Open Access Macedonian Journal of Medical Sciences

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ISSN / EISSN : 1857-9655 / 1857-9655
Total articles ≅ 4,498
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Fatma Siti Fatimah, Sumarni Mars, Raden Jaka Sarwadhamana, Rizka Mulyani, Putri Daru Handayani
Open Access Macedonian Journal of Medical Sciences, Volume 10, pp 1-4;

BACKGROUND: In Indonesia, the health sector has experienced a very significant development. Fair and equitable health care is one way to fulfill the health rights of each individual. Therefore, puskesmas are required to provide good service quality through conformity to standards with customer needs. The creation of service quality will certainly create customer satisfaction for service users when using health assurance and non-assurance. AIM: This study was to know a comparison of patient satisfaction when using the insured and non-insured in Public Health Center (Puskesmas Kasihan 1) Bantul, Indonesia. METHODS: This study was a cross-sectional study, with 222 samples with 111 respondents using health assurance and 111 non-assurance. Samples were collected with a cluster sampling technique taken from nine service polyclinics in Puskesmas Kasihan 1 Bantul. Data were analyzed using independent sample t-test. RESULTS: The study found that the average patient satisfaction with health insurance was 34.76 more than the average patient satisfaction with non-health insurance was 29.10. Based on the results of the analysis, the mean ± sd of patient satisfaction with health insurance was 29.10 ± 3.04 compared to the satisfaction of non-health insurance patients, namely, 34.76 ± 3.61 with a Sig value of 0.000, which means that there is a significant difference between patient satisfaction using the insured and non-insured.
Lina Indrawati, Marni Br. Karo, Ernauli Meliyana, Harun Alrasyid
Open Access Macedonian Journal of Medical Sciences, Volume 10, pp 11-15;

BACKGROUND: Many health workers have experienced fatigue due to high workloads with the number of patients who were confirmed positive for COVID-19 with moderate and severe symptoms who were hospitalized. Researchers identified several factors that affect the readiness of health workers in the management of COVID- 19 patients, including knowledge, family status, availability of personal protective equipment (PPE), health status, and reward. Optimal self-preparation is needed to achieve COVID-19 management that is in line with expectations by examining these factors more deeply. AIM: The aim of this study was to identify and knowing factors are affect the readiness of Health personnel for COVID-19 patients’ treatment in hospital. METHODS: This research method uses a descriptive correlation design with a cross-sectional approach aimed at knowing the relationship between variables, where the independent variable and dependent variable are identified at the same time. The number of samples used as many as 34 students of the transfer class who already work as nurses in hospitals. RESULTS: There were two factors that had an influence on the readiness of transfer students in the management of COVID-19 at the hospital, namely, the family status factor and the availability of PPE with p values of 0.036 and 0.007 and three factors that had no effect, namely knowledge, health status, and giving rewards with p > 0.05.
Siska Ariftiyana, Lieyan Nurfikasari, Dwi Murniyati, Agus Prastowo, Yulinda Kurniasari, Hamam Hadi, Veriani Aprilia
Open Access Macedonian Journal of Medical Sciences, Volume 10, pp 127-131;

BACKGROUND: Diabetes mellitus (DM) is a group of metabolic diseases indicated by hyperglycemia. Dietary regulation represents a viable means of controlling blood glucose levels. Porang (Amorphophallus oncophyllus) is a local tuber that has a low glycemic index due to its high glucomannan content. In combination with Strobilanthes crispus (SC), which is rich in antioxidants, porang flour could be a promising treatment approach for DM. AIM: This study aimed to determine the effect of porang flour macerated with SC on the blood glucose levels of diabetic rats. METHODS: Thirty-five Wistar (Rattus norvegicus) rats were divided into five groups on the basis of their diets: Normal/negative control (NC) group (non-diabetic, standard AIN-93 diet), positive control (PC) group (streptozotocin [STZ]-induced diabetic), glibenclamide (GB) group (STZ-induced diabetic, medicated with GB 100 mg/200 g body weight [BW]), porang (NP) group (modified AIN-93 diet, fiber substituted with 11% porang flour [equal to 1.1 g/200 g BW]), and SC-macerated porang (SP) group (modified AIN-93 diet, fiber substituted with 11% porang flour macerated with SC [equal to 1.1 g/200 g BW]). The rats’ food intakes, stools, and BWs were recorded throughout the study, while their blood glucose levels were measured before the induction of DM, 3 days after the induction of DM, and at the end of the study (14-day treatment period). The data were statistically analyzed using a one-way analysis of variance combined with Duncan’s multiple range test. RESULTS: The rats’ feed intakes during the 14-day treatment period were almost the same, which influenced their BWs. After the induction of DM, the rats’ BWs appeared to decrease, albeit not to a statistically significant extent. This weight loss may have been better controlled in the treatment groups because the glucomannan content of the porang led to an improvement in the rats’ glucose metabolism, especially in the NP and SP groups. The rats’ stools appeared normal in consistency and moisture, and it was confirmed that there were no diarrhea incidents. The glucomannan content also decreased the blood glucose levels in the NP and SP groups. The SP group showed the best results in terms of decreased glucose levels due to the addition of SC as a source of antioxidants.
Fahrun Nur Rosyid, , Dian Hudiyawati, Sugiyarti Sugiyarti, Ahmad Fadhlur Rahman
Open Access Macedonian Journal of Medical Sciences, Volume 10, pp 122-126;

BACKGROUND: Diabetes mellitus is a serious disease that affects more than 340 million people and causes approximately 20% of diabetic ulcer cases worldwide. Wound healing is a complex and dynamic process in restoring cellular structures and tissue layers. It consists of four continuous overlapping phases that are precisely programmed AIM: This study aims to examine the adjuvant administration of bitter melon leaf extract to increase the healing of diabetic foot ulcers (DFU). METHODS: This study used a randomized, double-blind, and placebo-controlled trial. A total of 30 DFU patients with a perfusion, extent, depth, infection, and sensation (PEDIS) score of 1–8 who met the criteria were divided into two groups, namely, the treatment group with adjuvant administration of bitter melon leaf extract at a dose of 6 g/day as many as 15 patients and the control group 15 patients with placebo. This intervention was carried out for 4 weeks. DFU cure was measured by PEDIS scores at baseline, weeks 2, 3, and the end of week 4. Data were analyzed using paired t-test and independent t-test. RESULTS: After 4 weeks of treatment, the PEDIS score in the treatment group decreased at week 2 (0.9 ± 1.8), but not significant (p = 0.19), decreased at week 3 (1.9 ± 1.9) and significant (p = 0.01), decreased in week IV (2.3 ± 2.1) and significantly (p = 0.001). The control group experienced a decrease in week 2 (0.3 ± 2.3), but not significant (p = 0.71), decreased in week 3 (1.2 ± 2.5), but not significant (p = 0.18), decreased in week 4 (1.9 ± 2.7) and significantly (p = 0.03), and there was an effect of adjuvant administration of bitter melon leaf extract on the cure of DFU (p = 0.004).
Eva Nurinda, Nurul Kusumawardani, Ari Susiana Wulandari, Annisa Fatmawati, E. Emelda, Husnatun Nisa, Nurjani A. Hasan, Wahyu Fajar Iriyanti, Mardiatun Rohmah, Puji Lestari, et al.
Open Access Macedonian Journal of Medical Sciences, Volume 10, pp 1-6;

Background: Cinnamon has been widely used by Indonesian people as a complementary therapy to treat hyperglycemia such as in diabetes mellitus patients. While ginger is also used as a mixture in traditional anti hyperglycemia herb. There is not known how much antidiabetic effect of cinnamon ethanolic extract when combined with ginger, and not many studies have analyzed the correlation of lowering blood glucose levels associated with increasing of insulin of this combination. Objectives: This study aimed to investigates antidiabetic activity of cinnamon extract, zingiber extract, and mixture on streptozotocin-induced diabetic rats. Methods: This pharmacological study used Wistar strain male rats under hyperglycemia condition induced by streptozotocin at a dose of 45mg/kg. Sample were grouped with 6 animals in each where there was a positive and negative control group and also an intervention group given ethanol extract for 14 days. Results: The result showed that all intervention groups experienced an increase in insulin levels and a decrease in blood glucose levels after 14 days. The One Way Anova test showed that the increase of insulin levels treated with combination of ethanolic extract cinnamon bark at the dose 150mg/200gr and ginger ethanolic extract at the dose 100mg/200gr was comparable to Glibenclamide (p=0.355), but the decrease in blood glucose levels between groups showed a difference that was not statistically significant. There was a relationship between insulin levels and blood glucose levels linearity with the equation Y (insulin level) = -5.261 + (-0.060) blood glucose level. Conclusions: The combination of cinnamon and ginger showed beneficial synergistic anti-diabetic activity. It can increase insulin levels, making it possible to control blood sugar levels in high blood glucose conditions.
, Arief Nurrochmad, Abdul Rohman, Agung Endro Nugroho
Open Access Macedonian Journal of Medical Sciences, Volume 10, pp 16-22;

Background: Chemical agents such as streptozotocin (STZ) and nicotinamide (NAD) are used in animal models of diabetes mellitus and their related consequences in the kidneys. Several studies have been conducted to determine the modeling, however, the results are still unclear. Moreover, diabetic nephropathy is considered to begin with an inflammatory reaction in the kidneys. Objectives: This study aims to investigate the metabolic profile STZ and NAD induce inflammation in the kidney. Methods: The male Wistar rats used were divided into control and STZ-induced diabetes. Half of the diabetes group received a single dose of nicotinamide (230 mg/Kg) 15 minutes after STZ injection and all groups were monitored for 6 weeks. Furthermore, the profiles of creatinine, urea, and uric acid from serum and urine were observed and the kidney inflammation was tested by immunohistochemistry (IHC) with IL-6 and TNF-α parameters. Results: The result shows that the administration of a single dose of 230 mg/kg NAD in diabetic rats induced with 50 mg/kg and 65 mg/kg STZ affects body weight and kidney organ index. For 6 weeks of testing, both doses of STZ were enhanced several parameters of kidney damage in diabetic rats in blood and urine chemical parameters. Furthermore, the use of NAD to promote inflammation in STZ-induced diabetic rats gave no significant difference. However, NAD can help mice live longer and avoid problems throughout the test. Conclusions: The use of NAD leads to inflammation in Streptozotocin-induced diabetic rats. Therefore, the administration of Nicotinamide is recommended since it helps the rats live longer during the experiment.
Erni Samutri, Widyawati Widyawati, Wenny Artanty Nisman, Joel Gittelsohn, Hamam Hadi, Emma C. Lewis, Lia Endriyani, , Artha Mevia Ruly Afita
Open Access Macedonian Journal of Medical Sciences, Volume 10, pp 114-121;

Background: Perinatal death results in physical loss of a child as well as symbolic loss (loss of self, hope and self-esteem) experienced by many parents. Loss is often expressed via a grief response that can develop into chronic sorrow. Ineffective coping strategies may increase susceptibility to complications associated with chronic sorrow. These complications can include clinical depression, dysthymic disorder, post-traumatic stress disorder, attachment disorder, drug dependence, psychosis, and suicidal ideation. Therefore, it is crucial to understand the barriers and facilitators to chronic sorrow particularly among vulnerable populations. Aim: To explore the experience of chronic sorrow among Indonesian women who have suffered perinatal loss. Methods: The present qualitative study utilized a descriptive phenomenological approach. Participants included women who experienced chronic sorrow due to perinatal loss within the past seven weeks to three years. Maximum variation sampling was used based on women’s current number of children. Data were collected using semi-structured interviews and analyzed using a modified Stevick-Colaizzi-Keen method. Results: Three key themes emerged from the data: (1) recurrent experiences of grief are common particularly when exposed to certain triggers (memories from pregnancy, mementos); (2) adequate coping strategies and emotional support are needed to help treat grief; and (3) specific characteristics of chronic sorrow are associated with perinatal loss, such as grief that feels diminished and the presence of another child serving as both a cure and a trigger of sorrow. Conclusion: Chronic sorrow as a result of perinatal loss is experienced repeatedly when mothers face certain triggers. We have identified two characteristics (diminished grief, having another child serve to both cure and trigger sorrow) that are specific to the experience of chronic sorrow compared to that of general grief. It is important to understand the experience of chronic sorrow and how coping strategies and a support system can help grieving mothers to overcome their loss.
Wahyuningsih Wahyuningsih, Dina Putri, Lia Endriyani, Siti Nurunniyah, Sri Ayu Candra A. Misali, Hamam Hadi
Open Access Macedonian Journal of Medical Sciences, Volume 10, pp 97-101;

Background: The use of contraceptives in reproductive women is still a problem today. The association between contraceptive use and parity and pregnancy intention amongs legally married reproductive women has never been studied Objectives: To determine the relationship between parity and pregnancy intention with contraceptive use among legally married women. Methods: A cross-sectional study was conducted with the involvement of 262 legally-married reproductive women, aged 15-49 years, in Bantul District, Indonesia. Socio-demographic data including age, education, income, parity, pregnancy intentions, and use of contraceptives were collected using a structured questionnaire by trained enumerators. Chi-square test was used to test the association between socio-demographic data and parity and pregnancy intention, while simple logistic regression models were used to examine the relationship between contraceptive use and parity and pregnancy intention. Data analysis was performed using statistical software by SPSS. Results: Thirty-eight point five per cent of women of reproductive age who have ≥ 3 children and 16.5% of women of reproductive age who do not want to have children do not use contraception. Parity in women of childbearing age was not related to contraceptives (OR=2.58; 95%:0.67-1.76). Women of reproductive age who had intention of getting pregnant were 61% less likely (OR= 0.39; 95%: 0.37-0.74) to use contraceptives than those who did not have intention of getting pregnant. Conclusions: The pregnancy intention is associated with a low contraceptive use in reproductive-age women. Thus, it is necessary to educate women in the reproductive age, their partners and family regarding the importance of birth spacing.
Prasetya Lestari, Fatimah Fatimah, Lia Ayuningrum, Herni Dwi Herawati, Nisrina Afifaturrohmah
Open Access Macedonian Journal of Medical Sciences, Volume 10, pp 81-85;

Background: Lactation problems often occur in the early postnatal period. One of them is the readiness of the mother in early breastfeeding. Early breastfeeding is one of the effective efforts in providing nutrition for newborns and preventing lactation problems. In 2019, in Indonesia, the percentage of newborns who received early breastfeeding was 75.58%. The success rate of this is closely related to lactation readiness in early postpartum. To support the success of lactation, postpartum mothers need to be given education on methods to stimulate milk production at the beginning of the puerperium with oxytocin massage. Good breast milk production will support the nutritional adequacy of the baby and reduce lactation problems in the early postpartum period. Objectives: the purpose of this study was to determine the effectiveness of oxytocin massage on lactation problems and infant growth. Methods: This study was pre-experimental research using posttest only design and true-experiment using posttest only control group design. The research locations were in the Mother and Child Health Clinic and Midwives Independent Practice (PMB) in Bantul, Sleman, and Gunung Kidul Yogyakarta. Implementation from April until September 2020. The population of this study was all the families of postpartum mothers from the first to the third day and after 1 week an evaluation of breastfeeding. The sampling technique uses total sampling was 80 postpartum mothers on the first-third day of childbirth until the baby was 2 months old. The research instruments were the oxytocin massage checklist, lactation problems, and body length observation sheet. Test analysis using Wilcoxon. Results: The results of this study were that the majority of respondents performed oxytocin massage with a frequency more than 3 times (51%) the first week of postnatal, respondents experienced lactation problems in the first week of postnatal by 16.3% and at the 4th postnatal visit all respondents had no lactation problems. The average increase in the length of the baby's body at the age of 2 months is 8.44. The majority of the baby's body length at the age of 2 months corresponds to age (98.8%). The results of bivariate analysis of oxytocin massage were effective in reducing lactation problems (p=0.000) and supporting infants' growth (p=0.000). Conclusion: Oxytocin massage is effective in reducing lactation problems and supporting infants' growth. Oxytocin massage should be implemented in postnatal care to prevent lactation problems and support breastfeeding.
Mila Sari, Merita Merita, Arnati Wulansari, Faridah Faridah, Dyan Heru Prabowo
Open Access Macedonian Journal of Medical Sciences, Volume 10, pp 74-80;

Background: Adolescents in traditional community of Suku Anak Dalam (SAD) are a group that susceptible to experiencing nutritional problems and their nutritional status needs to be considered, because it is a transitional period from childhood to adulthood who live as marginalized. Objectives: This study aims to know the nutritional problems of adolescents among the traditional community of SAD in the working area of the Pematang Kabau Health Center, Sarolangun District. Methods: This study used a cross sectional study design which was conducted in the working area of Pematang Kabau Health Center in July until August 2020. The sample in this study was 30 adolescents with a purposive sampling. Measuring instruments used include microtoice, scales and 2 times 24-hours food recall questionnaire. Data were collected by conducting guided interviews using a questionnaire and direct measurement of nutritional status. The data analysis used univariate analysis. Results: The results showed that a large proportion SAD adolescents have normal nutritional status (83.3%), poor eating habits (56.7%), adequate levels of macronutrients are deficits (80%), no food taboo (76.7%), and parental education is low (100%). Conclusions: Based on the results of the study, it can be concluded that there are still nutritional problems in adolescents with SAD, especially in the aspects of consumption and eating habits. Therefore, it is hoped that nutrition and health workers will be active in providing regular education to SAD adolescents so as not to cause nutritional problems
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