Abstract:Background: Cardiovascular disease (CVD) continues to be the predominant cause of global mortality. Polypill techniques that integrate various cardiovascular drugs into a single formulation have emerged as a potential method…
thod for primary prevention, especially in intermediate-risk populations.
Objective: To systematically review and synthesize evidence regarding the efficacy and safety of polypill formulations (comprising antihypertensive medications, statins, with or without aspirin) in comparison to standard care or placebo for the primary prevention of major adverse cardiovascular events (MACE) in intermediate-risk populations.
Methods: We conducted systematic review and meta-analysis in accordance with PRISMA 2020 standards (Systematic Review Registration: PROSPERO CRD420251184718). Various databases (PubMed, Cochrane Library, ScienceDirect, Scopus) were examined for original research published from January 2015 to October 2024. Studies were eligible if they assessed polypill therapies in individuals aged 30 to 70 years with intermediate cardiovascular risk (10-20% 10-year risk), reported composite major adverse cardiovascular events (MACE) outcomes, and included a minimum follow-up of 6 months. Two independent reviewers conducted screening, data extraction, and risk of bias evaluation utilizing the Cochrane RoB 2.0 tool.
Results: Of the 161 records discovered, 4 randomized controlled studies (HOPE-3, TIPS-3, PolyIran, PolyPars) with 31,501 people fulfilled the inclusion criteria. Polypill therapies showed a substantial decrease in composite MACE relative to control groups (pooled HR 0.67 (95% CI 0.60-0.75, p<0.001). Individual trial hazard ratios varied from 0.50 (PolyPars) to 0.66 (PolyIran) and 0.79 (TIPS-3) with moderate heterogeneity (I²=35.2%, p=0.20). Polypills were generally well- tolerated, with a safety profile consistent with the individual components. Medication adherence was enhanced with the polypill in comparison to multiple-pill regimens.
Conclusions: Polypill techniques markedly reduce major adverse cardiovascular events (MACE) in intermediate-risk patients for primary cardiovascular prevention, achieving around a 33% relative risk reduction. The fixed-dose combination strategy provides benefits in compliance and ease of use. These findings hold significant implications for healthcare systems in low-to-
middle-income nations, such as Indonesia, where the burden of cardiovascular disease is substantial and access to long-term cardiovascular drugs is frequently hindered by cost and complexity.
Abstract:Background: Elderly individuals are at high risk of experiencing degenerative diseases, one of which is gout arthritis, caused by the accumulation of monosodium urate crystals in the joints due to hyperuricemia. Non-pharmacological…
macological therapies such as bay leaf (Syzygium polyanthum), which contains flavonoids, tannins, and essential oils, are believed to naturally reduce uric acid levels. Objective: To determine the effect of bay leaf decoction on reducing uric acid levels in elderly patients with gout arthritis in Serang Village. Method: This research used a descriptive approach with a case study method. The subject was one elderly person with gout arthritis who was given an intervention in the form of bay leaf decoction twice a day for four days. Results: The uric acid level before the intervention was 8.2 mg/dL and after the intervention was 4.2 mg/dL. The reduction of 4 mg/dL indicates that the bay leaf decoction was effective in lowering uric acid levels. Conclusion: Bay leaf decoction affects the reduction of uric acid levels in elderly patients with gout arthritis and can be used as a safe, easy, and affordable nonpharmacological alternative therapy.
Abstract:Hypertension is a non-communicable disease indicated by high blood pressure above 140/90 mmHg. This condition leads to major complications if treatment is not received. As a result, managing health is essential to control…
rol hypertension. The study aims to investigate the relationship between self-care and the decrease in blood pressure among hypertensive patients in Sukamakmur Public Health Center. The population was 110 hypertensive patients, and 86 respondents were selected as the sample using a random sampling technique. The research was conducted from 15 to 21 April 2025. A quantitative correlational research design was used with a cross-sectional approach. The research instruments were the Hypertension Self-Management Behavior Questionnaire (HSMBQ) and blood pressure assessed using a digital sphygmomanometer. The data that was analyzed from the Chi-Square test analysis showed a p-value of 0.020 (p<0.05). This finding indicated a relationship between self-care management and blood pressure decline in hypertensive patients at the Sukamakmur Community Health Center. This study suggests that patients should be more active and consistently do self-care management to help maintain stable blood pressure levels.
Abstract:Laboratory examinations play an important role in supporting disease diagnosis and treatment, one of which is the measurement of uric acid levels. The accuracy of laboratory results is significantly influenced by the pre-analytical…
-analytical stage, including the type of blood collection tube used. Two commonly used tubes are the plain vacutainer and the clot activator vacutainer, each with different additives that may affect blood clotting time and test results. This study aimed to determine the differences in uric acid test results and clotting time using these two types of tubes. A simple experimental method with a comparative design was conducted at Klinik Pratama Rawat Jalan Mambal Medical Care from March to April 2025. The sample consisted of 15 respondents, each undergoing two blood draws using both tube types. The results showed that the average clotting time for the clot activator tube was 9.27 minutes, while for the plain tube it was 24.67 minutes. The average uric acid level measured using the clot activator tube was 5.27 mg/dL, compared to 5.14 mg/dL using the plain tube. Statistical analysis using the Wilcoxon signed-rank test indicated a significant difference in clotting time but no significant difference in uric acid levels (p > 0.05). It can be concluded that the use of clot activator vacutainer tubes accelerates the blood clotting process but does not significantly affect uric acid levels compared to plain tubes.
Abstract:Background: Mental disorders are conditions that affect a person's emotions, thought patterns, and behavior that can interfere with activities and social interactions. WHO (2022) notes that around 24 million people worldwide…
wide experience mental disorders, where more than 60% of sufferers experience self-care deficits. Self-care deficit is a condition when a person is unable to care for themselves optimally, this has a major impact on the individual's social and self-care functions, including in personal hygiene activities such as brushing their teeth. Where around 45% of patients with self-care deficits show reluctance to brush their teeth which increases the risk of oral disease and other systemic infections. Brushing teeth in patients with self-care deficits is needed to improve oral hygiene and the patient's ability to care for themselves personally. Objective: To determine nursing care from assessment to evaluation in miss Y with self-care deficits with a focus on brushing teeth. Method: The method used is the case study approach method. Results: After nursing care was carried out on miss Y with self-care deficits, it was proven to increase the miss Y's self-care ability, especially brushing their teeth. Conclusion: The act of brushing teeth is effective in increasing self-care awareness in miss Y with self-care deficits.
Abstract:Fever is the most common disease in children. Fever in children can be found in various conditions such as infection, inflammation, or other unknown causes. One of the laboratory tests that can be used is the hs-CRP and…
erythrocyte sedimentation rate examination. The purpose of this study was to determine the relationship between hs-CRP levels and erythrocyte sedimentation rate in pediatric febrile patients. The research method was observational with a cross-sectional method using secondary data of 62 samples. Data analysis used the Spearman's rho test. The results of the study showed that most of the pediatric patients who experienced fever were male (59.7%), and the age of the child was 5 years (21%). In pediatric patients with fever, the average hs-CRP level was 19.34 mg/l, and the erythrocyte sedimentation rate was 32.73 mm/hour. The results of the correlation test using the Spearman's rho test method obtained p = 0.001 with r = 0.575, so it can be concluded that there is a moderate and positive relationship between hs-CRP levels and erythrocyte sedimentation rate in pediatric patients with fever.
Abstract:Background: Gout arthritis is a degenerative disease commonly experienced by the elderly due to elevated uric acid levels in the blood. One safe non-pharmacological treatment alternative is the use of herbal remedies such…
h as soursop leaves (Annona muricata L), which contain active compounds like flavonoids and alkaloids that may reduce uric acid levels. Objective: To describe the effect of boiled soursop leaf water on reducing uric acid levels in elderly patients with gout arthritis in Karangjambu Village, Karangjambu Subdistrict, Purbalingga Regency. Method: This study employed a case study method. Subjects were given an intervention of 200 ml of boiled soursop leaf water daily (100 ml in the morning and 100 ml in the evening) for seven consecutive days. Uric acid levels were measured before and after the intervention. Results: After seven days of soursop leaf water administration, uric acid levels decreased from an average of 8.7–9.0 mg/dl to 5.5–5.8 mg/dl. This suggests that the active compounds in soursop leaves are effective in inhibiting xanthine oxidase and promoting uric acid excretion through urine. Conclusion: Boiled soursop leaf water is effective in lowering uric acid levels in elderly patients with gout arthritis and can serve as a safe and practical complementary non-pharmacological therapy within the community.
Abstract:Diabetes Mellitus (DM) is a disease caused by pancreatic failure in performing its function of producing insulin. A lack of insulin will lead to an increase in blood glucose levels, also known as hyperglycemia. Hemoglobin…
n A1c and microalbuminuria are screening examinations used to detect the early onset of diabetic nephropathy. Diabetic nephropathy is defined as a clinical syndrome in diabetes mellitus patients characterized by persistent albuminuria, an irreversible decrease in glomerular filtration rate, and increased arterial blood pressure. The purpose of this study is to determine the relationship between Hemoglobin A1c and microalbuminuria in diabetes mellitus patients at Prodia Sunter. The research method used is quantitative analytic with a cross-sectional approach. The data collected were secondary data from the period of January–July 2024 with a total of 60 samples. Sampling was conducted using purposive sampling and met the inclusion criteria, namely patients over 60 years of age, Hemoglobin A1c value ≥7, diagnosed with diabetes mellitus, no history of thalassemia, and who had undergone Hemoglobin A1c and microalbuminuria examinations. The results of this study show a significant unidirectional positive relationship with a very strong correlation between Hemoglobin A1c levels and microalbuminuria in diabetes mellitus patients, with sig (2-tailed) = 0.000 and correlation coefficient value = 0.892. The relationship between Hemoglobin A1c levels and microalbuminuria is unidirectional positive, meaning that the higher the Hemoglobin A1c levels, the higher the microalbuminuria levels.
Abstract:The accuracy of disease diagnosis coding is an important indicator in the management of medical records and health service claims. This study aims to determine the percentage of accuracy in coding pneumonia diagnoses based…
ed on ICD-10 according to the 2023 National Medical Practice Guidelines (PNPK) at Udayana Hospital II in Denpasar. The research method used was quantitative descriptive with a total sampling approach of 72 medical records of pneumonia patients during the period from October 1, 2024, to December 31, 2024. The research instrument was a checklist for assessing the accuracy of diagnosis codes based on the provisions of ICD-10 and PNPK Pneumonia 2023. The results showed that 51 files (70.8%) were coded accurately, while 21 files (29.2%) were coded inaccurately. The inaccuracy in coding was due to a lack of supporting tests, such as microbiological tests, as well as the excessive workload of the coders. These findings indicate the need for an analysis of coders' workload to measure the effectiveness and efficiency of their tasks, time management, and priorities. This study is expected to serve as evaluation material to improve the quality of service and efficiency of hospital administration.
Abstract:This study aimed to obtain information about socio-demographic factors associated with HL of NCD patients in East Bolaang Mongondow Regency. The method used was quantitative method with cross sectional study design with…
a total sample of 383 NCD patients (purposive sampling) with stratified sampling technique. Data were collected using questionnaires both socio and demographics and HL of NCD patients. The results of this study were [education (p=0.023, OR=2.711); gender (p=0.017, OR=2.001); language (p=0.001, OR=1.013); age (p=0.020, OR=2.968); employment status (p=0.001, OR=1.248); residence (p=0.012, OR=2.068); personal health condition (p=0.031, OR=5.840); access to health information (p=0.020, OR=2.968). In the logistic regression test, the personal health condition factor was most associated with HL of NCD patients (p=0.010, OR=5.840). In conclusion, the study showed that socio-demographic factors (education, gender, language, age, employment status, residence, personal health condition and access to health information simultaneously or partially influenced the HL of patients with NCDs. The most dominant factor associated with HL of patients with NCDs was personal health conditions. The role of health workers provides many sources of information to develop and learn solutions and support for people with various types of NCDs.