Journal Of The Indonesian Medical Association

The Use of Caffeine Citrate in Preterm Infants

Putri Maharani Tristanita Marsubrin — 2024-09-25

Apnea is a manifestation of immature breathing and frequently occurs in preterm infants treated in the Neonatal Intensive Care Unit. Apnea of prematurity (AOP) is characterized by episodes of apnea (cessation of breathing) lasting 15–20 seconds or more, or shorter episodes accompanied by bradycardia and/or desaturation. The incidence of AOP is inversely related to gestational age (GA) and birth weight. Caffeine is one of the pharmacological treatments for managing AOP. Caffeine belongs to the methylxanthine class, like theophylline and aminophylline. Caffeine has been used as a therapy of choice for AOP in developed countries since the 1970s. Meanwhile, in developing countries, aminophylline remains the most commonly used drug for AOP management. Compared to aminophylline and theophylline, caffeine has better therapeutic effects and absorption, a longer half-life, and fewer side effects. Therefore, caffeine is the first-line therapy for AOP management.

The Role of Malondialdehyde Measurement as a Marker of Oxidative Stress in Stunted Children: Systematic Review

Ananda Putri Tarigan — 2024-09-26

Introduction: Stunting is a form of chronic malnutrition which is still a nutritional problem in Indonesia. Stunting is characterized by a decrease in insulin-like growth factor-1, closely related to the release of excess reactive oxygen species that trigger oxidative stress. An increase in reactive oxygen species that bind to membrane lipids produces lipid peroxidase, which impacts cell damage. The research aims to obtain information regarding the role of malondialdehyde measurement as an early marker and a prognostic determinant of oxidative stress in protein-energy malnutrition children, such as stunted and marasmic.
Method: Systematic literature was conducted with published works journal searches from 23rd – 30th November 2023, relevant keywords related to the research topic in ScienceDirect, PubMed, and Cochrane databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 method. The quality of selected studies was evaluated using The Joanna Briggs Institute Critical Appraisal Tools. The research protocol was registered at PROSPERO (CRD42024568540).
Results: The data obtained were five articles from cross-sectional studies with the results had increased oxidative stress biomarkers, including malondialdehyde, which is significantly higher in protein-energy malnutrition children, such as stunted and marasmic, than in healthy children (p less than 0.05).
Conclusion: The malondialdehyde levels as biomarkers of oxidative stress were found to be high in stunted children.

The Effect of Virtual Reality Game Training on Fear of Falling and Quality of Life After Subacute Ischemic Stroke

Joudy Gessal — 2024-09-26

Introduction: Fear of falling after a stroke can be caused by a lack of balance, muscle weakness, or impaired motor control. This can affect a patient's ability to move around and their overall quality of life after a stroke. However, virtual reality (VR) technology has the potential to help with this issue by providing simulated physical exercises that are safe and controlled. By combining VR rehabilitation with conventional stroke care, it's possible to improve a patient's ability to move around safely and their quality of life after a stroke.
Methods: An experimental study was conducted on 18 ischemic post-stroke patients who sought treatment at the Medical Rehabilitation Installation of Prof. Dr. R. D. Kandou Hospital Manado from June to July 2023. The study aimed to analyze the impact of VR game training using Xbox 360° and Kinect^TM devices on fear of falling and post-stroke quality of life. The assessment of fear of falling was done using the Fall Efficacy Scale (FES) and quality of life using the EQ-5D. The intervention included four types of game exercises scheduled three times per week, with each session lasting 30 minutes with a total of eight sessions for each subject.
Results: Following VR game training, there was a significant reduction in fear of falling (t = 15.353, p less than 0.001) and an improvement in quality of life across five dimensions of health problems as well as EQ-5D (t = 23.777, p less than 0.001).
Conclusion: VR game training combined with conventional stroke care can reduce the fear of falling and improve the quality of life of post-stroke patients.

The Role of the Hospital Ethics and Law Committee in Improving Service Quality, Patient Safety, and Medical Dispute Resolution at Syarif Hidayatullah Hospital in 2023

Mahesa Paranadipa Maikel — 2024-09-26

Introduction: The Hospital Ethics and Law Committee (HELC) holds the primary responsibility of ensuring adherence to ethical and legal regulations within the hospital. However, due to the absence of specific provisions regarding the HELC, its role has often not been fully optimized. This study aims to evaluate the role of the HELC in enhancing the quality of services, ensuring patient safety, and resolving medical disputes at Syarif Hidayatullah Hospital, Jakarta.

Methods: This cross-sectional study combines quantitative and qualitative methods, involving employees of Syarif Hidayatullah Hospital as respondents. Data collection was conducted through interviews from January to February 2024. The data were analyzed using univariate and bivariate methods, followed by multivariate variance analysis.

Results: A total of 53.1% of respondents assessed the role of the HELC as well-executed. An effectively executed HELC role is correlated with increased patient safety, enhanced service quality, and effective resolution of medical disputes (all p less than 0.001). Multivariate variance analysis revealed that the HELC's role has the most significant impact on the improvement of hospital service quality (adjusted R-squared = 0.885).

Conclusion: The role of the HELC is associated with improvement of patient safety, service quality, and the resolution of medical disputes in Syarif Hidayatullah Hospital. Hospital management needs to empower the HELC and enhance coordination with other committees and units within the hospital.

Correlation Between Health-Related Life Quality and Dyspnea Severity in Aged COVID-19 Survivors in Indonesia

Siti Chandra Widjanantie — 2024-09-26

Introduction: COVID-19 is a disease that can severely reduce life quality, particularly in the aged population. The research aim was to establish the correlation between health-related life quality and dyspnea severity within aged COVID-19 survivors.
Method: The cross-sectional study was conducted on older COVID-19 survivors at Persahabatan Hospital, Jakarta. The use of WhatsApp^® video call and Zoom^® video conference applications for audio and video evaluation in data collection. The European Quality of Life-5Dimensions-5L (EQ-5D-5L) and the European Quality of Life-Visual Analog Scale (EQ-VAS) were used to assess health-related quality of life. Modified Borg and modified Medical Research Council (mMRC) dyspnea scale were used to assess dyspnea severity. The data were analyzed using correlation test.
Results: Based on 44 data collected, it was found that seven (15.9%) of the participants experienced mild breathlessness, while three patients (6.8%) had severe level of dyspnea on the modified Borg dyspnea scale assessment. The mMRC dyspnea scale assessment indicated that over nine patients (20.4%) had mMRC value greater than one. The study found a significant correlation (p less than 0.01) between the EQ-5D-5L and the modified Borg Dyspnea Scale, particularly in the areas of anxiety or depression (r=0.52), self-care (r=0.51), mobility (r=0.42), and EQ-VAS (r=-0.53). The EQ-5D-5L and the mMRC dyspnea scale showed a significant correlation (p less than 0.01), particularly in relation to usual activities (r=0.69), self-care (r=0.62), and mobility (r=0.65), as well as EQ VAS (r=-0.58).
Conclusion: Moderate positive correlations existed between life quality issues including self-care, anxiety, depression and dyspnea severity .

Degree of Hearing Loss and Location of Tympanic Membrane Perforation in CSOM Patients: A Case Series

Rano Aditomo — 2024-09-26

Introduction: Chronic suppurative otitis media (CSOM) is an inflammation of the middle ear characterized by a perforation of the tympanic membrane with mucoid or mucopurulent secretions that persists or intermittently for 8 weeks. Tympanic membrane perforation causes a decrease in the surface area of the tympanic membrane for sound transmission and causes sound waves to be directly transmitted to the middle ear. CSOM may cause hearing loss from mild to deafness.

Case reports: This research is a case series was conducted at the ENT Department in Sultan Agung Islamic Hospital Semarang during September 2022-January 2023. A total of 7 patients were admitted to the ENT Department in Sultan Agung Isalmic Hospital with diagnosis of CSOM. 6 patients (86%) had hearing loss and 1 patient (14%) had only tinnitus without any hearing loss. As many as 67% had CHL and 19% had MHL and SNHL. The most common perforations were found in the AI quadrant (43%) followed by the AS and PI quadrants (28.5% each). Patients with perforation experienced the heaviest degree of hearing loss in the AS quadrant (82.5db) and the mildest in the AI quadrant (32.5db).

Conclusion: Patients with perforations in the PI quadrant have a worse degree of hearing loss than those with perforations in the AI quadrant, especially in cases of Conductive Hearing Loss. Patients with a larger perforation area have a worse degree of hearing loss than those with smaller area of perforation.

Menarche and Early Puberty: A Recent Review of the Causes of Early Puberty and Its Impact on Women's Health

Siti Khuzaiyah — 2024-09-26

Recently, the cases of early menarche are increasing. Early menarche has a negative impact on a woman’s physical and mental health. It is necessary to study the latest theory about early menarche as a promotive and preventive effort for early menarche. This paper aims to present the latest findings on early menarche, including its causes, impacts, and management strategies. This article summarized the last five years of research presented in the PubMed database. The author used the keyword “causes early menarche”, and found 182 articles published from 2018 - 2023. Furthermore, the author used the keyword “effect early menarche”, and obtained 153 articles. From a total of 335 articles found, the authors conducted a screening and found 74 articles that were relevant to the topic of this paper. The entire contents of the article were reviewed, summarized and presented thematically. The results of cross-sectional studies, cohort studies, and systematic reviews confirmed that early menarche is when a young woman experiences her first menstruation at the age of less than 10 years. Some factors that cause early menarche are hormonal factors, body weight, environment, pollution, lifestyle, activity patterns, nutritional patterns and prenatal factors. The long-term effects of early menarche include cancer, melanoma, obesity, cardiovascular disease, high blood pressure, metabolic system diseases (such as diabetes), less physical activity, asthma, pain, menopausal complaints, and psychosocial effects such as anxiety and self-injury.