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The Effects of Slow Stroke Back Massage and Lavender Aromatherapy on Blood Pressure in Hypertensive Patients Sani, Fakhrudin Nasrul; Irdianty, Mellia Silvy
Indonesian Journal of Medicine Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Elderly is an age group which is extremely susceptible to suffer from health problems such as hypertension. Hypertension among the elderly is instigated by structural and functional changes in blood vessels. The changes include atherosclerosis, loss of connective tissue elasticity, and decreased vascular muscle relaxation that it reduces the distension and tensile strength of blood vessels. One of the therapies that may be implemented to elderly with hypertension is slow stroke back massage (SSBM) and lavender aromatherapy. The study aims to discover the effects of slow back massage (SSBM) and lavender aromatherapy toward the reduced blood pressure among hypertensive elderly.Subjects and Method: It was a quasi-experiment study with no control group which had been conducted in Posyandu (Integrated Health Post) Kamboja, Plesungan, Gondangerjo, Karanganyar, Central Java, in July 2019. A sample of 40 elderlies was selected by using total sampling. The dependent variables were systolic and diastolic blood pressure. The independent variables were slow stroke back mass-age (SSBM) and lavender aromatherapy. Blood pressure was measured by sphygmomanometer. The data were analyzed by using Wilcoxon. Results: The average systolic blood pressure post slow stroke back massage therapy and la-vender aroma therapy was (Mean=133.63; SD= 7.34) compared with prior therapy was (Mean= 167.80; SD= 6.12) with the value of p<0.001. The average diastolic blood pressure post slow stroke back massage therapy and lavender aroma therapy was (Mean= 68.28; SD= 4.25) compared with the prior therapy was (Mean= 68.88; SD= 5.72) with the value of p<0.001. Conclusion: Slow stroke back massage (SS-BM) lavender aromatherapy may lower down blood pressure of hypertensive elderly.Keywords: Hypertension, slow stroke back massage, Lavender aromatherapy, elderlyCorrespondence: Fakhrudin Nasrul Sani. School of Health Sciences Kusuma Husada, Surakarta. Email: fakhrudin_ns@ymail.com.Indonesian Journal of Medicine (2020), 05(03): 178-184https://doi.org/10.26911/theijmed.2020.05.03.01

Meta-Analysis: Effects of Obesity and Family History of Diabetes Mellitus on the Risk of Gestational Diabetes Mellitus Sitorukmi, Galuh; Dewi, Yulia Lanti Retno; Murti, Bhisma
Indonesian Journal of Medicine Vol. 6 No. 1 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Gestational diabetes mellitus is a serious complication of pregnancy, this is due to impaired carbohydrate tolerance which results in increased blood sugar levels and was first noticed during pregnancy. Gestational diabetes mellitus is a global problem in terms of its incidence and impact. Studies suggest that obesity and a family history of diabetes mellitus are important risk factors for gestational diabetes mellitus. This study aimed to analyze the influence of obesity and family history of diabetes mellitus on the incidence of gestational diabetes mellitus by meta-analysis.Subjects and Method: This was a systematic review and meta-analysis carried out by following the PRISMA flow diagram. The electronic database for article searches is as follows: PubMed, Science Direct, Springer Link, Scopus, and Google Scholar. The search for articles was carried out on articles published from 2010 to 2020. The keywords used were "gestational diabetes mellitus AND obesity", "gestational diabetes mellitus AND family history. The inclusion criteria were full text articles, used English, cross-sectional study design, and results reported in adjusted odds ratio (aOR). P= Pregnant mother. I= Obesity and family history of diabetes mellitus. C= No obesity and no family history of diabetes mellitus. O= gestational diabetes mellitus. Articles that meet the requirements are analyzed using the Revman 5.3.Results: Nine articles were reviewed in this study with a total of 11,657 subjects. The results of the meta-analysis showed that obesity increased the risk of gestational diabetes mellitus 1.81 times compared with non-obese (aOR= 1.81; 95% CI= 1.53 to 2.15; p <0.001). Having a family history of diabetes mellitus increased the risk of gestational diabetes mellitus 2.08 times compared with those without a family history of diabetes mellitus (aOR= 2.08; 95% CI= 1.34 to 3.22; p <0.001).Conclusion: Obesity and a family history of diabetes mellitus increase the risk of gestational diabetes mellitus.Keywords: obesity, family history of diabetes mellitus, gestational diabetes mellitusCorrespondence: Galuh Sitorukmi. Masters Program in Public Health. Universitas Sebelas Maret, Jl.Ir. Sutami 36A, Surakarta 57126, Central Java. Email: galuh.sitorukmi1210@gmail.com. Mobile: 085799333013.Indonesian Journal of Medicine (2021), 06(01): 1-13https://doi.org/10.26911/theijmed.2021.06.01.01.

Hypnosis and Dyspareunia: A Meta Analysis Kumalasari, Ratna Dewi; Tamtomo, Didik Gunawan; Prasetya, Hanung
Indonesian Journal of Medicine Vol. 5 No. 4 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Sexual satisfaction refers to a person's pleasant feelings from the type of sexual relationship that forms an important part of one partner's impression of another. 75% of women experience sexual problems. Symptoms of sexual dysfunction occur in nearly half of the marriage period and 75% of couples need therapy. This study aims to analyze the effect of hypnosis on pain during sexual activity and the intensity of pain.Subjects and Method: This study was a meta-analysis and a systematic study. The articles used were obtained from several electronic databases including Pubmed, Science Direct, Springer Link, and Google Scholar. Articles were collected for 4 weeks. The keywords to search for articles were as follows: "non-medical therapy", "non-medical care", "randomized control trial", "sexual disturbance", "sexual function", "sexual satisfaction". The articles studied were full text articles with an observational research design. Articles were collected using PRISMA diagrams, and analyzed using the Review Manager 5.3 application.Results: The effects of hypnosis on pain during sexual activity (aOR= 3.55; 95% CI= 2.63 to 4.79; p = 0.001) and intensity of pain (aOR= 2.39; 95% CI= 1.96 to 2.82; p= 0.006).Conclusion: Hypnosis can reduce pain during sexual activity and the intensity of pain.Keywords: Hypnosis, sexual dysfunctionCorrespondence: Kumalasari. Masters Program in Public Health Sciences, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: logicakinanthi@gmail.com. Mobile: +62812623900900.Indonesian Journal of Medicine (2020), 05(04): 291-298https://doi.org/10.26911/theijmed.2020.05.04.04.

The Differences of Folliculogenesis between Treated with Letrozole and Letrozole-Electroacupuncture in Women with Polycystic Ovary Syndrome Yulyanti, Yulyanti; Budihastuti, Uki Retno; Melinawati, Eriana; Sulistyowati, Sri; Nurwati, Ida
Indonesian Journal of Medicine Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Polycystic Ovary Syndrome (PCOS) is an endocrine disorder that most often causes infertility. It occurs due to the failure of folliculogenesis, thus causing non-ovulation. Letrozole is a 3rd generation drug of non-steroidal aromatase inhibitors, which can increase ovulation rates. Electroacupuncture is the insertion and manipulation of needles into acupuncture points (acupoints) that are selected specifically based on the meridian system and connected to the electrode stimulator. This study aimed to determine the differences of the effects of letrozole and letrozoleelectroacupuncture (letrozole-EA) on the improvement of folliculogenesis in women with PCOS.Subjects and Method: This was an analytic observational study with a case-control design. This study was conducted at the Gynecology Polyclinic and Sekar Clinic, Dr. Moewardi Hospital, Surakarta. A sample of 30 infertile women aged 20-45 years was selected by fixed disease sampling. The criteria of the PCOS were determined based on Rotterdam criteria. The dependent variable was the diameter of the follicle. The independent variables were the administration of letrozole and letrozole-EA. Transvaginal ultrasound of Voluson P6 was used to measure the folliculogenesis. The data were analyzed by independent t-test.Results: On the second day after treatment, the diameter of the follicles in the letrozole-EA group (mean= 6.92; SD= 1.60) was bigger than the letrozole group (mean=5.66; SD=1.11), and it was statistically significant (p=0.004).Conclusion: Combination of letrozole and letrozole-EA therapy is more effective in increasing follicular diameter development than letrozole therapy only.Keywords: polycystic ovary syndrome, folliculogenesis, Letrozole, electro-acupunctureCorrespondence: Yulyanti. Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta, Central Java, Indonesia. Email: dr.yulyanti@gmail.com. Seluler: +6285264806570.Indonesian Journal of Medicine (2020), 05(03): 214-223https://doi.org/10.26911/theijmed.2020.05.03.06

The Effect of Sleep Duration on Overweight or Obesity in Female Adolescents: A Meta-Analysis Study Jannah, Putri Isriyatil; Pamungkasari, Eti Poncorini; Prasetya, Hanung
Indonesian Journal of Medicine Vol. 6 No. 1 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Overweight or obesity is a condition of excessive accumulation of fat in the body which is indicated by a Body Mass Index value exceeding 25 kg/m2. WHO estimated that in 2022 adolescents will experience more obesity cases than underweight cases. One of the behaviors that can reduce the risk of overweight and obesity is having adequate sleep duration. This study aimed to analyze the magnitude of the effect of sleep duration on overweight or obesity in female adolescents with a meta-analysis study.Subjects and Method: This was a systematic review and meta-analysis study. The study was carried out by following the PRISMA diagram. The process of the search for articles through a database that included: PubMed, Google Scholar, and Springer Link. The articles were selected in the period 2009-2020. The keywords used include: "sleep duration" AND adolescents, overweight AND "female adolescents", obesity AND adolescent, "sleep duration" OR "overweight obesity" OR adolescents OR "cross-sectional", "sleep duration" AND "overweight obesity "AND adolescent," sleep timing "AND obesity AND girls. The inclusion criteria were full-text articles with cross-sectional study design, English and Indonesian articles, and articles that used multivariate analysis with adjusted Odds Ratio. The articles that qualify were analyzed using the Review Manager 5.3 application.Results: A total of 9 primary articles from Korea, China, and the USA had conducted a meta-analysis with a sample of 104,726 female adolescents. The results of the meta-analysis showed that female adolescentswith short sleep duration had a risk of overweight or obesity 1.44 times compared with female adolescents with long sleep duration (aOR= 1.44, 95% CI= 1.24 to 1.69, p<0.001).Conclusion: Short sleep duration significantly increases overweight/obesity in female adolescents.Keywords: duration of sleep, overweight or obesity, female adolescentsCorrespondence: Putri Isriyatil Jannah. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: putriisriyatil@gmail.com. Mobile: 089634956745.Indonesian Journal of Medicine (2021), 06(01): 52-61https://doi.org/10.26911/theijmed.2021.06.01.06.

The Relationship of Amount of Pleural Fluid and Time of Pleurodesis with the Results of Pleurodesis in Malignant Pleural Effusions Sutanto, Yusup Subagio; Sigit, Indarto; Kurniawan, Hendra
Indonesian Journal of Medicine Vol. 5 No. 4 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Pleural effusion can be an early sign of lung cancer in more than 25% of cases. Lung cancer is the most common cause of malignant pleural effusion (MPE). Pleurodesis is performed when the amount of pleural fluid is <150 ml/day, but it is difficult as its productive nature. This study aimed to find the right time to perform pleurodesis on patients with MPE, which is expected to achieve optimal results.Subjects and Method: This was a cross-sectional study conducted at Dr. Moewardi Hospital, Surakarta, Central Java, from June to July 2020. The study subjects were 17 patients with malignant pleural effusion (MPE) diagnosed with lung cancer who underwent water seal drainage (WSD) and indicated for pleurodesis. The dependent variable was the success of the pleurodesis procedure. The independent variables were the amount of evacuated pleural fluid and the time of pleurodesis performed. The study instruments were diagnosis of lung cancer with anatomic pathology, measurement of the amount of pleural fluid, and posteroanterior chest X-ray evaluating the success of pleurodesis. The data were analyzed using Spearman correlation, ANOVA to determine the differences in the amount of pleural fluid at the first, second, and third hours, and continued with post hoc LSD analysis using SPSS 21.Results: The pleurodesis success rate had positive correlation with the amount of pleural fluid (r= 0.24; p= 0.345) and the time of pleurodesis performed at the first hour (r= 0.10; p= 0.701), second hour (r= 0.03; p= 0.921), and third hour (r= 0.41; p= 0.106). Pleurodesis performed at the second hour had the lowest amount of pleural fluid (Mean= 84.66; SD= 38.88), followed by third hour (Mean= 110.77; SD= 65.57), and first hour (Mean= 111.22; SD= 57.83), but the differences were not statistically significant (p= 0.285).Conclusion: The pleurodesis success rate has a positive correlation with the amount of pleural fluid and the time of pleurodesis, but it was not statistically significant. There is no significant difference in the amount of pleural fluid evacuated at the three different times of pleurodesis. The least amount of pleural fluid obtains at the second hour (14.00-22.00).Keywords: malignant pleural effusion, amount of pleural fluid, pleurodesis, pleurodesis timeCorrespondence: Yusup Subagio Sutanto. Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Sebelas Maret, Dr. Moewardi Hospital, Surakarta. Jl. Kolonel Sutarto 132, Surakarta 57126, Central Java. Email: dr_yusupsubagio@yahoo.com. Mobile: +62811284165.Indonesian Journal of Medicine (2020), 05(04): 337-342https://doi.org/10.26911/theijmed.2020.05.04.09.

A Case Report of Wellens’ Syndrome: An Ominous Sign of Left Anterior Descending Artery Critical Stenosis and Impending Anterior Myocardial Infarction Willim, Herick Alvenus; Agustyana, Andini; Arilaksono, Dwisetyo Gusti; Proklamartina, Nurnajmia Curie; Furqon, Muhammad
Indonesian Journal of Medicine Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Wellens’ syndrome is a potentially life-threatening condition, characterized by biphasic or deeply inverted T-waves changes in electrocardiographic (ECG) precordial leads, which associated with critical stenosis of left anterior descending (LAD) coronary artery and impending anterior myocardial infarction in patients presenting with unstable angina. This syndrome is an important sign for clinicians because delay in coronary angiography and revascularization may lead toanterior myocardial infarction, left ventricular dysfunction, and even death.Case presentation: A 50-year-old woman came to emergency department in a hospital in Bontang, with new onset intermittent typical chest pain lasting since 3 days. She had history of hypertension without regular medication. Physical examination was in normal ranges. An ECG obtained during chest pain-free period showed Wellens’ type A with biphasic T waves in V2-V6 and preserved R-wave progression. Troponin T was slightly elevated. During observation, the ECG pattern changed from Wellens’ type A to Wellens’ type B with deep T-wave inversions in V2-V6 and preserved R-wave progression.Results: The patient was initially treated with conservative treatment. On the next day, she was referred to percutaneous coronary intervention-capable hospital in Samarinda. Coronary angiography revealed 90% stenosis of mid LAD. A drug-eluting stent was successfully implanted with restoration of LAD flow. She was discharged on the following day in good condition with medication of dual antiplatelet therapy, angiotensin-converting enzyme inhibitor, beta-blocker, and statin.Conclusion: Clinicians should be aware of the ECG changes in Wellens’ syndrome, which may occur during pain-free period. Early recognition is crucial to avoid the development of anterior myocardial infarction. Immediate coronary angiography and revascularization is needed.Keywords: Wellens’ syndrome, critical stenosis, myocardial infarctionCorrespondence: Herick Alvenus Willim. Dr. Agoesdjam General Public Hospital, Ketapang, West Kalimantan. Email: herick_alvenus@yahoo.co.id.Indonesian Journal of Medicine (2020), 05(03): 246-252https://doi.org/10.26911/theijmed.2020.05.03.10

The Effect of Kinesio Taping on the Reduction of Pain in Patients with Carpal Tunnel Syndrome: Meta-Analysis Setiawan, Cahyo; Tamtomo, Didik Gunawan; Prasetya, Hanung
Indonesian Journal of Medicine Vol. 6 No. 1 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Carpal tunnel syndrome (CTS) is the most common occurrence of nerve compression. Some cases of CTS have chronic symptoms. The most common complaint is "Nocturnal Acroparesthesia", which is tingling pain at night. Physiotherapy interventions can be done to relieve complaints of CTS one of which is the use of Kinesio Taping. This study aimed to analyze the effect of Kinesio taping on the reduction of pain in patients with carpal tunnel syndrome from some previous studies.Subjects and Method: This was a systematic and meta-analysis study. The study used the PICO model as follows Population=Patients with Carpal Tunnel Syndrome, Intervention= Given Kinesio Taping, Comparison= Not Given Kinesio Taping, and Outcome=Reductionof Pain. The articles used in this study were obtained from several databases including PubMed, ScienceDirect, and Google Scholar. The articles were collected in a month. The keywords for searching the articles were as follows: "kinesio taping" OR "kinesio tape" OR "pain" OR "carpal tunnel syndrome" AND "Randomized Controlled Trial". The articles included in this study were full-text articles with a randomized controlled trial study design. The articles were collected using PRISMA flow diagrams and analyzed using the Review Manager 5.3 application.Results: The total of seven articles reviewed in this meta-analysis study was from Turkey, Poland, the Republic of Korea, Egypt, and the USA. The studies showed that giving KT could reduce pain in CTS and it was statistically very significant (Standardized Mean Difference= -1.21; 95% CI= -2.14 to -0.28; p<0.01).Conclusion: Kinesio Taping can reduce pain in Carpal Tunnel Syndrome.Keywords: kinesio taping, reduction of pain, carpal tunnel syndrome.Correspondence: Cahyo Setiawan, Masters Program In Public Health, Sebelas Maret University, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: setiawan.cahyo10@gmail.com.Mobile Phone: 089693257305.Indonesian Journal of Medicine (2021), 06(01): 104-111https://doi.org/10.26911/theijmed.2021.06.01.11.

Effect of L- Arginin on Placental Hipoxia Inducible Factor -1-Alpha (HIF-1-A) Expression at Preeclampsia Mice Models Anggraini, Nutria Widya Purna; Sulistyowati, Sri; Pramono, Besari Adi; Kristanto, Herman
Indonesian Journal of Medicine Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Placental hypoxia is one of the theories that cause preeclampsia. In placental hypoxia of preeclampsia, there is an increase of Hipoxia Inducible Factor 1 Alpha (HIF-1-A) expression as a response to hypoxia. L-Arginine administration through the L-Arginine-Nitric Oxide pathway is expected to improve placental hypoxia. This study aimed to examine the effect of L- Arginin on placental HIF-1-A expression at preeclampsia mice models.Subjects and Method: Experimental study with parallel group post-test only design. The study was carried out at the Veterinary Medicine Faculty of Airlangga University. Thirty six preeclampsia mice models were made with intravenous injection 10ng anti-Qa-2 on day 1-4 of pregnancy. They were divided into 2 groups: (1)18 mice without treatment (control) and (2) 18 mice were given L-Arginin 200 mg/kgBW/day on day 7-15 of pregnancy. They were terminated on day 16 then immunohistochemistry examination of HIF-1-A expression was done on the placental samples. The dependent variable was placental Hipoxia Inducible Factor-1-Alpha (HIF-1-A) expression. The independent variables were L-Arginin administration. HIF-1-A expression was measured by H-Score method. The data were analyzed by t-test. Results: The mean of placental HIF-1-A expressions of treatment group was lower (Mean= 7.98; SD=9.35) than control group (Mean=41.95; SD= 32.20), and it was statistically significant (p <0.001).Conclusion: L-Arginin reduces the Placental Hypoxia Inducible Factor Alpha (HIF-1-A) expression on preeclampsia mice model.Keywords: L-Arginine, HIF-1-A, PreeclampsiaCorrespondence: Nutria Widya Purna Anggraini. Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Sebelas Maret/ Dr. Moewardi General Hospital Surakarta. Jl Kolonel Sutarto 132, Surakarta, Central Java, Indonesia. Email: nutria_dr@staff.uns.ac.id. Mobile: 08122651819.Indonesian Journal of Medicine (2020), 05(03): 191-199https://doi.org/10.26911/theijmed.2020.05.03.03

Determinants of Delay in Diagnosis and Treatment in Multi Drug-Resistant Tuberculosis Patients in Health Facilities Sutanto, Yusup Subagio; Murti, Paulus Wisnu Kuncoro; Reviono, Reviono; Probandari, Ari Natalia; Kurniawan, Hendra
Indonesian Journal of Medicine Vol. 6 No. 1 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Multidrug-resistant tuberculosis (MDR-TB) is a serious threat to global TB control programs. According to WHO, there are 23,000 cases of TB multidrug-/rifampicin-resistant (MDR/RR-TB) in Indonesia. In 2017, there were 442,000 of TB cases. There were 8,600 - 15,000 MDR/RR-TB cases, of which 2.4% were new cases and 13% were previously treated TB cases. This study aims to determine the factors that influence the delay in diagnosis and treatment of MDR-TB patients.Subjects and Method: This study was a cross-sectional study conducted at Dr. Moewardi hospital, from September to October 2017, Surakarta, Central Java. A sample of 73 MDR-TB patients with disabilities on medical records was selected for this study. The dependent variables were delay in diagnosis and delay in therapy of MDR-TB cases. The independent variables were age, gender, distance to health facilities, and type of health facilities. Data were collected from medical records of MDR-TB patients who were treated from March 2012 to March 2017. Data were analyzed using the chi-square model.Results: Median delay in diagnosis = 4 days. Median treatment delay = 12 days. The average patient who had delayed MDR-TB therapy (≥4 days) was 44 years old (Mean= 44.19; SD= 12.64). Delay in MDR-TB diagnosis was not significantly associated with gender (OR= 0.53; 95% CI= 0.18 to 1.57; p= 0.264), distance to health facility (OR= 1.56; 95% CI= 0.58 to 4.21; p= 0.389), and type of health facility (OR= 0.60; 95% CI= 0.26 to 1.41; p= 0.983). The average of patient who had delayed MDR-TB therapy (≥12 days) was 41 years old (Mean= 41.39; SD= 12.69). Treatment delay was not significantly related to gender (OR= 0.45; 95% CI= 0.16 to 1.26; p= 0.137), distance to health facility (OR=1.44; 95% CI= 0.55 to 3.78; p= 0.466), and type of health facility (OR= 2.31; 95% CI= 1.03 to 5.21; p= 2.967).Conclusion: There was no statistically significant relationship between gender, distance from the patient's home to health facilities, and type of health facility with the delay in diagnosis and treatment of MDR-TB patients.Keywords: diagnosis, treatment, TB-MDRCorrespondence: Yusup Subagio Sutanto. Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta. Jl. Kolonel Sutarto No.132, Jebres, Surakarta, Central Java 57126. Email: dr_yusupsubagio@yahoo.com. Mobile: 0811284165.Indonesian Journal of Medicine (2021), 06(01): 14-22https://doi.org/10.26911/theijmed.2021.06.01.02

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