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Hypoxic Liver Injury as Predictor of Major Adverse Cardiac Events in Acute Myocardial Infarction patients admitted to Intensive Coroner Care Unit of Cipto Mangunkusumo National General Hospital Muhadi, Muhadi; Prihartono, Nurhayati Adnan
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 3
Publisher : UI Scholars Hub

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Abstract

Introduction. Major adverse cardiac events (MACE) is a complicating myocard infarct which consist of acute heart failure, cardiogenic shock, and fatal arrhytmia. An accurate, easy and cost-effective biomarker is needed to predict MACE and mortality in patients with myocard infarct. Hypoxic liver injury (HLI) is a potential biomarker using serum glutamic-oxaloacetic transaminase (SGOT) level as the parameter. This study is aimed to discover HLI’s role in predicting MACE in non ST elevation myocard infarct (NSTEMI). Methods. This study was designed as cross sectional to predict MACE and prospective cohort for survival analysis. Study population was all NSTEMI patients admitted to ICCU of Cipto Mangunkusumo Hospital and study sample were NSTEMI patients admitted to ICCU of Cipto Mangunkusumo Hospital that meets all criteria during 2006-2016. Cut-off level of SGOT for HLI to predict MACE and mortality was analyzed using ROC curve and AUC. Survival analysis was done using Kaplan Meier curve and the difference was tested with log-rank. Results. A total of 277 subjects were included in this study. Incidence of MACE in this study was 51.3% (acute heart failure 48.4%, fatal arrhytmia 6.5%, and cardiogenic shock 7.2%). The mortality rate was 6.13%. The median of SGOT level on all subject was 35 U/L, 40 (range 8-2062) U/L in subjects with MACE and 31 (range 6-1642) U/L in subjects without MACE (p = 0.003). Cut-off level for SGOT used to predict MACE was 101 U/L (sensitivity 21.8%; specificity 89.6%; POR 2.727 (CI 95% 1.306- 5.696), p = 0.006). In multivariate analysis, HLI was insignificantly related to MACE. Cut-off level for SGOT used to predict survival was 99 U/L (sensitivity 23.5%; specificity 83.8%; likelihood ratio +1.46). There were no significant difference of survival between groups with HLI level below and above the cut-off SGOT level. Conclusion. Hypoxic liver injury (HLI) cannot be used to predict MACE in NSTEMI patients unless combined with other variables. There is no significant difference of survival between subjects with or without HLI.
Pengaruh Terapi Metotreksat pada Pasien Artritis Reumatoid terhadap Penurunan Fungsi Kognitif: Meta-Analisis Berdasarkan Telaah Sistematik Fauzia, Fara; Prihartono, Nurhayati Adnan; Hidayat, Rudy; Araminta, Abirianti P.
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 2
Publisher : UI Scholars Hub

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Introduction. Rheumatoid arthritis (RA) is a systemic and chronic autoimmune disease involving the joints disorder as the main manifestations. Methotrexate (MTX) is currently still the drug of choice for RA treatment due to the good clinical response. However, there was a case reported by the American Geriatric Society in 2015 regarding the presence of reversible dementia after treatment with low-dose oral methotrexate. This study aimed to identify the effect of MTX treatment on cognitive disorder in RA patients. Methods. The study protocol was registered with PROSPERO (CRD42023414937). A systematic literature search was conducted in Medline Embase database, Scopus, CENTRAL to identify cohort observational studies, case controls, and randomized control trial (RCT) studies, evaluating the effect of methotrexate therapy on cognitive function disorder in RA patients. The Newcastle-Ottawa Scale (NOS Scale) was used to analyze the quality of existing observational studies and The COCHRANE was used to analyze the RCT studies which included in the journals reviewed. Results. There were 4 observational studies that met the criteria, including 2 case control studies and 2 cohort studies. Pooling was carried out in two different types of studies. The OR was 0.81 (95%CI 0.4 – 1.68) in the case control studies group, whereas the RR was 0.88 (95% CI 0 .6 – 1.3) in the cohort studies group. The heterogeneity of each type of case-control studies and cohort studies were I2 92% (p-value277% (p-value Conclusion. Methotrexate therapy has not been proven to have an effect on cognitive disorder in RA patients either as a protective factor or as a risk factor.
Spatial study of the implementation of ivermectin, diethylcarbamazine citrate, and albendazole in an urban area Nafilata, Ikrimah; Supali, Taniawati; Wahyono, Tri Yunis Miko; Prihartono, Nurhayati Adnan; Hikmah, Kholisotul; Devi, Yuli Puspita
International Journal of Public Health Science (IJPHS) Vol 14, No 1: March 2025
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v14i1.24822

Abstract

Studies on lymphatic filariasis (LF) in Indonesia have mostly focused on the disease determinants with limited focus on spatial-based and the determinants of implementing ivermectin, diethylcarbamazine citrate, and albendazole (IDA). This study aimed to identify the causes of program failure. A cross-sectional survey was conducted from November to December 2022 in nine urban villages with high endemic records and one sentinel village in Pekalongan City, Central Java, Indonesia. The analysis using Quantum Geographical Information System (QGIS) and Pearson correlation. Slum settlements were linked to the presence of open sewers (p=0.000; r=0.974) and overcrowding (p=0.033; r=0.672), while the first round of IDA medication adherence correlated with knowledge of medication (p=0.054; r=-0.623) and willingness to take the medication in the second round (p=0.051, r=0.603). Adverse effects of the treatment are strongly correlated with drug boredom from taking medication (p=0.003; r=0.828) and assistance from health workers (p=0.027; r=0.791). We identified gaps in slum settlements, open sewers, overcrowding and medication adherence, including low knowledge of medication, unwillingness to take second-round medication, adverse effects, and boredom with taking medication. We recommend effective strategies by engaging health education between health workers, local leaders, and private sectors as key to ensuring elimination program.
Optimizing chest X-rays as a leading diagnostic modality for handling COVID-19: a diagnostic study Purbasari, Utami; Prihartono, Nurhayati Adnan; Helda, Helda; Antariksa, Budhi; Audita, Fatira R.
International Journal of Public Health Science (IJPHS) Vol 14, No 2: June 2025
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v14i2.24653

Abstract

Recent studies have highlighted that chest CT scans are crucial for accurately diagnosing COVID-19. However, in rural areas of Indonesia, people may have difficulty assessing CT scans, leading to increased undetected cases. To address this issue, we investigated whether chest X-rays (CXR) could replace CT scans in diagnosing COVID-19 patients. A diagnostic cross-sectional-based study was conducted at Fatmawati General Hospital from January to September 2021. The study included suspected COVID-19 patients in isolation wards and ICU who were over 18, with or without comorbidities, and had complete clinical data and laboratory tests. We analyzed imaging data through reverse transcription-polymerase chain reaction (RT-PCR) tests, CXR, and chest CT scans. This study enrolled 150 eligible patients. With RT-PCR as the gold standard, we found that CXR had a sensitivity of 86.6% (95% CI: 78.9-92.3%) and chest CT scan had a sensitivity of 91.1% (95% CI: 84.2-95.6%). Similar performance was observed when detecting ground glass opacities (GGO), bilateral laterobasal, and influenza-like syndrome and dyspnea (ILI) between CXR and CT scans. Receiver operating characteristic (ROC) curves demonstrated that CXR is comparable to CT scan, especially in ground glass opacity (GGO) and consolidation (AUC=0.72; 95% CI: 0.61-0.83 and AUC=0.710; 95% CI: 0.64-0.78). The proposed CXR method can be a reliable primary imaging tool for diagnosing COVID-19 by considering ILI. However, chest CT scans remain the most effective diagnostic method for COVID-19. These findings may be useful for the utilization of CXR for diagnosing COVID-19 in areas with limited access to CT scans.
Validation and adaptation of the Indonesian version of thyroid cancer quality of life questionnaire Pramono, Laurentius Aswin; Shatri, Hamzah; Subekti, Imam; Prihartono, Nurhayati Adnan; Hatma, Ratna Djuwita; Kurniawidjaja, Meily; Prasetyo, Sabarinah; Kurniawan, Felicia
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257639

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BACKGROUND The rising incidence of thyroid cancer in Indonesia has become a public health concern. This study was aimed to evaluate the validity of the thyroid cancer-quality of life-Indonesian version (ThyCa-QoL-ID). METHODS This cross-sectional study involved translating the original ThyCa-QoL questionnaire from English to Indonesian (T1), which was then back-translated into English (T2). The T2 questionnaire was compared with the original ThyCa-QoL questionnaire to refine T1, resulting in T3. The T3 questionnaire underwent cognitive and transcultural validation through individual assessment and focus group discussions with 10 doctors and 10 nurses at Cipto Mangunkusumo Hospital and St. Carolus Hospital, and 5 patients with thyroid cancer from St. Carolus Hospital. This process ensured cultural, language, and literacy adaptation processes for patients across different age groups. RESULTS The ThyCa-QoL questionnaire demonstrated validity, with all questions showing correlation calculation (r) above the r table. Test-retest reliability was measured by calculating the intraclass correlation coefficient for each question on the ThyCa-QoL questionnaire. The reliability test can be seen in the value of Cronbach’s alpha (0.915), exceeding the standard Cronbach’s alpha value standard (0.6). CONCLUSIONS The ThyCa-QoL-ID was confirmed as a valid and reliable tool for assessing the QoL of patients with thyroid cancer in Indonesia.
Teknik Lateral Flow Assay LD-Bio Untuk Deteksi Antibodi Spesifik Aspergillus Spp. pada Pasien Terduga Aspergilosis Paru Kronik (APK) Sofvina, Winda; Prihartono, Nurhayati Adnan
Action Research Literate Vol. 8 No. 12 (2024): Action Research Literate
Publisher : Ridwan Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46799/arl.v8i12.2551

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Indonesia merupakan negara dengan beban Tuberkulosis (TB) paru yang tinggi. Tuberkulosis paru dapat dicegah dan diobati, namun pasien dengan TB paru tetap memiliki risiko untuk mengalami penyakit paru lain pasca pengobatan. Infeksi paru dapat terjadi, salah satunya adalah infeksi jamur Aspergillus dalam bentuk Aspergilosis Paru Kronik (APK). Dapat dikatakan bahwa beban APK akan sejalan dengan beban TB. Penegakkan diagnosis APK harus memenuhi kriteria klinis, radiologis, dan laboratorium. Kriteria laboratorium dapat berupa deteksi antibody dan atau kultur specimen saluran napas. Kriteria serologi yang diharapkan untuk diagnosis cepat adalah alat diagnostic dengan biaya terjangkau, metode kerja yang sederhana dan dapat diaplikasikan pada area dengan sumber daya terbatas. Studi literatur ini membahas akurasi teknik Lateral Flow Assay (LFA) LdBio sebagai alternatif untuk deteksi antibodi Aspergillus. Pada studi ini ditemukan bahwa berbagai penelitian melaporkan sensitivitas dan spesifisitas LFA Ldbio cukup tinggi.
Risk Factors of COVID-19 Infection Among Health Workers Post-Vaccination in Jakarta Saputra, Rahmat; Prihartono, Nurhayati Adnan; Sudaryo, Mondastri Korib; Mahkota, Renti; Devita, Yeni; Arisanti, Ni Wayan Deisy
Kesmas Vol. 19, No. 4
Publisher : UI Scholars Hub

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One of the best approaches to stop the COVID-19 pandemic is vaccination. In Indonesia, the first round of vaccinations was prioritized for health workers on January 14, 2021 (first dose) and March 1, 2021 (second dose). However, some health workers who have been vaccinated were found to be reinfected after receiving the second dose. This cross-sectional study examined the risk factors for COVID-19 infection among health workers after vaccination using secondary and primary data. The data analysis was carried out in univariate (examining the frequency distribution and proportion of independent variables), bivariate (Chi-square test to explore the relationship between independent and dependent variables), and multivariate (Logistic Regression to assess the strength of the relationship between independent and dependent variables). The results showed that the variables associated with post-vaccination infection included COVID19 infection history (PR: 2.16, p-value <0.05), age (PR: 0.64, p-value <0.05), hypertension (PR: 1.52, p-value <0.05), direct contact with patients (PR: 2.02, p-value <0.05). It is recommended that health workers aged >37 years with a history of diabetes mellitus, hypertension, or previous COVID-19 infection, working directly with patients, and using Personal Protective Equipment level 1 daily should be prioritized for booster vaccinations.
PENYAKIT TIDAK MENULAR PRIORITAS DI PROVINSI DKI JAKARTA TAHUN 2022; STUDI ANALISIS SITUASI Gea, Intan Permata Hati; Prihartono, Nurhayati Adnan; Inggariwati, Inggariwati
Jurnal Ilmu Kedokteran dan Kesehatan Vol 11, No 3 (2024): Volume 11 Nomor 3
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v11i3.13451

Abstract

Angka morbiditas penyakit tidak menular (PTM) di tingkat global maupun nasional menujukkan kecenderungan peningkatan dalam beberapa tahun terakhir. WHO mengidentifikasi empat faktor risiko utama yang berkontribusi terhadap peningkatan PTM tersebut, yaitu konsumsi tembakau, kurangnya aktivitas fisik, penyalahgunaan alkohol, dan diet yang tidak sehat. DKI Jakarta merupakan ibu kota Indonesia yang menghadapi berbagai persoalan dalam pengendalian PTM. Dengan permasalahan tersebut serta sumber daya yang terbatas, perlu dilakukan analisis situasi yang bertujuan untuk menetapkan prioritas PTM di Provinsi DKI Jakarta. Kegiatan ini menggunakan desain desktiptif dengan pendekatan kuantitatif dan kualitatif. Penetapan prioritas masalah melibatkan pejabat dan pengelola program PTM di Dinas Kesehatan Provinsi DKI Jakarta serta Kepala Seksi Pencegahan dan Pengendalian Penyakit di Suku Dinas Kesehatan seluruh wilayah Provinsi DKI Jakarta sebanyak enam belas orang. Skoring dan penentuan rangking dihitung menggunakan metode Hanlon. Berdasarkan hasil identifikasi masalah diperoleh delapan masalah penyakit tidak menular, yaitu hipertensi, diabetes melitus, kanker, stroke, penyakit jantung koroner, penyakit ginjal kronik, asma, dan penyakit paru obstruktif kronik. Hasil penilaian terhadap masalah tersebut menempatkan diabetes melitus (skor 17), penyakit jantung koroner (skor 16) dan hipertensi (skor 14) sebagai tiga prioritas utama masalah penyakit tidak menular di Provinsi DKI Jakarta.
Perbandingan Penggunaan Penghambat Pompa Proton Dosis Tinggi dan Rendah terhadap Mortalitas pada Pasien Coronavirus Disease-19 (COVID-19) yang Menjalani Rawat Inap: Studi Kohort Retrospektif Liwang, Frans; Prihartono, Nurhayati Adnan; Harareed, Haya; Panjaitan, Lucas Welfried
Majalah Kedokteran Indonesia Vol 72 No 2 (2022): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.72.2-2022-802

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Introduction: The role of proton pump inhibitor (PPI) in Coronavirus Disease-19 (COVID-19) is still debatable. PPI is commonly used to prevent or treat upper gastrointestinal bleeding and/or dyspeptic symptoms. However, previous studies showed that PPI may lead to adverse outcomes in COVID-19 patients, thus the dose of PPI may play an important role. This study aimed to compare the risk of mortality between high vs low dose PPI in hospitalized COVID-19 patients. Methods: We performed retrospective cohort study from two COVID-19 referral centers in Jakarta between June 2021 and September 2021. We included hospitalized COVID-19 patients, moderate-critically ill cases, who had been given intravenous PPI for more than 7 days. We defined high dose PPI for omeprazole greater than 40 mg/day or pantoprazole greater than 40 mg/day, and low dose PPI for omeprazole ≤40 mg/day or pantoprazole ≤40 mg/day. Results: Of the total 365 patients (median age[Q1–Q3] 55 [45–64] years old), 216 subjects were given high dose PPI. Subjects with high dose PPI had a significantly higher mortality rate than the low dose PPI according to bivariate analysis (54.2% vs 26.1%; p less than 0.001), but quite similar length of stay (median[Q1–Q3] 12.5 [9–16] vs 13 [9–18] days). After conducting a multivariate analysis to control the confounders, we found that high dose PPI still led to higher mortality (aOR 3.04; 95%CI 1.22–7.60; p=0.017). Conclusion: High dose PPI may increase risk of mortality in hospitalized COVID-19 patients.
Faktor-Faktor Yang Mempengaruhi Keberhasilan Pengobatan Metotreksat Pada Pasien Artritis ReumatoidDA PASIEN ARTRITIS REUMATOID Fauzia, Fara; Prihartono, Nurhayati Adnan; Hidayat, Rudy
Majalah Kedokteran Indonesia Vol 72 No 6 (2022): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.72.6-2022-850

Abstract

Rheumatoid arthritis (RA) is a systemic and chronic autoimmune disease with joint manifestations. Delays in RA treatment will pose a risk of permanent joint damage and increased mortality risk. Diagnosis as early as possible, followed by appropriate therapy, will prevent various complications due to RA, aiming to achieve a condition of remission or minimal low disease activity. The treatment choice for RA is currently a group of disease-modifying anti-rheumatic drugs (DMARDs), with methotrexate (MTX) as the first choice. Various studies have reported various factors that play a role in the success of MTX treatment, including younger age, male sex, normal body mass index, not smoking, early treatment, number of joints involved, inflammatory factors (LED/CRP) and negative serological factors (RF/anti-CCP).