Damianus Journal of Medicine

Netizens' Perceptions Towards the Policy for Using Rapid Antigen Test During the COVID-19 Pandemic in Indonesia

Nindya Yulianti — 2022-12-31

Introduction: The Indonesian government has taken a number of steps to address the Coronavirus Disease 2019 (COVID-19) pandemic, including raising the number of tests to find positive cases and restricting travel to break the transmission chain. Due to direct activity limits, there was an increase in the number of internet and social media users during the pandemic. The goal of this research was to find out what Indonesian internet users thought about the policy of using rapid antigen tests as a requirement for domestic travel. The public's perceptions can assist the government, institutions, or parties involved in health promotion in determining the public's attitudes and responses to this policy.

Methods: This research is a descriptive study using a combination method called the explanatory sequential method. The object of this research is the tweets of Indonesian citizens uploaded on Twitter from December 19, 2020, to June 30, 2021. The validation test in this study uses member-checking and triangulation methods between another researchers.

Results: From a sample of 655 tweets, there were 51% negative perceptions, 25% positive perceptions, and 24% neutral perceptions. There are two types of narratives, namely medical and non-medical narratives. Non-medical narratives dominate at 85%, while medical narratives are only 15%.

Conclusion: In order to deal with COVID-19 in Indonesia, efforts must be made to raise public awareness about the uses and benefits of the COVID-19 examination before and after travel.

Key Words: COVID-19, perception, rapid test antigen, travel restrictions

HUBUNGAN TINGKAT PENGETAHUAN DAN PERILAKU MASYARAKAT TENTANG PANDEMI COVID-19 DI DUSUN PLAKARAN KECAMATAN BANGUNTAPAN, BANTUL

Febriana Astuti — 2022-12-31

Pendahuluan: Pandemi Coronavirus Disease 2019 (COVID-19) yang terjadi akibat terinfeksi virus SARS CoV-2 (Severe Acute respiratory Syndrome Coronavirus-2) menjadi peristiwa yang mengancam kesehatan masyarakat seluruh dunia. Berdasarkan data Gugus Tugas COVID-19 Republik Indonesia, per tanggal 18 Maret 2021 terdapat kasus positif sebesar 1.443.853 jiwa. Provinsi Daerah Istimewa Yogyakarta per tanggal 14 Maret 2021 menempati posisi kesebelas di Indonesia dalam jumlah pasien positif COVID-19, yaitu sebesar 30.117 (2,1%), di Kabupaten Bantul memiliki jumlah pasien yang

dirawat tertinggi yaitu sebesar 4.493 jiwa. Upaya preventif terbaik yang dilakukan adalah dengan menghindari paparan virus dengan didasarkan pada PHBS (Perilaku Hidup Bersih dan Sehat). Pengetahuan dan tindakan yang nyata dari pemerintah dan masyarakat terkait PHBS mampu menurunkan jumlah kasus COVID-19, sehingga masa pandemi COVID-19 dapat berakhir dengan cepat. Tujuan dari penelitian ini untuk mengetahui hubungan tingkat pengetahuan dan perilaku masyrakat tentang covid-19 di Dusun Plakaran kecamatan Banguntapan Bantul.

Metode: Penelitian kuantitatif dengan desain deskriptif analitik, subjek penelitian adalah 120 masyarakat di Dusun Plakaran, Banguntapan Bantul yang memenuhi kriteria inklusi. Adapun kriteria inklusi sebagai berikut masyarakat dusun plakaran yang ber-KTP dan berdomisili di Dusun Plakaran dengan rentang usia 17- 65 tahun, bisa membaca dan menulis serta bersedia menjadi responden. Pengambilan sampel menggunakan teknik purposive sampling.

Hasil: Hasil uji korelasi rumus korelasi Spearman p=0,007 (nilai p<0,05) dari data dapat disimpulkan bahwa terdapat hubungan yang signifikan antara pengetahuan dan perilaku masyarakat Dusun Plakaran Kecamatan Banguntapan Bantul terhadap COVID-19.

Simpulan: Terdapat hubungan antara pengetahuan dan perilaku terhadap COVID-19.

Kata Kunci: pengetahuan, perilaku, COVID-19

Use Patterns of Over The Counter (OTC) Products in Medical Students with Acne Vulgaris

Regina Regina — 2022-12-31

Abstract

Introduction: Acne vulgaris (AV) is a skin disorder caused by inflammation in the pilosebaceous unit and may cause psychosocial burden for the patients. Self medication is common in medical students, including in treating AV. This study aimed to determine the behavioural characteristics of using over the counter (OTC) products for acne-prone skin in medical students in Jakarta. Methods: This was a cross-sectional observational study in 100 medical students with AV. The study was conducted by using questionnaires consisting of clinical survey, medications, and use of OTC products. The clinical assessment of the severity of AV was determined with the Global Acne Grading System (GAGS) criteria. Results: Sixty-nine study subjects only used OTC products for their acne management. The most common OTC product was facial cleanser, which is facial soap (89 subjects) and cleansing oil (29 subjects). Fifty-percent of the study subjects did not know the active ingredients in the products, 15% used benzoyl peroxide, 13% topical retinoid, and 12% nicotinamide. Conclusion: Self medication with OTC products for acne-prone skin is frequent in medical students in Jakarta, and the most commonly used product is facial cleanser. Most study subjects did not know the active ingredients in the OTC products that they use.

THE CORRELATION BETWEEN NUTRITIONAL STATUS AND CD8+ T CELL LEVELS IN THE ELDERLY AFTER THE COVID-19 VACCINATION IN PALEMBANG, INDONESIA

Khoirun Mukhsinin Putra — 2022-12-31

The coronavirus disease (COVID-19) is caused by the SARS-CoV-2 virus. WHO officially declared it a pandemic on March 9, 2020. The COVID-19 vaccine has been widely used to control the pandemic, but special attention is needed to some high-risk factors that can affect the vaccine's effectiveness. Elderly patients are 60 years old and have a higher risk of COVID-19. There is a decrease in CD8+ T cell levels due to the involution of the thymus and changes in the cortex and medulla tissue into fat tissue. In addition, malnutrition causes decreased levels of CD8+ T cells. This study aims to determine the correlation between nutritional status and CD8+ T cell levels in elderly patients after COVID-19 vaccination. This research is a pilot study with a cross-sectional design. A consecutive sampling technique did the sampling. On day 28, after the second vaccine, the Mini Nutritional Assessment (MNA) and the number of CD8+ T cells in the blood were used to check the nutrition status. From May through November 2021, 40 subjects were collected. The average CD8+ T cell level in the elderly was 517.32±41.67. As a result, 5 people (12.5%) were at risk of malnutrition, while the normal nutritional status was 35 (87.5%). Correlation analysis showed that MNA and CD8+ levels had a significant correlation (P < 0.05). There is a correlation between nutritional status and CD8+ T cell levels in elderly patients after COVID-19 vaccination in Palembang.

Keywords: Elderly, COVID-19 Vaccination, CD8+ T Cells, Nutritional Status

Tumor Wilms Asimptomatik pada Anak

Nicodemus Suwandy — 2022-12-31

Introduction: Wilms tumor is one of the malignancies frequently found in children, especially children under five years. It is frequently found incidentally by parents or caregivers who notice a lump in the abdomen.

Case :This case reported Wilms tumor found incidentally in an 8-year-old boy. The patient presented with complaints of right lower quadrant pain accompanied by nausea, vomiting and fever. Tenderness and leukocytosis were also found in right lower quadrant. Initial suspicion led to acute appendicitis, however, physical examination also found a mass in the right upper quadrant the patient did not complain of. An abdominal CT scan showed the mass in the right kidney, suggesting a Wilms tumor. The patient underwent surgery.

Discussion : Based on the intraoperative findings of“spillage” and anatomical pathology of “favorable”, the patient was categorized as having stage III favorable Wilms tumor. This case report suggested that careful clinical approach is needed and Wilms tumor should be considered as a differential diagnosis in children with abdominal mass findings.

Keywords : tumor, Wilms tumor, children

Revisiting the role of electrocardiography for screening of congenital heart disease in young adults

Giovanni Jessica — 2022-12-31

Introduction: Congenital heart disease (CHD) is the most prevalent congenital disability found in newborns. Many cases remain unknown until complications occur, usually in young adults. Transthoracic and Doppler echocardiography are modalities of choice for CHD detection, but these are limited in Indonesia. Electrocardiography (ECG) is a widely available and low-cost test. This study investigated the role of ECG as a screening modality for CHD.

Methods: A cross-sectional study was held in Atma Jaya School of Medicine and Health Science from August to November 2019. Participants were students aged 18 years old or more. Exclusion criteria was previously detected CHD. Data were collected through history taking, anthropometrics, blood pressure measurement, and 12 leads ECG. ECG results were interpreted independently by two cardiologists.

Results: A total of 193 students, 78 male and 115 female, were participated. The mean age was 19.22±1.85 years. ECG abnormalities were discovered in 57 (29.5%) participants:15 crochetage sign, 13 right axis deviation, 3 left axis deviation, 9 right ventricle hypertrophy and 9 left ventricle hypertrophy, 6 left bundle branch block, and 2 defective T wave. Further evaluation was done with echocardiography in 20 participants, which resulted in one participant having mitral valve prolapsed (MVP).

Conclusion: ECG could detect the characteristic patterns suggestive of CHD, but ECG alone is insufficient to confirm cardiac structural abnormalities.

Key Words: Congenital heart disease, electrocardiography, echocardiography, screening

Comparison of Intra-articular Injection Therapy of HA, LP-PRP, and LR-PRP Effectiveness Against Knee Pain Complaints in Osteoarthritis: Meta-analysis.

Laurentia Avelia Agatha — 2022-12-31

Background: Osteoarthritis can reduce a person's quality of life due to pain and limitation of motion. Treatment of OA using analgesic and anti-inflammatory drugs has the risk of causing gastric bleeding. Invasive therapy with IA injection has become an option, but because of the risks due to injection and the high cost, it is necessary to conduct a meta-analysis to determine which one is the most effective in reducing pain in knee osteoarthritis (KOA) patients. The results of this study are expected to assist the selection of intra-articular injection therapy that is more effective and appropriate in providing therapy to KOA patients.

Method: Search for RCT articles assessing the effectiveness of IA PRP (LP-PRP or LR-PRP) with IA-HA on pain, with WOMAC score as an outcome measure, from Pubmed, Cochrane, Proquest, ScienceDirect, Clinical Key, and EBSCO hosts. Articles are rated for quality on the JADAD scale. Then the selected will be carried out meta-analysis. The flow of article selection will be presented in the PRISMA flow chart.

Results: Six studies met the eligibility criteria separated based on their variable, leukocyte poor platelet rich plasma and HA and leukocyte rich platelet rich plasma and HA. There is a significant mean difference of WOMAC score in LR-PRP compared to HA (mean difference -5,24) and LP-PRP compared to HA (mean difference-3,82).

Conclusion: The findings of this meta-analysis reveal that intra-articular injection therapy with LR-PRP is superior to LP-PRP and HA at 6 and 12 months, especially for symptomatic knee pain.

Keywords: Knee pain · Knee osteoarthritis · PRP · Platelet-rich plasma · Hyaluronic acid · Meta-analysis · Systematic review · Leukocyte Poor Platelet Rich Plasma · Leukocyte Rich Platelet Rich Plasma ·

Perbandingan Obesitas General dan Obesitas Sentral terhadap Risiko Hipertensi pada Usia Dewasa di Wilayah Kecamatan Cisauk Kabupaten Tangerang

Komang Ardi Wahyuningsih — 2022-12-31

Introduction: Obesity and hypertension are a major health problem worlwide. The incidence of hypertension and obesity increased in recent decades. Obesity is used as risk factors or indicators of hypertension. The objective of this study is to compare the risk of general and central obesity to the hypertension in 26-45 years adult in the District of Cisauk, Tangerang Regency.
Methods: We performed a cross-sectional study, in 26-45 years adult of both sexes with general obesity (body mass index/BMI ≥ 25 kg / m2) and central obesity (waist to height ratio/WtHR >0.50). Each group was 88 subjects collected by using non-probability sampling technique with consecutive sampling method. Body weight, height, waist circumference, and blood pressure were measured in each subject.
Results: Of the 176 adults studied, 26 (14.8%) early adults (26-35 years) while 63 (35.8%) late adults (36-45 years) had hypertension. Prevalence of hypertension in men were 13.6% (24) and women were 36.9% (120). Subjects with a family history of hypertension and currently experiencing hypertension were 52 (29.5%) and 37 (21.0%) without a family history of hypertension. Subjects with family history of hypertension have 2.7 times risk for hypertension than subjects without family history (OR (CI 95%) =2.670 (1.450 –4.919)). Subjects with general obesity significantly have 0.5 times risk for hypertension than subjects without general obesity (OR (CI95%) = 0.457 (0.250 –0.835), p=0.016) and subjects with central obesity have 0.5 times risk for hypertension than subjects without cetral obesity (OR (CI 95%) =0.489 (0.420 –0.569), p=0.243).
Conclusion: The result suggest that the risk of hypertension in general obesity is as strong as in central obesity, based on this result, the health professional can assign obese people and identify the risk of hypertension by calculate BMI or WtHR.
Key Words: body mass index; central obesity; general obesity; hypertension; waist to height ratio.

HUBUNGAN ANTARA PENGGUNAAN ZAT DAN KUALITAS HIDUP PADA SISWA SMA DENGAN RISIKO GANGGUAN BIPOLAR DI KELURAHAN PENJARINGAN JAKARTA UTARA

Josephine Emerencia Stephanie Sudirman — 2022-12-31

Pendahuluan: Gangguan bipolar merupakan gangguan jiwa yang bersifat persistent, dialami seumur hidup, dan memiliki risiko tinggi terjadinya penyalahgunaan zat yang berdampak pada kualitas hidup yang buruk. Penelitian ini bertujuan untuk mengetahui hubungan antara pengunaan zat dan kualitas hidup pada siswa SMA dengan risiko gangguan bipolar di Kelurahan Penjaringan Jakarta Utara.

Metode: Penelitian ini adalah penelitian potong lintang pada 203 siswa SMA di Kelurahan Penjaringan Jakarta Utara. Alat ukur yang digunakan adalah kuesioner demografi, kuesioner World Health Organization Quality of Life - BREF (WHOQOL-BREF), dan Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) yang diisi langsung oleh responden. Analisis data secara deskriptif dan bivariat (chi-square).

Hasil: Sebanyak 96,6% responden didapatkan dengan risiko gangguan bipolar tipe I dan 3,4% tipe II. Terdapat (24,1%) responden dengan risiko gangguan bipolar disertai penggunaan zat dengan zat terbanyak pada laki-laki adalah tembakau (84,6%) dan pada perempuan adalah alkohol (60%). Gambaran kualitas hidup buruk pada responden perempuan dijumpai pada domain hubungan sosial (38,9%), sedangkan gambaran kualitas hidup buruk pada laki-laki dijumpai pada domain hubungan sosial (27,1%) dan lingkungan (27,1%). Analisis bivariat menunjukkan adanya hubungan bermakna antara penggunaan zat dan kualitas hidup domain hubungan sosial dengan risiko gangguan bipolar (p=0,001; 95% CI=1,505-5,659; OR=2,918).

Simpulan: Penyandang gangguan bipolar dengan penggunaan zat memiliki kualitas hidup buruk pada domain hubungan sosial.

Kata Kunci: bipolar, kualitas hidup, remaja, penggunaan zat

Liquid Biopsy in Colorectal Cancer: Hopes and Challenges

Rebecca Noerjani Angka — 2022-12-31

Introduction: Global Cancer Statistics 2020 shows the incidence of colorectal cancer is in third ranks with the second highest mortality rate. Liquid biopsy in colorectal cancer have begun to study circulating tumor cells, namely circulating tumor cells (CTCs) and cell-free circulating tumor DNA (ctDNA/cfDNA). The purpose of writing this article is to find and review the studies that have been conducted on liquid biopsy both in terms of methods, results and clinical benefits in colorectal cancer.

Methods: The literature searches were conducted through Embase, Scopus and PubMed. From the 143 articles found during the initial search, after going through the final selection stage, 16 articles were determined that met the inclusion criteria.

Results: Liquid biopsy can be used to detect mutations that are not found in the primary tumor of colorectal cancer patients and the combined analysis of circulating cell-free DNA (ccfDNA) and ctcDNA can increase the number of detected mutations. Analysis of serially collected plasma ctDNAs enables the detection of emerging mutant ctDNA, which can be used to monitor patient disease progression and discover resistance mechanisms. Serial sampling of patients showed that a decrease in methylation occurred in patients who responded well to treatment, both surgery and chemotherapy. In contrast, untreated or relapsed patients showed increased methylation. MSI status in colorectal cancer detected via cfDNA was relatively consistent with that in tumor tissue samples.

Conclusion: The advantage of liquid biopsy is that blood is easier to obtain, effective and less invasive than biopsy, especially in tumors that are difficult to reach by biopsy. Liquid biopsies can be repeated serially so that they can be used to monitor disease progression, determine treatment response and determine prognosis.

Key Words: colorectal cancer, liquid biopsy, mismatch repair