Forced Expiratory Volume in 1 Second and Forced Vital Capacity in Bronchial Asthma Patients in Relation with Asthma Exercise

Background: Aerobic physical activity is one of the non-pharmacology management approaches of asthma. The Asthma Foundation of Indonesia (Yayasan Asma Indonesia, YAI) has designed an aerobic physical activity for people with asthma, known as Asthma Exercise. Asthma exercise is expected to increase the overall functional capacity of the lungs. One way to measure lung function is by measuring the score of forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC). The objective of the study was to explore the difference in FEV1 and FVC between bronchial asthma patients with and without asthma exercise. Methods: This study involved asthma patients from the Bandung Asthma Association (Perhimpunan Asma Bandung, PAB) who did asthma exercise (n=28), and as control patients from the Pulmonology Clinic in Dr. Hasan Sadikin General Hospital were selected who did not do asthma exercise. The research data used were primary data from the spirogram examination. Asthma patients were selected based on inclusion and exclusion criteria. This research used unpaired numerical comparative analytical hypothetical tests with a cross-sectional design.Results: The study showed the mean of FEV1 and FVC in the group with asthma exercise (1.6107±0.3780L and 2.0396±0.3465L) was higher than the group without asthma exercise (1.3750±0.4702L and 1.7164±0.4632L). Statistical difference test using independent t-test indicated a score of p=0.044 for FEV1 and p=0.005 for FVC between the two groups.Conclusions: There are significant differences in FEV1 and FVC between bronchial asthma patients with and without asthma exercise. Furthermore, asthma exercise is recommended for asthma patients to improve their lung function.

Pulmonary Function of Tuberculosis Patients in Medication at Dr. Hasan Sadikin General Hospital Bandung 2013–2014

Background: Tuberculosis (TB) is a dangerous global disease that already affects millions of people in the world and acts as the second most frequent cause of death in infectious diseases. Tuberculosis mostly attacks the lung and the inflammation process causes lung damage. The lung damage causes a decrease in pulmonary function. There has been no study about tuberculosis patient lung function in the advanced stage of medication.Methods: This study was conducted from August–October 2014 at DOTS Policlinic of Dr. Hasan Sadikin General Hospital Bandung. The study population was lung TB patients. The inclusion criteria were 1st category lung TB patients with anti-TB drug treatment on intensive phase. The exclusion criteria were extrapulmonary TB patients, patients with lung surgery history, and patients with asthma or chronic obstructive pulmonary disease (COPD). This study used purposive sampling. The subjects were given a spirometry test where the forced expiratory volume 1 second (FEV1), forced vital capacity (FVC), and their ratio were collected and then interpreted.Results: Among the 60 subjects included in this study, the data showed that 83.4% of the subjects had a decreased pulmonary function consisting of obstructive (6.7%) and restrictive patterns (76.7%).Conclusions: The majority of pulmonary TB patients treated with 1st category anti-TB drugs during intensive phase have a decrease in pulmonary function and most of them have restrictive pattern of pulmonary function

Geographical Factors in Diagnostic Delay among Multidrug Resistant Tuberculosis Patients

Background: Diagnostic delay is a  factor that can increase the high burden of multi-drug resistant tuberculosis (MDR-TB). Xpert Mycobacterium tuberculosis/Rifampicin known as Xpert is a rapid diagnostic test to detect MDR-TB. Diagnostic delay defined  the duration between a positive result of Acid Fast Bacilli (AFB) smear and positive result of MDR-TB by Xpert examination. This study aimed to compare the analysis of the geographical factors in the diagnostic delay of MDR-TB patients at Dr. Hasan Sadikin General Hospital as the top referral hospital in West Java Indonesia.Methods: This study was conducted in the period July−December 2016 using cross sectional design. A total of 152 MDR-TB patient data were collected from medical records of MDR-TB patients registered in MDR-TB clinic at Dr. Hasan Sadikin General Hospital in the period 2015−2016.  The socio-demographic characteristics were collected and analyzed descriptively The diagnostic delay among MDR-TB patients was analyzed by Mann Whitney test.Results: Diagnostic delay of MDR-TB patients was 15 days in median, with a minimal and maximal delay of 2−140 days. There was a significant difference of diagnostic delay between  patients from Bandung with a median of 9(2-135) days and patients from outside of Bandung with a median of 18(2-140) days, with p<0.01.Conclusions: MDR-TB patients from outside Bandung have a longer diagnostic delay than patient from Bandung . A further expansion of using Xpert as a rapid diagnostic test for MDR-TB patient is needed

Correlations between COPD Assessment Test and Modified British Medical Research Council Scoring and Degree of Airflow Limitation

Background: Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT) and Modified British Medical Research Council (MMRC) dyspnea scale are tools used to assess health status in COPD patients, while Forced Expiratory Volume in one second (FEV1) may represent the degree of airflow limitation. Assessment of COPD patients is rarely performed comprehensively. This study aimed to determine the relationships of CAT and MMRC dyspnea scale and the degree of airflow limitation in COPD patients. Methods: The study was conducted from September until October 2014 after obtaining approval from the Hasan Sadikin General Hospital Ethics Committee. This observational analytic study was performed on 77 medical records of COPD patients at Hasan Sadikin General Hospital. Patients’ medical records included in this study were those with spirometry measurements results, CAT and MMRC dyspnea scale scoring. Data normality was analyzed using Kolmogorov-Smirnov Test. Pearson’s Correlation was used for parametric variables. Spearman’s correlation was used for non-parametric variables. Results: Results showed Pearson’s correlation of CAT and FEV1 (p value=0.035 and r=0.240), and Spearman’s correlation of MMRC dyspnea scale and FEV1 (p value=0.198 and r=0.148). Conclusions: CAT scoring is significantly correlated with the degree of airway limitation. MMRC dyspnea scale is not significantly correlated with the degree of airway limitation

Geographical Factors in Diagnostic Delay among Multidrug Resistant Tuberculosis Patients

Background: Diagnostic delay is a  factor that can increase the high burden of multi-drug resistant tuberculosis (MDR-TB). Xpert Mycobacterium tuberculosis/Rifampicin known as Xpert is a rapid diagnostic test to detect MDR-TB. Diagnostic delay defined  the duration between a positive result of Acid Fast Bacilli (AFB) smear and positive result of MDR-TB by Xpert examination. This study aimed to compare the analysis of the geographical factors in the diagnostic delay of MDR-TB patients at Dr. Hasan Sadikin General Hospital as the top referral hospital in West Java Indonesia.Methods: This study was conducted in the period July−December 2016 using cross sectional design. A total of 152 MDR-TB patient data were collected from medical records of MDR-TB patients registered in MDR-TB clinic at Dr. Hasan Sadikin General Hospital in the period 2015−2016.  The socio-demographic characteristics were collected and analyzed descriptively The diagnostic delay among MDR-TB patients was analyzed by Mann Whitney test.Results: Diagnostic delay of MDR-TB patients was 15 days in median, with a minimal and maximal delay of 2−140 days. There was a significant difference of diagnostic delay between  patients from Bandung with a median of 9(2-135) days and patients from outside of Bandung with a median of 18(2-140) days, with p<0.01.Conclusions: MDR-TB patients from outside Bandung have a longer diagnostic delay than patient from Bandung . A further expansion of using Xpert as a rapid diagnostic test for MDR-TB patient is needed

Knowledge, Attitude, and Practice of Undergraduate Medical Students in Indonesia on the COVID-19 Prevention

Background: Coronavirus Disease 2019 (COVID-19) caused a global pandemic since March 2020. Undergraduate medical students, who would later be referred to as students, were encouraged to educate Indonesian society about COVID-19. This study aimed to evaluate the knowledge, attitude, and practice of Indonesian students on COVID-19 prevention. Methods: An online cross-sectional study was conducted between August 22 and September 2, 2020, with a minimum sample size of 1068 subjects. The questionnaire was sent to 86 Faculty of Medicine (FoM) in Indonesia. The questionnaire consisted of knowledge, attitude, and practice section, with a total score, 15, 60, and 45, respectively. Scores above median were considered as sufficient knowledge, and positive attitude, and positive practice. Association between knowledge, attitude, and practice with gender, year of study, location of FoM, and source of information were tested using Chi-Square Test. Correlation among knowledge, attitude, and practice scores was tested using Spearman Rank Test. Results: Among 1390 participated students, 51.4%, 55.7%, and 56.3% had sufficient knowledge, positive attitude, and, positive practice, respectively. There were associations between knowledge and gender, year of study, location of FoM, and source of information (p&lt;0.05), between attitude and gender, year of study, and source of information (p&lt;0.05), and between practice and gender and source of information (p&lt;0.05). There were weak correlations between knowledge with attitude (r=0.246, p&lt;0.001) and between attitude and practice (r=0.272, p&lt;0.001). Conclusions: Half of medical students in Indonesia showed sufficient knowledge, positive attitude, and positive practice on COVID-19 prevention. Hence, improvement towards COVID-19 prevention is required

Nursing Knowledge, Attitude, and Practice to Influenza Vaccination at Suburban Hospital in West Java, Indonesia

Background: High epidemiology of influenza in the world and Indonesia causes some groups to have high risk for getting infected with influenza, one of which is healthcare workers. The low rates of influenza vaccination among healthcare workers, especially in nurses, cause the need for an educational strategy to prevent influenza. This study aimed to measure the level of knowledge, attitude and practice among nurses in suburban hospital in West Java.Method: This was a cross-sectional study with random sampling method which started on July-August 2018 at Annisa Medical Center General Hospital. Knowledge, attitude, and practice of research subjects were measured using questionnaire containing 37 questions. The questionnaire sheet is the result of adaptation of several questionnaires and validity test has been conducted. The data obtained was then analyzed descriptively by the proportion of the score of knowledge, attitude, and practice.Result: Of 104 respondents, there were 19% respondents had low level, 74% respondents had moderate level and 7% respondents had high level of knowledge toward influenza vaccination. For attitude, 67% respondents had positive attitude and 33% respondents had negative attitude. The study also showed 58% respondents had positive practice and 42% respondents had negative attitude.Conclusion: Nurses possess adequate knowledge and they showed positive attitude and practice toward influenza vaccination. Continuous educational strategy was needed to improve nurses’ knowledge, attitude and practice on influenza vaccination.  Keywords: Attitude, influenza vaccination, knowledge, nurses, practic

Comorbidity among Hospitalized Patients with Chronic Obstructive Pulmonary Disease in a Teaching Hospital, West Java Indonesia

Background: One of the most important causes that can increase the risk of hospitalization and death in  chronic obstructive pulmonary disease is comorbidity. The aim of this study was to identify the proportion of comorbidity among hospitalized patients with chronic obstructive pulmonary disease in a teaching hospital, West Java, Indonesia, from January to December 2012.Methods: A descriptive study was conducted from  September to November 2013 in Internal Medicine Department of Dr. Hasan Sadikin General Hospital Bandung. The study used 107 medical records that consisted of data about patients with chronic obstructive pulmonary disease (COPD) who were hospitalized between January to December 2012. The medical records were collected using simple random sampling. Variables identified in this study were characteristics of the patients (age, sex, and smoking history) and comorbidity events. Comorbidity events were coronary artery disease (CAD), lung cancer, diabetes mellitus (DM) type 2, anemia, dyslipidemia, osteoporosis, depression, pulmonary artery hypertension (PAH), andhypertension. Age variable was divided into 3 categories with interval 20 years. All collected data were presented in frequency distribution.Results: Most of the patients in this study were 50–69  years old, male, and had smoking history. The highest proportion of comorbid condition was hypertension, followed by anemia and coronary artery disease.Conclusions: Patients with COPD have one or more other diseases (comorbidity). Three most frequent comorbidities are hypertension, anemia, and coronary artery disease. [AMJ.2015;2(4):485–91] DOI: 10.15850/amj.v2n4.63

Knowledge toward Drugs Resistant Tuberculosis in One of the Highest Burden Drug Resistant Country

Background: Drug resistant tuberculosis (DR-TB) is the biggest threat in TB case control worldwide. West Java Province is one of the three provinces with the most DR-TB burden in Indonesia. Knowledge level in DR-TB patients influences the perception, health search effort, and patient compliance towards DR-TB treatment. This study was aimed to identify the knowledge level about DR-TB in DR-TB patients at Hasan Sadikin General Hospital. Methods: This cross-sectional, descriptive quantitative study used consecutive sampling. In the study 96 patients were included. Primary data were collected through interview with questionnaire towards DR-TB patients at MDR-TB Clinic Hasan Sadikin General Hospital during September-November 2016. The questionnaire contained sociodemographic data and knowledge about DR-TB which consisted of definition, transmission, risk factors, resistance types, symptoms, medication, and prevention of DR-TB. The collected data were analyzed using statistical software for descripitive statistical analysis.Results: The average age of patients was 38 years (SD±11.7) and mostly ranging from 36–45 years old. Male had a higher distribution compared to female (55.2%). Analysis results showed 20% patients had “Adequate” knowledge level, 34.4% of the patients had “Sufficient” knowledge, and 39.6% of the patients had “Poor” knowledge about DR-TB.Conclusions: DR-TB patients at MDR-TB Clinic Dr. Hasan Sadikin General Hospital Bandung have “poor” knowledge regarding DR-TB.