Sumatera Medical Journal

Parasite Contamination of Water Source at Pangkalan Masyhur Sub-district, Medan Johor District

Sunna Vyatra Hutagalung — 2024-09-05

According to World Health Organisation (WHO) estimates, at least 1,8 billion people consume contaminated water worldwide, hence most of the diarrheal disease in the world is attributable to unsafe water, and the lack of sanitation and hygiene. Water utilization by humans and animals can generate biological pollutants which may contaminate the water. These contaminants come from waste products that may contain bacteria, protozoa, and other parasites. This was a descriptive study with cross sectional design and simple random sampling to determine the contamination of water source by pathogens, particularly parasites at Region V Pangkalan Masyhur sub-district, Medan Johor district, Medan, North Sumatera in 2012. Samples were obtained from each house, depending on the main water source used, either from tap water, open wells, or the nearby river streams. Modified Caldwell’s sedimentation technique was applied to examine the samples under light microscope. Out of the 103 water samples collected, most were from tap water (78 samples), followed by open wells (19 samples), and only six were from the nearby river streams. We found Paramecium caudatum from nine samples (8,7%) collected from the open wells and the nearby river streams, followed by hookworm larva in one tap water sample (1%). No protozoa such as Entamoeba spp., Cryptosporidium spp., and Giardia spp. found in any of the samples. Based on this data, the abundant presence of P.caudatum represented the condition of high organic debris in the open wells and the nearby river streams. Additionally, the presence of hookworm larva in the tap water indicated the distribution system was contaminated with the surrounding soil. Hence it is imperative to provide counseling about optimal environmental sanitation and clean water management, including proper maintenance for water source and its distribution system. Tap water distribution, including its network of pipe deliverance system, must be checked and maintained regularly.

Frequency Distribution of Oncology Patients Who Come to Emergency Department at H. Adam Malik Hospital, Medan

Kamal Basri Siregar — 2024-09-05

A multidisciplinary approach is needed to comprehensively evaluate cancer patient’s condition and understanding patient demographic characteristics can improve health care by adapting to each patient's needs. This research is a descriptive observational study with a cross-sectional study design conducted at the Haji Adam Malik General Hospital in Medan on oncology patients who met the inclusion criteria. Data with a numerical measuring scale will be presented in mean+standard deviation (SD) and data with a categorical measuring scale will be presented in frequencies and percentages. The results showed that majority of patients were in 46–59 year age group as much as 32 patients (37.2%) and 58 patients (67.4%) were female. The highest level of education was found in 26 patients (30.2%) as bachelor, and 45 patients (52.3%) lived in Medan City. Most patients came to be treated at the surgical installation as many as 50 patients (25.6%). The research results found that majority of patients are in the age group 46-59 years, female, bachelor, domicile in Medan and are treated in surgical installation.

Associations between Knowledge, Attitude and Behavior with Helminthiasis in Children

Agnesia Alyssa — 2024-09-05

Soil-transmitted helminths (STH) infection is currently one of the highest prevalence neglected tropical diseases in children. Factors contributing to such case are children’s hygiene, as well as the existence of helminths in the surrounding soil. A child’s education has large influence on their behavior and attitude towards hygiene. However, previous studies showed varying results on wether hygiene affects the rate of STH infection. Therefore, this research is done to determine whether there is significant association between hygiene and STH infection in children. This observational analysis with a cross-sectional design was conducted on elementary school children by interviewing the children and obtaining fecal samples. Analysis of 197 fecal samples shows that 14.7% of the children were infected with STH and results of the interview show more children had poor knowledge about STH infection (69%). Good hygiene attitude and behavior were found in the majority of the subjects (58.9% and 81.7% respectively). The chi-square analysis performed shows no significant relation between knowledge (p=0.626), attitude (p=0.975), and behavior (p=0.376) and the incidence of STH infection. In this study, although children demonstrated poor knowledge of STH infection but had good hygiene attitudes and behaviors, there was no significant link between these factors and STH infection. This emphasizes the need for ongoing hygiene education in elementary school children.

Lipid Profile in Type 2 Diabetes Mellitus Patients with and without Diabetic Retinopathy

Fadhlan Hatta Agustian — 2024-09-05

Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia due to abnormalities in insulin secretion, insulin action, or both. Diabetic retinopathy is the most common microangiopathic complication of DM and one of the leading causes of blindness in the world. Poor lipid profile levels are one of the risk factors for diabetic retinopathy. Objective: To analyze differences in the proportion of lipid profile categories in type 2 DM patients with and without diabetic retinopathy. Methods: This was a hospital-based cross-sectional study with 45 samples. The independent variables assessed were the lipid profile, including LDL, HDL, triglycerides, and total cholesterol levels. The dependent variable assessed was the incidence of diabetic retinopathy. The analysis used were univariate and bivariate (Chi-square and Fisher exact). Results: The prevalence of diabetic retinopathy was 37.8%, consist of 17.8% of NPDR and 20% of PDR. There were significant differences in the proportion of LDL categories (p=0.007) and total cholesterol (p=0.038) in type 2 DM patients with and without diabetic retinopathy, and there were no significant differences in the proportion of HDL categories (p=0.719) and triglycerides (p=1) in type 2 DM patients with and without diabetic retinopathy. Conclusion: There were significant differences in the proportion of LDL categories and total cholesterol in type 2 DM patients with and without diabetic retinopathy.

Parents Education is One of Affected Factor in Stunted Children Profile in Pekanbaru

Nabillah Nastiti Wardhana — 2024-09-05

Stunting is a developmental disorder in children caused by poor nutrition, recurrent infections, and inadequate psychosocial stimulation, marked by the child's height or length being below the threshold (Z-Score) of -2 standard deviations. The prevalence of stunting in Pekanbaru remained high, at 11.4%. To examine the family profiles with stunted children based on indicators of acceleration stunting reduction. This was descriptive research with quantitative data, and the sample size was 75. The variables studied included family profiles based on the stunting reduction acceleration indicators according to Presidential Regulation No. 72 of 2021. The family profile of those with stunted children included fathers with mostly secondary education (64%), mothers with secondary education (57.3%), 19 mothers experiencing short stature (CED), with only four mothers receiving additional food (Pemberian Makanan Tambahan/PMT), mothers who took iron supplements during pregnancy (80%), children with stunting who were exclusively breastfed (78.7%) and introduced to complementary feeding (80%), children with stunting taken to integrated health posts (Posyandu) for regular growth and development monitoring (76%), children with stunting receiving complete immunization (57.3%), families participating in family planning programs (60%), and children with stunting resulting from unwanted pregnancies (40%). The majority of parents with stunted children had a lower to middle education level, low income, did not participate in the national health insurance program (JKN), and did not receive either cash or food assistance.

COVID-19 Pandemic Effect on Stress Levels and Sleep Patterns

Dirga Filannira Desky — 2024-09-05

Coronavirus disease (COVID-19) is an respiratory disease caused by the SARS-CoV-2 virus that cause serious illness and death. Physical distancing has important role to prevent and slow down its transmission but has some negative psychological effects such as stress, confusion, frustation, and sleep pattern changes. The aim of this study was to determine the effect of the COVID-19 pandemic on stress levels and sleep patterns. The subjects of this study were 100 medical students of Universitas Sumatera Utara. The data of this study was obtained by questionnaires and analyzed using Spearman correlation test. This study found that based on the stress level, there were 59 students categorized normal, mild 16 students, moderate 10 students, severe 9 students, and very severe 6 students. The sleep patterns described that only 11 students slept normally and 89 students experienced sleep disturbances during the COVID-19 pandemic. This study found there was a significant correlation between the COVID-19 pandemic on stress levels (p:0.01 and r:0.58) and sleep patterns (p:0.01 and r:0.36).

Amoebic Liver Abscess Multifocal with Bilateral Parapneumonic Effusion: A Case Report

Bayu Arief Hartanto — 2024-09-05

A liver abscess is defined as a pus-filled mass in the liver that can develop from injury to the liver or an intraabdominal infection disseminated from the portal circulation. The majority of these abscesses are categorized into pyogenic or amoebic, although a minority is caused by parasites and fungi. Most amoebic infections are caused by Entamoeba histolytica. Complications of amoebic liver is abscess Pleuropulmonary involvement, which is reported in 20–30% of patients. A male patient, 53 years old, was admitted to Hospital for Upper right abdominal pain, Fever, Cough, Pain in the lower right chest. Chest examination found weakened bronchovesicular breath sounds as high as RIC V, Pleural Friction Rub, wet crackles. Abdominal Examination found supel palpation, liver palpable 2 fingers below the arcus costae and 2 fingers below the process xiphoid, blunt edge, soft consistency, tenderness pain in the dextra hypochondrium. Laboratory report Anti Amoeba : Positive 40,3 unit. The patient was given intravenous metronidazole therapy 3x750 mg for 10 days. Complications of Amoebic Liver Abscess is Pleuropulmonary involvement. Pulmonary and pleural amebiasis is an uncommon disease, usually occurring on the right side of the lung compared to the left side. Pulmonary amoebiasis is a life-threatening, but treatable, condition.

Iron Overload Cardiomyopathy

Retno Eka Sari — 2024-09-05

Iron overload cardiomyopathy is a condition of excessive iron accumulation in cardiomyocytes due to abnormal iron absorption or repeated blood transfusion. In the early stages, the patient may be asymptomatic with good ventricular systolic function. Iron deposit in ventricular cause dyspnea on effort due to left ventricular systolic dysfunction then in atrial cause atrioventricular block and supraventricular arrhythmic. For severe symptom due to dilated cardiomyopathy is characterized by left ventricular dilatation and risk of sudden cardiac death. Diagnosis of iron overload cardiomyopathy can be made if there is evidence of heart disease, the presence of iron overload (serum ferritin > 300 ng/mL and transferrin saturation > 55%) and cardiac siderosis with cardiac MRI T2 * < 20 ms as gold standard. Patient management involves lowering systemic iron levels and preventing iron entry into cardiomyocytes. Therapy with phlebotomy or iron chelation as indicated. Administration of calcium channel blockers and resveratrol antioxidant therapy may be considered to reduce morbidity and mortality due to cardiac siderosis.