Journal Of The Indonesian Medical Association

Can We Inhibit Chronic Kidney Disease Progression in Children? : a Proteomic Prospective

Ahmedz Widiasta — Thu, 05 Jun 2025 13:22:17 +0700

Penyakit ginjal kronik (PGK) merupakan penyakit tidak menular dengan morbiditas, mortalitas dan penurunan kualitas hidup yang bermakna, ditandai dengan adanya kerusakan struktural dan gangguan fungsional ginjal.^1,2 Meskipun begitu, data prevalensi PGK pada populasi anak di dunia diperkirakan mencapai 18 per 1 juta orang.^3,4

Addressing Barriers to HPV Screening Among Women: A Study Overview

Thu, 05 Jun 2025 13:20:10 +0700

Introduction: A major challenge in the success of HPV screening programs is achieving 70% coverage of women aged 30-69. This study conducted a survey to examine the factors influencing the willingness of woman in that age group to actively engage HPV screening program.
Method: Socio-demographic data, knowledge levels, cervical cancer screening uptake, and willingness to participate in the government’s routine screening program were collected digitally using cross-sectional study. Factors associated with knowledge, participation, and willingness to engage program measured using logistic regression analysis.
Result: Among the 87 eligible respondents, 96.6% had heard about cervical cancer mostly via internet, and 51% categorized as having low level knowledge. The percentage of participants willingness to participate in program was 67.82% below the percentage government target coverage. Factors correlated with willingness included: age group 36-40 (aOR = 1.865, 95% CI = 0.567-6.129) and 41-45 (aOR = 2.93, 95% CI = 0.762-11.272), monthly household expense (aOR = 1.682, 95% CI = 0.684-4.138), having relatives suffer cervical cancer (aOR = 2.764, 95% CI = 0.790-9.672), history of HPV vaccination (aOR = 1.187, 95% CI = 0.593-7.539).
Conclusion: Respondent willingness to participate in HPV screening program remains to be improved. Various ways to increase participation in screening programs need to be developed to reach various populations of women.

The Relationship between Energy Intake and Neutrophil Lymphocyte Ratio in Critically-ill Patient

Thu, 05 Jun 2025 13:24:01 +0700

Introduction: Critically-ill patients experience catabolic stress and inflammatory responses resulting in increased catabolism to meet energy demands. Neutrophil lymphocyte ratio (NLR) is used to assess immune and stress responses.

Method: This study was a cross-sectional study of subjects aged ≥18 years admitted to the intensive care unit of Dr. Cipto Mangunkusumo National Central General Hospital and University of Indonesia Hospital. The characteristics of the study subjects included age, gender, nutritional status, diagnosis of ICU admission, protein intake, fat intake, and carbohydrate intake. Bivariate analysis was performed to evaluate the correlation between energy intake and neutrophil-lymphocyte ratio.

Result: There were 44 subjects with a median age of 55 years (19-86). Nutritional status based on body mass index (BMI) obtained 31.8% normal nutritional status, 20.5% severe malnutrition, 25% obesity grade 1. The most common diagnoses were surgery and trauma 20.5% of subjects and sepsis 20.5% of subjects. Median RNL was 10.39 (2.51-59.5), energy intake was 10.5 (3-29) kcal/kg BW/day, protein intake was 0.4 (0-1.2) g/kg BW/day, fat intake was 18 (0-29)% and carbohydrate intake was 92 (23-184) g/day.

Conclusion: There was no correlation between energy intake and NLR.

Effectiveness of Adding Expiratory Muscle Strengthening Exercise to “Senam Lansia” on Cardiorespiratory Fitness of Pre-Frail Elderly

Ratih Dwiratna Hakim, Lanny Indriastuti, Erna Setiawati — Thu, 05 Jun 2025 13:25:50 +0700

Introduction: The aging process will cause anatomical and physiological changes in various organs and the body systems, including changes in the cardiovascular, respiratory, and musculoskeletal systems which then progressively reduce cardiovascular and pulmonary functional capacity, ultimately affecting cardiorespiratory fitness, which can be assessed by a 6-minute walk test/6MWT. Aerobic exercise, including senam lansia, will affect cardiorespiratory fitness by increasing muscles blood flow. Adding expiratory muscle strengthening exercises with a Positive Expiratory Pressure/PEP threshold will strengthen expiratory muscles, the most common muscles affected in aging. This study aims to prove the effectiveness of adding expiratory muscle-strengthening exercises to senam lansia on the cardiorespiratory fitness of the pre-frail elderly.

Method: 24 subjects who met the study criteria were randomly divided into an intervention group (n=12) who receive PEP 5 times per week + senam lansia 3 times per week for 6 weeks, and a control group (n=12) who only had senam lansia 3 times per week for 6 weeks. Cardiorespiratory fitness was measured before and after intervention using the 6MWT.

Result: There was an increase in 6MWT scores before and after treatment in both the intervention group (p=0.002) and the control group (p<0.001). Comparison between groups showed a significant 6MWT score difference in the intervention group (p<0.001).

Conclusion: The addition of expiratory muscle strengthening exercises to senam lansia for 6 weeks had a better improvement in cardiorespiratory fitness compared to only having senam lansia.

Effectiveness of Adding Lower Extremity Strengthening Exercises on Cardiorespiratory Fitness Improvement of Hajj Pilgrims Candidate

Muhammad Anang Eko Fahrudin, Sri Wahyudati, Rahmi Isma Asmara Putri — Thu, 05 Jun 2025 13:27:35 +0700

Introduction: Good health condition of Hajj pilgrims candidate will support the optimal performance of worship and decrease morbidity. One of the important health parameters is cardiorespiratory fitness. Exercise is important for improving cardiorespiratory fitness. The level of participation and implementation of structured training activities among Hajj pilgrims candidate is still lacking. The aim of this study was to determine the effectiveness of additional lower extremity strengthening exercises on the cardiorespiratory fitness of prospective Hajj pilgrims who received walking aerobic training.

Method: The research was conducted in Salatiga City in February-March 2023. The research design was a randomized control trial, the subjects were 36 Hajj pilgrims candidate, divided into treatment group (n=18) and control group (n=18). The treatment group was given lower extremity strengthening exercise 2x/week intensity 40-50% 1-RM, 2-4 set, 20 repetition and walking aerobic exercise 30 minutes 5x/week and the control group performed walking aerobic exercise 30 minutes 5x/week. Training was carried out for 6 weeks. Measurement of cardiorespiratory fitness (VO2max) with a 6 minute walk test before and after intervention.

Result: There was a statistically significant difference in the mean pre- and post-intervention VO2max values at the treatment group (19.53 ± 4.76; p=0.0002) and the control group (18.36 ± 3.38; p=0.000). The increase of the mean difference/delta VO2max between groups was higher at the treatment group than the control group (4.16 ± 2.03 vs 2.87 ± 1.89; p = 0.031).

Conclusion: The addition of lower extremity strengthening exercises to walking aerobics can increase cardiorespiratory fitness higher in hajj pilgrims candidate compared to walking aerobics alone.

Respiratory Asymptomatic Lung Tuberculosis with Ascites Caused By Intestinal Tuberculosis: A Case Report

Heri Krisnata Ginting, Arya Marganda Simanjuntak, Latifah Humairoh — Thu, 05 Jun 2025 13:28:59 +0700

Introduction: Tuberculosis (TB) is usually suspected when the patient has symptoms. Ascites is generally suspected if the patient has liver disease, organ failure or malignancy. In this case, we found something that is not usually found and is an important lesson.

Case Report: Mrs. RS, a 58-year-old woman, presented with abdominal swelling worsening 5 days before admission with red bloody stools. Previous USG in another hospital showed no abnormalities were found. On physical examination, a right upper lung with ronchi and weak percussion was discovered. The abdomen was distended, and there was a throbbing pain and dull ache that moved about. The bilirubin, stool analysis, and liver function values were all normal. While GeneXpert sputum was negative, abdominal ultrasound revealed ascites, stool samples were positive for TB bacteria, and chest X-ray revealed cavities in the right upper lung. Following treatment with isoniazid (R), rifampicin (R), pyrazinamide (Z), and ethambutol (E), the patient was released and instructed to await examination by the physician.

Case Discussion: Although clinical signs like coughing and shortness of breath are frequently used to diagnose tuberculosis, this case was discovered to be silent pulmonary TB, which Kendall et al characterized as subclinical TB infection.

Conclusion: Ascites as a result of intestinal TB is rare but possible. Increased TB suspicion testing is necessary, particularly in locations where the disease is prevalent. Instances of intestinal tuberculosis and pulmonary TB without respiratory symptoms make treating tuberculosis cases more difficult.

Hypothyroidism On The Aging Process And Aesthetics

Ratna Shintia Defi — Thu, 05 Jun 2025 00:00:00 +0700

Aging is a biological process that affects various bodily functions, with the endocrine system, particularly thyroid hormones, playing a crucial role in this process. Thyroid hormone dysregulation, especially hypothyroidism, commonly found in older adults, can accelerate signs of aging both physiologically and aesthetically. The decline in thyroid gland function leads to reduced thyroid hormone production, resulting in slowed metabolism, dry and rough skin, brittle hair, and decreased skin elasticity. Although the symptoms of hypothyroidism often overlap with common signs of aging, thyroid hormone replacement therapy can help restore bodily function and slow down the aging effects. This study aims to analyze the relationship between thyroid hormone dysregulation, particularly hypothyroidism, and the aging process, as well as its impact on physical appearance. This review shows that treating hypothyroidism can minimize its negative effects on body aesthetics and improve the quality of life in the elderly.