Spatial Autocorrelation of Dengue and Its Relationship with Population Density in South Kalimantan, Indonesia

Background: Dengue is a viral infection transmitted to humans through the bite of Aedes aegypti and Ae. Albopictus mosquitoes. Demographic factors that may influence the development and prevalence of dengue cases include variations in population density, community characteristics, and economic and social demographics. This study aimed to determine the distribution, spatial autocorrelation, and relationship between population density and dengue.Methods: Secondary data analysis was conducted in Hulu Sungai Selatan District, South Kalimantan, Indonesia. Data on dengue cases, population density for each sub-district, and base maps were collected to and then be used as analysis material. Spatial autocorrelation was analyzed using the Moran's index and Local Spatial Autocorrelation Index (LISA), then the correlation of population density with dengue was carried out using linear regression.Result: Spatial Autocorrelation had positive autocorrelation and clustered spatial patterns in 2017 and 2018; whereas in 2019-2021 was negative and the spatial pattern was spread. There was a decrease in cases from high to low (HL) in Kandangan District in 2021, which was previously high to high (HH) in 2017-2019. There was a correlation between population density and dengue (R-value=0.448) with a moderate category.Conclusion: Dengue cases are more widespread in Kandangan. The spatial autocorrelation of dengue that occurs between sub-districts in Hulu Sunga Selatan District is due to sub-district location in the city center. There is a correlation between dengue and population density. Therefore, controlling dengue should be prioritized in the city center area first to break the chain of dengue transmission between sub-district in Hulu Sunga Selatan District.

Correlation of Platelet to Lymphocyte Ratio and C-Reactive Protein to Albumin Ratio with MEX-SLEDAI Scores in Patients with Systemic Lupus Erythematosus

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, p0.05) 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

Effect of the Dates Milkshake on the Duration of the First Stage of Labor

Background: Prolonged labor can occur due to malnutrition during the first stage of labor. During the labor process, women need foods rich in sugar, such as dates milkshake, to optimize uterine contractions. This study aimed to explore the effect of dates milkshake on the duration of the first stage of labor.Method: This study was a quasi-experiment conducted from August to November 2021 in Bengkulu City, Indonesia using a posttest-only design with nonequivalent groups. Participants included 34 primigravida and multigravida women who were then divided into intervention group who received dates milkshake and control group who received local fruit juice, each with 17 participants. Daily routine consumption and the partographs during labor were observed. The data obtained was analyzed using Mann Whitney and Cochran’s and Mantel-Haenszel.Results: The duration of labor in mothers given dates milkshake averaged 4.1 hours (± 0.697), ranging from 3 to 5 hours; meanwhile the control group averaged 7 hours (± 1.904), ranging from 5 to 11 hours. There was a significant difference in the duration of labor between mothers given dates milkshake and local fruit juice (p= 0.000, OR=4.0).Conclusions: Dates milkshake has an effect on shortening the duration of the first stage of labor. Dates milkshake can be used as a viable food choice for pregnant women to help maintain and increase maternal energy availability during childbirth

Correlation between Gibbus and Neurological Status in Patients with Tuberculous Spondylitis and its impact after Operative Intervention

Background: Tuberculous (TB) spondylitis is a chronic infectious disease associated with Mycobacterium tuberculosis that affects the spine. This disease is a challenging disease to treat due to its serious complications and high morbidity rate. Neurological deficits and spinal deformities that can occur along with gibbus are some of the most common complications. Early diagnosis and treatment are essential to cure this disease, with the administration of anti-TB drugs and operative intervention. This study aimed to analyze the correlation between gibbus and neurological status as well as the impact of operative intervention on the degree of gibbus and neurological status.Methods: This was an observational-analytic study with a cross-sectional design on 32 medical records of TB spondylitis patients who underwent operative intervention from January 2018 to December 2021 at Dr. Hasan Sadikin General Hospital. Gibbus determined by x-ray analysis and neurological status determined by the American Spinal Injury Association (ASIA) impairment scale (AIS) were examined before and after the intervention. The sample was chosen based on consecutive sampling. All data collected was tested using Spearman's correlative analysis, paired t-test, and Wilcoxon sign-rank test with a p-value <0.05 considered statistically significant.Results: There was a significant correlation between gibbus and neurological status-AIS (r=-0.708; p<0.05); and a significant positive impact of operative intervention on the degree of gibbus (p<0.05) and neurological status-AIS (p<0.05).Conclusion: There is a correlation between gibbus and neurological status-AIS. In addition, operative intervention also has a significant positive impact on the degree of gibbus and AIS, resulting in good clinical and radiological outcomes

Significant Relationship between Hypertension and Obesity among Female Patients at A Hospital in Kupang, Indonesia

Background: Hypertension or high blood pressure is one of the most common non-communicable diseases found nowadays, affecting 1.28 billion people worldwide and causing about 7.5 million deaths annually. Many factors contribute to hypertension, one of which is obesity. This study aimed to explore further the relationship between hypertension and obesity, especially in female patients in Kupang, Indonesia.Methods: This study was an analytical observational with a cross-sectional approach, including female patients visited the outpatient’s clinic of internal medicine at a hospital in Kupang, Indonesia from July to August 2022. A purposive sampling technique was used. Data collection used an aneroid sphygmomanometer, stethoscope, and health scale. Data analysis was performed using the Chi-Square test. The strength of the correlation was tested with the coefficient of contingency.Results: Of the 100 female patients, 28% had hypertension and 41% were obese. The majority were housewives, aged 46–66 years. Chi square test results showed a significant relationship between obesity and hypertension (p=0.006). However, the correlation test with the contingency coefficient showed a positive correlation with weak correlation (r = 0.283).Conclusions: There is a relationship between hypertension and obesity in female patients at a hospital in Kupang, Indonesia. This finding highlights the need for effective management and prevention strategies, as well as promoting healthy lifestyles

Characteristics of Extraneural Tuberculosis in Patients with Tuberculous Meningitis Hospitalized at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia in 2017–2021

Background: Tuberculous (TB) meningitis is the most severe manifestation of extrapulmonary TB and contributes to a high mortality rate. The presence of extraneural TB may raise suspicion of TB meningitis (TBM). This study aimed to explore the characteristics of extraneural TB in TBM patients.Methods: This was a cross-sectional descriptive study using secondary data from medical records of TBM patients admitted at Dr. Hasan Sadikin General Hospital Bandung, Indonesia from 2017 to 2021. Demographic and clinical data were collected, including HIV status. TBM cases were classified into grades I, II, and III using Medical Research Counsil (MRC) criteria that were based on Glasgow Coma Scale (GCS) score and the presence of focal neurological deficits. The clinical classification diagnosis of TBM was made based on the Marais diagnostic criteria which included several diagnostic items and corresponding scoring which further divides TBM into three classes. Extraneural TB is defined as the finding of TB outside the nervous system. Disseminated TB was diagnosed based on the finding of ≥2 infected locations.Results: During the study period, 497 medical records were analyzed. Most TBM patients experienced Grade II (76.9%) and extraneural TB site was found in 65.4%, with pulmonary TB as the common site (77%). The highest mortality rate was in disseminated TB (50%). The finding of extraneural TB did not differ between HIV-negative and HIV-positive patients (67.8% vs. 67.9%; p=0.101).Conclusion:  The presence of extraneural TB is common in patients with TBM. Therefore, extraneural TB evaluation is important to ensure TBM diagnosis. Further studies are needed to explore factors related to TBM diagnosis to ensure TBM patient’s wellbeing

Patients Satisfaction with the Chronic Disease Management Program in Indonesia Using the Importance-Performance Matrix

Background: Indonesia still has a high prevalence of hypertension and diabetes mellitus. On the other hand, essential health services were disrupted during the COVID-19 pandemic. Hence, the quality of service still needs to be prioritized. The government also obliges the government-owned primary healthcare facilities (Pusat Kesehatan Masyarakat, Puskesmas) to conduct customer satisfaction surveys to evaluate service quality. This study was conducted to analyze patients’ satisfaction with the chronic disease management program (Program Pengelolaan Penyakit Kronis, Prolanis) provided by Puskesmas in Bogor City.Methods: Quantitative research with a survey approach using the CSI-29 questionnaire was conducted from October to November 2021 on 104 Prolanis participants from 6 Puskesmas in Bogor City, West Java, Indonesia. The variables were 9 dimensions of satisfaction based on the CSI-29 questionnaire. Data was transformed using the Rasch model and analyzed using the Importance-Performance Matrix (IPM).Results: Of the 104 participants, there were 78 (75%) were satisfied with the Prolanis services provided by the Puskesmas. The IPM analysis showed that the dimensions of requirements, procedures, costs, type of service products, and attitudes of health workers had low expectations and perceived performance level.Conclusions: Most of the Prolanis participants were satisfied with the Prolanis services provided by the Puskesmas in Bogor City

Maternal Risk Factors among Pregnant Women with Miscarriage

Background: Approximately, 4.1% of maternal deaths in Indonesia occur due to miscarriage. Miscarriage might be caused by various factors such as fetal, maternal, and external factors. Monitoring and early detection of maternal factors might prevent miscarriage.  This study aimed to analyze the influence of maternal factors on the incidence of miscarriage. Methods: This was an analytic observational study with a case-control design conducted in Banjar District, South Kalimantan in August–September 2022. Data was collected from the medical records of pregnant women who experienced miscarriage (n=60) and pregnant women who did not (n=120). Data was analyzed using the chi square test and logistic regression. The level of maternal risk factors for the incidence of miscarriage was determined from the odds ratio (OR) value at a 95% confidence interval.Results: The results revealed that parity (p=0.000; OR=2.2), nutritional status (p=0.000; OR=77.1), level of education (p=0.001; OR=3.5), and employment status (p=0.000; OR=8.1) had a significant effect on the incidence of miscarriage.Conclusion: Maternal factors such as parity, nutritional status, education level, and employment status influence on the incidence of miscarriage, therefore, it is essential to educate pregnant women on various factors related to miscarriage

Experiences of patients with Breast Cancer in Selecting Conventional and Complementary Therapies in Remote Areas: A Qualitative Study

Background: The selection of therapy is a challenging issue to overcome. The selected therapy must be based on the condition of breast cancer patients and has advantages such as increasing life expectancy, being able to overcome the symptoms and complaints of breast cancer patients and improving the quality of life. This study aimed to explore the experiences of people with breast cancer regarding the reasons for choosing therapy, namely complementary and conventional therapies.Methods: This study was qualitative research with a descriptive phenomenological study approach. Participants obtained using purposive sampling techniques were included until the data was saturated. Research data was collected through in-depth interviews conducted in a semi-structured manner. The thematic analysis used in this study consisted of several stages using the Colaizzi method.Results: This study illustrated that complementary and conventional therapies were beneficial to cancer treatment. The three themes from the analysis results included the benefits of complementary and conventional therapies, access to therapy and treatment costs. The choice of therapy depended on available access and costs for breast cancer treatment.Conclusion: People with breast cancer in remote areas choose complementary therapies, such as herbal medicine, meditation, reflexology, and acupuncture as the first choice and conventional therapies, such as surgery and chemotherapy as alternative therapies. This is because the choice of therapy also depends on the ease of access to treatment and the availability of costs for breast cancer patients

Factors Affecting Breast Milk Substitute in Pidie Jaya, Aceh, Indonesia

Background: Breast milk is the first, main, and best natural food for babies. Breast milk contains various nutrients needed in the process of growth and development of babies. Breastfeeding is a health behavior carried out by mothers. This study aimed to analyze the factors that influence the provision of breast milk substitutes.Methods: This was a quantitative study, using a cross-sectional design. Data collection was carried out from July to August 2022 on 71 mothers who had babies aged up to 6 months at the Bandar Baru Public Health Center, Pidie Jaya, Aceh, Indonesia. Consecutive sampling technique was used. The variables studied included behavior intentions, social support, accessibility of information, personal autonomy, and situational action. Chi-square was used to assess the relationship between independent variables and the dependent variables.Results: Most mothers were aged 20–35 years (70.4%), had junior high school education (78.9%), were unemployed (76.1%), and most did not provide breast milk substitutes (70.4%). Mothers who provided breast milk substitutes was significantly associated with the mother’s intention to give breast milk (p=0.002) and environmental conditions/situations for action (p=0.001). Mothers with low intentions tended to substitute breastmilk (53.8%). Furthermore, the situation of action influenced mothers to provide breast milk substitutes (48.6%).Conclusion: Factors that influence mothers to provide breast milk substitutes are low intention and environmental conditions/situations to act. Therefore, education for mothers to give exclusive breast milk is encouraged.