http://localhost:8080/xmlui/handle/123456789/8738 65 - 130 2026-04-09T03:10:08Z http://localhost:8080/xmlui/handle/123456789/8748 Title: Diagnostic Challenge of Adult-onset Type 1 Diabetes Mellitus in a Remote Hospital Authors: Arista Hartono, Bryan; Henrina, Joshua; M. Turmudzi, Doddy Abstract: Type 1 Diabetes Mellitus (T1DM) is a chronic endocrinological disease due to an autoimmune process. The prevalence of T1DM is 9.5% worldwide, with the incidence of 15 out of 100,000 people, ranging from childhood to 40 years of age. Autoimmunity-related late-onset Diabetes Mellitus (DM) patients could be diagnosed as classic T1DM or latent autoimmune diabetes in adults (LADA). A 30-year-old male patient with unremarkable previous medical history was admitted to the emergency room with dyspnea for the last three days that was worsened six-hour before admission. Physical examinations showed a body Mass Index (BMI) of 18.75 kg/m2, irregular pulse, and Kussmaul breathing. The patient was diagnosed with diabetic ketoacidosis (DKA) on May 23, 2019. He was discharged with subcutaneous insulin pen injections. Two years later, he was readmitted with DKA due to discontinuing his treatment. He stated that the reason for stopping the insulin was because he was tired of injecting it. The patient was hospitalized and was discharged with oral antidiabetic agents to cope with his injection tiredness issue. One week later, the patient complained of dyspnea and was diagnosed with recurrent DKA. He was hospitalized and prescribed subcutaneous insulin. In this kind of situation, a diagnosis of LADA for patients presenting with DKA without prior history of DM in early adulthood needs to be considered. In contrast to the classic T1DM, the need for insulin occurs late in LADA. Affordable and widely available ancillary examinations are needed, including in remote hospitals. Finally, motivational support for patients is as important as the pharmacological treatment since lifelong insulin injections are needed. Keywords: Adult onset, autoimmunity, diabetic ketoacidosis, type 1 diabetes mellitus 2023-01-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/8747 Title: Effective Visual Media to Increase Knowledge and Comprehension of Multidrug Resistant Tuberculosis Among Patients and Their Caregivers Authors: Chaidir, Lidya; Nurkartika Pascapurnama, Dyshelly; Selviyanti, Claudia; Natasha, Cindy; Nurul Jihadah, Mutiah; Santoso, Prayudi Abstract: Indonesia ranks third among countries with the largest number of TB cases after India and China. Globally, more than 3-4% of all TB cases are Multidrug-Resistant Tuberculosis (MDR TB). MDR TB is a more complicated TB that needs extra treatments, which extend treatment time and increase adverse effects. Thus, MDR TB patients and their families often feel demotivated about completing treatment, leading to loss to follow up, which contributes to the never-ending transmission and greatly affects the success rate of the national TB control program. Thus, better knowledge and perception on MDR treatment for patients and families plays a crucial role in dealing with this issue. A cross-sectional study was performed from April to June 2019 to evaluate the effectiveness of visual educational media for TB patients and their caregivers. Participants consisted of 144 patients diagnosed with MDR TB and their caregivers or family members (n=22). A pre-test was administered before an education session by a nurse and visual media were used as the educational material. At the end of the session, a post-test was performed. The post-test score was then compared to the pre-test score to evaluate the session’s effectiveness using the paired t-test. Result showed significant increase in the post-test score (t= 3.249, df=3, p=0.04), with the caregivers attained a higher score, showing better improvement in knowledge after the session compared to the patient group. Hence, the MDR TB educational intervention using visual media is considered effective to increase participants ‘understanding of MDR TB. It is expected that with increased knowledge on MDR TB, the treatment success rate will increase and becomes the catalyst for the nationwide TB control strategy. Keywords: Multidrug resistant tuberculosis, MDR TB knowledge, MDR TB education, visual educational media 2023-01-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/8746 Title: Therapeutic Outcome of High Flow Nasal Cannula (HFNC) for Severe COVID-19 Patients in Isolation Intensive Care Unit Authors: Aflah, Baginda; Pradian, Erwin; Dian Kestriani, Nurita Abstract: This retrospective descriptive study aimed to understand the outcomes of HFNC therapy in severe COVID-19 patients admitted to isolation ICU during the period of January to June 2021 in Dr. Hasan Sadikin General Hospital Bandung, Indonesia. A total of 134 patients with severe COVID-19 were admitted to the isolation ICU and received HFNC. Among them, 44 patients (32.8%, N:134) were successfully weaned from HFNC and 90 patients (67.2%, N:134) failing HFNC with 10 patients (7.5%, n:134) died on HFNC use, 72 patients (53.9%, n:134) died on ventilator use, 4 patients (2.9%, n:134) moved rooms under HFNC use, and 4 patients (2.9%, n:134) moved to non-ICU isolation with ventilator use as the outcome. Patients’ median age was 60 years, most were male (52.3 %, n:134), median BMI was 25.4 kg/m2, with hypertension and diabetes mellitus as the main comorbidities. There was an improvement in the SpO2 on the first day after the use of HFNC. The ROX index had a median value of 3.6 on the first day, with the lowest ROX index of 3.2 and the highest of 4.4 during the treatment time. There was an improvement in the P/F Ratio in successful patients with a median initial P/F Ratio of 86.7 to 200.1 at the end of treatment. Overall, HFNC improves the hypoxemic conditions in early admission but does not correlate with general patient outcomes. Keywords: High flow nasal cannula, intensive care, ROX index, severe COVID-19, therapeutic outcome 2023-01-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/8745 Title: Predictors of Urethral Stricture After Transurethral Resection of the Prostate Procedure Authors: Saputra, Daniel; Agil, Ahmad; Mustafa, Akhmad Abstract: Transurethral resection of the prostate (TURP) is the most frequently used urology surgical method to manage benign prostate hyperplasia (BPH). Despite the relatively efficacious treatment, urethral stricture (US) may form after TURP. The prevalence of the urethral strictures (US) following TURP ranges from 2.2% to 9.8%. The study aimed to identify the predictors of urethral strictures in patients receiving TURP. This study was a retrospective cohort study on patients underwent TURP in Dr. Hasan Sadikin General Hospital Bandung, Indonesia, between 2015 and 2019. Data were obtained from medical records and urology registry of a minimum 12-month follow-up period. Data on patient demographics, estimated volume of the prostate, total resected prostate, and operating time were extracted. Multiple logistic regression was utilized to determine the odds ratio difference between groups. A total of 451 TURP cases were performed between 2015 and 2019, with 22 (4.87%) cases of post TURP US identified. The mean estimated prostate weight was 45.6 g and resected prostate weight was 20.4 g, with a 0.37 g/min resection rate. Prostate weight, operating time, and duration of catheterization after surgery were not significantly different statistically. Slower resection rate and smaller resected volume are the statistically significant predictors of increased occurrence of urethral stricture (p<0.05). Lower resection rate is also a predictor for urethral stricture after TURP procedure. Keywords: Predictor factor, TURP, urethral stricture 2023-01-01T00:00:00Z