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Metode. Penelitian ini menggunakan desain kohort retrospektif. Populasi dalam penelitian ini yaitu pasien COVID-19 yang dirawat di RSUD Al Ihsan pada periode Maret 2020 sampai dengan 31 Desember 2021 dengan kriteria inklusi merupakan pasien konfirmasi COVID-19 melalui pemeriksaan Polymerase Chain Reaction (PCR) berusia lebih dari sama dengan 18 tahun. Perbedaan probabilitas kesintasan didapatkan dari analisis kesintasan dengan kaplan meier. Analisis Cox Proporsional Hazard digunakan untuk mengetahui hubungan diabetes melitus tipe 2 dengan kematian COVID-19.
Hasil. Sebanyak 308 pasien konfirmasi COVID-19 terlibat dalam penelitian ini. Selama 21 hari pengamatan, probabilitas kesintasan pasien COVID-19 dengan diabetes melitus tipe 2 lebih rendah dibandingkan dengan tanpa diabetes melitus tipe 2 (71,24% vs 84,13%). Sampai akhir pengamatan selama 49 hari, probabilitas kesintasan pasien COVID-19 dengan diabetes melitus tipe 2 menurun dan berbeda dengan pasien COVID-19 tanpa diabetes melitus tipe 2 yang mana probabilitas kesintasannya 48,98% vs 84,13% dengan nilai p 0,0056. Terdapat hubungan yang signifikan secara statistik antara diabetes melitus tipe 2 dengan kematian COVID-19 setelah dikontrol dengan variabel confounder yaitu umur, gejala batuk, ARDS, vaksinasi, gagal ginjal kronis, penggunaan ventilator, terapi antivirus dan persentase BOR Isolasi COVID-19 saat admisi. Hazard ratio adjusted hubungan diabetes melitus tipe 2 dengan kematian COVID-19 pada model akhir analisis multivariat sebesar 2,676 (95% IK 1,24-5,73).
Kesimpulan. Probabilitas kesintasan pasien COVID-19 dengan diabetes melitus tipe 2 lebih rendah dibandingkan dengan pasien COVID-19 tanpa diabetes melitus tipe 2.
Diabetes melitus tipe 2 meningkatkan resiko kematian pada pasien COVID-19.
Introduction. The high prevalence of diabetes in the population causes diabetes to become one of the comorbidities that many COVID-19 patients suffer from. Patients with diabetes have a higher risk of experiencing serious complications from COVID-19 and even death. This study aims to determine the difference in survival probability of COVID-19 patients with type 2 diabetes mellitus and to determine the relationship between type 2 diabetes mellitus and COVID-19 mortality at Al Ihsan Hospital, West Java Province.
Methods. This study used a retrospective cohort study design. The population of study were COVID-19 patients who were treated at Al Ihsan Hospital in the period March 2020 to December 31, 2021 with inclusion criteria being confirmed as COVID-19 patients through Polymerase Chain Reaction (PCR) examination and aged ≥ 18 years. Differences in survival probability were obtained from survival analysis with Kaplan-Meier. Cox Proportional Hazard analysis was used to determine the relationship between type 2 diabetes mellitus and COVID-19 mortality.
Results. Results indicated that a total of 308 confirmed positive COVID-19 patients were involved in this study. During the 21 days of observation, survival probability of COVID-19 patients with type 2 diabetes mellitus was lower than those without type 2 diabetes mellitus (71.24% vs. 84.13%). Until the end of the 49-day observation, survival probability of COVID-19 patients with type 2 diabetes mellitus decreased and differed from that of COVID-19 patients without type 2 diabetes mellitus which the survival probability was 48.98% vs. 84.13% (p = 0.0056). There was a statistically significant relationship between type 2 diabetes mellitus and COVID-19 mortality after controlling for confounder variables, age, cough symptoms, ARDS, vaccination, chronic kidney disease, ventilator use, antiviral therapy and the percentage of Bed Occupation Rate COVID-19 isolation at admission. The hazard ratio adjusted relationship between type 2 diabetes mellitus and COVID-19 mortality in the final model of multivariate analysis was 2,676 (95% CI 1,24-5,73).
Conclusion. It appears that survival probability of COVID-19 patients with type 2 diabetes mellitus is lower than those without type 2 diabetes mellitus. Type 2 diabetes mellitus increases the risk of death in COVID-19 patients.
Pneumonia merupakan penyebab kematian terbesar pada anak di seluruh dunia. Setiap tahunnya diestimasikan sekitar 18% kematian anak di bawah usia 5 tahun di seluruh dunia disebabkan oleh pneumonia. Faktor risiko pasti yang berkontribusi diantaranya yaitu balita yang tidak mendapatkan ASI eksklusif.
Tujuan studi ini untuk mengetahui hubungan pemberian ASI eksklusif terhadap kejadian pneumonia balita usia 12 -23 bulan setelah dikontrol terhadap confounder. Studi kasus kontrol ini dilakukan di tiga wilayah puskesmas Kota Cimahi berdasarkan angka insidens kasus pneumonia balita yang tertinggi di tahun 2012. Kasus adalah balita usia 12 - 23 bulan yang berkunjung ke sarana puskesmas penelitian periode Januari - Desember 2012 dan didiagnosa sebagai kasus pneumonia. Kontrol merupakan tetangga dari kasus, dengan perbandingan jumlah kasus dan kontrol yaitu 1:1. Besar sampel minimal sebanyak 133 untuk masing - masing kelompok. Analisis multivariat dengan menggunakan regresi logistik. Besar asosiasi balita yang tidak mendapat ASI eksklusif memiliki OR untuk terjadinya pneumonia sebesar 3,58 kali (95% CI: 2,08 - 6,19) dibandingkan yang mendapat ASI eksklusif setelah dikontrol terhadap confounder.
Penelitian ini memperkuat penelitian terdahulu yang membuktikan kekuatan hubungan pemberian ASI eksklusif terhadap kejadian pneumonia pada balita. Berfokus pada daerah dengan angka insiden kasus penumonia yang tinggi, pihak dinas kesehatan dan puskesmas dapat lebih meningkatkan upaya promosi dan fasilitasi ASI eksklusif, menciptakan kawasan tanpa asap rokok di tingkat rumah tangga, pengurangan adanya paparan asap pembakaran di dalam rumah, peningkatan pengetahuan ibu berkaitan faktor risiko pneumonia.
Pneumonia is the biggest cause of death in children worldwide. Each year approximately 18% of estimated deaths of children under five worldwide are caused by pneumonia. Definite risk factors that contribute to them are children under five who are not exclusively breastfed.
The purpose of this study to determine the relationship of exclusive breastfeeding on the incidence of pneumonia children under five age 12 -23 months after controlling for confounders.Case-control study was conducted in three areas of public health centers Cimahi City based incidence rates were highest children under five cases of pneumonia in 2012. Cases were children aged 12-23 months who visited the research public health centers means the period of January to December 2012 and was diagnosed as a case of pneumonia. Control is a neighbor of the case, the ratio of the number of cases and controls is 1:1. Minimum sample size for each of as many as 133 - each group. Multivariate analysis using logistic regression. Major association children under five who are not exclusively breastfed for the occurrence of pneumonia had an OR of 3.58 (95% CI: 2.08 to 6.19) than those who are breastfed exclusively after controlling for confounders.
This study reinforces previous research that proves the strength of association of exclusive breastfeeding on the incidence of pneumonia in infants. Focusing on areas with a number of high incidence of cases of pneumonia, the health department and public health center could further enhance the promotion and facilitation of exclusive breastfeeding, creating a smoke-free area at the household level, reduction in exposure to combustion fumes in the house, increasing maternal knowledge of risk factors associated pneumonia.
Kata kunci: Skizofrenia, kasus kontrol, Kabupaten Bogor
Schizophrenia is a a chronic and severe mental disorder that affects thinking, feeling, and behavior of a person. In Indonesia, the prevalence of schizophrenia is 1.7 per 1,000 populations. The number of visits of mental disorders in puskesmas of Bogor Regency has increased significantly from 1,648 to 13,390 in 2013-14. This study aimed to determine the factors associated with schizophrenia in Bogor Regency 2017. An unmatched case-control was conducted in 63 health centers of Bogor regency from May-June 2017. Cases were schizophrenic patient aged 15-50 years diagnosed by physicians/specialists and recorded in the register of Bogor district health centers in 2017. Controls were the healthy people aged 15-50 and domiciled in Bogor Regency. A total of 229 cases and 229 controls were selected by multistage sampling technique. Probability proportional to size was usedto determine the number of samples from each puskesmas. A pre-tested semi structured questionnaires was used to collect relevant data from controls and one of the family members of cases. Chi square test and multivariate logistic regression were applied for data analysis. Folowing factors were associated with schizophrenia: male gender (AdjOR: 11.68; 95% CI: 4.96 -27.50), family history of schizophrenia (AdjOR: 4.02; 95 %CI: 1,90-8,48), basic education (AdjOR: 30.63; 95%CI: 4.21-222.81), secondary education (AdjOR: 25.35; 95% CI: 3.51-182.90), unemployed (AdjOR: 5.6; 95 %CI 2,52-12,45), unmarried (AdjOR: 10,20; 95%CI 2,52-12,45), problems in the family (AdjOR: 4.93; 95%CI 2.43-9.99) and problems at work / school (AdjOR: 32.60; 95%CI 7.29 - 145.76). In the study setting, biological (male and family history of schizophrenia),sociodemographic (low level of education, unemployment and unmarried) and environmental factors (problems in family, workplaceor school) were associated with schizophrenia. Prospective analytical studies are needed to further explore these associations.
Keywords: Schizophrenia, case control, Bogor district
Diphtheria was a major cause of child mortality in Indonesia. The high diphtheria immunization coverage was needed in reducing the child mortality. This cross sectional study aimed to identify factors associated with diphtheria immunization for school children (DT). Sample was all children aged 6-8 years in the Assessment of Second Dose Measles Immunization and Immunization for School Children in Two Provinces in Indonesia 2017. Multivariate analysis was used to examine the predisposing, enabling, need, reinforcing factors associated with the immunization.
