1.The Development of an Assessment Instrument for Behavior Toward Hypoglycemia Risk Among Type 2 Diabetes Mellitus Outpatients in Jakarta, Indonesia
Putu Rika VERYANTI ; Rani SAURIASARI ; Ratu Ayu Dewi SARTIKA ; Berna ELYA ; Muhammad Ikhsan MOKOAGOW
Journal of Preventive Medicine and Public Health 2025;58(1):31-43
Objectives:
The purpose of this study was to develop a valid and reliable instrument for assessing patients’ behavior toward the risk of hypoglycemia through self-assessment. Insufficient education and supervision of type 2 diabetes mellitus (DM) outpatients by healthcare providers is a significant concern, affecting their behavior during the treatment process. Additionally, inappropriate behavior typically increases the risk of hypoglycemia. To mitigate this risk, several studies have recommended evaluating patients’ behavior, necessitating the development of a new instrument.
Methods:
The study procedures were conducted in 3 stages: instrument development (face and content validity, stage I), construct validity and reliability test (stage II), and criterion validity (stage III). Stage I involved 5 healthcare practitioners, including internal medicine doctors, nurses, dietitians, and pharmacists in hospitals and community health centers. Stage II included 20 respondents using a 1-shot test method. Stage III involved 237 type 2 DM outpatients at Central General Hospital (RSUP) in Jakarta, employing a cross-sectional design and consecutive sampling.
Results:
The results indicated that the developed instrument was valid and reliable, comprising 9 domains (29 questions). These domains included behavior toward blood glucose monitoring, diet, physical activity, medication, assistance from healthcare providers, hypoglycemia management, self-care, family support, and insulin use. Furthermore, poor behavior was found to increase the risk of hypoglycemia by 2.36 times.
Conclusions
Based on these results, the developed instrument could be effectively used to evaluate behavior toward hypoglycemia among type 2 DM outpatients, confirming its validity and reliability.
2.Non-Communicable Diseases in Patients with Human Immunodeficiency Virus and Their Risk Factors
Dian DANIELLA ; Anak Agung Ayu Yuli GAYATRI ; I Ketut Agus SOMIA
Infection and Chemotherapy 2025;57(1):131-137
Background:
The increasingly widespread use of antiretroviral drugs (ARV) to manage human immunodeficiency virus (HIV) infection has significantly reduced mortality. Accordingly, the number of patients with HIV with a life expectancy >50 years is increasing. With advanced age, the risk of non-communicable diseases (NCD) increases.According to a study in Uganda in 2017, the prevalence of at least one NCD in patients with HIV was 20.7%, with 11–30% of deaths due to NCDs, especially cardiovascular disease. This emphasizes that NCDs in patients with HIV are of clinical concern, as are the factors that increase the risk of these diseases. However, most studies on HIV and NCDs focus on African countries, while research in Asia is limited. Differences in genetics, lifestyle, and co-existing health burdens may influenced NCD prevalence and risk factors. This study aimed to determine the prevalence of and risk factors for NCDs in patients with HIV.
Materials and Methods:
This was an analytical cross-sectional study conducted at the outpatient clinic of the Ngoerah Hospital from June 8, 2023, to July 7, 2023. Descriptive and multivariate analyses were performed.
Results:
In total, 1,644 patients with HIV were included in this study. The prevalence of NCDs was 1.9% for hypertension, 1.1% for diabetes mellitus, 0.7% for dyslipidemia, 1.0% for kidney disorders, 0.1% for stroke, 0.3% for cancer, 0.3% for cardiovascular disease, and 0.2% for autoimmune diseases. After conducting a multivariate test, we found that age >50 years increased the risk of comorbid NCDs by 7.886 times, while male sex increased the risk by 2.568 times, and an ARV regimen of two nucleoside reverse transcriptase inhibitors (NRTIs) + non-NRTI (NNRTI) decreased the risk by 2.625 times.
Conclusion
Hypertension was the most common NCD in patients with HIV, followed by diabetes mellitus. Male patients and those aged >50 years were at a greater risk of developing NCDs, whereas a history of using the two NRTIs + NNRTI regimen was associated with a lower risk of NCDs.
3.Non-Communicable Diseases in Patients with Human Immunodeficiency Virus and Their Risk Factors
Dian DANIELLA ; Anak Agung Ayu Yuli GAYATRI ; I Ketut Agus SOMIA
Infection and Chemotherapy 2025;57(1):131-137
Background:
The increasingly widespread use of antiretroviral drugs (ARV) to manage human immunodeficiency virus (HIV) infection has significantly reduced mortality. Accordingly, the number of patients with HIV with a life expectancy >50 years is increasing. With advanced age, the risk of non-communicable diseases (NCD) increases.According to a study in Uganda in 2017, the prevalence of at least one NCD in patients with HIV was 20.7%, with 11–30% of deaths due to NCDs, especially cardiovascular disease. This emphasizes that NCDs in patients with HIV are of clinical concern, as are the factors that increase the risk of these diseases. However, most studies on HIV and NCDs focus on African countries, while research in Asia is limited. Differences in genetics, lifestyle, and co-existing health burdens may influenced NCD prevalence and risk factors. This study aimed to determine the prevalence of and risk factors for NCDs in patients with HIV.
Materials and Methods:
This was an analytical cross-sectional study conducted at the outpatient clinic of the Ngoerah Hospital from June 8, 2023, to July 7, 2023. Descriptive and multivariate analyses were performed.
Results:
In total, 1,644 patients with HIV were included in this study. The prevalence of NCDs was 1.9% for hypertension, 1.1% for diabetes mellitus, 0.7% for dyslipidemia, 1.0% for kidney disorders, 0.1% for stroke, 0.3% for cancer, 0.3% for cardiovascular disease, and 0.2% for autoimmune diseases. After conducting a multivariate test, we found that age >50 years increased the risk of comorbid NCDs by 7.886 times, while male sex increased the risk by 2.568 times, and an ARV regimen of two nucleoside reverse transcriptase inhibitors (NRTIs) + non-NRTI (NNRTI) decreased the risk by 2.625 times.
Conclusion
Hypertension was the most common NCD in patients with HIV, followed by diabetes mellitus. Male patients and those aged >50 years were at a greater risk of developing NCDs, whereas a history of using the two NRTIs + NNRTI regimen was associated with a lower risk of NCDs.
4.The Development of an Assessment Instrument for Behavior Toward Hypoglycemia Risk Among Type 2 Diabetes Mellitus Outpatients in Jakarta, Indonesia
Putu Rika VERYANTI ; Rani SAURIASARI ; Ratu Ayu Dewi SARTIKA ; Berna ELYA ; Muhammad Ikhsan MOKOAGOW
Journal of Preventive Medicine and Public Health 2025;58(1):31-43
Objectives:
The purpose of this study was to develop a valid and reliable instrument for assessing patients’ behavior toward the risk of hypoglycemia through self-assessment. Insufficient education and supervision of type 2 diabetes mellitus (DM) outpatients by healthcare providers is a significant concern, affecting their behavior during the treatment process. Additionally, inappropriate behavior typically increases the risk of hypoglycemia. To mitigate this risk, several studies have recommended evaluating patients’ behavior, necessitating the development of a new instrument.
Methods:
The study procedures were conducted in 3 stages: instrument development (face and content validity, stage I), construct validity and reliability test (stage II), and criterion validity (stage III). Stage I involved 5 healthcare practitioners, including internal medicine doctors, nurses, dietitians, and pharmacists in hospitals and community health centers. Stage II included 20 respondents using a 1-shot test method. Stage III involved 237 type 2 DM outpatients at Central General Hospital (RSUP) in Jakarta, employing a cross-sectional design and consecutive sampling.
Results:
The results indicated that the developed instrument was valid and reliable, comprising 9 domains (29 questions). These domains included behavior toward blood glucose monitoring, diet, physical activity, medication, assistance from healthcare providers, hypoglycemia management, self-care, family support, and insulin use. Furthermore, poor behavior was found to increase the risk of hypoglycemia by 2.36 times.
Conclusions
Based on these results, the developed instrument could be effectively used to evaluate behavior toward hypoglycemia among type 2 DM outpatients, confirming its validity and reliability.
5.Non-Communicable Diseases in Patients with Human Immunodeficiency Virus and Their Risk Factors
Dian DANIELLA ; Anak Agung Ayu Yuli GAYATRI ; I Ketut Agus SOMIA
Infection and Chemotherapy 2025;57(1):131-137
Background:
The increasingly widespread use of antiretroviral drugs (ARV) to manage human immunodeficiency virus (HIV) infection has significantly reduced mortality. Accordingly, the number of patients with HIV with a life expectancy >50 years is increasing. With advanced age, the risk of non-communicable diseases (NCD) increases.According to a study in Uganda in 2017, the prevalence of at least one NCD in patients with HIV was 20.7%, with 11–30% of deaths due to NCDs, especially cardiovascular disease. This emphasizes that NCDs in patients with HIV are of clinical concern, as are the factors that increase the risk of these diseases. However, most studies on HIV and NCDs focus on African countries, while research in Asia is limited. Differences in genetics, lifestyle, and co-existing health burdens may influenced NCD prevalence and risk factors. This study aimed to determine the prevalence of and risk factors for NCDs in patients with HIV.
Materials and Methods:
This was an analytical cross-sectional study conducted at the outpatient clinic of the Ngoerah Hospital from June 8, 2023, to July 7, 2023. Descriptive and multivariate analyses were performed.
Results:
In total, 1,644 patients with HIV were included in this study. The prevalence of NCDs was 1.9% for hypertension, 1.1% for diabetes mellitus, 0.7% for dyslipidemia, 1.0% for kidney disorders, 0.1% for stroke, 0.3% for cancer, 0.3% for cardiovascular disease, and 0.2% for autoimmune diseases. After conducting a multivariate test, we found that age >50 years increased the risk of comorbid NCDs by 7.886 times, while male sex increased the risk by 2.568 times, and an ARV regimen of two nucleoside reverse transcriptase inhibitors (NRTIs) + non-NRTI (NNRTI) decreased the risk by 2.625 times.
Conclusion
Hypertension was the most common NCD in patients with HIV, followed by diabetes mellitus. Male patients and those aged >50 years were at a greater risk of developing NCDs, whereas a history of using the two NRTIs + NNRTI regimen was associated with a lower risk of NCDs.
6.The Development of an Assessment Instrument for Behavior Toward Hypoglycemia Risk Among Type 2 Diabetes Mellitus Outpatients in Jakarta, Indonesia
Putu Rika VERYANTI ; Rani SAURIASARI ; Ratu Ayu Dewi SARTIKA ; Berna ELYA ; Muhammad Ikhsan MOKOAGOW
Journal of Preventive Medicine and Public Health 2025;58(1):31-43
Objectives:
The purpose of this study was to develop a valid and reliable instrument for assessing patients’ behavior toward the risk of hypoglycemia through self-assessment. Insufficient education and supervision of type 2 diabetes mellitus (DM) outpatients by healthcare providers is a significant concern, affecting their behavior during the treatment process. Additionally, inappropriate behavior typically increases the risk of hypoglycemia. To mitigate this risk, several studies have recommended evaluating patients’ behavior, necessitating the development of a new instrument.
Methods:
The study procedures were conducted in 3 stages: instrument development (face and content validity, stage I), construct validity and reliability test (stage II), and criterion validity (stage III). Stage I involved 5 healthcare practitioners, including internal medicine doctors, nurses, dietitians, and pharmacists in hospitals and community health centers. Stage II included 20 respondents using a 1-shot test method. Stage III involved 237 type 2 DM outpatients at Central General Hospital (RSUP) in Jakarta, employing a cross-sectional design and consecutive sampling.
Results:
The results indicated that the developed instrument was valid and reliable, comprising 9 domains (29 questions). These domains included behavior toward blood glucose monitoring, diet, physical activity, medication, assistance from healthcare providers, hypoglycemia management, self-care, family support, and insulin use. Furthermore, poor behavior was found to increase the risk of hypoglycemia by 2.36 times.
Conclusions
Based on these results, the developed instrument could be effectively used to evaluate behavior toward hypoglycemia among type 2 DM outpatients, confirming its validity and reliability.
7.Chronic Pain and Erectile Dysfunction: Mechanism, Treatment, and Future Perspective
I Putu Eka Widyadharma ; Eric Hartono Tedyanto ; I Made Oka Adnyana ; Ida Ayu Sri Wijayanti
Malaysian Journal of Medicine and Health Sciences 2024;20(No.1):304-311
Erectile dysfunction is a problem with multiple causes and is challenging to diagnose. Chronic pain has been associated with erectile dysfunction in some studies. Chronic pain can be a potential direct or indirect cause of sexual
dysfunction. A decreased sexual desire due to restricted sexual activity in chronic pain can result in erectile dysfunction. Erectile dysfunction has been linked to migraines, chronic pain, and psychological factors. Multiple neurotransmitters may contribute to the pathophysiology of erectile dysfunction. Depression and anxiety, as well as painkillers
like pregabalin and opioids, can be indirect causes of erectile dysfunction. Numerous factors affect the occurrence
of erectile dysfunction; therefore, erectile dysfunction must be treated holistically.
8.Letter to the Editor: Pathogens detected from patients with acute respiratory infections negative for SARS-CoV-2, Saitama, Japan, 2020
Yuzo Arima ; Yuuki Tsuchihashi ; Osamu Takahara ; Reiko Shimbashi ; Takeshi Arashiro ; Ayu Kasamatsu ; Yusuke Kobayashi ; Katsuhiro Komase ; Takuri Takahashi ; Kanako Otani ; Fangyu Yan ; Taro Kamigaki ; Kiyosu Taniguchi ; Motoi Suzuki
Western Pacific Surveillance and Response 2024;15(1):78-79
Utilizing data presented in the article by Miyashita et al., we illustrate the importance of testing data when assessing surveillance data. Accounting for the number of tests (denominator) and positivity (proportion of tests positive for a specific pathogen(s)) improves data interpretation in ways not possible from numerator case data alone.
9.Effects of diethylene glycol contamination of pharmaceutical products on unexplained acute kidney injury in children: a systematic review
Sani Rachman SOLEMAN ; Muhammad Luthfi ADNAN ; Hilmi Ardian SUDIARTO ; Satria Bintang MAHATHMA ; Alya Ayu TAZKIA ; Hana Afifah FIRDAUS ; Alfreda Amelia KHOTIJAH ; Miranti Dewi PRAMANINGTYAS ; Emi Azmi CHOIRONI
Clinical and Experimental Pediatrics 2024;67(8):395-402
Unexplained acute kidney injury (AKI) in children owing to diethylene glycol (DEG) contamination during drug production has gained attention in recent years. This qualitative study investigated the effects of DEG exposure on the incidence of unknown AKI in children. A systematic review following the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines was proposed to search for studies using predefined search terms in the PubMed, EBSCO, and Web of Science data-bases without publication date restrictions. The inclusion criteria are observational study, case study, case report, and case series design; and having provided accurate data for DEG poisoning and AKI diagnosis in children. All authors performed the study screening, data extraction, and data synthesis processes. Consensus was reached by mutual agreement. The data synthesis was conducted according to the DEG and unexplained AKI in children by examining the statistical data using Microsoft Excel 2017 and storing the data using the cloud service of Universitas Islam Indonesia. Of the 115 included studies, 21 met the inclusion criteria, including 2 case-control studies, 1 cross-sectional study, 4 case studies, and 14 case reports. DEG-contaminated paracetamol caused unexplained AKI in children. Other drugs including cough expectorants, antihistamines, and sedatives were administered. Chemicals other than DEG, such as propylene glycol and ethylene glycol, also induce AKI owing to overprescription and unintentional exposure. A recent epidemic of unexplained AKI showed contaminated paracetamol as the poisoning agent regardless of formula.
10.Parental support and exclusive breastfeeding at 3 months in West Java, Indonesia: a mixed-methods approach
Ratu Ayu Dewi SARTIKA ; Fadila WIRAWAN ; Wawan GUNAWAN ; Primasti Nuryandari PUTRI ; Nurul Husna Mohd SHUKRI
Clinical and Experimental Pediatrics 2024;67(7):358-367
Background:
The exclusive breastfeeding (EBF) rate in Indonesia is lower than expected. Among the key factors affecting breastfeeding practices, paternal support has been suggested.Purpose: To explore the role of paternal support in EBF failure among 3-month-old infants.
Methods:
This sequential mixed-methods study, part of an ongoing cohort study in West Java in early 2022, included 225 infants. The parents of 3-month-old infants were interviewed. Paternal support was assessed using a 15-point validated questionnaire for a total score of 15–60 points. Multivariate binary regression was used to determine adjusted odds ratios (aORs). The qualitative exploration was based on in-depth interviews (IDIs) and forum group discussions (FGDs) following the quantitative survey.
Results:
Of the 225 infants, 52.2% were no longer EBF. High paternal support (greater than the mean score) of breastfeeding was determined in 52.9% of cases (mean± standard deviation, 38.7±6.7 for the overall population vs. 37.5±6.3 and 40.2±6.8 for infants who were and were not EBF at 3 months of age, respectively). Low paternal support was associated with an increased EBF failure rate (aOR, 2.84; 95% confidence interval [CI], 1.46–5.54). Other variables that remained as predictors in the final model were a low birth rate (aOR, 7.35; 95% CI, 1.73–31.20), negative maternal attitude (aOR, 3.31; 95% CI, 1.63–6.75), lower self-efficacy (aOR, 4.82; 95% CI, 2.43–9.57), and lower maternal education level (aOR, 2.87; 95% CI, 1.03– 8.03). The IDIs and FGD observed the importance of the father’s support of the mother and EBF. The qualitative exploration revealed a lack of knowledge about EBF as a parental support barrier.
Conclusion
Paternal support is important for EBF. Paternal involvement in EBF planning encouraged themother to continue. Plans that include fathers in breastfeeding education may help increase paternal support.


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