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INDONESIA
Indonesian Journal of Medicine
Published by Universitas Sebelas Maret
ISSN : -     EISSN : 25490265     DOI : -
Core Subject : Health,
Medicine & Pharmacology Public Health
Indonesian Journal of Medicine (IJM) is an international, open-access, and double-blind peer-reviewed journal, focusing on the intersection of biomedical science, clinical medicine, and community medicine. The journal began its publication on August 20, 2015, and is published online three times yearly. It is academically designed for all physicians, health researchers, and health care professionals, regardless of their medical specialties, or type of employment.
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Articles 12 Documents
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Search results for , issue "Vol 6, No 3 (2021)" : 12 Documents clear
Meta-Analysis of Re-perfusion Injury and Ischaemic Conditioning in Limb Surgery
Indonesian Journal of Medicine Vol 6, No 3 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

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 Effectiveness of Using Antiplatelet Drugs Uptake in Decreasing Mortality in COVID-19 Patients
Indonesian Journal of Medicine Vol 6, No 3 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Viscoelastic coagulation testing in COVID-19 patients often found elevated concentrations of D-dimer and fibrinogen. Thrombotic complications can be in the form of Venous Thromboembolism (VTE), where this thrombotic disease is one of the factors associated with increased mortality of COVID-19 patients. This study aims to analyze the effectiveness of antiplatelet drugs in reducing mortality in COVID-19 patients.Subjects and Method: This is a meta-analysis study using PRISMA flowchart guidelines. The article search process was carried out between 2020-2021 using PubMed, Science Direct, Google Scholar, and Scopus databases. The article search was carried out by considering the eligibility criteria defined in the PICO model. Population= COVID-19 patients, Intervention= using antiplatelet drugs, Comparison= not using anticoagulant drugs, Outcome= mortality. The keywords used were "antiplatelet" AND "mortality" AND "COVID-19". The inclusion criteria used were English full-text cohort papers and the relationship measure used as the adjusted odds ratio (aOR). Based on the database, 9 articles fulfilled the inclusion criteria. The analysis was carried out using RevMan 5.3 software.Results: The meta-analysis was carried out on 9 articles from the UK, Spain, Germany, Poland, America, Israel, and China. The results of data processing showed that COVID-19 patients who received antiplatelet drugs had a 0.70 times risk of dying than those without antiplatelet drugs, and it was not statistically significant (aOR= 0.70; CI 95%= 0.46 to 1.07; p= 0.100).Conclusion: The use of anticoagulant drugs reduces the mortality risk of COVID-19 patients, but it is not statistically significant.Keywords: antiplatelet, mortality, COVID-19Correspondence: Happy Nurhayati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: happyajja3@gmail.com. Phone: +62 81226160538.Indonesian Journal of Medicine (2021), 06(03): 315-324https://doi.org/10.26911/theijmed.2021.06.03.09
The Relationship between Tumor Size and Carcinoembryonic Antigen (CEA) Levels in Stage IV Colorectal Adenocarcinoma Patients at Dr. Moewardi Hospital, Indonesia
Indonesian Journal of Medicine Vol 6, No 3 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Colorectal adenocarcinoma is one of the most common types of colorectal cancer based on histopathology, accounting for about 10% of cancer cases diagnosed worldwide each year. Tumor size and levels of carcinoembryonic antigen (CEA) are used to determine the presence and evaluation of colorectal cancer. However, studies on the correlation between the size of colorectal cancer based on CT scan abdominal with contrast and the CEA levels are still very minimal in the Indonesian population. This study aimed to analyze the relationship between tumor size examined by abdominal CT scan with contrast and carcinoembryonic antigen (CEA) levels in stage IV colorectal adenocarcinoma patients.Subjects and Method: A cross-sectional study was conducted at the radiology department, Dr. Moewardi hospital, Surakarta, from February 2021 to July 2021. A total of 40 patients with stage IV colorectal adenocarcinoma were selected in this study. The patient already had the examination results of blood CEA levels and performed an abdominal CT scan with contrast. The dependent variable was blood CEA levels. The independent variable was tumor size. Data were collected from medical records and analyzed by the Spearman test.Results: There was a positive and significant relationship between tumor size and CEA levels (r= 0.47; p= 0.003).Conclusion: Tumor size is positively correlated to blood CEA levels in patients with stage IV colorectal adenocarcinoma.Keywords: colorectal adenocarcinoma, contrast abdominal CT scan, carcinoembryonic antigen (CEA).Correspondence: Sulistyani Kusumaningrum. Department of Radiology Dr. Moewardi Hospital/ Faculty of Medicine of Universitas Sebelas Maret, Surakarta. Email: sulistyani_sprad@staff.uns.ac.idIndonesian Journal of Medicine (2021), 06(03): 285-290https://doi.­org/10.26911/theijmed.2021.06.03.05
Association between Troponin I and Mortality in COVID-19 Patients: Meta-Analysis Study
Indonesian Journal of Medicine Vol 6, No 3 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: COVID-19 is a new disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 became a pandemic disease that killed 4 million people for almost 2 years. COVID-19 patients with comorbidities or risk factors are more prone to have a worse prognosis, one of which is heart disease which can be checked through troponin I values. This study aimed to determine the relationship between troponin I levels and mortality in patients with COVID-19.Subjects and Method: This was a systematic review and meta-analysis by searching for articles from databases such as Science Direct, Springer, Google Scholar, and PubMed using the keywords: troponin I, cohort, fatality, cardiac biomarker, death, coronavirus, COVID-19 mortality, and COVID-19. Ten accredited articles published between 2019-2021 were included for meta-analysis. The subjects of this study were 10,499 COVID-19 patients. The intervention in this study was high troponin I levels, while the comparison was normal troponin I levels. The outcome of this study is mortality in COVID-19 patients. Data processing using Review Manager software version 5.3 for the relationship between troponin I levels and mortality in COVID-19 patients.Results: From a meta-analysis of 10 primary research articles in China, Spain, New York (United States), France, Turkey, and Philadelphia (United States) showed an association between high troponin I levels and an increased risk of mortality in COVID-19 patients (aOR= 3.07; 95% CI= 1.68 to 5.61; p<0.003).Conclusion: High troponin I levels increase the risk of mortality in COVID-19 patients.Keywords: troponin I, heart disease, mortality, COVID-19.Correspondence: Hesthi Krisnawati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: hesthikrisna86@gmail.com. Mobile: +62852780­67840.Indonesian Journal of Medicine (2021), 06(03): 347-353https://doi.org/10.26911/theijmed.2021.­06.03.12 
The Effectiveness of Ethanol Extract Chayote (Sechium Edule (Jacq.) Swartz) Fraction and Juice on Pancreatic β-Cell Diameter of Male White Rats Wistar Strain with Type 2 Diabetes Mellitus
Indonesian Journal of Medicine Vol 6, No 3 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Diabetes Mellitus is character­rized by metabolic disturbances due to pro­longed hyperglycemia, causing oxidative stress, which destroys pancreatic β cells. Adjuvant therapy that has antihyperglycemic effective­ness and is required to improve the diameter of pancreatic beta cells, one of which comes from Sechium edule (Jacq.) Swartz has poten­tial as an antihyperglycemic, antioxidant, anti­apop­tosis, cardioprotective, insulin resistance. This study aimed to examine the effectiveness of ethanol extract, Chayote (Sechium Edule (Jacq.) Swartz) fraction, and juice on the pancreatic β-cell diameter of white male rats Wistar strain with type 2 diabetes mellitus.Subjects and Method: This was a rando­mized controlled trial. Sample was Rattus novergius sp. 54 tails. The dependent variable was the diameter of the pancreatic β cells. The independent variables were ethanol extract, Sechium edule (Jacq.) Swartz fraction and juice, at a dose of 50 mg/kg BW, 100 mg/ kg BW, 150 mg/kg BW. The data were analyzed by the ANOVA test.Results: The group of mice induced by Strep­tozotocin 50 mg/kg BW + nicotinamide (120 mg/ kg BW) + HFD and obtained ethanol extract of chayote fruit 150 mg/ kg BW, orally, had the highest pancreatic β cell diameter com­pared to the other groups (Mean= 284.03; SD= 5.15).Conclusion: Sechium edule (Jacq.) Swartz has potential as an anti-apoptosis that can inhibit pancreatic β cell damageKeywords: pancreatic β cells, anti-apoptosisCorrespondence: Sanggam Bangun Hutagalung. Department of Anatomical Pathology, Faculty of Medicine, Universitas Methodist Indonesia, Medan. Jl. Setia Budi Pasar II Tj. Sari, Medan 20132, North Sumatera. Email: sanggam1973@­gmail.com.Indonesian Journal of Medicine (2021), 06(03): 239-245https://doi.org/10.26911/theijmed.­2021.06.03.01 
Comparison of the Effectiveness of the Chemosurgery and Cryosurgery for the Treatment of Patients with Condyloma Acuminatum at Dr. Moewardi Hospital, Surakarta
Indonesian Journal of Medicine Vol 6, No 3 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Condyloma acuminatum (CA) is one of the most common sexually transmitted infections. Several therapeutic modalities that can be used are chemosurgery with trichloroacetic acid and cryosurgery with liquid nitrogen. Recurrence in CA often occurs, so selecting the right therapeutic modality and eliminating the lesion also prevents recurrence. This study aimed to compare the effectiveness of chemosurgery and cryosurgery therapy in patients with CA who are treated at Dr. Moewardi Hospital, Surakarta.Subjects and Method: A retrospective cross-sectional study was conducted at the Dermatology and Venereology Polyclinic, Dr. Moewardi Hospital, Surakarta, from January 1, 2018, to December 31, 2020. The study subjects were 78 patients diagnosed with CA based on ICD-10 criteria, while chemosurgery and cryosurgery procedures were based on ICD-9. The dependent variable was healing time in weeks. The independent variables were chemosurgery and cryosurgery therapy. The data came from the patient's medical record. Data were analyzed using an independent t-test.Results: Based on univariate analysis, most patients were male (67.9%), and the age group was 20-29 years (51.28%). Most of the CA patients work as private employees (46.15%). The most sexual orientation was heterosexual (53.8%), the most common site of lesions was genital (47.4%), and 52.6% were coinfected with HIV. Most CA patients received chemosurgery (70.5%). Bivariate analysis showed that chemosurgery therapy provided faster clinical improvement (Mean= 23.34; SD= 26.45) than cryosurgery therapy (Mean= 28.69; SD= 19.84), and the difference was statistically significant (p= 0.037).Conclusion: Treatment of CA using chemosurgery provides clinical improvement faster than cryosurgery, so that faster treatment time can reduce treatment costs and improve the patient's quality of life.Keywords: chemosurgery, cryosurgery, HPV, condyloma acuminatumCorrespondence: Prasetyadi Mawardi. Department of Dermatology and Venereology, Faculty of Medicine of Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta, Central Java, Indonesia. Email: prasetyadimawardi@gmail.com/ prasetyadi_m@staff.uns.ac.id. Mobile: +6281229750211.Indonesian Journal of Medicine (2021), 06(03): 290-297https://doi.org/10.26911/theijmed.2021.06.03.06
The Effectiveness of Electro-acupuncture in Reducing Body Weight in Obese Patients: A Meta-Analysis
Indonesian Journal of Medicine Vol 6, No 3 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Obesity is a problem that is starting to be found, not only in urban areas with high socioeconomic status but also in children living in rural areas, even from middle to lower socio­economic groups. This study aimed to examine the effectiveness of electro-acupuncture in obesity cases.Subjects and Method: Meta-analysis was carried out with PICO: The population in this study were obese patients aged 16-65. The intervention was in the form of electro-acupuncture therapy. Comparison in the form of sham/ placebo acupuncture. The outcome is weight loss. A meta-analysis study was applied with electronic data sources: Clinical Key, Google Scholar, MED­LINE/PubMed, Science Direct, Scopus. The articles included were full-text with a Ran­domized Control Trial (RCT) study design. There were 10 articles used in this study with a sam­ple size of 818 people who were divided into two groups (455 people in the acupuncture group and 363 people in the sham/placebo acupuncture group). Articles were analyzed using the Review Manager 5.4 application. The data were analyzed using Standardized Mean difference (SMD) and the heterogeneity of the research sample.Results: There was high heterogeneity between one experiment and another (I2= 86%; p<0.001), so the Random Effect Model (REM) was used. Electroacupuncture therapy was effective in reducing body weight with a Standardized Mean Different (SMD) of 0.50 compared to false acupuncture (SMD= -0.50; 95% CI= -0.92 to -0.08; p= 0.020).Conclusion: Acupuncture therapy can lose weight in obesity cases with a Standardized Mean Different (SMD) of 0.50 compared to fake acupuncture.Keywords: acupuncture, obesityCorrespondence: Nurmila Mutiah. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta, Central Java, Indonesia. Email: nurmilamutiah77@gmail.com.Mobile: +6287730797747.Indonesian Journal of Medicine (2021), 06(03): 325-335https://doi.org/­10.26911/theijmed.­2021.06.03.10 
Meta-Analysis of the Effect of Telemonitoring on Blood Sugar Levels and Quality of Life in Diabetes Patients
Indonesian Journal of Medicine Vol 6, No 3 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Type 2 diabetes mellitus (DM), a chronic disease, requires continuous monitoring and treatment to have a better quality of life. Telemonitoring is a medium that may help in monitoring patients with type 2 DM. This study aimed to analyze the effect of using telemonitoring on blood sugar levels and quality of life of patients with type 2 DM with a meta-analysis study.Subjects and Method: This was a systematic review and meta-analysis conducted with PRISMA flow diagram. The arti­cles were collected through journal databases, including PubMed, Google Scholar, Science Direct, and ProQuest, published in 2000-2021. The keywords used were ("tele­medicine" OR "tele-monitoring" OR "tele-monitoring") AND ("diabetes" OR "diabetes mellitus" OR "diabetes mellitus type 2") AND ("glucose level") AND ("quality of life"). The searching of articles used the PICO model. Population: people with type 2 diabetes mellitus, Intervention: telemonitoring, Comparison: not using telemonitoring, Outcome: blood sugar level and quality of life. Inclusion criteria were full-text articles with Randomized Controlled Trial (RCT) study design, published in English, with the effect measure of Mean SD. Eligible articles were analyzed using Revman 5.3.Results: A meta-analysis of 11 primary studies on the use of telemonitoring of blood sugar level showed a decrease in blood sugar (HbA1c) levels in patients with type 2 diabetes by 0.20 times compared to not using telemonitoring (SMD= -0.20; 95% CI= -0.39 to -0.01; p= 0.040). A meta-analysis of 6 primary studies on the use of telemonitoring on quality of life showed an increase in quality of life in type 2 diabetes patients by 0.16 times compared to not using telemonitoring (SMD= -0.16; 95% CI= -0.29 to -0.03; p= 0.020).Conclusion: Telemonitoring can improve blood sugar levels and the quality of life of patients with type 2 diabetes.Keywords: telemonitoring, type 2 diabetes mellitus, quality of life, meta-analysisCorrespondence: Anisa Asri Sholihah. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Suta­mi 36A, Surakarta 57126, Central Java. Email: anisaasri92@gmail.com. Mobile: 085740972­908.Indonesian Journal of Medicine (2021), 06(03): 246-257https://doi.org/10.26911/theijmed.2021.06.03.02 
The Agreement of Immunoglobulin Gamma Release Assay (IGRA)/ T-SPOT Tuberculosis and Tuberculin Skin Test to Detect Latent TB Infection in Diabetes Mellitus Patients
Indonesian Journal of Medicine Vol 6, No 3 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: WHO identifies diabetes mellitus (DM) as a neglected risk factor for tuberculosis (TB). Currently, there is no gold standard test for latent TB infection (LTBI). Centers for Disease Control and Prevention (CDC) recommends using Tuberculin Skin Test (TST) and Immunoglobulin Gamma Release Assay (IGRA) to diagnose LTBI. TST is an LTBI classic diagnostic tool that has low sensitivity and specificity. But it is still preferred in diagnosing LTBI due to its lower price, and more health facilities can perform the examination compared to IGRA (T-SPOT.TB). The study aimed to measure the agreement of TST and T-SPOT.TB testing in detecting LBTI in DM and the correlation of HbA1c with TST and T-SPOT.TB.Subjects and Method: Subjects were DM patients who underwent TST and T-SPOT.TB testing. If the results of TST and T-SPOT.TB was positive, the test would be continued with Xpert MTB/RIF microbiological testing. TST used PPD RT23 2TU. T-SPOT.TB was performed toward peripheral blood mononuclear cells. The degree of agreement between TST and T-SPOT.TB testing was calculated using the Test of Agreement (Kappa Cohen). The degree of correlation between the two variables was calculated by using Pearson correlation.Results: The selected 30 study subjects with DM undergoing antidiabetic therapy showed 6 (20%) detected LTBI and 24 (80%) without LTBI using TST and T-SPOT.TB test. There was a substantial agreement level between TST and T-SPOT.TB testing in detecting LTBI among diabetes mellitus patients undergoing anti-diabetic therapy with kappa value= 0.62 (p<0.001). HbA1c increased T-SPOT (r= 0.07; p= 0.716) and TST (r= 0.11; p= 0.956).Conclusion: TST testing may substitute T-SPOT.TB to detect LTBI among diabetes patients undergoing antidiabetic therapy.Keywords: latent tuberculosis infection, diabetes mellitus, TST, Immunoglobulin Gamma Release Assay (IGRA), T-SPOT.TBCorrespondence: Reviono. Department of Pulmonology and Medical Respiratory, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta, Indonesia. Email: reviono@staff.uns.ac.id.Indonesian Journal of Medicine (2021), 06(03): 298-306https://doi.­org/10.26911­/theijmed.2021.06.03.07
Meta Analysis the Effectiveness of Acupuncture vs Sham Acupuncture on Low Back Pain
Indonesian Journal of Medicine Vol 6, No 3 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Low Back Pain is pain, aches and pains that occur in the lower back area and can be local pain or radicular pain. Acupuncture is a non-pharmacological therapy that can be used as an option to treat low back pain. This study aims to examine the effectiveness of acupuncture and sham acupuncture on reducing pain in cases of low back pain.Subjects and Method: Meta-analysis was carried out with PICO as follows: The population in this study were patients with low back pain with an age range of 20-95 years. Intervention in the form of acupuncture therapy. Comparison in the form of sham acupuncture. Outcome in the form of pain scale. A meta-analysis study was applied to this study with electronic data sources Clinical Key, Google Scholar, MEDLINE/PubMed, Science Direct, Scopus, and Springer. The article used is a full-text article with a Randomized Control Trial (RCT) study design. There are 9 articles used in this study. Articles were analyzed using the Review Manager 5.3 application. The results of this study aim to determine the Standardized Mean difference (SMD) and the heterogeneity of the research sample.Results: The heterogeneity in the results of this study was I^2=79%; p < 0.001, so it was analyzed by Random Effects Model (REM). Acupuncture was more effective in reducing pain than sham/placebo acupuncture, with a statistical significance of (SMD -0.59; 95% CI = -0.88 to -0.30; p<0.001.Conclusion: Acupuncture is more effective than sham/placebo acupuncture in reducing pain scale in cases of low back pain.Keywords: Acupuncture, Sham Acupuncture, Low Back PainCorrespondence: Nurtama Aditya Nugraha. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Su­ta­mi 36A, Surakarta 57126, Central Java. Email: nurtamaaditya@gmail.com. Mobile: +628222­0212767.Indonesian Journal of Medicine (2021), 06(03): 336-346https://doi.org/10.26911/theijmed.2021.06.03.11 

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