conclusion of this study is that the more compliant the patient is with ARV therapy, the higher the increase in body mass index and the smaller the possibility of becoming underweight.

Depression Levels and CD4 Counts in HIV Patients at Dr. Saiful Anwar General Hospital Malang Budiarti, Niniek; Patra Utama, Haniel; Agustin Purwantiningrum, Danik; Dwiastuti Wisnu Putri, Winarni Dian
Jurnal Kedokteran Brawijaya Vol. 33 No. 3 (2025)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2025.033.03.2

Untreated depression in HIV patients is associated with lower CD4 cell counts attributed to the excessive HPA axis activity, which leads to increased cortisol secretion. This can accelerate the progression of HIV through shifting cytokine production from Th1 to Th2, which triggers CD4 cell destruction and stimulates HIV replication. This study aimed to determine the relationship between depression levels and CD4 counts in HIV patients at Dr. Saiful Anwar General Hospital Malang. This study used a quantitative method with an analytical observational study design and a cross-sectional approach. A total of 30 participants were selected through purposive sampling. The Beck Depression Inventory-II (BDI-II) questionnaire was used to evaluate the participants' depression levels. Six participants were identified with moderate depression, while 24 participants exhibited either no depression or minimal depression. The Spearman's Rank Correlation Coefficient test showed p=0.183, p>0.05, with a correlation coefficient of -0.250, indicating no significant relationship between the depression levels and CD4 cell count in HIV patients at Dr. Saiful Anwar General Hospital Malang. Nevertheless, among the study subjects with moderate depression (6 participants), low CD4 counts (≤345cells/mm3) were observed, suggesting a tendency for depression levels to be associated with CD4 count.

Hubungan Antara Kepatuhan Terapi Antiretroviral terhadap Terjadinya Kondisi Underweight, Lingkar Betis, Handgrip Strength, dan Skinfold Triceps pada Pasien HIV/AIDS di RSSA Malang Budiarti, Niniek; Kurniawan, Fitto; Soenarti, Sri
Jurnal Klinik dan Riset Kesehatan Vol 4 No 1 (2024): Edisi Oktober
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.04.1.4

Background: Human Immunodeficiency Virus or commonly known as HIV is a virus that infects CD4 cells thereby impaired the human immune system. The number of new HIV cases in Indonesia in 2019 was reported to have reached 50,282 cases and tends to increase from year to year. What often happens in people with HIV/AIDS (PLWHA) tends to experience weight loss accompanied by opportunistic infections that do not occur in normal people. Adherence to therapy is the main factor that must be emphasized by PLWHA in order to achieve treatment success. However, ARV therapy adherence rates are reported to be <80%. This number can be a predictor of therapy failure. One indicator of the success of therapy is when there is clinical improvement in the patient's condition, such as no opportunistic infections or weight gain. Aim: The aim of this study was to determine whether there is a relationship between adherence to antiretroviral therapy and underweight conditions in HIV/AIDS patients. Methods: This study used a cross sectional design with an analytical observational nature and the research subjects were patients at RSSA Malang who visited from June to August 2023. Results: The results of the study showed that there was a significant relationship between adherence to taking ARVs and being underweight (p=0.018) and there was no significant relationship between adherence to taking ARVs with calf circumference, handgrip strength, and triceps skinfold. Conclusion: The conclusion of this study is that the more compliant the patient is with ARV therapy, the higher the increase in body mass index and the smaller the possibility of becoming underweight.

The Role of Plasma Osmolarity in the Mortality of Patients with Covid-19 Indiastari, Dewi; Candradikusuma, Didi; Sutanto, Heri; Budiarti, Niniek; Samsu, Nur
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.12

Covid-19 (Coronavirus disease 2019) is a new infectious disease that attacks the respiratory tract and is caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), causing multiorgan failure, often requiring temporary support such as the use of a ventilator or hemodialysis equipment. This condition is related to an imbalance in fluid distribution associated with changes in osmolarity or hyperosmolarity. This research aims to explain the role of plasma osmolarity in Covid-19 patients at dr. Saiful Anwar Hospital, Malang, in patient outcomes, especially death outcomes. The sample for this study was 205 medical records of Covid-19 patients, recorded from September 2021 to May 2022. This study used a retrospective cohort design to describe plasma osmolarity in Covid-19 patients and the outcome of hospitalized patients. There were 205 patient data obtained, with 85 patients dying aged <65 years. Sixty-eight patients of Covid-19 with comorbidities (DM, HT, AKI, CKD, combination) died. There was no difference in plasma osmolarity for living and deceased patients. Repeated plasma osmolarity (retest) had a good degree of accuracy in predicting the outcome of Covid-19 patients, where sensitivity was 71.3% and specificity was 73.4% at a cut-off value of 277.32mOsm/L. The repeat plasma osmolarity value of ≥277.32 had a PPV value of 75%, while plasma osmolarity <277.32 had an NPV value of 69.3%. The OR value was 6.77, meaning that Covid-19 patients with repeated plasma osmolarity levels ≥277.32 would have 6.77 times the risk of mortality compared to Covid-19 patients with repeated plasma osmolarity levels <277.32.

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