Early Detection of Diabetic Peripheral Neuropathy in Diabetic Patients: A Cross-Sectional Study.

BACKGROUND: Diabetic Peripheral Neuropathy (DPN) is a chronic complication in Type 2 Diabetes Mellitus (T2DM) patients and is characterized by paresthesia, pain, and hypoesthesia of the extremities. The Diabetic Neuropathy Symptom-Score (DNS) is a quick, inexpensive, and easy-to-perform tool to detect DPN in clinical practice. Biochemical markers like Nitric Oxide (NO) and Vascular Endothelial Growth Factor (VEGF) play a role in the early detection of DPN. This study aims to investigate the relationship between risk factors and these biomarkers. So, it is expected to improve the prevention and treatment of diabetic neuropathy more effectively. METHOD: A cross-sectional method was used for this study. The sample size was 85 patients with T2DM who visited several primary healthcare in Medan, selected by consecutive sampling method based on eligibility criteria. Data collected included DNS, assessment of NO, VEGF, Glycated Hemoglobin (HbA1C), plasma blood glucose (PBG), and lipid profile. The collected data were analyzed using an independent T-test. RESULT: The results showed that most T2DM patients, namely 73 people (85.9%), experienced DPN. From the bivariate analysis results, the risk factors associated with the prevalence of DPN in T2DM patients were found to be increased levels of total cholesterol, HbA1c, NO, and VEGF (p < 0.05). Meanwhile, blood pressure, fasting BGL, HDL-C, LDL-C, and triglycerides were not related to the occurrence of DPN in this study (p> 0.05). CONCLUSION: DNS can be used as a quick and easy initial screening tool implemented in clinical practice for screening DPN. Diabetic patients with DPN tend to have lower NO and increased VEGF; besides, NO levels are also associated with the progression of DPN. Furthermore, education, blood sugar control, and physical exercise, especially leg exercises, can prevent progressive DPN.

Health science students perception on professional learning after the application of IPE

OBJECTIVE: To study students' perceptions based on IPE learning model in hospital. METHOD: This study is performed using a method of quantitative which involved 20 respondents from four faculties, including faculties of medicine, pharmacy, nursing, and public health. All respondents were from the Universitas Sumatera Utara, quantitative methods were based on quasi-experimental design type nonequivalent control group design pre and post interventions. The questionnaire using interprofessional Learning Readiness Scale (RIPLS) which has been validated. The data were analyzed by t-dependent. RESULTS: This study showed a significant increase in the perception (p < 0.05) on each aspect of learning IPE (except aspects of the communication and team work with p > 0.05) after this intervention. CONCLUSION: These finding conclude that the IPE model learning can be used as a strategy to make sure all aspects of professionalism can be done in medical practice in the future

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The Relationship between the Duration of Playing Gadget and Mental Emotional State of Elementary School Students.

BACKGROUND: Technology has provided a type of facility in the world that currently makes the world like a virtual globe. One of the technologies currently used by humans is gadgets. Generally, children and adolescents nowadays often use gadget excessively. They use it excessively which may affect their social and emotional functions. AIM: This study aims to determine the relationship between the duration of playing gadget and mental-emotional state of elementary school students. METHODS: This study uses Strength and Difficulties Questionnaire (SDQ) which contains 25 questions that can be used for children aged 8 to 16 years. This research was conducted in August 2018 with fourth-grade students of Public Elementary School and Private Elementary School Medan as respondents. This study uses a cross-sectional study method with the chi-square test as a statistical hypothesis test. The number of respondents in this study was 103 students consist of 73 students of Public Elementary School and 30 students of Private Elementary School Medan. RESULTS: The results of this study found a relationship between the duration of playing gadgets on mental-emotional at elementary school students with a probability value of 0.0001 (p < 0.05) and the relationship between the frequency of using gadgets and mental-emotional with a probability value of 0.001 (p < 0.05). CONCLUSIONS: There is a significant relationship between mental emotional and the duration of playing gadgets and the frequency of using gadgets elementary school students.

The Difference in Effect of Arabica Coffee Gayo Beans and Leaf (Coffea Arabica Gayo) Extract on Decreasing Blood Sugar Levels in Healthy Mice.

BACKGROUND: High incidence rate of diabetes mellitus (DM) and increased incidence of complications from DM as well as the use of less effective antidiabetic drugs and high financing to treat demands alternative therapy. AIM: This study was conducted to determine the difference in the effect of Arabica coffee gayo bean and leaf extract on blood sugar levels in healthy mice before and after the intervention of extract and fasting and postprandial blood glucose level after consumption of glucose. METHODS: This research is an experimental research study. The study used experimental animals which were divided into 8 groups which are the control group (Aquadest), group given Acarbose, the group given the Arabica coffee gayo bean extract with dosage of 50 mg, 100 mg and 200 mg in healthy mice, the group given the Arabica coffee gayo leaf extract with dosage of 30 mg, 60 mg and 120 mg in healthy mice. RESULTS: The results of the study obtained are before and after the intervention of extract showed the difference of p= 0.523 and after consumption of glucose the fasting and postprandial result showed the difference of p = 0.005. CONCLUSION: The use of Arabica coffee gayo bean and leaf extract showed a high decrease in blood glucose levels (BGL) compared to the control group.

Diabetic Neuropathy among Type 2 Diabetes Mellitus Patients at Amplas Primary Health Care in Medan City.

BACKGROUND: Diabetic neuropathy is one of the most complicated complications of diabetes patients with Type 2 diabetes. AIM: The purpose of this study was to determine the diagnosis of diabetic neuropathy based on Clinical Neurological Examination (CNE) and the factors that influence the occurrence of diabetic neuropathy in Type 2 DM patients at Amplas Primary Health Care (PHC) in Medan City. METHODS: The research design was descriptive-analytic with the cross-sectional approach. The study population was all Type 2 DM patients who came to Amplas PHC with a total sample of 53 people using the consecutive sampling. The research data source is primary data, namely the assessment of diabetic neuropathy using the Clinical Neurological Examination (CNE) criteria. Data were processed using SPSS and analysis using the chi-square test. RESULTS: The results showed the majority of Type 2 DM patients had mild neuropathy as many as 24 people (45.3%). The Chi-square test results showed there was a relationship between age and duration of diabetes with the incidence of diabetic neuropathy in Type 2 DM patients at Amplas Primary Health Care. CONCLUSION: Education and early detection with proper management can prevent more severe complications so that the quality of life of patients can be maintained better.

The Difference of Educational Effectiveness Using Presentation Slide Method with Video About Prevention of Hypertension on Increasing Knowledge and Attitude in People with the Hypertension Risk in Amplas Health Center.

BACKGROUND: The prevalence of prehypertension in the world reaches 20-25% with a figure that is still high in Indonesia (48.4%). The role of health promotion is substantial in an effort of prevention and treatment of hypertension. AIM: This study aims to determine the difference of effect between health promotion using media slides presentation and with video in increasing knowledge and attitude regarding the prevention of hypertension in patients at risk hypertension at Puskesmas Amplas. METHODS: his study uses a Quasi-Experimental design which from 48 samples that meet the criteria inclusion will be immediately given health promotion interventions with slides presentation and video. Respondents will be asked to fill out a questionnaire about knowledge and attitudes before and after the intervention. Data processing is done using the SPSS version 20 application. RESULTS: Distribution level of the knowledge of respondents before the intervention (Pretest) and after the intervention (Posttest) is (9.8, 2.68 vs 13.2, 1.58). Distribution of the pretest vs respondent's attitude level. Post test is (29.7, 2.76 vs 33.2, 3.52). Based on the comparison of effectiveness between video and slide presentation, the significance value of knowledge was 0.072, and the significance value of attitude was 0.000. CONCLUSION: There was a significant difference in effectiveness between video with a slide presentation on improving attitudes towards hypertension prevention, and there were no significant differences in effectiveness between videos with slides presentation on increasing knowledge about prevention of hypertension.

Adherence to Consuming Medication for Hypertension Patients at Primary Health Care in Medan City.

BACKGROUND: Hypertension is one of the major health issues among senior citizens considering the increase in the population of a senior citizen's over the age of 60 in Indonesia. The use of antihypertensive drugs alone has proved to be inadequate to exhibit long-term effects of blood pressure control if it is not supported by adherence. AIM: This study aims to investigate the relationship between knowledge, attitude, action, and doctor's communication to adherence of hypertensive patient in taking medication. METHODS: This is an analytical study with a cross-sectional design. The population of this study consist of patients who have been diagnosed with hypertension and are consuming antihypertensive drugs. Eighty samples were randomly recruited. The research data were collected using a guided interview questionnaire and were an analysed using the chi-square test. RESULTS: This study shows that the patient percentages with poor knowledge are 76.3%, 82.5% with a bad attitude, 82.5% for negative action, 56.3% for lack of doctor's communication, and 58% for poor levels of adherence. Chi-square test shows a significant relationship (p < 0.05). CONCLUSION: There is a relationship between knowledge, attitude, action, and doctor's communication towards the adherence of hypertensive patient in taking medication.

Risk Factors Associated with Premature Hair Greying of Young Adult.

BACKGROUND: Many researchers have been indicated that premature hair greying (PHG) may be associated with the multifactorial problem include genetic, trace elements deficiencies and some medical problems such as metabolic disorders. However, the risk factors for premature hair greying are not well known for young adult. AIM: This study aimed to determine the risk factors of hair greying in young adult. METHODS: We conducted a cross-sectional study recruited 100 respondents of a college student at the Universitas Sumatera Utara (USU) with the inclusion criteria: male, less than 25 years old with hair greying and not have skin pigmentation disorders. The questionnaires about greying of hair status, family history of greying and history of family disease were collected by self-report. RESULTS: The age of participants in this study was 20.09 ± 2.01 years (mean ± SD). The mean onset of PHG was 15.23 ± 3.52 years (range: 9 - 22 years). The family history of PHG was 39% with paternal in 262%; maternal in 10%% and both parents in 3%. There was a significant difference between several grey hairs with a family history of PHG P = 0.045. The family history with metabolic disorders; hypertension was 29%, obesity was 25%, and diabetes Mellitus (DM) was 15%. Limitations: Owing to the use of questionnaires, the possibility of recall bias exists. The young female was not evaluated in this study. CONCLUSION: The family history of PHG and onset of greying are important risk factors associated with PHG of a young adult.

Procalcitonin Level in Non-Small Cell Lung Cancer Patients among Indonesian Population.

BACKGROUND: Serum Procalcitonin (PCT) is a biomarker that is frequently used to diagnose an infection. In some cases of thoracic malignancy, procalcitonin level appears to increase. However, the role of procalcitonin to diagnose malignancy is not certain yet, and the causes have not been known. AIM: This study aimed to investigate procalcitonin levels in non-small cell lung cancer patients. METHODS: This was an observational study with a cross-sectional design. All lung cancer patients did not diagnose based on cytology/histopathology results with no evidence nor were signs and symptoms of infection recruited through consecutive sampling. The subtypes of lung cancer include adenocarcinoma, squamous cell carcinoma, and large cell carcinoma, staged III and IV. The procalcitonin levels were analysed from blood using immunofluorescent assay. Data were then analysed with the Chi-Square test by Epi Info™ 7 programs in which p-value < 0.05 was considered statistically significant. RESULTS: A total of 68 lung cancer patients fulfilled the criteria of this study, 55 men (80.9%) and 13 women (19.1%). The highest percentage of cytology/histopathology type found was adenocarcinoma (80.9%), and 60.3% of those were diagnosed in stage IV. An increased procalcitonin level (greater than 0.01 ng/mL) occurred in 80.9% of Non-Small Cell Lung Cancer (NSCLC) patients. It appears that the higher the stage of lung cancer, the lower procalcitonin levels would be, although it was not statistically significant. There was no association between lung cancer subtype with procalcitonin levels. CONCLUSION: An increased level of procalcitonin may be an indication not only for infection but also for Non-Small Cell Lung Cancer.

The Correlation between Adherence and Asthma Patients Quality of Life in Medan, Indonesia.

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.

Analysis of Concordance of Medication-Taking Behaviour in Tuberculosis Patients in Medan, Indonesia.

AIM: This study aimed to analyse tuberculosis (TB) medication-taking behaviour based on the concept of concordance between health workers and TB patients in Medan, Indonesia. METHODS: This study was an analytical study with a cross-sectional design. A total of 100 patients undergoing TB treatment at several public health centres in Medan City participated in the study. RESULTS: The results showed that there was a relationship between the concordance behaviour of the health workers with the attitude and medication-taking behaviour of the patients (p < 0.05). However, there was no relationship found between concordance and knowledge of the patients (p > 0.05). CONCLUSION: The results showed that most of the concordance behaviour, knowledge, attitude, and behaviour in the sample were good.