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Althea Medical Journal
Published by Universitas Padjadjaran
ISSN : -     EISSN : 23374330     DOI : 10.15850/amj
Core Subject : Health,
Medicine & Pharmacology
Althea Medical Journal (AMJ) is a peer reviewed electronic scientific publication journal which is published every 3 months (March, June, September, and December). Althea Medical Journal publishes articles related to research in biomedical sciences, clinical medicine, family-community medicine, and public health.
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Search results for , issue "Vol 11, No 3 (2024)" : 10 Documents clear
Rationality of Empirical Antibiotic Usage among Digestive Surgery Inpatients at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia: Gyssens Criteria Analysis Yunivita, Vycke; Assyifa, Nanda; Yarman, Indra Prasetya; Bashari, Muhammad Hasan; Satriasih, Tulus
Althea Medical Journal Vol 11, No 3 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v11n3.3299

Abstract

Background: Many empirical antibiotics are prescribed unnecessarily, contributing to the rise in the incidence of antibiotic resistance. Preventing infection of surgical sites is one of the most frequent purposes of empirical antibiotic usage. Therefore, this study aimed to analyze the rationality of empirical antibiotic usage among digestive surgery inpatients based on the Gyssens criteria and clinical features outcomes.Methods: A descriptive method was used with a cross-sectional design. Data was collected from medical records of patients underwent digestive surgery and had received empirical antibiotic therapy post-surgery from July to September 2021 at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Subsequently, the data was analyzed using the Gyssens method to qualitatively assess the rationality of antibiotic use based on specific criteria, classified from rational (category 0) to various levels of irrational use (categories I-VI). Clinical outcomes were evaluated by assessing leukocyte count, clinical symptoms of fever, and the appearance of surgical site infection before and after administration of empirical antibiotics.Results: In total, 70 empirical antibiotic prescriptions were obtained from 42 patients, with only 40% of patients using rational antibiotics, whereas 60% of antibiotics were used inappropriately (category I-VI). Clinical evaluation showed no fever, edema, or erythema and reduced leukocytosis and exudate/pus post-therapy.Conclusions: Inappropriate empirical antibiotic prescription for digestive surgery inpatients at Dr. Hasan Sadikin General Hospital based on the Gyssens criteria is high. Nonetheless, clinical outcomes showed improvements in infection-related parameters. These results emphasize the importance of stricter adherence to antibiotic stewardship and regular evaluation of empirical antibiotic practices to optimize usage and patient outcomes.
Internet Usage and Its Utilization for Outpatient Treatment among Older Adults in Indonesia: Evidence from the 2020 National Socioeconomic Survey Rahardja, Mugia Bayu; Puspitasari, Mardiana Dwi; Surbakti, Indra Murty
Althea Medical Journal Vol 11, No 3 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v11n3.3404

Abstract

Background: Health insurance is essential for older adults to get healthcare services. Interestingly, only around half of older adults in Indonesia had used the health insurance for outpatient care. Recently, internet usage has increased and is considered a predisposing factor for seeking therapy. This study aimed to explore the internet use among older adults for outpatient therapy.Methods: The National Socioeconomic Survey (SUSENAS)-core 2020 had included 29,905 older adults who had poor self-rated health and were unable to work or carried out other daily activities. Regression analysis was performed to determine the factors that influence the outpatient treatment.Results: Outpatient treatment utilization was highly associated with all predisposing factors such as age, gender, marital status, and education (p<0.05). Older adults who did not use the internet were 1.4 times more likely not obtain outpatient care (OR 1.362; 95% CI (1.207–1.537)). Those without health insurance had a higher probability of not seeking outpatient care (OR 1.643; 95% CI (1.551–1.741)) than those who had health insurance. Enabling factors, such as household wealth and living arrangements, were significantly associated with outpatient treatment utilization (p<0.05).Conclusions: Although health insurance remains the most significant factor, internet use is emerging as a way to increase coverage of outpatient treatment for the older adults.
Shallot-Peel Extract Supplementation Increases Glutathione Levels in Gastritis Rat Model Febianti, Zahrah; Utama, Bagas Wahyu; Handoko, Adelia
Althea Medical Journal Vol 11, No 3 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v11n3.3250

Abstract

Background: Mefenamic acid can cause gastritis. Glutathione is one of the oxidative stress defense mechanisms and nutrient supplementation containing high antioxidants. Peel of shallot (Allium cepa var. Ascalonicum) contains higher antioxidant compounds and may increase glutathione levels. This study aimed to analyze the effect of shallot peel extract supplementation on gastric glutathione (GSH) levels in gastritis rats model.Methods: This was an experimental study using 24 male Wistar rats which were divided into 4 groups, namely  group K0 (given 2 ml of aquadest for 14 days); group K1 (given mefenamic acid 23.25 mg/day for the first 7 days, then Na-CMC 2 ml/day for the next 7 days), group P1 and P2 (given mefenamic acid 23.25 mg/day for the first 7 days, then given shallot peel extract for the next 7 days at dose of 600 mg/kgBW/day or 1200 mg/kgBW/day). Gastric GSH levels were determined by the Ellman method. The data was analyzed by ANOVA and post hoc test.Results: The shallot peel extract supplementation at a dose of 600 mg/kgBW and 1200 mg/kgBW significantly increased gastric GSH levels in gastritis rats (p<0.05), however, GSH levels did not reach normal conditions. Linear regression analysis showed an R coefficient of 0.751.Conclusion: Shallot peel extract supplementation increases gastric GSH levels in gastritis rats model in a dose-dependent manner, suggesting an effective dose of shallot peel extract. Further study to develop shallot peel extract into phytopharmaca is imperative.
Suicide among Older Adults in Gunungkidul, Indonesia Nurdiyanto, F A; Wulandari, Ririn Mamiek; Primasari, Ardi; Harjanti, Enggar Putri
Althea Medical Journal Vol 11, No 3 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v11n3.3330

Abstract

Background: Older adults are vulnerable to suicidal crises due to decreased cognitive, health and psychosocial functions. Gunungkidul is a regency in Indonesia that has a demographic structure with an increasing older population and a high prevalence of suicide. This study aimed to determine the characteristics of suicide among older adults in Gunungkidul, Indonesia, from 2012 to 2022.Methods: This was a retrospective analytical descriptive study examining forensic reports of suicide from the Gunungkidul Resort Police, Indonesia, from 2012 to 2022. A total of 388 suicide reports were included, with 186 of them pertaining to older adult suicides. Demographic data and suicide methods were collected using descriptive statistics, and Chi-square analysis was performed to examine any associations or differences in the data.Results: Suicide cases in older adults were more dominant (55.03%) in all suicide cases in Gunungkidul. Hanging was the most prevalent method of suicide (96.2%) among older adults, and there was no difference in suicide methods between males and females (p=0.35). Furthermore, the older adults consisting of males (n=120) were more dominant than females (n=66), however, there was no significant difference across the age group in the youngest-old (60–69 years), the middle-old (70–79 years), and the oldest-old (≥80 years) age group (p>0.01).Conclusions: The prevalence of suicide in older adults in Gunungkidul exceeds other productive age groups, mostly males, and hanging is the most predominant method. Addressing suicide among older adults in Gunungkidul requires a holistic approach by considering individual and societal factors, which necessitates immediate attention to their health, psychological, and socio-economic needs through targeted interventions.
Expression Levels of Intestinal Toll-Like Receptors 2 and 4 in Acute Inflammation Caused by Intestinal Candidiasis: An Experimental Study in Wistar Rats Tania, Putu Oky Ari; Masfufatun, Masfufatun; Baktir, Afaf
Althea Medical Journal Vol 11, No 3 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v11n3.3345

Abstract

Background: Candida albicans grows in the gastrointestinal tract as a normal microflora that may cause intestinal candidiasis, characterized by formation of biofilm and inflammation. Candida is recognized by toll-like receptors (TLRs). This study aimed to explore the relationship between intestinal TLR 2 and TLR 4 expression levels in candidiasis at each phase of inflammation.Methods: An experimental study was performed using a simple randomized sampling on 30 male Wistar rats divided into a control and a treatment group. Each group was inoculated with Candida albicans. Dysbiosis conditions were designed in the treatment group using multiple antibiotics and on day 5 the rats were injected with subcutaneous cortisone acetate. The groups were terminated in five different times (days 7, 14, 21, 28 and 35). On the termination day, intestinal tissue was isolated and the TLR 2 and TLR 4 expression were analyzed by immunohistochemistry. The data were analyzed by parametric test with SPSS (p<0.05) and completed by post-hoc test Least Significance Difference (LSD) to compare pairs of groups.Results: The expression of TLR 2 and TLR 4 between control and treatment groups showed significant differences (p=0.005). In the treatment group, there was a gradual increase in the TLR2 and TLR 4 expressions.  Positive expression of TLR appeared more in the submucosal or basal area than apical surface. The treatment group showed the highest expression of both TLR2 (82.37%) and TLR4 (87.40%) on termination day 35.Conclusions: Inflammation caused by intestinal candidiasis can result in increased expression of intestinal TLR2 and 4 contributing to an increased risk of biofilm formation.
Distribution of Hypertension Cases Based on Primary Health Care 2017–2021 in Malang, Indonesia: Spatial Analysis Imtinani, Alifia Irbah; Qurniyawati, Eny
Althea Medical Journal Vol 11, No 3 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v11n3.3291

Abstract

Background: Malang Regency is one of the cities in East Java, Indonesia that has a high trend of hypertension cases. The study aimed to describe the distribution of hypertension cases at the primary health care level in Malang Regency, Indonesia using spatial analysis.Methods: This was a descriptive analysis study using secondary data obtained from the Health Profile of Malang Regency from 2017 to 2021. The total sampling method was used.  Data on hypertension cases from 16 primary health cares was collected. Quantum geographic information system (QGIS) was used to visualize the distribution of cases. Data was presented in the tables and a map with different coloring based on the high-low categories of hypertension cases in a region.Results: There was a tendency for an increase in hypertension cases every year in 3 of 16 primary health care. Primary Health Cares with an increased prevalence of cases during 2017–2021 were Arjowinangun (7.65% to 24.24%), Mojolangu (17.20% to 31.57%), and Kendalsari (8.84% to 27.29%). However, cases decreased from 2017 to 2018, and experienced a very high increase from 2018 to 2019.Conclusion: The distribution of hypertension cases in Malang Regency from 2017 to 2021 tends to fluctuate from year to year. An education program for the community about a healthy lifestyle and the importance of conducting regular health checks is needed to decrease hypertension cases.
Correlation of Platelet to Lymphocyte Ratio and C-Reactive Protein to Albumin Ratio with MEX-SLEDAI Scores in Patients with Systemic Lupus Erythematosus Amelia, Rachel; Wasilah, Fajar; Suraya, Nida Suraya
Althea Medical Journal Vol 11, No 3 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v11n3.3255

Abstract

Background: One of the methods used to assess systemic lupus erythematosus (SLE) disease activity is the Mexican systemic lupus erythematosus disease activity index (MEX-SLEDAI) score. Markers of SLE  disease activity such as anti-dsDNA antibodies, complement, and anti C1q  have limitations in terms of sensitivity and specificity.  In rural areas where these markers are not available, simpler alternative markers are valuable. This study aimed to explore markers related to SLE disease activity based on the platelet to lymphocyte ratio (PLR) and C-reactive protein albumin ratio (CAR) using the MEX-SLEDAI score.Methods: This was a cross-sectional study using a correlational analytical design. Data collection was carried out retrospectively using secondary data taken from medical records of patients with SLE treated at Dr. Hasan Sadikin General Hospital Bandung, Indonesia in 2019–2021 and the Laboratory Information System (LIS). The data was analyzed using the Spearman rank correlation test.Results: Of the 51 participants, 92% were female with median MEX-SLEDAI scores of 9. The median value of PLR and CAR were 247.07 and 2.01, respectively. The CAR showed a moderate positive correlation (r=0.563, p<0.001), whereas the PLR showed no correlation (r=0.023, p>0.05) with the MEX-SLEDAI score.Conclusions: MEX-SLEDAI scores has a moderate positive correlation with CAR, suggesting that CAR may be used as a marker in assessing disease activity in adult patients with SLE.
Prevalence and Resistance Patterns of Candida albicans in Diabetic and Non-Diabetic Patients with Urinary Tract Infections Prijana, Christian; Parwati, Ida; Prihatni, Delita
Althea Medical Journal Vol 11, No 3 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v11n3.3351

Abstract

Background: Candida spp. is an opportunistic fungi genus that can turn into pathogens, especially in those with inadequate immune response such as in patients with diabetes mellitus (DM), of which Candida albicans is the most common species. This study aimed to determine the prevalence and antifungal resistance patterns of Candida albicans in DM and non-DM patients with urinary tract infections (UTIs).Methods: A retrospective descriptive observational study was conducted in 2023 using medical record data of DM and non-DM patients with UTIs who were treated at a tertiary hospital in Bandung, Indonesia from July 2019 to December 2021. Data on patient characteristics, proportion of fungal species causing UTI, and antifungal resistance patterns of Candida albicans were analyzed using Microsoft Excel 2019 and presented in tabular form and chart.Results: Of a total 291 patient data, 21 were DM patients and 270 were non-DM patients, mostly were female, 71.4% and 58.2%, respectively. The prevalence of Candida albicans in DM patients was 66.7% and in non-DM patients was 70.7%, mostly resistant to micafungin (7.1% and 8.9%, respectively).Conclusion: Female is more susceptible to UTIs. More than half of DM and non-DM patients with UTIs are infected with Candida albicans, and mostly resistant to micafungin. Antifungal treatment guidelines based on resistance patterns and education on personal hygiene to prevent UTIs are recommended.
Accuracy of Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score System as An Early Diagnostic Predictor of Necrotizing Fasciitis in A Tertiary Referral Hospital in Bandung, Indonesia Djajakusumah, Teguh Marfen; Septrina, Rani; Dwinanda, Arief
Althea Medical Journal Vol 11, No 3 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v11n3.3341

Abstract

Background: Necrotizing fasciitis (NF) is a serious infection that can rapidly kill tissue and potentially lead to multiple organ failure. Early diagnosis and treatment are essential for survival. The laboratory risk indicator for necrotizing fasciitis (LRINEC) score may aid in early detection of NF. Although initially promising, studies on the effectiveness of LRINEC have shown mixed results. This study aimed to investigate the accuracy of LRINEC in predicting NF.Methods: This was an observational prospective cohort study, including patients with NF as well as skin and soft tissue infection (SSTI) who were treated at a tertiary referral hospital in Bandung, Indonesia in 2022. The LRINEC scores was calculated to measure sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The accuracy of LRINEC scores was specified in the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. Results: Of the total 70 patients, 33 were diagnosed with NF and 37 with SSTI. The LRINEC score with ≥6 points cut-off showed a sensitivity of 90.9% (95%CI; 75.67–98.08%), specificity of 75.60% (95%CI; 58.80–88.23%), PPV of 76.9% (95%CI; 60.67–88.87%), and NPV 90.30% (95%CI; 74.25–97.96%). The area under the ROC (AUROC) curve for the accuracy of the LRINEC scores was 0.895 (95%CI; 0.821–0.969).Conclusions: The laboratory risk indicator for necrotizing fasciitis (LRINEC) score is an accurate predictor and feasible early diagnostic indicator in NF. However, clinical judgment remains a crucial factor in diagnosing NF.
Effect of Cnidoscolus aconitifolius Leaf Extract in Lowering Triglyceride Levels and Body Weight of Wistar Rats with Metabolic Syndrome Sarsanti, Arifa Sherina Noor; Putranto, R. Prihandjojo Andri; Sarsono, Sarsono; Nurwati, Ida; Baihaqy, Fathu Thaariq
Althea Medical Journal Vol 11, No 3 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v11n3.3315

Abstract

Background: Cnidoscolus aconitifolius has the potential to be antidyslipidemic which has the effect of lowering triglyceride levels. This study aimed to explore the effect of Cnidoscolus aconitifolius leaf extract on triglyceride levels and body weight of Wistar rats with metabolic syndrome.Methods: This randomized controlled trial with a pre- and posttest design was conducted in 2021 at the Center for Food and Nutrition Studies, Yogyakarta, Indonesia. Male Wistar rats were subjected into metabolic syndrome state with a high-fat and high-fructose diet (HFHFD) for 21 days, then injected with Streptozotocin (STZ, 45 mg/kg) and Nicotinamide (NA, 110 mg/kg), and designated as positive control group. The intervention group was given 150 mg/kg, 300 mg/kg, and 450 mg/kg dose of leaf extract for 28 days. Triglyceride, glucose, high-density lipoprotein or HDL, and cholesterol were measured before and after intervention, using serum samples taken from the retro-orbital vein and analyzed using an enzymatic colorimetric method. The Wistar weight was measured every week. Data was analyzed by paired T-test and One-way ANOVA with Post-hoc Bonferroni and Games-Howell.Results: There was a significant decrease in triglyceride levels after the intervention (p< 0.005). Interestingly, there was also a significant increase in weight gain in all groups after the intervention (p=0.000), both were dose dependent.Conclusion: Cnidoscolus aconitifolius leaf extract is significantly lowering triglyceride levels in the Wistar rats model. In addition, weight gain has also been observed after intervention. Clinical studies are needed to further explore the potential of Cnidoscolus aconitifolius leaves as anti-dyslipidemia.

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