Background: A long term treatment can happen for patients with diabetes mellitus (DM), which can negatively affect their lives and their families. Family support is an important factor to help them adapt to their DM and maintain their self-management. Doctors must assess family function of the patients with DM during their treatment.Objective: This study aimed to observe the effects of family function on blood sugar control in type 2 DM patients who were included in PROLANIS (chronic disease management program) at Puskesmas Banguntapan 2 Bantul, D.I. Yogyakarta, Indonesia.Methods: This quantitative analytical study was conducted with a cross-sectional design in November-December 2019 by using the Family APGAR instrument and fasting blood sugar tests from the DM patients’ venous blood. Its sampling technique was the total sampling of the PROLANIS participants who suffered from DM and met inclusion criteria of this study. All obtained data of this study were analyzed by Spearman Product Moment analysis to determine the effects of family function on their fasting blood sugar levels.Results: This study found that there was a significant effect of family function on blood sugar control in the patients with type 2 DM (p=0.008). This finding indicated that the family function was an important aspect in controlling their blood sugar.Conclusion: The family function was an influential factor to optimize the treatment of patients with type 2 DM. The assessment on the family function should be a part of their routine examination in primary healthcare units.
Background: Heart failure is a major health problem in the world. It is associated with high morbidity and high mortality especially in elderly patients. Most studies reported that N terminal pro-B type natriuretic peptide (NT-proBNP) is used in the diagnosis of heart failure, but tests in determining severity levels of heart failure in the elderly remains unclear.Objective: This study is to determine differences of NT-pro BNP levels based on severity of heart failure in elderly patients. Methods: This was an observational study with a cross sectional design. Its subjects were patients with heart failure and age of ≥ 60 years. Patients were divided into two groups: mild and severe heart failure groups according to severity of heart failure based on New York Heart Association (NYHA). The NT Pro-BNP levels were measured for all subjects in both groups. All obtained data was analysed by using unpaired t test and was considered significant if p <0.05. Results: This study involved 24 subjects. The mean age of the subjects was 64.50 ± 4.65 years with a minimum age of 60 years and a maximum age of 78 years. The NT pro-BNP levels in the severe heart failure group (1.2587.58 ± 574.85 pg/ml) was higher than the mild heart failure group (867.83 ± 333.27 pg/ml), andit was statistically significant with p = 0.040. Conclusion:The levels of NT-pro BNP serum in the elderly patients with severe heart failure (NYHA III-IV) were significantly higher than in patients with mild heart failure (NYHA I-II).
The Covid-19 pandemic has lasted for 1,5 years. There are many patients who suffered from many conditions or symptoms post Covid-19. In this report, we share our experience of caring for a post Covid-19 who suffered from worsening symptoms of breathlessness. Clinicians should be aware of post Covid-19 syndrome, and try to find the underlying cause and solve the problems. A 65year-old man came to Universitas Islam Indonesia Hospital with severe dyspnea 3 months after discharged from hospitalization for Covid-19 diagnosis. Clinical examination showed bilateral massive pleural effusion and was confirmed by chest x-ray. From echocardiography, we found a 42% decrease in ejection fraction of systolic function. After furosemide treatment, there was only marginal improvement. In order to reduce the pleural effusion, we conducted pleural effusion tapping, and we tapped 1200 ml serous discharge from the right pleura and 1100 ml from left pleura. From the laboratory examination we concluded that the discharge was transudation from reduced cardiac function. There was no evidence of bacterial infection nor mycobacterial tuberculosis infection. The patient had diabetes mellitus as comorbidity; however, the blood glucose remained stable and controlled with diet during hospitalization. Follow-up several months after discharge showed that maintenance treatment with diuretic, beta-blocker and Angiotensin II Receptor blocker showed good results and there was no recurrence of pleural effusion. Post Covid-19 symptoms can manifest as severe dyspnea from pleural effusion caused by reduced cardiac function. Several diagnostic tests should be performed to exclude other causes of pleural effusion. The symptom will improve with pleural tapping and administration of diuretic, beta-blocker and Angiotensin II receptor blocker.
Kasus reinfeksi COVID-19 berhubungan dengan faktor imunitas tubuh pada pasien yang telah sembuh dengan perjalanan alami patogen penginfeksi. Meski demikian, kemampuan reinfeksi COVID-19 masih belum banyak diketahui. Tujuan dari tinjauan ini adalah untuk membahas studi terkait reinfeksi, termasuk penyebab dan manifestasi klinis serta manajemen terkait penanganan reinfeksi. Reinfeksi dapat terjadi akibat infeksi virus SARS-CoV-2 yang memiliki genom berbeda dengan infeksi sebelumnya. Manifestasi klinis yang ditimbulkan pada kondisi reinfeksi dibandingkan dengan infeksi sebelumnya masih belum jelas. Walaupun demikian, dipercaya bahwa pada populasi yang rentan, reinfeksi dapat memiliki luaran yang lebih buruk. Vaksinasi menjadi pilihan utama untuk mengurangi tingkat keparahan akibat reinfeksi. Diperlukan studi lebih lanjut untuk memahami mekanisme dan manajemen reinfeksi COVID-19. Dengan demikian, pengembangan pengobatan dan vaksin COVID-19 bisa lebih efektif.
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