Pola Pelayanan Penderita Hipertensi Peserta JKN di FKRTL Provinsi Jawa Barat Tahun 2015-2016

Tekanan darah tinggi merupakan faktor risiko independen penyakit kardiovaskular. Hipertensi di Jawa Barat masih menjadi masalah dengan angka kejadian yang terus meningkat. Beberapa kasus hipertensi harus dirujuk ke Fasilitas Kesehatan Rujukan Tingkat Lanjut (FKRTL) untuk mendapatkan pelayanan spesialis/sub spesialis. Penelitian ini bertujuan untuk mengetahui Pola Pelayanan Penderita Hipertensi Peserta Jaminan Kesehatan Nasional (JKN) di Fasilitas Kesehatan Rujukan Tingkat Lanjut (FKRTL) Provinsi Jawa Barat Tahun 2015-2016. Penelitian  menggunakan desain deskriptif kuantitatif. Data yang digunakan merupakan data tersier yaitu data sampel BPJS Kesehatan tahun 2015-2016. Subyek penelitian ini merupakan penderita hipertensi yang menerima pelayanan di Fasilitas Kesehatan Rujukan Tingkat Lanjut (FKRTL) Provinsi Jawa barat tahun 2015-2016. Seluruh data yang memenuhi syarat dan sebagian besar variabelnya terisi lengkap diikutsertakan dalam analisis dengan menggunakan pembobotan yang disediakan dalam data sampel. Proporsi penderita hipertensi yang dilayani di FKRTL sebanyak 6,3%. Kelompok yang paling banyak ditangani di FKRTL adalah kasus hipertensi primer (53,8%), usia >64 tahun (31,2%), perempuan (63,9%), dan orang yang sudah menikah (72,3%). Hipertensi yang dikelola di FKRTL lebih banyak diberikan kepada kelas premi I (43,8%) dan segmen pekerja bukan penerima upah (33,6%). Jenis fasilitas kesehatan rujukan tingkat lanjut yang dikunjungi paling banyak adalah rumah sakit (99,9%), fasilitas kesehatan asal rujukan paling banyak adalah puskesmas (51,8%), dan klinik yang melayani pasien hipertensi terbanyak adalah klinik penyakit dalam (44,4%). Jenis pelayanan yang diberikan kepada penderita hipertensi terbanyak adalah rawat jalan (81,3%) dan status pulang terbanyak pada penderita hipertensi dengan rawat inap adalah sehat (93%). Sebagian besar pasien hipertensi adalah hipertensi primer, berusia >64 tahun, berjenis kelamin perempuan, status sudah menikah, segmen PBPU, dan kelas premi I. Hipertensi paling banyak terdiagnosis di rumah sakit, dilayani pada klinik penyakit dalam, dan dirujuk dari puskesmas. Jenis pelayanan yang diberikan kepada penderita hipertensi terbanyak adalah rawat jalan dan sebagian besar penderita hipertensi dengan rawat inap pulang dalam keadaan sehat. High blood pressure is an independent risk factor for cardiovascular disease. Hypertension in West Java is still a problem with increasing incidence. Some cases of hypertension must be referred to Advanced Level Health Facilities (FKRTL) for specialist/sub-specialist services. This study aims to describe the pattern of services for hypertension patients who participate in the National Health Insurance (JKN) at the Advanced Level Health Facility (FKRTL), West Java Province in 2015-2016. This research used  quantitative descriptive design. The data used is tertiary data, BPJS Health sample data 2015-2016. The subjects of this study were hypertensive patients who received services at the Advanced Level Health Facility (FKRTL) in West Java Province in 2015-2016. Data that meet the requirements and most of the variables filled in completely are included in the analysis using weights provided in the data sample. The proportion of hypertensive patients served at the FKRTL was 6.3%. The groups managed by FKRTL the most were primary hypertension (53.8%), age> 64 years (31.2%), women (63.9%), and married people (72.3%). Hypertension that is managed in FKRTL is mostly given to premium class I (43.8%) and non-wage worker (33.6%). Types of advanced level health facilities visited the most were hospitals (99.9%), health facilities from which the most referrals originated were puskesmas (51.8%), and clinics that served the most hypertensive patients were internal medicine clinics (44.4 %). Most of the services provided to hypertensive patients were outpatient (81.3%) and most patients with hypertension who hospitalized were healthy (93%). Most hypertensive patients are primary hypertension,> 64 years old, female, married, PBPU segment, and premium class I. Hypertension is most diagnosed in hospitals, served at internal medicine clinics, and referred from puskesmas. Most types of services provided to hypertensive patients are outpatient and most hypertensive patients with hospitalization go home in good health

Nasal Endoscopy Findings in Acute and Chronic Rhinosinusitis Patients

Background: According to European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) 2012, rhinosinusitis is diagnosed based on symptoms, nasal endoscopy, and CT scan. The CT scan is the gold standard to diagnose rhinosinusitis, but its high cost and lack of availability become the problems in Indonesia. Hence, nasal endoscopy is a choice to diagnose rhinosinusitis. This study was aimed to describe the findings of nasal endoscopyin in acute and chronic rhinosinusitis. Methods: This cross-sectional descriptive study was performed using medical record of acute and chronic rhinosinusitis patients. The samples were chosen with consecutive sampling. Inclusion criteria of this study were patients that underwent nasal endoscopy examination in Otorhinolaryngology–Head and Neck Surgery Clinic Dr. Hasan Sadikin General Hospital Bandung in 2014.The collected data were analyzed in the form of tables.Results: Among 138 patients, the number of female patients (55.1%) was higher than male patients. Majority of the patients (37.5%) were 25–44 years old. Majority of the chief complaint was nasal obstruction (48.6%). The patients with allergic history (48.6%) were higher than patients without allergic history (19.6%). According to nasal endoscopy results, nasal discharge and edema were found in most of the patients (68.8% and 63.0%), but nasal polyp was only found in 15.9% patients. Other findings, such as hypertrophy concha or nasal septum deviation, were also found on 87.7% patients. Conclusions: Most of the rhinosinusitis patients are found with at least one of the following results of nasal endoscopy, which are nasal discharge, edema, or nasal polyp.

Cardiovascular-Related Death Risk Factors in Hypertensive Patients: Indonesia Family Life Survey 2000-2014

Objective: To determine the characteristics of the risk factors of cardiovascular death in hypertensive patients in Indonesia based on the Indonesian Family Life Survey (IFLS) longitudinal data.                                  Methods: This was a retrospective descriptive study on secondary data from the IFLS population starting from2000 and was followed up in 2007 and 2014. The inclusion criteria for participation were15 years old or older, had hypertension, had cardiovascular events as thecause of death, and had complete data in both IFLS 3 (2000) and IFLS 4 (2007).Results: The IFLS 5 (2014) reported 918 deaths among eligible subjects  with complete data, both in IFLS 3 (2000) and IFLS 4 (2007). Of those, a total of 608 subjects experienced hypertension started from 2000 and/or 2007. Of these deaths, 112 were due to cardiovascular events. Cardiovascular death was more common in males (58.9%), age of >65 years old  when died (47.3%), had poor socioeconomic status (24.1%), and with normal body mass index (54.9%).Conclusion: Male, late adulthood, low level of education, normal BMI, and poor socioeconomic status represented the greater risks of cardiovascular death among hypertensive patients in Indonesia.

Penyuluhan Penyakit Tidak Menular (PTM) untuk Menumbuhkan Kesadaran Pencegahan pada Masyarakat di Desa Cipacing, Jawa Barat

ABSTRAKTingginya angka prevalensi penyakit tidak menular (PTM) di Indonesia, termasuk di Desa Cipacing, Kecamatan Jatinangor, Kabupaten Sumedang, Provinsi Jawa Barat, belum diikuti oleh kesadaran masyarakat untuk melakukan upaya pencegahan; meski mereka mengetahui bahwa penyakit ini berdampak serius pada fisik dan sosial-ekonomi. Kegiatan sosialisasi mengenai pencegahan PTM ini bertujuan membangun kesadaran masyarakat pada pentingnya upaya pencegahan. Kegiatan ini dilakukan melalui penyuluhan dan pemeriksaan tekanan darah, gula darah, asam urat, dan kolesterol bagi warga masyarakat sebagai upaya deteksi dini pada risiko PTM. Hasil deteksi dini menunjukkan bahwa sebagian besar warga di Desa Cipacing memiliki risiko tinggi pada PTM terutama penyakit tekanan darah tinggi. Kombinasi penyuluhan dan pemeriksaan deteksi dini berdampak positif dalam membangun kesadaran para warga untuk melakukan pencegahan. Kegiatan ini telah mendorong masyarakat untuk melanjutkan kegiatan pencegahan PTM melalui Pos Pembinaan Terpadu (Posbindu) PTM yang ada di tingkat RW.Kata Kunci: Sosialisasi, Pencegahan, Penyakit Tidak MenularCounseling on Non-Communicable Diseases (NCDs) to Raise Awareness of Prevention in the Community in Cipacing Village, West Java          ABSTRACTThe prevalence of non communibacle diseases (NCDs) in Indonesia is considerably high, including those in Cipacing village,  Jatinangor sub-district, Sumedang District in the West Java Province. Despite this fact, there is low awareness of prevention among the villagers, eventhough they aware of the serious impact of the diseases towards their health  and social-economic status. This activity aims at build awareness among villagers towards non-communicable diseases prevention. In this activity, combination of information dissemination and NCD scrining has effectively endorsed the villagers to build their awareness of the disease and has inspired them to initiate action for prevention. The scrining result showed that most of the villagers are at high risk of NCDs, in particular hypertension. This data has successfully endorsed the villagers to establish NCD scrining and mangement in their own neighborhood through Pos Pembinaan Terpadu (Posbindu) PTM, a community-based activity of NCD prevention and management. Keywords: Information dissemination, Prevention, Non-communicable Disease

Persepsi Warganet Mengenai Kebijakan Penggunaan Rapid Test Antigen Selama Pandemi COVID-19 di Indonesia

Introduction: The Indonesian government has taken a number of steps to address the Coronavirus Disease 2019 (COVID-19) pandemic, including raising the number of tests to find positive cases and restricting travel to break the transmission chain. Due to direct activity limits, there was an increase in the number of internet and social media users during the pandemic. The goal of this research was to find out what Indonesian internet users thought about the policy of using rapid antigen tests as a requirement for domestic travel. The public's perceptions can assist the government, institutions, or parties involved in health promotion in determining the public's attitudes and responses to this policy. Methods: This research is a descriptive study using a combination method called the explanatory sequential method. The object of this research is the tweets of Indonesian citizens uploaded on Twitter from December 19, 2020, to June 30, 2021. The validation test in this study uses member-checking and triangulation methods between another researchers. Results: From a sample of 655 tweets, there were 51% negative perceptions, 25% positive perceptions, and 24% neutral perceptions. There are two types of narratives, namely medical and non-medical narratives. Non-medical narratives dominate at 85%, while medical narratives are only 15%. Conclusion: In order to deal with COVID-19 in Indonesia, efforts must be made to raise public awareness about the uses and benefits of the COVID-19 examination before and after travel. Key Words: COVID-19, perception, rapid test antigen, travel restrictionsPendahuluan: Pemerintah Indonesia telah melakukan berbagai upaya untuk mengatasi pandemi Coronavirus Disease 2019 (COVID-19), diantaranya peningkatan jumlah tes sebagai upaya deteksi kasus positif serta membatasi perjalanan orang untuk mencegah dan memutus rantai penularan COVID-19. Selama pandemi juga terjadi peningkatan jumlah pengguna internet dan media sosial akibat pembatasan kegiatan secara langsung. Tujuan penelitian ini adalah untuk mengetahui dan menggambarkan persepsi warganet Indonesia mengenai kebijakan penggunaan rapid test antigen sebagai syarat perjalanan dalam negeri. Gambaran persepsi warganet dapat membantu pemerintah, institusi, atau pihak yang berperan dalam promosi kesehatan untuk mengetahui sikap dan respon masyarakat terhadap kebijakan penggunaan rapid test antigen sebagai syarat perjalanan dalam negeri. Metode: Penelitian ini adalah penelitian deskriptif menggunakan metode kombinasi explanatory sequential. Objek penelitian ini adalah twit warganet Indonesia yang diunggah di Twitter pada 19 Desember 2020 hingga 30 Juni 2021. Uji validasi dalam penelitian ini menggunakan metode member checking dan triangulasi antar-peneliti. Hasil: Dari sampel 655 twit, didapatkan 51% persepsi negatif, 25% persepsi positif, dan 24% persepsi netral. Terdapat dua jenis narasi yaitu narasi medis dan non-medis. Narasi medis mendominasi yaitu sebesar 85% sedangkan narasi medis hanya sebesar 15%. Simpulan: Diperlukan upaya peningkatan pemahaman masyarakat terkait kegunaan dan manfaat dari pemeriksaan COVID-19 sebelum dan sesudah melakukan perjalanan sebagai upaya pengendalian COVID-19 di Indonesia. Kata Kunci: COVID-19, persepsi, pembatasan perjalanan, rapid test antige

Nasal Endoscopy Findings in Acute and Chronic Rhinosinusitis Patients

Background: According to European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) 2012, rhinosinusitis is diagnosed based on symptoms, nasal endoscopy, and CT scan. The CT scan is the gold standard to diagnose rhinosinusitis, but its high cost and lack of availability become the problems in Indonesia. Hence, nasal endoscopy is a choice to diagnose rhinosinusitis. This study was aimed to describe the findings of nasal endoscopyin in acute and chronic rhinosinusitis. Methods: This cross-sectional descriptive study was performed using medical record of acute and chronic rhinosinusitis patients. The samples were chosen with consecutive sampling. Inclusion criteria of this study were patients that underwent nasal endoscopy examination in Otorhinolaryngology–Head and Neck Surgery Clinic Dr. Hasan Sadikin General Hospital Bandung in 2014.The collected data were analyzed in the form of tables.Results: Among 138 patients, the number of female patients (55.1%) was higher than male patients. Majority of the patients (37.5%) were 25–44 years old. Majority of the chief complaint was nasal obstruction (48.6%). The patients with allergic history (48.6%) were higher than patients without allergic history (19.6%). According to nasal endoscopy results, nasal discharge and edema were found in most of the patients (68.8% and 63.0%), but nasal polyp was only found in 15.9% patients. Other findings, such as hypertrophy concha or nasal septum deviation, were also found on 87.7% patients. Conclusions: Most of the rhinosinusitis patients are found with at least one of the following results of nasal endoscopy, which are nasal discharge, edema, or nasal polyp.

The optimization of electrochemical immunosensors to detect epithelial sodium channel as a biomarker of hypertension

The epithelial sodium channel (ENaC) is a transmembrane protein that regulates the balance of sodium salt levels in the body through its expression in various tissues. The increase in sodium salt in the body is related to the expression of ENaC, thereby increasing blood pressure. Therefore, overexpression of the ENaC protein can be used as a biomarker for hypertension. The detection of ENaC protein using anti-ENaC in the biosensor system has been optimized with the Box-Behnken experimental design. The steps carried out in this research are screen-printed carbon electrode modification with gold nanoparticles, then anti-ENaC was immobilized using cysteamine and glutaraldehyde. Optimum conditions of the experiment, such as anti-ENaC concentration, glutaraldehyde incubation time, and anti-ENaC incubation time, were optimized using the Box-Behnken experimental design to determine the factors that influence the increase in immunosensor current response and the optimum conditions obtained were then applied to variations in ENaC protein concentrations. The optimum experimental conditions for anti-ENaC concentration were 2.5 μg/mL, the glutaraldehyde incubation time was 30 minutes, and the anti-ENaC incubation time was 90 minutes. The developed electrochemical immunosensor has a detection limit of 0.0372 ng/mL and a quantification limit of 0.124 ng/mL for the ENaC protein concentration range of 0.09375 to 1.0 ng/mL. Thus, the immunosensor generated from this study can be used to measure the concentration of normal urine samples and those of patients with hypertension

Sweet Taste Threshold among Medical Students with Family History of Diabetes Mellitus

Background: Diabetic patients have low sensitivity towards sweet taste, thus consuming more sugar. A young adult with family history of diabetes mellitus (FHD) who lives with diabetic parents may have an increased risk of overconsumption of sugar due to a similar dietary pattern, leading to diabetes. This study aimed to explore the difference in the sweet taste threshold (STT) between students with and without a family history of diabetes mellitus.Methods: This cross-sectional study was conducted in October –November 2018 on Class 2018 medical students living in a student dormitory who were divided into those with family history of diabetes (FHD) and those without it (non-FHD). Family history of diabetes and other known diseases were self-reported. The three-Ascending Forced Choice method was used to determine the sweet recognition threshold. Mann-Whitney analysis was used to compare the sweet taste thresholds between the two groups.Result: A total of 183 subjects participated in this study. The non-FHD group had a higher rank of sweet taste threshold than subjects in the FHD group (94.21 vs 81.16), albeit insignificant (p=0.192). Interestingly, the modes of best estimation threshold (BET) for non-FHD group was than the FHD group (0.067 M vs 0.043 M).Conclusion: The BET for students without family history of diabetes is higher than those with family history of diabetes. It is imperative that low sugar consumption campaign should also aim young people without FHD.