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All Journal Acta Interna : The Journal of Internal Medicine Jurnal Kebijakan Kesehatan Indonesia Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Journal of Health (JoH) Medica Hospitalia Indonesian Journal of Global Health research Indonesian Community Journal Berita Kedokteran Masyarakat Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management) Indonesian Journal of Pharmacology and Therapy
Yanri Wijayanti Subronto
Department Of Internal Medicine, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada, Yogyakarta
Agriculture, Biological Sciences & Forestry Computer Science & IT Dentistry Economics, Econometrics & Finance Education Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Other

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Length of Hospitalization and Polypharmacy in Diabetes Multimorbidity with Infectious Diseases Tasrif Ahmad; Hari Saktiningsih; Firdy Permana; Perigrinus Hermin Sebong; Yanri Wijayanti Subronto; Riris Andono Ahmad
Indonesian Journal of Global Health Research Vol 4 No 2 (2022): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (222.853 KB) | DOI: 10.37287/ijghr.v4i2.1195

Abstract

Patients with chronic condition have a higher risk of death and disability than others without chronic condition. Meanwhile, low to middle income countries facing challenges in reducing the burden of Non-Communicable Diseases (NCDs) and controlling infectious diseases such as Human Immunodeficiency Virus, Tuberculosis and Malaria. Patients with Diabetes are more often facing infection than people without diabetes. This research aimed to evaluate the length of hospitalization and polypharmacy in patients with multimorbidity of Diabetes with TB, HIV, and Malaria. Design of this research was a retrospective cohort study. All patients diagnosed with Diabetes since 2008 were grouped according to their illnesses to examine the impact of the diseases from the clinical perspective. Data were collected and extracted from the electronic medical records of PT. Freeport Indonesia since 2008. Determination of level of multimorbidities was performed by using principal component analysis, then the clinical impact of those multimorbidities analyzed using ANOVA tests. Multimorbidities have a significant effect on length of stay (p<0.05) and polypharmacy (p<0.05). The highest need for hospitalization and medication was in the Diabetes-Malaria-Tuberculosis group compared to the other multimorbidity groups. Multimorbidities have a significant impact on length of stay and polypharmacy.
Implementasi Teknologi Pengolahan Gel Aloe vera sebagai Es Krim Fungsional Pada Kelompok Tani di Ghra Sambiroto, Nanggulan, Kulon Progo, Daerah Istimewa Yogyakarta Chatarina Wariyah; Riyanto; Yanri Wijayanti Subronto
I-Com: Indonesian Community Journal Vol 3 No 4 (2023): I-Com: Indonesian Community Journal (Desember 2023)
Publisher : Fakultas Sains Dan Teknologi, Universitas Raden Rahmat Malang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33379/icom.v3i4.3586

Abstract

Ghra Sambiroto adalah nama kebun lidah buaya yang terletak di Banyuroto, Nanggulan, Kulon Progo, DIY. Terdapat 2 Ha kebun lidah buaya varietas sinensis dengan ribuan tanaman lidah buaya. Umur panen lidah buaya berkisar antara 8 sampai 24 bulan. Saat ini daun lidah buaya dimanfaatkan sebagai alo vera gel drink dan produk non pangan. Dalam bentuk gel drink, produk lidah buaya sangat disukai, namun proses pengolahan menggunakan panas yang memicu kerusakan antioksidan gel lidah buaya.  Kegiatan ini bertujuan untuk diseminasi pengolahan es krim lidah buaya fungsional dengan aktivitas antioksidan tinggi dan cara pengemasannya. Kegiatan dilakukan dengan penyuluhan, praktek  pengolahan dan pendampingan. Hasilnya menunjukkan bahwa peserta menjadi paham terhadap manfaat gel lidah buaya untuk kesehatan dan terampil dalam membuat es krim fungsional sampai pengemasannya. Komponen es krim yang dihasilkan adalah jumlah padatan 31,60-37,15%, gula sukrosa 18,54-21,56%,70%, protein 9,20-9,74% dan aktivitas antioksidan dengan nilai Radical Scavenging Activity (RSA) 12,52-14,40 %.
Self-stigma among people living with HIV/AIDS: revisiting human rights values for inclusive health service Ida Nur Faizah; Renie Cuyno Mellen; Syafriani Syafriani; Yanri Wijayanti Subronto; Mubasysyir Hasanbasri; Retna Siwi Padmawati
BKM Public Health and Community Medicine PHS8 Accepted Abstracts
Publisher : Universitas Gadjah Mada

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Abstract

Purpose: This study explores self-stigma in people living with HIV/AIDS (PLHIV) who used Puskesmas services in Yogyakarta and its impact on their health service access. Method: Data come from in-depth interviews with three PLHIVs (one male and two female). Results: Self-stigma occurs among the respondents at the first diagnosis as HIV positive. Self-stigma is triggered by wrong judgments about HIV disease from health workers and communities. Self-stigma is based on negative thoughts of feeling different, having exclusivity (different from their environment). Thus, it is easier to feel rejected, showing the worst if they are discriminated against. The first thought when the respondent was diagnosed with positive HIV was, “how do I die? How will I die tomorrow?” "Not expect, why should I?" "My world has been destroyed; I have no hope anymore.” Feeling of vulnerability and helplessness related to death and illness trigger hypersensitive responses, so they tend to withdraw from social relationships. Continuous exposure will result in a reluctance to access health services due to decreased motivation for treatment. Conclusions Self-stigma is a defense mechanism to fight stigma and discrimination. Hypersensitivity protects to anticipate rejection from the surrounding environment. Thus, PLWHA understands disclosure to reveal the status or not to the closest people. However, this condition needs to be regulated so that self-stigma does not develop to interfere with life functions such as social relations, economy, and work. Self-stigma can reduce treatment prognosis and increase comorbidity and mortality due to lack of a support system, decreased treatment motivation. Therefore, Puskesmas should collaborate with families and communities. Puskesmas can create volunteer groups from people with stigmatized diseases as agents of change to build trust between PLWHA, families, and health workers. For suggestion, meetings with patients as well as an activity to support human rights in celebration day to develop equal and acceptance feelings.
Predictor Factors of Tuberculosis Treatment Success in Sleman Regency of Indonesia: Predictor Factors of Tuberculosis Treatment Success in Sleman Regency of Indonesia Andriyanto, Eko; Wijayanti Subronto, Yanri; Ida Safitri Laksanawati
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 2 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (265.462 KB) | DOI: 10.36408/mhjcm.v9i2.756

Abstract

Background : Tuberculosis (TB) is the leading cause of mortality worldwide. Several studies have created risk scores to predict treatment success in TB patients. However, cohort study did not consider other clinical forms of TB, such as negative AFB smears and extrapulmonary TB. The objectives of this study was to knowing the predictor factors for the success of TB treatment in Sleman Regency by taking into account other  clinical forms of TB such as negative smear and extrapulmonary TB. Methods : The type and design of this study was an analytical study using a cross- sectional design conducted on TB patients in Sleman Regency from 2015 – 2018. Data were collected from TB 01 or TB 03 register of the Sleman District Health Office, including age, sex, BMI at the beginning of treatment, OAT (Antituberculosis Drugs) guideline, anatomic location, initial AFB status, AFB conversion status in intensive phase, type of TB patient, and treatment outcome. Chi-Square analysis and logistic regression were used to  determine the predictors of TB treatment success. Results : The research sample was 2308 people: 2158 successful treatments and 150 patients whofailed. AFB conversion in the intensive phase was the only variable to have a role in the TB treatment success (OR = 6.655, 95% CI: 3.354–13,207, p = 0.000). Conclusion : Conversion of AFB status in the intensive phase is a variable that contributes to the success of TB treatment. Age, sex, BMI at the beginning of treatment, OAT guidelines, anatomic location, initial AFB status, and type of TB patient are not predictors of TB success.
Prognostic Factors for Mortality in Patients With HIV/AIDS in Sardjito Hospital Helmi, Hamid; Subronto, Yanri Wijayanti; Wijisaksono, Doni Priambodo
Acta Interna The Journal of Internal Medicine Vol 13, No 1 (2024): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.101185

Abstract

Background. There are 3.8 million people infected with HIV in the Southeast Asia region. Even though it tends to fluctuate, cases of HIV AIDS infection in Indonesia continue to increase every year. HIV infection in Yogyakarta is also still relatively high. The treatment of HIV infection using ARV drugs is one of the spearheads to extend the life expectancy. The risk factors that influence the outcomes of patients receiving ARV therapy are varied. Slow immune improvement is greatly influenced by the patient's condition at the start of ARV therapy, such as age, long duration of HIV infection before therapy, specific immune activation, low CD4 count, and the period of AIDS at the start of ARV therapy.Objective. To find out the factors that significantly contributed to the mortality of patients with HIV/AIDS on ARV treatment at Sardjito Hospital.Methods. An observational study was conducted using a cohort retrospective method on HIV/AIDS patients who received ARV therapy for the first time in the period January 2008 – December 2021. Data extraction was conducted from December 2021 - February 2022. Multivariable analysis was carried out using multiple logistic regression. Survival analysis was measured by Kaplan-Meier curves.Results. The total number of HIV patients in the study was 1,591 people, with 199 patients having died. Variables associated with mortality in HIV patients in bivariate analysis were age, tuberculosis status, CD4 count, occupation, and clinical stage. Multiple logistic regression showed that occupation, CD4 count, and clinical stage were consistently associated with mortality among HIV patients. One and five-year survival rates for HIV patients were 89% and 87%.Conclusion. The CD4 count, occupation, and clinical stage of HIV are associated with mortality in HIV/AIDS patients receiving ARV treatment. Although variables other than the clinical stage are not independently related, some of these variables must still be considered in the care of HIV patients.
The affected factors of loss to follow up (LFU) among HIV patients with antiretroviral therapy (ART) in Dr. Sardjito General Hospital, Yogyakarta, Indonesia Sri Purwaningsih; Yanri Wijayanti Subronto; Erna Kristin
Indonesian Journal of Pharmacology and Therapy Vol 1 No 1 (2020)
Publisher : Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada and Indonesian Pharmacologist Association or Ikatan Farmakologi Indonesia (IKAFARI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijpther.481

Abstract

HIV infection is a global issue which is related to the increasing cases of HIV and AIDS in various countries including in Indonesia. Antiretroviral therapy (ART) that addressed for reducing the virus proliferation is not always followed by good medication adherence among patients. The ART loss to follow up (LFU) is a common problem in Indonesia. However, information concerning the affected factors of LFU among HIV patients with ART is limited. This study aimed to investigate the affected factors of LFU among HIV patients in the early two years of ART. A retrospective cohort study was conducted in Dr. Sardjito General Hospital, Yogyakarta among 369 medical records of HIV patients that met the inclusion and exclusion criteria. The inclusion criteria were HIV patients who started ART in January 2008 to December 2012, aged > 17 years with a complete medical records. The data of sociodemography and medical status patients were obtained from medical record, ART, and pharmacy register of the patients. Patient characteristics observed in this study included demographic factors such as age, sex, residence, education level, risk factors, and also medical status factors such as clinical stage, tuberculosis (TB) co-infection, functional status, and CD4 cell counts. The data were analyzed using Kaplan Meier and Cox Proportional Hazard. The results showed that patients with TB co-infection in early therapy and working functional status were significant factors of LFU (p<0.05). Patients without TB co-infection were half as much protected from LFU compared to patients with TB infection (HR=0.50; 96%CI: 0.34-0.75). It can be concluded that TB coinfection in early therapy and working fuctional status are the significant factors that influenced the LFU incidents in the two years of early therapy.
Early drug-induced hepatotoxicity in newly diagnosed HIV-positive patients on ARV therapy: A retrospective follow-up study of liver function profiles Lukman Ade Chandra; Yanri Wijayanti Subronto; Jarir At Thobari
Indonesian Journal of Pharmacology and Therapy Vol 4 No 2 (2023)
Publisher : Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada and Indonesian Pharmacologist Association or Ikatan Farmakologi Indonesia (IKAFARI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijpther.7817

Abstract

Antiretroviral therapy (ART) is a primary therapeutic modality for managing individuals with Human Immunodeficiency Virus (HIV) infection, and its efficacy has been established. However, the safety profiles of ART need to be continually monitored, including early elevated liver function test (LFT) after antiretroviral (ARV) initiation. This study aimed to assess the incidence of abnormal LFT among HIV-positive patients receiving initial ARV and to identify factors associated with abnormal LFT. A retrospective cohort study without a control group summarised medical records from Dr Sardjito General Hospital, Yogyakarta between January 2014 and December 2021. The study subjects were adult HIV patients taking their first ARV and underwent follow-up visits for at least two weeks. Study outcomes were LFT levels, abnormal LFT, and factors associated with abnormal LFT during follow-up visits at 2 wk, 6 mo, and 12 mo. Univariate and multivariate analyses will be performed with a significance level of p<0.05. A total of 137 subjects with 203 visits were retrieved from medical records. The subjects' mean age was 33.4 years, predominantly male, younger, unmarried, in the early stage of HIV infection, and without comorbidities. The findings showed a significant increase in alanine transaminase (ALT) at all three follow-up visits: 2 wk (p=0.02), 6 mo (p=0.003), 12 mo (p=0.001) and an increase in aspartate aminotransferase (AST) after 6 mo (p=0.007) and 12 mo (p=0.04). Abnormal LFT levels (AST and/or ALT) were observed in 23.4% of patients after a normal baseline, with ALT increase being more common. Furthermore, homosexuality was identified as a significant independent factor associated with abnormal LFT (AOR=3.1; 95% CI 1.27-7.51; p=0.01). The findings indicate exceptionally elevated LFT levels and the occurrence of abnormal LFTs among HIV-positive patients initiating ARVs. The increase in abnormal LFTs was significantly associated with patients identifying as homosexual, where hepatitis co-infection may be a contributing factor. The limited study design and measured variables warrant further investigation.
Co-Authors Awani Luksita Chatarina Wariyah Dibyo Promono Doni Priambodo Dwi Agustiana Sari Dwi Agustiana Sari, Dwi Agustiana Eko Andriyanto Erna Kristin Firdy Permana Hari Saktiningsih Helmi, Hamid Hermanto Ida Nur Faizah Ida Safitri Laksanawati Jarir At Thobari Juvita Kurniawan Listy Handayani Lukman Ade Chandra Mohammad Hakimi Mubasysyir Hasanbasri Nurjanah Widiastuti, Erma Ratna Kusumasari Purbani Renie Cuyno Mellen Retna Siwi Padmawati Riris Andono Ahmad Riyanto Rizka Humardewayanti Asdie Saktiawati, Antonia Morita Iswari Sebong, Perigrinus Hermin Seruni Angreni Susila Sri Purwaningsih Syafriani Syafriani Tasrif Ahmad Tiara Marthias Wijisaksono, Doni Priambodo Wiwin Lismidianti Wiwin Lismidianti, Wiwin Yodi Mahendradhata Yodi Mahendrahata