Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)

Comparison of Rapid Typhidot Test Based on Sanitation Environment in Healthy Individuals in Medan

Robby Awaluddin Perangin-Angin, Rina Amelia, Jelita Siregar — Wed, 20 Nov 2024 00:00:00 +0700

Typhoid fever is a gastrointestinal tract infectious disease frequently found endemic in Indonesia, which can be transmitted by oro-fecal from food or water contaminated directly or vector carries these bacteria. Medan Belawan subdistrict has a high rate of diarrhea cases and a low percentage of a health-house model. Otherwise, the Medan Petisah subdistrict has fewer diarrhea cases and a high percentage of the health-house model. This study was aimed to compare the presence of antibodies from the Typhidot Test in people living in poor and healthy sanitation conditions. This study is an observational study with a cross-sectional design. The population is all people around Medan Petisah and Medan Belawan health center. All data were calculated using SPSS and analyzed with Chi-Square and Regression Logistics tests. The result indicates no significant association between the presence of IgM and IgG from the results of the Typhidot test on environmental sanitation in Medan (p>0.05). Thus, it can be concluded that Sanitation conditions did not affect the formation of IgM and IgG against Salmonella Typhi bacteria.

Factors Associated with Treatment Outcome of Shorter Treatment Regimen (STR) for MultiDrug-Resistant Tuberculosis (MDR-TB)

Wed, 20 Nov 2024 00:00:00 +0700

ABSTRACT
Background: Indonesia ranked 2^nd around the world for TB cases with case population continue increasing. In 2018, Shorter Treatment Regimen (STR) was introduced as a new regimen for treating MDR-TB patient. The aim of this study is to determine factors associated with treatment outcome of MDR-TB patients treated with Shorter Treatment Regimen Methods: This is a descriptive-analytic study using cross sectional design which was conducted at Adam Malik Hospital Medan. Subject was 150 patients with drug-resistant Pulmonary TB at MDR-TB polyclinics according to inclusion and exclusion criteria Results: MDR-TB patients that treated with STR was mostly < 50 years old (65.2%) and 107 subjects (70.4%) were male. The majority of subjects with comorbidity were 94 subjects (61.8%); 43 subjects (28.3%) with DM, 5 subjects (3.3%) with CHF, 3 subjects (2.0%) with HIV, 1 subject (0.7%) with DM & CHF, and 1 subject (0.7%) with DM & HIV. When evaluated the patients treatment outcome, 47.4% were cured, 6.6% were failed, 34.8% were default and 11.2% were death. A chi square test was conducted to assess association between age with treatment outcome. Age was significantly associated with treatment outcome (p=0.038) but gender and comorbidity were not associated with treatment outcome with p-value 0.152 and 0.497 (p>0,05) respectively. Conclusions: There is a significant association between age and treatment outcome but no significant association between gender and comorbidity with treatment outcome.

ABSTRAK
Latar Belakang: Indonesia menduduki peringkat ke-2 dunia untuk kasus TBC dengan populasi kasus yang terus meningkat. Pada tahun 2018, Shorter Treatment Regimen (STR) diperkenalkan sebagai rejimen baru untuk mengobati pasien TB-MDR. Tujuan dari penelitian ini adalah untuk mengetahui faktor-faktor yang berkorelasi dengan hasil pengobatan pasien TB-MDR yang diobati dengan Regimen STR. Metode: Penelitian ini merupakan penelitian deskriptif-analitik dengan desain cross-sectional yang dilakukan di Rumah Sakit Adam Malik Medan. Subyek penelitian adalah 150 pasien TB Paru Resisten Obat di poliklinik TB MDR sesuai kriteria inklusi dan eksklusi. Hasil: Pasien TB-MDR yang diobati dengan STR sebagian besar berusia <50 tahun (65,2%) dan berjenis kelamin laki-laki sebanyak 107 subjek (70,4%). Mayoritas subjek dengan penyakit penyerta sebanyak 94 orang (61,8%); 43 orang (28,3%) DM, 5 orang (3,3%) CHF, 3 orang (2,0%) HIV, 1 orang (0,7%) DM & CHF, dan 1 orang (0,7%) DM & HIV. Hasil pengobatan adalah 47,4% sembuh, 6,6% gagal, 34,8% putus berobat dan 11,2% meninggal. Uji chi square dilakukan untuk menilai hubungan antara usia dengan hasil pengobatan dan didapatkan nilai p = 0,038 yang menunjukkan adanya hubungan yang signifikan namun berdasarkan jenis kelamin dan penyakit penyerta ditemukan nilai p masing-masing 0,152 dan 0,497 (p>0,05) yang menunjukkan tidak ada hubungan antara jenis kelamin dan penyakit penyerta terhadap hasil pengobatan. Kesimpulan: Terdapat hubungan yang signifikan antara usia dan hasil pengobatan namun tidak ada hubungan yang signifikan antara jenis kelamin dan penyakit penyerta dengan hasil pengobatan.

Role of Malondialdehyde Levels in The Occurrence of Hypogonadism in Transfusiondependent Thalassemia Male Patients

Wed, 20 Nov 2024 00:00:00 +0700

Male hypogonadism is a clinical syndrome resulting from the failure of the testes to produce adequate testosterone. Thalassemia major is an autosomal recessive disorder characterized by the absence or severe deficiency of the synthesis of the ß-globulin chain of hemoglobin that causes severe anemia requiring lifelong transfusions. Chronic blood transfusion in patients with ß-thalassemia leads to the accumulation of transfusion-associated iron in the tissues. Iron accumulation in the testes and pituitary gland generally leads to a state of hypogonadism. In patients undergoing repeated transfusions, there can be increased oxidative stress which can be assessed by examining malondialdehyde (MDA) levels. Increased oxidative stress can also affect a person's reproductive process through damage to pituitary tissue and LH hormones, which ultimately results in a decrease in a person's testosterone levels. Our aim is to see the correlation between malondialdehyde levels and free testosterone in male patients with transfusion-dependent thalassemia. This study used a cross-sectional design conducted at the Thalassemia polyclinic of RSCM and Fatmawati from January to March 2023. The study samples were transfusion-dependent thalassemia patients who met the acceptance criteria of the study subjects. Each patient underwent venous blood collection and was examined for serum ferritin levels, transferrin saturation, FSH levels, LH levels, free testosterone levels and MDA. The data obtained will be recorded and processed using the SPSS 20 program. Forty-one male subjects with transfusion-dependent thalassemia had a median free testosterone of 14.53 pg/mL (minimum-maximum 0.1-35.78). Twelve subjects (29%) of them had low testosterone levels. The median MDA level was 2.22 uM (0.18-2.61). There was no significant correlation between free testosterone and MDA (r=-0.18, p=0.261). There were high MDA levels in men with transfusion-dependent thalassemia. High MDA levels had no correlation with free testosterone in men with transfusion-dependent thalassemia.

HYDROGEL-BASED WOUND DRESSING IN THE TREATMENT OF DIABETIC FOOT ULCERS: A NARRATIVE REVIEW

Faisal Rozi Sembiring, Brama Ihsan Sazli — Wed, 20 Nov 2024 00:00:00 +0700

ABSTRACT
Background: The aim of this case study is to determine the effectiveness of hydrogel-based wound dressing (HBWD) in the treatment of diabetic foot ulcer (DFU) in diabetic patients.
Methods: Method in this case study is evidence-based case report. The clinical question used: Are HBWDs effective in the treatment of DFU, especially in the limited-resources healthcare facilities? To answer this question, we search the evidence from PubMed, Cochrane Database, Semantic Scholar, and Google Scholar with various keywords based on the clinical question. The studies were selected based on pre-determined inclusion and exclusion criterias and were critically appraised.
Results: Four randomized controlled trials (RCTs) that met the inclusion and exclusion criterias were found. There are no significant difference in reduction of ulcer area (RUA) rate or complete wound closure (CWC) rate in all RCTs. When compared to control or non-hydrogel group, three studies reported some favoring aspect in HBWD group, such as less inflammatory signs and faster CWC mean time.
Conclusion: HBWDs are recommended in the treatment of DFU because they are widely available, cost-effective, and relatively easy to use.

THE RELATIONSHIP BETWEEN CD4 LEVELS AND FEATURES TOXOPLASMOSIS ENCEPHALITIS FROM NON-CONTRAST HEAD CT-SCAN HIV PATIENTS

Muhammad Rizky Ananda Hasibuan, Henny Maisara Sipahutar — Wed, 20 Nov 2024 00:00:00 +0700

Background: HIV/AIDS is known to cause central nervous system disorders, including opportunistic infections such as toxoplasmosis, triggered by Toxoplasma gondii. The activation of T. gondii is particularly prevalent in immunocompromised individuals, especially those with CD4 counts below 50. CT scans are commonly used for diagnosing cerebral toxoplasmosis.

Methods: This analytical research employs a cross-sectional design starting from February 2023 at H. Adam Malik General Hospital, Medan. Descriptive data analysis includes variables like age, gender, and CD4 levels. Bivariate analysis was conducted using Chi-square and Fisher Exact tests.

Results: The majority of subjects were male (66.7%), with an average age of 36.43 years. Sixty percent of patients had CD4 levels < 200 cells/mm3, while 40% had CD4 levels > 200 cells/mm3.

Conclusion: HIV patients with toxoplasmosis encephalitis typically exhibit clinical symptoms such as headaches and altered consciousness. CD4 levels are associated with the localization of lesions in brain lobes (frontal, occipital, temporal, parietal) and perifocal edema.

ASSOCIATION OF TRIGLYCERIDE / HIGH-DENSITY LIPOPROTEIN RATIO (TG/HDL RATIO) TO SPECIFIC RISK FACTORS OF DIABETES AND PREDIABETES

Melati Silvanni Nasution, Muhammad Aron Pase, Ali Nafiah Nasution — Wed, 20 Nov 2024 00:00:00 +0700

Background: Diabetes is a group of metabolic diseases characterized by hyperglycemia due to defects in insulin secretion, insulin action, or both. Prediabetes is a precursor before the diagnosis of diabetes. Patients with prediabetes and diabetes have several risk factors, one of which is dyslipidemia. The TG/HDL ratio is found to be positively associated with insulin resistance and CVD. This study was conducted to determine whether there is a relationship between TG/HDL ratio and the incidence of prediabetes and diabetes.

Method: This analytic cross-sectional study was conducted on July-December 2023. The study samples were prediabetic and diabetic patients who met the acceptance criteria of the study subjects. They were tested for BMI, BG, HbA1C and lipid profile. Data analysis used paired t test and Pearson correlation

Result: In this study, BMI was greater in the prediabetes group than the diabetes group. There was a negative correlation between age, BG and HDL levels on TG/HDL ratio in prediabetic and diabetic patients. There was a significant relationship between fasting BG, 2 hours after meals BG, HbA1C and TG/HDL ratio when compared between the prediabetes and the diabetes group.

Conclusion: In this study, there was no association between TG/HDL ratio in prediabetes and diabetes.

Keywords: Prediabetes, diabetes, TG, HDL, HbA1c