Colloids Versus Albumin in Large Volume Paracentesis to Prevent Circulatory Dysfunction: Evidence-based Case Report

Large volume paracentesis may cause paracentesis induced circulatory dysfunction (PICD). Albumin is recommended to prevent this abnormality. Meanwhile, the price of albumin is too expensive and there should be another alternative that may prevent PICD. This report aimed to compare albumin to colloids in preventing PICD.Search strategy was done using PubMed, Scopus, Proquest, dan Academic Health Complete from EBSCO with keywords of “ascites”,  “albumin”, “colloid”, “dextran”, “hydroxyethyl starch”, “gelatin”, and “paracentesis  induced  circulatory  dysfunction”. Articles was limited to randomized clinical trial and meta-analysis with clinical question of “In hepatic cirrhotic patient undergone large volume paracentesis, whether colloids were similar to albumin to prevent PICD”.We found one meta-analysis and four randomized clinical trials (RCT). A meta analysis showed that albumin was still superior of which odds ratio 0.34 (0.23-0.51). Three RCTs showed the same results and one RCT showed albumin was not superior than colloids. We conclude that colloids could not constitute albumin to prevent PICD, but colloids still have a role in patient who undergone paracentesis less than five liters

Universal health coverage in Indonesia – the forgotten prevention

[no abstract available

Quarter century of Medical Journal of Indonesia: Between national and international publications for building capacity building

[no abstract available

The dream comes true–start for the new beginning

[no abstract available

Health Issues Among Healthcare Workers During COVID-19 Pandemic: a Psychosomatic Approach

Healthcare workers as the front-liner to fight COVID-19 pandemic, need reassurance of their safety. The stress and the demands from the healthcare system can affect their health as well as the morality. Hence, psychosomatic approach should be used to keep their condition in good shape. The combination between biological, psychological, and social approaches may affect their vulnerability from SARS-CoV-2 infection. The biological aspect includes personal protective equipment, nutrition, and resting/sleeping time. The psychological distress is shown to affect the immune system; and mental relaxation and management of work shift may reduce the distress. There should be an effort from the stakeholders to keep the morality of the healthcare workers. The social aspect such as providing place to live, having supportive family members, and avoiding stigmatization also improve their psychological health. In conclusion, psychosomatic approach is important to keep the healthcare workers healthy

Metabolic syndrome and Framingham risk score in obese young adults

<p style="text-align: justify;"><strong>Background</strong>: The increase number of the metabolic syndrome (MetS) among young adults was mostly caused by obesity. MetS increases the risk of coronary heart disease (CHD) which can be estimated by Framingham risk score (FRS). The study was aimed to know the prevalence of MetS and FRS in obese young adults and to associate them with the components of MetS.<br /> <strong></strong></p><p style="text-align: justify;"><strong>Methods:</strong> A total of 70 male and female students aged 18 to 25 years with BMI ≥ 25 kg/m² in Faculty of Medicine Universitas Indonesia were selected consecutively. The blood samples used to test fasting blood glucose, total cholesterol, high-density lipoprotein, and triglyceride were examined in Department of Clinical Pathology, Cipto Mangunkusumo Hospital after fasting for 14 to 16 hours. International Diabetes Federation (IDF) definition was used to diagnose MetS. Univariate and bivariate analysis were done.<br /> <strong></strong></p><p style="text-align: justify;"><strong>Results: </strong>The prevalence of MetS based on IDF definition was 18.6% among obese young adults. The most associated MetS components was hypertriglyceridemia (OR 12.13; 95% CI 2.92-50.46; p = 0.001), followed with high blood pressure (OR 9.33; 95% CI 2.26-38.56; p = 0.001), low-HDL (OR 8.33; 95% CI 2.17-32.05; p = 0.003), and impaired fasting glucose (p = 0.03). Four subjects had FRS ≥ 1% and 66 subjects had risk &lt; 1%. Increased FRS was not associated with MetS (p = 0.154). There was no component of MetS associated with increased FRS.<br /> <strong></strong></p><p style="text-align: justify;"><strong>Conclusion:</strong> Prevalence of MetS in obese young adults was similar with obese children and adolescents. Although no association of MetS and FRS was found, they are significant predictors for CHD which should not be used separately.<em> <strong>(Med J Indones. 2013;22:100-6)</strong></em></p><p style="text-align: justify;"><strong>Keywords:</strong> <em>Abdominal obesity, Framingham risk score, metabolic syndrome, young adults</em></p

Low birth weight profiles at H. Boejasin Hospital, South Borneo, Indonesia in 2010-2012

Background The prevalence of low birth weight (LBW) is still high in Indonesia. Intrauterine growth restriction (IUGR) and prematurity are the most frequent causes. Prematurity has higher mortality rate. Cultural diversity has an impact on regional LBW profiles in Indonesia. However, data on LBW is unavailable in South Borneo. Objective To describe the LBW profiles and in-hospital mortality of newborns at H. Boejasin Hospital, South Borneo. MethodsThis was a cross-sectional study using secondary data from medical records and neonatal registry at H. Boejasin Hospital, Pelaihari, South Borneo from 2010 to 2012. Subjects were newborns with birth weight <2,500 grams. Categorical data was presented in percentages, while survival analysis was assessed by Kaplan-Meier test. The difference among groups was analyzed with log-rank test. Results The proportion of LBW was 20.2% of total live births and the mortality rate was 17.3%. Mortality rates according to birth weight category was 96% in <1000 g group, 62% in 1,000-1,499 g group, 19% in 1,500-1,999 g group, and 4% in 2,000-2,499 g group. The highest hazard ratio was in the <1,000 gram birth weight group (HR 40.21), followed by the 1,000-1,499 gram group (HR 12.95), and the 1,500-1,999 gram group (HR 4.65);(P<0.01). Asphyxia, hyaline membrane disease (HMD), and sepsis were the most common causes of mortality (at 50%, 21%, and 16%, respectively). Conclusion The prevalence of LBW in this study is quite high and mortality of LBW infants is significantly different between each low birth weight category. [Paediatr Indones. 2016;56:155-61.]

Prehypertension and hypertension among young Indonesian adults at a primary health care in a rural area

Background: Prehypertension and hypertension were related with many complications of nearly every organ, but often neglected by young adults in rural area. This research was done to observe the prevalence of prehypertension and hypertension among young adult in a primary health care of rural area at Cicurug, Sukabumi District, West Java.Methods: This cross-sectional study was done in Cicurug Public Health Center, Sukabumi District, West Java. The subjects were consecutively recruited from the outpatient clinic on Monday until Saturday in September 2012,18–25 years old, not pregnant nor having shock. They were interviewed about their age, gender, physical activity, sitting hours, smoking habit, alcohol consumption, and family history and examined by trained health professionals (weight, height, body mass index [BMI], systolic and diastolic blood pressure).Results: From 111 young adults, 34.2% had prehypertension and 17.1% had hypertension. Within sex groups, the prevalence of prehypertension was higher in females, whereas hypertension was occurred more in males. Neither of family history from mother nor father were associated with prehypertension and hypertension compared with normotension. Total activity was not associated with prehypertension (OR = 2.6; p = 0.052) and hypertension (OR = 1.758; p = 0.498). BMI was associated with hypertension (OR = 3.354; p = 0.041) and not associated with prehypertension (OR = 2.343; p = 0.099).Conclusion: Prevalence of prehypertension and hypertension were relatively high among young adult in primary health care of rural area. Intervention to prevent further complications needs to be done early with lifestyle modification because blood pressure is associated with modifiable risk factors, such as BMI and total activity. (Med J Indones. 2013;22:39-45)Keywords: Hypertension, prehypertension, rural area, young adult</p

Gastro-esophageal reflux disease among type-2 diabetes mellitus patients in a rural area

Background: One of the most neglected complications of diabetes mellitus (DM) is gastro-esophageal reflux disease (GERD) which arises from autonomic neuropathy and diabetic gastropathy related to the extent of DM. This study was done to find prevalence of GERD in DM patients with GERD-questionnaire (GERDQ), dietary factor proportion, and their association with other GERD risk factor in rural area. Methods: This cross sectional study was conducted in Puskesmas Pelaihari from August to September 2013. Subjects with DM aged ≥ 18 were selected consecutively from both newly and previously diagnosed patients with exclusion criteria: pregnancy, in proton-pump inhibitor therapy, and had other metabolic disease(s). DM was diagnosed with ADA criteria, while GERD was diagnosed in patients with score of ≥ 8 of Indonesian GERDQ. Results: There were 30 subjects (29.7%) with GERD among 101 patients with DM and dietary factors found in GERD patients were spicy diet (90%), high-fat food (90%), irritative beverages (87%), and irritative diet (23%). Only female gender was associated with GERD vs non-GERD in DM patients (87% vs 68%, p = 0.048). Meanwhile, duration of DM (2 [0-13] vs 2 [0-19], p = 0.976), obesity (37% vs 38%, p = 0.897), age (53.2±10.5 vs 54.7 ± 9.3, p = 0.481), and uncontrolled diabetes (90% vs 94%, p = 0.421) were not associated with the GERD among DM patients.Conclusion: Prevalence of GERD in DM is somewhat high in this study. Female group with DM needs to be screened for GERD as early as possible.</p