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The Effects of Ethanol Extract, Chayote (Sechium Edule (Jacq.) Swartz) Fraction and Juice on the High-density Lipoprotein Level in Male White Mice Siahaan, Jekson Martiar; Anto, Endy Juli; Fauzi, Tengku Muhammad
Indonesian Journal of Medicine Vol. 6 No. 2 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Cholesterol imbalance occurs in Diabetes Mellitus, where high-density lipoprotein (HDL) levels are low and low-density lipoprotein (LDL) increases, where this imbalance results in the appearance of atherosclerosis. HDL has antiarterosclerotic potential so it needs to be targeted for therapy. One of the bioactive compounds that have this effect is found in chayote (Sechium edule (Jacq.) Swartz). This study aimed to examine the effects of ethanol extract, Chayote (Sechium Edule (Jacq.) Swartz) fraction and juice on the hdl level in male white miceSubjects and Method: A randomized controlled trial study was conducted to test HDL level in 54 male white rats of the Wistar strain (Rattus novergius sp.) after received ethanol extract, Chayote (Sechium Edule (Jacq.) Swartz) fraction and juice. The dependent variable was the HDL level. The independent variable was the variation in the dose of ethanol extract, fraction and Sechium edule (Jacq.) Swartz Juice. The data were analyzed using Anova test.Results: The treatment group induced by Streptozotocin 50 mg / kgBW + nicotinamide (120 mg/kgBW) + HFD and obtained ethanol extract of chayote fruit 150 mg / kgBW, orally had the highest average HDL levels compared to other groups (Mean = 17.31; SD = 3.14).Conclusion: The ethanol solvent found in the ethanol extract is better because it attracts biaoctive compounds so that it has a better effect than the ethyl acetate fraction and the n-hexane fraction.Conclusion: The ethanol solvent found in the ethanol extract is better because it attracts biaoctive compounds so that it has a better effect than the ethyl acetate fraction and the n-hexane fraction.Keywords: HDL, Flavonoid, Sechium edule (Jacq.) SwartzCorrespondence: Jekson Martiar Siahaan. Department of Physiology, Faculty of Medicine, Universitas Methodist Indonesia. Jl. Setia Budi Pasar II Tj. Sari, Medan 20132, North Sumatera. Email: jekson.siahaan.sked@gmail.comIndonesian Journal of Medicine (2021), 06(02): 145-151https://doi.org/10.26911/theijmed.2021.06.02.03

The Effectiveness of Hypnotherapy in Reducing Pain in Patients with Cervical Cancer Prasetya, Hanung; Kusumawati, Heni Nur; Wardiyatmi, Wardiyatmi
Indonesian Journal of Medicine Vol. 6 No. 2 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Complaints of pain in cervical cancer patients make the patient suffer more. Pain is a subjective matter so that hypnotherapy can reduce the pain suffered by patients. The use of hypnotherapy in cancer patients focuses on the emotional aspects and dynamics that occur in the client's subconscious mind. Hypnotherapy can change sensations, perceptions, thoughts, feelings or behavior after being suggested. Positive suggestions given are able to influence the perception of someone who is in a hypnotic state so that they behave or perceive according to the suggestions given. The purpose of this study was to analyze the effect of hypnotherapy as a complementary therapy in reducing pain in cervical cancer patients.Subjects and Method: The experimental study used a random control trial which was conducted at the Dr. Moewardi Hospital from January to September 2019. A sample of 90 patients was selected by purposive sampling. 45 subjects from the treatment group received the hypnotherapy intervention and 45 subjects from the control group received standard care. The dependent variable is the level of pain. The independent variable is hypnotherapy. The level of pain is measured by a numerical pain scale of 0 to 10. Hypnotherapy is performed using hypnosis recording/ audio. Data analysis was performed using an independent t test.Results: The mean pain level after hypnotherapy (Mean= 0.8; SD= 1.96) was lower than the control group (Mean= 3.2; SD= 1.7), effect size= -1.31, and it was statistically significant (p <0.001).Conclusion: Hypnotherapy complementary therapy can help reduce pain levels in cervical cancer patients.Keywords: hypnotherapy, pain, cervical cancerCorrespondence:Hanung Prasetya. Study Program in Acupuncture, Health Polytechnics, Ministry of Health. Jl. Letjend Sutoyo, Mojosongo, Surakarta 57127, Central Java. Email: Hanungprasetya71@yahoo.com. Mobile: +628122638908.Indonesian Journal of Medicine (2021), 06(02): 152-158https://doi.org/10.26911/theijmed.2021.06.02.04

Accuracy of Uric Acid and Cholesterol Levels Examination in Distinguishing Pleural Effusion Fluid Exudates and Transudates Sutanto, Yusup Subagio
Indonesian Journal of Medicine Vol. 6 No. 2 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Light's criteria was reported 25% of misclassification transudates as exudates. This study aimed to analyse the accuracy of examining uric acid levels and pleural fluid uric acid levels, and pleural fluid cholesterol and cholesterol ratios to distinguish the exudates and transudates in pleural effusions.Subjects and Method: This was a cross-sectional study design conducted at Dr. Moewardi Hospital, Surakarta, Central Java, from July to August 2019. The study subjects were 30 pleural effusion patients treated in the pulmonology ward. The dependent variables were pleural fluid exudates and transudates. The independent variables were (1) Uric acid levels in pleural fluid; (2) The ratio of uric acid levels between pleural fluid and serum; (3) Pleural fluid cholesterol levels; and (4) The ratio of cholesterol levels between pleural fluid and serum. The study instruments were Light's criteria and laboratory examination. The diagnosis's accuracy was analysed using sensitivity, specificity, and the area under the ROC (AUC) curve.Results: Pleural fluid cholesterol showed sensitivity and specificity of 86% and 83%, with a cut-off of 32.00 for transudate results. AUC value = 0.82 with p = 0.012. Serum cholesterol showed sensitivity and specificity of 71% and 61%, with a cut-off of 175.50 for transudate results. AUC value = 0.67 with p = 0.194. Pleural fluid uric acid levels showed a sensitivity and specificity of 86% and 87%, with a cut-off of 7.25 for transudate results. AUC value = 0.83 with p = 0.009. Examination of serum uric acid levels showed a sensitivity and specificity of 86% and 70%, with a cut-off of 7.10 for transudate results. AUC value = 0.65 with p = 0.249.Conclusion: Examination of uric acid and pleural fluid cholesterol levels can be used in routine pleural effusion examinations to distinguish exudates and transudates.Keywords: accuracy, uric acid, exudates, cholesterol, transudatesCorrespondence: Yusup Subagio Sutanto. Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Sebelas Maret, Dr. Moewardi Hospital, Surakarta. Jl. Kolonel Sutarto 132, Jebres, Surakarta 57126, Central Java. Email: dr_yusupsubagio@yahoo.com. Mobile: +62811284165.Indonesian Journal of Medicine (2021), 06(02): 159-167https://doi.org/10.26911/theijmed.2021.06.02.05

The Effect of Hypnotherapy on Postpartum Pain and Depression in Women with Post Caesarean Delivery Mahandaru, Araafi Hariza; Respati, Supriyadi Hari; Sulistyowati, Sri; Laqif, Abdurahman; Prasetya, Hanung
Indonesian Journal of Medicine Vol. 6 No. 2 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Postoperative pain is one of the most common problems in women after cesarean section. Caesarean section is also associated with post-partum depression. Hypnotherapy is one of the complementary therapy options that are effective and efficient in reducing pain symptoms and post-partum depression. This study aimed to analyze the effect of hypnotherapy on the level of pain and post-partum depression in post-cesarean section patients.Subjects and Method: This was an experimental single-blind randomized controlled trial with a post-test group design, which was conducted from January to April 2021, at the Dr. Moewardi and Universitas Sebelas Maret Hospitals, Surakarta. A sample of 80 patients with cesarean section was divided into two groups, namely 40 patients in the hypnotherapy group and 40 patients in the control group. The independent variable was hypnotherapy. The dependent variables were pain and depression. Hypnotherapy was carried out by self-hypnosis using audio recordings of hypnotherapy in 2 sessions before and after the cesarean section procedure. The pain was measured by the Numeric Rating Scale. Post-partum depression was measured by the Edinburgh Postnatal Depression Scale. The data were analyzed by an independent t-test.Results: Post-cesarean section pain in the group of hypnotherapy (Mean= 4.58; SD= 1.20) was lower than without hypnotherapy (Mean= 6.48; SD= 1.01), and it was statistically significant (p<0.001). Postpartum de-pression in the group of hypnotherapy (Mean= 6.08; SD= 1.60) was lower than non-hypnotherapy group (Mean= 8.48; SD= 3.78), and it was statistically significant (p <0.001).Conclusion: Hypnotherapy has a significant effect on reducing pain and post-partum depression in post-cesarean section patients.Keywords: Hypnotherapy, pain levels, post-partum depression, post-cesarean sectionCorrespondence: Araafi Hariza Mahandaru. Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta, Jl. Kolonel Sutarto, Jebres, Surakarta 57126, Central Java. Email: mahandarurafi@gmail.com.Indonesian Journal of Medicine (2021), 06(02): 194-205https://doi.org/10.26911/theijmed.2021.06.02.08

Effectiveness of Mirror Therapy on Post Stroke Functional Ability: A Meta-Analysis Galang Aji Samudera; Hanung Prasetya; Bhisma Murti
Indonesian Journal of Medicine Vol. 8 No. 1 (2023)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Stroke is the third leading cause of death after heart disease and cancer. One of the impacts of stroke is it causes a decrease in the functional ability to carry out daily activities, therefore mirror therapy is carried out to restore the functional ability. The study aims to determine the effect of mirror therapy on the functional ability of post-stroke patients based on previous primary studies.Subjects and Method: It was a systematic review and meta-analysis study with PICO as follows: P= post-stroke patients, I= mirror therapy, C= conventional therapy, and O= functional ability. Data collection was conducted from databases, namely: Google Scholar and PubMed. The inclusion criteria used were full-text articles in English, with randomized control trial design, published in 2006-2021. The keywords used were "stroke" AND "mirror therapy" AND "functional independence measure" OR "FIM" AND "randomized control trial". The inclusion criteria of the study were articles using a randomized control trial study design, the effect size used was the Mean SD, the subjects of the study were patients with poststroke conditions, the intervention given was mirror therapy, the comparison was conventional therapy, with the outcome was increased functional ability. The articles were analyzed using Review Manager 5.3. application.Results: The meta-analysis was conducted on 9 primary studies from several countries such as Turkey, South Korea, India, and Italy. The results of the study showed that there was an effect of mirror therapy on the functional ability of post-stroke patients. Patients who obtained mirror therapy had a functional ability of 0.92 units higher than conventional therapy. The results were statistically significant (SMD= 0.92; 95% CI= 0.67 to 1.17; p<0.001).Conclusion: mirror therapy can improve the functional ability of post-stroke patients.Keywords: mirror therapy, functional ability, post-strokeCorrespondence: Galang Aji Samudera. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: ghalangsamudera@gmail.com. Mobile: +6287836783209.Indonesian Journal of Medicine (2023), 08(01): 1-11https://doi.org/10.26911/theijmed.2023.08.01.01

Meta-Analysis of Re-perfusion Injury and Ischaemic Conditioning in Limb Surgery Utomo, Pamudji Utomo; Yudistira, Mochamadsyah Beizar
Indonesian Journal of Medicine Vol. 6 No. 3 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Pneumatic tourniquet commonly used for orthopedic surgery is associated with morbidity related to ischemia-reperfusion injury. Ischaemia conditioning (IC) had shown beneficial effects to attenuate these outcomes. This study aimed to systematically review the evidence of IC effect on outcomes of the patient undergoing orthopedic surgery.Subjects and Method: This was a systematic review and Meta-Analysis conducted through the online database search from PubMed, Central, Clinicaltrials.gov, and Scopus with topics related to IC and all possible orthopedic surgical interventions. Articles were searched with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocols used keywords "Ischemic conditioning," "Reperfusion injury," "Orthopaedic surgery." The data were extracted from the eligible study within inclusion and exclusion criteria. Two independent reviewers collected the study characteristics. Each study was examined for the risk of bias. The pooled data were analyzed using RevMan 5.3 in Standardized Mean Difference (SMD) as a summary measure with 95% Confidence Interval (CI).Results: Out of 12 eligible studies collected for qualitative analysis, eight studies with the same outcomes were analyzed for quantitative analysis. A random-effect model was used for analysis with high heterogeneity. The pooled SMD data for IC compared to control for postoperative pain were -0.50 (95% CI= -0.95 to 0.06; p<0.001). Outcome measures for hemodynamic stability, systemic inflammation, and end-organ injury were pooled with MD= 4.81 (95% CI= 3.19 to 6.44); SMD= -1.33 (95% CI= -2.06 to -0.60); SMD= 0.15 (95% CI= -0.14 to 0.71); respectively.Conclusion: Ischaemic conditioning significantly reduces postoperative pain, inflammation response and maintains hemodynamic stability. A better study design with a higher population number is needed for further study.Keywords: ischaemic conditioning, reperfusion injury, orthopedic surgery, Meta-AnalysisCorrespondence: Pamudji Utomo. Dr. Soeharso Ortopedic Hospital. 157th Ahmad Yani St. Sukoharjo 57162, Central Java, Indonesia. pamudji_utomo@staff.uns.ac.id.Indonesian Journal of Medicine (2021), 06(03): 271-284 https://doi.org/10.26911/theijmed.2021.06.03.04

Meta-Analysis of the Effects of Diet and Physical Activity on HbA1c in Type II Diabetes Mellitus Patients Kusumaningrum, Utari; Murti, Bhisma; Prasetya, Hanung
Indonesian Journal of Medicine Vol. 7 No. 2 (2022)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Type II Diabetes Mellitus is still a global health problem. The prevalence of diabetes has increased over the decades due to the increased incidence of Type II DM. This study aims to analyze the effectiveness of diet therapy and physical activity on HbA1c levels in type II DM patients.Subject and Method: This study is a systematic and meta-analysis study, with the following PICO Population = Patients diagnosed with type II DM. Intervention= High physical activity and diet therapy. Comparison = Low physical activity and no diet. Outcome= HbA1c level. The articles used in this study were obtained from several databases, including PubMed, Science Direct, Scopus, Clinical Key, and Google Scholar. The keywords used were: “tertiary prevention and DM”, “diet”, “physical activity”, “diet and DM” “physical activity and DM”, “diet and tertiary prevention and DM”. The inclusion criteria were full-text articles, experimental study design using randomized controlled trial (RCT). Articles were collected using PRISMA flow diagram. Articles were analyzed using Review Manager 5.3 application.Results: A meta-analysis of 9 articles on the effectiveness of diet therapy on HbA1c levels from Spain, the United States, Japan, the United Kingdom, and Israel concluded that Type II DM patients on diet therapy had an HbA1c level of 0.49 units compared to Type II DM patients without treatment, and the results were statistically significant (SMD= -0.49; 95% CI= -0.56 to -0.42; p < 0.001). A meta-analysis of 9 articles on the effectiveness of physical activity on HbA1c levels from the United States, Australia, Italy, and India concluded that Type II DM patients with high physical activity had HbA1c levels by 0.81 units lower than Type II DM patients with low physical activity, and the results were statistically significant (SMD= -0.81; 95% CI= -1.20 to -0.43; p < 0.001).Conclusion: Diet therapy and high physical activity reduce HbA1c levels in type II DM patients.Keywords: Physical activity, diet, HbA1c, type II DMCorrespondence: Utari Kusumaningrum. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: utariikusuma@gmail.com. Mobile: +6289636061501.Indonesian Journal of Medicine (2022), 07(02): 172-187https://doi.org/10.26911/theijmed.2022.07.02.06

Analysis of the COVID-19 Severity Based on NLR and the Mortality Rate of Pregnant Women with COVID-19 at Dr. Moewardi General Hospital, Surakarta, Central Java, Indonesia Dhea Fitria Rachma; Teguh Prakosa; Sigit Setyawan; Abdurahman Laqif
Indonesian Journal of Medicine Vol. 7 No. 4 (2022)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Coronavirus Disease 2019 (COVID-19) is a disease of the human respiratory system. Pregnant women are more susceptible to respiratory infections due to physiological changes in the immune and cardiopulmonary systems. Routine laboratory biomarkers such as lymphocytes, neutrophils, and NLR are considered prognostic in COVID-19. This study aimed to analyzed the severity of COVID-19 based on NLR on the mortality of pregnant women with COVID-19 at Dr. Moewardi, Surakarta.Subjects and Method: This study used analytic observational with a cross-sectional. The study subjects were 82 pregnant women with confirmed COVID-19, aged over 18 years, and being treated at RSUD Dr. Moewardi Surakarta between March 2020 to January 2022. The samples were taken using the consecutive sampling technique. The independent variable is the severity of COVID-19 based on clinical presentation. The dependent variable is the laboratory results in lymphocytes, neutrophils, and NLR. Data were collected from medical records and anlayzed using SPSS software.Results: There was correlation between NLR on the severity of pregnant women with COVID-19 (Mean= 10.11; SD= 4.10; p= 0.026) and there was a significant correlation between NLR on the mortality rate of pregnant women with COVID-19 (Mean= 9.92; SD= 3.94; p<0.001).Conclusion: NLR affected the severity and the mortality rate among pregnant women with COVID-19.Keywords: COVID-19, pregnancy, lymphocytes, neutrophils, NLR, mortalityCorrespondence: Dhea Fitria Rachma. Faculty of Medicine Universitas Sebelas Maret Surakarta. Jl. Ir. Sutami 36A, Surakarta 57126, Indonesia. Email: dheaf1020@student.uns.ac.id. Mobile: 085702594898.Indonesian Journal of Medicine (2022), 07(04): 401-410https://doi.org/10.26911/theijmed.2022.07.04.05

Effect of Garlic Powder Supplementation on Total Cholesterol and Low Density Lipoprotein Level in Patient with Hypercholesterolemia: A Meta-Analysis Zulkarnain, Zuraida; Dewi, Yulia Lanti Retno; Murti, Bhisma
Indonesian Journal of Medicine Vol. 7 No. 1 (2022)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Hypercholesterolemia is a risk factor for cardiovascular disease that can cause death and disability, so it must be managed properly. Garlic flour (GP) is one of the dosage forms of garlic that has the potential to reduce cholesterol. This study is a systematic review and meta-analysis that aims to determine the effectiveness of GP in reducing total cholesterol (TC) and low density lipoprotein (LDL).Subjects and Method: Search articles through the Pubmed database, Google scholar, Proquest, Springer link, and Science direct with the appropriate keywords. Population= patients with hypercholesterolemia. Intervention= GP. Comparison= placebo. Outcome= TC and LDL. Inclusion criteria included complete articles in English or Indonesian published from 2010-2022, Randomized Controlled Trial (RCT) design, subjects >18 years old with hypercholesterolemia, the study had a complete fat profile outcome, duration of intervention 2 weeks-12 months. The flow of article selection is based on the PRISMA flow diagram. Meta-analysis using RevMan 5.3 with effect size standardized mean difference (SMD) and Random Effect Model (REM) analysis model.Results: A total of 10 articles were eligible for a meta-analysis. The GP group had TC levels 1.49 units lower than the placebo group (SMD = -1.49; 95% CI = -1.95 to -0.55; p = 0.005) and LDL levels 0.68 units lower than the placebo group (SMD= -0.68; CI95). %= -1.08 to -0.27; p=0.001). Subgroup analysis based on the length of the intervention showed that administration of GP <12 weeks only significantly reduced TC while administration > 12 weeks significantly reduced TC and LDL.Conclusion: GP is effective in lowering TC and LDL especially at 12 weeks or more.Keywords: garlic powder, hypercholesterolemia, RCTCorrespondence: Zuraida Zulkarnain. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java 57126. Mobile: 081393933862. Email: zuraida.zu@gmail.com.Indonesian Journal of Medicine (2022), 07(01): 102-114https://doi.org/10.26911/theijmed.2022.07.01.11

Meta Analysis the Effect of Acupunctur Therapy and Ultrasound Therapy to Reduce Pain Caused by Carpal Tunnel Syndrome Noer, Afifah; Rahardjo, Setyo Sri; Prasetya, Hanung
Indonesian Journal of Medicine Vol. 6 No. 4 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Carpal tunnel syndrome is a condition of health problems in the form of pain, numbness, and tingling that occurs in a person's hands. This sensation can be felt in the thumb, index finger, middle finger, and 1/2 ring finger on the radial side, this occurs when the median nerve that passes through the carpal tunnel at the wrist is compressed or compressed. This study aims to estimate the effect of acupuncture therapy and ultrasound therapy on reducing pain in carpal tunnel syndrome cases.Subjects and Method: This was a systematic review and meta-analysis conducted using PRISMA flow diagrams. Article searches through journal databases include: PubMed, Science Direct, Scopus, Google Scholar, Springer Link, Hindawi, BMC. The PICOs of this study were, Population: carpal tunnel syndrome sufferers, Intervention: acupuncture therapy and ultrasound therapy, Comparison: no acupuncture and ultrasound therapy, Outcome: pain reduction. Using search keywords: (“acupuncture” OR “acupuncture therapy”) AND (“carpal tunnel syndrome” OR “cts”) AND (“ultrasound” OR “ultrasound therapy”) AND (“randomized controlled trial”) AND (“ acupuncture for carpal tunnel syndrome”) AND (“ultrasound for carpal tunnel syndrome”). Inclusion criteria were full paper articles with Randomized Controlled Trial (RCT) research method, the relationship measure used was Mean SD, the intervention given was acupuncture and ultrasound, study subjects were aged 18-85 years. Eligible articles were analyzed using the Revman 5.3 app.Results: Meta-analysis of 16 articles showed acupuncture treatment outcome of -0.34 units compared with other interventions or no intervention (SMD -0.34; 95% CI= -0.83 to 0.16; p=0.180), I2=78%, and treatment outcome. ultrasound as much as -0.76 units compared with other interventions or no intervention, and statistically significant value (SMD -0.76; 95% CI= -1.37 to -0.16; p=0.001), I2= 92%.Conclusion: Acupuncture therapy and ultrasound therapy have an effect on reducing pain in cases of carpal tunnel syndrome.Keywords: Acupuncture, ultrasound, carpal tunnel syndromeCorrespondence: Afifah Noer. Masters Program in Public Health. Universitas Sebelas Maret, Jl.Ir. Sutami 36A, Surakarta 57126, Jawa Tengah, Indonesia. Email: Afifahnoer97@gmail.com. Mobile: 085601564681.Indonesian Journal of Medicine (2021), 06(04): 399-411https://doi.org/10.26911/theijmed.2021.06.04.06

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