Challenges on management of heart failure in Indonesia: a general practitioner’s perspective

Rizki,; Siswanto, Bambang Budi

doi:10.13181/mji.v23i1.691

Cited by 2 publications

(2 citation statements)

References 19 publications

(38 reference statements)

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“…In their report, Siswanto, et al found that patients hospitalized for HF in Indonesia tend to have severe symptoms and lower LVEF [ 22 ]. It is a challenge for primary care providers and general practitioners in Indonesia to improve management of HF so that patients with HF will be not delayed to receive appropriate treatment [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Hyponatremia during hospitalization and in-hospital mortality in patients hospitalized from heart failure

Saepudin

Ball

Morrissey

2015

BMC Cardiovasc Disord

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BackgroundTo date, the majority of studies on hyponatremia focussed on hyponatremia at admission, and came from developed countries. This study aimed to identify the prevalence of hyponatremia during hospitalization in patients hospitalized for HF and its association with in-hospital mortality.MethodsThis was an observational study using retrospective data from patients’ records between 2010–2013. It focused on those patients carrying an ICD-10 code of 150.0(Congestive Heart Failure) as their primary diagnosis.Hyponatremia during hospitalization was defined as serum sodium level lower than 135 mEq/L obtained from a blood chemistry measurement on the next days after admission. Patients’ characteristics were examined and the association between hyponatremia during hospitalization and in-hospital mortality was analyzed.ResultsAmong 464 patients hospitalized for HF, hyponatremia during hospitalization was observed in 22 % of patients with 44 % of this group had normal serum sodium level on admission.Hyponatremia during hospitalization was associated with lower blood pressure on admission, both systolic and diastolic, peripheral oedema, ascites and fatigue. Patients having history of hospitalization for cardiac diseases and renal failure were higher in patients developing hyponatremia during hospitalization. In this group, amiodarone, heparin, insulin and antibiotics were administered more frequently. Factors potentially increase the risk of hyponatremia during hospitalization include history of fatigue (OR = 3.23, 95 % CI 1.79–5.82), presence of ascites (4.14, 1.84–9.31), and administration of heparin (3.85, 1.78–8.31) and antibiotics (3.08, 1.71–5.53). Length of hospital stay was significantly longer in patients with hyponatremia during hospitalization and in-hospital mortality was also higher compared to non-hyponatremic patients, 7.7 % and 29.1 %, respectively.ConclusionThis study found that the prevalence of hyponatremia during hospitalization in patients hospitalized for HF was almost the same as hyponatremia on admission and administration of heparin and antibiotics can potentially worsen hyponatremia during hospitalization. In this study population, hyponatremia during hospitalization was found to be associated with in-hospital mortality.

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Section: Discussionmentioning

confidence: 99%

Hyponatremia during hospitalization and in-hospital mortality in patients hospitalized from heart failure

Saepudin

Ball

Morrissey

2015

BMC Cardiovasc Disord

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“…Firstly, consumption of beta-blockers in Indonesia is expected to be considerably low, considering none of the beta-blockers is listed in the Bappenas top 50 pharmaceuticals list (Bappenas 2019 ). Secondly, cardioselective beta-blockers such as ATL and MPL are still considered not widely available in Indonesia; hence, they are less prescribed (Rizki and Siswanto 2014 ) and are not available over-the-counter. Additionally, studies have reported the use of other beta-blockers, e.g., bisoprolol and propranolol, by the Indonesian population (Rahmawati et al 2019 ; Sari 2020 ).…”

Section: Resultsmentioning

confidence: 99%

Contaminants of emerging concerns (CECs) in a municipal wastewater treatment plant in Indonesia

Astuti

Notodarmojo

Priadi

et al. 2022

Environ Sci Pollut Res

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This study provides the first set of quantitative data on the occurrence and fate of a wide range of contaminants of emerging concerns (CECs) in Indonesia’s largest wastewater treatment plant (WWTP). The WWTP employs waste stabilization ponds (WSPs) as the secondary treatment before discharging the effluent to the Citarum River. Fourteen out of twenty-two monitored CECs were detected in the wastewater influent, and seven were present in the effluent, with a total concentration of 29.8 ± 0.4 µg/L and 0.5 ± 0.0 µg/L, respectively. The occurrence of the CECs in this study was found to be well correlated with their possible use and known detection in surface waters in Indonesia. Caffeine (CAF) at 12.2 ± 0.1 µg/L, acetaminophen (ACT) at 9.1 ± 0.1 µg/L, N,N-diethyl-m-toluamide (DEET) at 5.0 ± 0.1 µg/L, ibuprofen (IBU) at 2.3 ± 0.0 µg/L, and triclosan (TCS) at 470 ± 64 ng/L were discovered as the five most prevalent CECs, followed by bisphenol A (BPA), trimethoprim (TMP), Tris(2-chloroethyl) phosphate (TCEP), sulfamethazine (SMZ), carbamazepine (CBZ), fluoxetine (FLX), benzotriazole (BTA), sulfamethoxazole (SMX), and metformin (METF). Biodegradable CECs (SMX, SMZ, ACT, IBU, TCS, BPA, CAF, DEET, and TMP) were efficiently removed (83–100%) by the WSP. In contrast, recalcitrant CECs achieved poor removal efficiencies (e.g., FLX at 24%), and for others, treatment processes even resulted in elevated concentrations in the effluent (CBZ by 85%, TCEP by 149%, and BTA by 92%). The CECs’ influent concentrations were determined to pose a moderate aquatic cumulative risk, while no such risk was associated with their effluent concentrations. The study demonstrates the importance of conventional WWTPs in reducing the concentrations of CECs to minimize their aquatic contamination risk. The findings are relevant for countries, such as Indonesia, with limited resources for advanced centralized wastewater treatments, and which are exploring the efficacy of centralized WSP against the existing decentralized treatments.

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Challenges on management of heart failure in Indonesia: a general practitioner’s perspective

Cited by 2 publications

References 19 publications

Hyponatremia during hospitalization and in-hospital mortality in patients hospitalized from heart failure

Hyponatremia during hospitalization and in-hospital mortality in patients hospitalized from heart failure

Contaminants of emerging concerns (CECs) in a municipal wastewater treatment plant in Indonesia

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