ABSTRACT
BACKGROUND: Indonesia is the country with the second highest number of tuberculosis in the world. Patient compliance with tuberculosis treatment is still very low. Thus the success rate of treatment is also unsatisfactory. Concordance behaviour is a model of the doctor-patient relationship that combines aspects of the partnership, sharing decision making and trust. It is considered better than adherence to improve compliance and quality of life in patients with pulmonary tuberculosis. AIM: This study aims to assess the relationship between concordance and the level of adherence to pulmonary tuberculosis treatment along with the quality of life in Medan. METHODS: A cross-sectional study was conducted on 259 tuberculosis patients from several clinics and hospitals in Medan from 2015 to 2017, by asking patients to fill out questionnaires that had been tested for validity and reliability first. The concordance behaviour questionnaire contains 56 questions covering aspects of knowledge, partnership, sharing decision making, trust, and support. While compliance was measured by 14 questions covering attitude and behaviour. Statistical analysis was performed by Chi-Square test in SPSS v20. RESULTS: This study shows that most TB patients (75.7%) have a good concordance, in which the aspect of knowledge, partnership, sharing and support were all good. However, the component of trust in the most patient (75.7%) was still low. Based on the level of compliance, 84.2% of patients had good compliance. However, the level of behaviour in 55.2% of patients was still low. Statistical analysis showed that there was a significant relationship between concordance and compliance (p = 0.009), in which patient with good concordance had 2.6 higher probability for good compliance. However, there was no significant association between concordance and quality of life (p = 0.63). CONCLUSION: Concordance behaviour is a good concept to be applied to improve treatment compliance of pulmonary TB patients.
ABSTRACT
BACKGROUND: Asthma is a chronic airway disease that is based on an inflammatory process and a serious health problem around the world. Asthma is often associated with treatment management factor. Adherence is the patient's compliance towards their doctor's advice, which is accompanied by their understanding and follows the doctors' advice consistently. AIM: This study aimed to get a valid and reliable adherence measure in asthma patients especially in Medan. METHODS: This research used the method of quantitative done by the cross-sectional approach. The sample (200 adult asthma patients) used standard asthma medication, stable asthma patients and did not suffer from severe asthma or other accompanying diseases. Data were analysed using univariate, bivariate and multivariate analysis, which is SEM (Structural Equation Modeling) analysis. RESULTS: The best dimension of medication adherence was the dimension of beliefs in medication 64%. The highest education adherence is at college education level which is 67.6%. Employment status with highest adherence value is medication on civil servant/military/police with the value of 67.7. CONCLUSIONS: There is a correlation between adherence and asthma patient's quality of life in Medan.
ABSTRACT
BACKGROUND: Cytochrome P450 2A6 (CYP2A6) is known as an enzyme which is responsible for the metabolism of chemical compounds. AIM: This study aimed to analyse the relationship between CYP2A6 gene polymorphism with nicotine metabolism rates and lung cancer incidence among smokers of Batak ethnic group in Indonesia. METHODS: This study was a case-control study involving 140 research subjects through a purposive sampling technique from three hospitals in Medan, Indonesia. An examination of nicotine metabolism rates was conducted for all subjects using the 3HC/cotinine ratio parameter with LC-MS/MS technique. The examination of the CYP2A6 gene was performed with PCR-RFLP. Data were analysed with Conditional Logistic Regression test using Epi Info 7.0 software. RESULTS: The allele frequencies of CYP2A6*1A, CYP2A6*1B, and CYP2A6*4A found were 44.3%, 48.9%, and 6.8%, respectively. The *1B allele showed the highest metabolism rate. It is found that slow metabolizer individuals were 5.49 times more likely to develop lung cancer (P = 0.01, 95%CI 1.2-24.8). CONCLUSION: Among the Bataknese smokers studied, the CYP2A6*1B allele was found to be the most common allele and showed the highest rate of nicotine metabolism. However, the results show the insignificant relationship among CYP2A6 genetic polymorphism, nicotine metabolism, and lung cancer incidence.
ABSTRACT
AIM: This research aimed to analyse the relationship between CYP2A6 gene polymorphism with nicotine dependence and its relation to the number of cigarette consumption among Bataknese smokers. METHOD: This study was a cross-sectional study involving 140 research subjects in Medan, Indonesia. RESULTS: Nicotine dependence rates were found to be significantly associated with the number of cigarette consumption expressed in the Brinkman Index. CONCLUSION: The *1A wild-type alleles have a greater risk of high-very high dependence rate compared to the other variants.
ABSTRACT
AIM: to analyze the occurrence of chronic obstructive pulmonary disease (COPD) and its association with the polymorphisms of -308G/A, -238G/A of TNF gene and +252A/G LT gene polymorphism in smokers. METHODS: cross-sectional study, comparing the genetic group of people who have COPD and who do not have COPD with the same smoking history. The study was conducted from January 2011 to March 2012 at several health centers; such as Adam Malik Hospital, Pirngadi Hospital, Tembakau Deli Hospital, Siti Hajar Hospital in Medan and several health centers in the city of Medan. Examination of lung function was done using spirometry and the existence of genetic polymorhisms in the TNF and LT gene was performed using polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP). RESULTS: of the total of 227 samples that met inclusion criteria and after equalizing the age and history of smoking, 186 subjects were enrolled, of which, 93 people as COPD group and 93 people as non-COPD group. Analysis of the association between the -308G/A polymorphism with the COPD revealed the odds ratio (OR) 0.436 (95% CI 0.224-0.850, p=0.014). Polymorphism at -238G/A of the TNF gene showed the OR 2.094 (95% CI 0.608 - 7.211, p=0.241). Polymorphism at +252A/G LT gene showed OR 1.256 (95% CI 0.694 - 2.272; p=0.450). The findings indicated that polymorphism at -308G showed a protective factor whereas the -238G/A of the TNF and +252A/G of the LT genes did not show any significant association with the COPD. CONCLUSION: polymorphism -308 TNF gene shown to be a protective factor for the occurrence of COPD. Polymorphism -238 TNF gene and +252 LT gene did not show any significant association with COPD.
