Low serum lipase levels in mothers of children with stunted growth indicate the possibility of low calcium absorption during pregnancy: A cross-sectional study in North Sumatra, Indonesia.

Stunting is caused by various factors, including low nutritional intake in the first two years of life. This study aimed to investigate the differences in sociodemographic factors and mineral, vitamin, and enzyme parameters in mothers associated with the occurrence of stunting in children. We conducted a cross-sectional study from September to November 2020 on North Sumatra Island, Indonesia. The data collected included sociodemographic characteristics, pregnancy history, birth history, food intake, and laboratory examinations, including measurements of calcium, iron, zinc, vitamin D, pancreatic amylase, and serum lipase levels. This study included 50 healthy mothers aged 18-50 years old with children aged 2 to 60 months. There was a significant difference in serum calcium levels between the groups of mothers of children with normal and stunted growth (p = 0.03, mean difference±standard error (SE) = 0.23±0.12, 95% CI: 0.19-0.45). All of the study subjects were categorized as vitamin D deficient. The mean lipase level in the group of mothers of children with stunted growth was significantly lower than that in the group of mothers of children with normal growth (p = 0.02, mean difference±SE = 4.34±1.83, 95% CI: 0.62-8.06). The conclusion was that serum lipase levels were significantly lower in mothers of children with stunted growth compared to mothers of children with normal growth. Serum lipase levels this low are likely to indicate that a mother is unable to meet her child's calcium needs during pregnancy, increasing the child's risk of stunted growth.

Finding a Link between Obesity and Senescence: A Systematic Review and Meta-Analysis.

Background: Cell aging is associated with changes in telomeres due to DNA damage arising from chronic inflammation in obese patients. The aim of the systematic review and meta-analysis was to find the relationship between obesity and aging or senescence. Methods: The systematic review was conducted through PRISMA guideline, beginning with literature search within 2012-2022 in several databases (PubMed, EBSCOHost, Science Direct, Scopus, and Cochrane) followed by screening process using predetermined PICO criteria. Original studies on the topic of obesity and senescence (aging), from preclinical studies to clinical research (cohort or cross-sectional studies) that were published within the last ten years. All studies were appraised using SYRCLE risk of bias tool for preclinical studies and Newcastle-Ottawa Scale (NOS) for cross-sectional and cohort studies. The data extraction on the studies' characteristic and outcome on aging or senescence were followed by quantitative analysis using MetaXL process on prevalence ratio and hazard ratio of obesity to comorbidities and mortality. Results: Fifteen studies were enrolled. Obesity and white adipose tissue cause increased levels of pro-inflammatory and pro-senescence cytokine and macrophage whilst the aging process lowers metabolism with increased insulin resistance and linked to increased risk of obesity. Obesity occurs in 22% (95% CI 18%-26%) of elderly population with higher prevalence rate in the women population. Obesity is associated with significant increased risk of multimorbidity by 56% (OR = 1.58 [95% CI 1.48-1.96]). Conclusion: The obesity and aging or senescence has reciprocal relationship between each other.

Early Detection of Diabetic Peripheral Neuropathy in Diabetic Patients: A Cross-Sectional Study.

BACKGROUND: Diabetic Peripheral Neuropathy (DPN) is a chronic complication in Type 2 Diabetes Mellitus (T2DM) patients and is characterized by paresthesia, pain, and hypoesthesia of the extremities. The Diabetic Neuropathy Symptom-Score (DNS) is a quick, inexpensive, and easy-to-perform tool to detect DPN in clinical practice. Biochemical markers like Nitric Oxide (NO) and Vascular Endothelial Growth Factor (VEGF) play a role in the early detection of DPN. This study aims to investigate the relationship between risk factors and these biomarkers. So, it is expected to improve the prevention and treatment of diabetic neuropathy more effectively. METHOD: A cross-sectional method was used for this study. The sample size was 85 patients with T2DM who visited several primary healthcare in Medan, selected by consecutive sampling method based on eligibility criteria. Data collected included DNS, assessment of NO, VEGF, Glycated Hemoglobin (HbA1C), plasma blood glucose (PBG), and lipid profile. The collected data were analyzed using an independent T-test. RESULT: The results showed that most T2DM patients, namely 73 people (85.9%), experienced DPN. From the bivariate analysis results, the risk factors associated with the prevalence of DPN in T2DM patients were found to be increased levels of total cholesterol, HbA1c, NO, and VEGF (p < 0.05). Meanwhile, blood pressure, fasting BGL, HDL-C, LDL-C, and triglycerides were not related to the occurrence of DPN in this study (p> 0.05). CONCLUSION: DNS can be used as a quick and easy initial screening tool implemented in clinical practice for screening DPN. Diabetic patients with DPN tend to have lower NO and increased VEGF; besides, NO levels are also associated with the progression of DPN. Furthermore, education, blood sugar control, and physical exercise, especially leg exercises, can prevent progressive DPN.

Factors Affecting the Outcomes of COVID-19 in Diabetes Patients at Haji Adam Malik General Hospital Medan, Indonesia.

Background: COVID-19 is a virulent viral infection by SARS-CoV-2 which caused pandemic and high mortality. One of the numerous risk factors for worse clinical outcomes in COVID-19 patients is the presence of comorbidity. Diabetes Mellitus is a chronic metabolic disease frequently in COVID-19 patients. Insulin resistance, causes chronic inflammation in the body, may aggravate the clinical outcome COVID-19 patients. Objective: The aim of the study was to examine factors that impact clinical outcomes in COVID-19 T2DM patients. Methods: The method used an analytical method with cross sectional design. Population is inpatients in Haji Adam Malik Hospital diagnosed with COVID-19 and Diabetes Mellitus Type 2 with 99 inpatients as sample. The data used are secondary data obtained through medical records from a hospital covering patients characteristics and laboratory result The data was analyzed using t-independent and chi square test with SPSS program. Results: Clinical outcomes for 99 patients are 60 patients are cured and 39 patients are dead. analytical study found a significant correlation between factors impacting clinical outcomes on COVID-19 patients with T2DM that are HbA1c level, D-dimer, cholesterol total and COVID-19 degree of severity and the clinical outcomes (p<0,05). Conclusion: HbA1c level, D-dimer, total cholesterol and the infection degree of severity affects the clinical outcomes on COVID-19 with T2DM (p<0,05).

Educational Model and Prevention on Prediabetes: A Systematic Review.

BACKGROUND: Prediabetes is a reversible condition before the onset of Type 2 Diabetes Mellitus. Untreated condition of prediabetes will develop into diabetes and its complications. The prevalence of prediabetes has been emerging worldwide and has a considerable socioeconomic impact. The current study reviews the roles of early detection, educational models, life modification, and prophylaxis of individuals with prediabetes in preventing the progression of prediabetes into Type 2 Diabetes Mellitus and complications in the future. METHODS: This study included published articles from several electronic databases. The obtained articles were limited to March 2023. Articles that were not open access and not in Indonesian or English were excluded. The protocol for this study used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020. RESULTS: Of 39627 articles, 39601 were excluded due to duplication and did not meet the eligibility criteria. At the final, there were 26 articles that were eligible for systematic review. CONCLUSION: Prevention of the development of prediabetes into diabetes is essential. A comprehensive understanding and training on intensive lifestyle modification protocols from local and national experts in diabetes prevention through digital-based education models and linguistically and culturally approach can be considered. Intensive lifestyle modification and pharmacological approaches may improve the outcome. Regular monitoring of glycemic control is also important for early diagnosis of diabetes, especially in patients with special conditions.

Citizens' perception of and willingness to receive COVID-19 vaccination in Medan. Indonesia.

One of the efforts to control the COVID-19 pandemic is through vaccination, which is targeted to build immunity and prevent severe disease and finally to control transmission. This study aimed to analyze the perception of and the willingness to receive the COVID-19 vaccine among citizens of Medan. This research is an analytic study with a cross-sectional research design. Data collection was carried out from 16 April 2021 to 18 April 2021 by having participants fill out a Google Forms questionnaire. The population in this study was adults and elderly citizens in Medan who had not yet been vaccinated against COVID-19, and the sample was taken by consecutive sampling technique, which was the group of people who met the inclusion and exclusion criteria. The measurements of perceptions of and willingness to receive the COVID-19 vaccine used a previously validated questionnaire. The data was processed using SPSS. Data analysis used the Chi-square test (p<0.05). This study indicates that 31.8% of respondents positively perceive the COVID-19 vaccine. In comparison, 68.2% of respondents have a negative perception. On willingness to receive the vaccine, 80.2% accepted being vaccinated, 5.2% did not, and 4.6% had not decided whether to be vaccinated. There is a relationship between perception and willingness to undergo COVID-19 vaccination.

Atherosclerotic Cardiovascular Disease in Diabetes Patients.

BACKGROUND: Diabetes mellitus (DM) is a metabolic disorder characterized by abnormally elevated levels of blood glucose. The hyperglycemic condition is caused by abnormalities in either insulin secretion, insulin action, or both. Two-thirds of diabetes-related deaths are caused by atherosclerotic cardiovascular disease (ASCVD). OBJECTIVE: The purpose of this study was to determine the risk of ASCVD and related factors in type 2 DM patients in Medan, North Sumatra. METHODS: We conducted a cross-sectional observational study. A total of 252 DM patients visiting primary health centers in Medan were recruited after fulfilling the inclusion and exclusion criteria. The level of risk of atherosclerotic cardiovascular disease (ASCVD) was determined by using ASCVD Risk Calculator. Data required to use this calculator are age, sex, race, total cholesterol, HDL-C, systolic blood pressure, diastolic blood pressure, history of diabetes, history of hypertension treatment, smoking history, and use of statins for anti-hyperlipidemia. The data were then analyzed with Chi-square Test (p < 0.0%) and processed with SPSS. RESULTS: There were 59 (23.41%), 140 (55.56%), and 53 (21.03%) participants who had high, moderate, and low risks of ASCVD, respectively. Bivariate analysis showed significant association between risk of ASCVD with age, SBP, total cholesterol level, HDL-C levels, and duration of diabetes (p < 0.05). Meanwhile, gender and familial history not related to ASCVD risks among DM patients (p > 0.05). CONCLUSION: The risks for atherosclerotic complications of cardiovascular disease in type 2 DM patients in Medan were predominantly high. The variables related to ASCVD risks included age, gender, HbA1C, systolic blood pressure (SBP), total cholesterol levels, HDL-C, and LDL-C levels.

Risk of Cardiovascular Complication Among Type 2 Diabetes Mellitus Patients in Medan, Indonesia. A Cross-sectional Study.

Background: Cardiovascular disease (CVD) is a disease associated with impaired heart and blood vessel function. The occurrence of Diabetes Mellitus (DM) is due to an imbalance in blood glucose that could cause damage to large and small blood vessels and increase platelet aggregation, contributing to atherosclerosis and cardiovascular disease. It could be attributed to high blood pressure, smoking, diabetes, lack of movement, obesity, high cholesterol, unbalanced diet. CVD can be prevented, especially in at-risk groups, with risk assessment utilizing the Framingham Risk Score (FRS). Objective: The study aimed to to analyze the risk of CVD according to the Framingham Risk Score (FRS) in type 2 DM patients in Medan. Methods: The data were collected with the Framingham Risk Score, which consisted of sub-variables of age, total cholesterol, HDL cholesterol, systolic blood pressure (SBM), history of DM, and history of smoking, which were assessed by gender. It was a cross-sectional analytic study with consecutive sampling on 252 respondents, namely DM patients who came for treatment or control to the health centers in Medan and fulfilled the inclusion and exclusion criteria. The data were then analyzed with SPSS. Results: The respondents consisted of 197 women (78.2%) and 55 men (21.8%). The results were predominated with high risk patients (139, 55.2%), followed by those with medium risks (80, 31.7%), and low risks (33, 13.1%). Chi-square test yielded a significant association between each sub-variable of CVD risk factors and the risks based on FRS in type 2 DM patients. Conclusion: Each sub-variable of CVD risk factors and the risks on FRS among type 2 DM patients. In future studies, it is recommended to include that a larger number of samples in the community with a balanced proportion of men and women.

Curcumin: Boosting the immunity of COVID-19-vaccinated populations.

The ongoing, highly infectious COVID-19 pandemic has prompted various drugs, vaccines, and phytochemical research to control the disease. The accelerated development of vaccines showed the importance of immune boosters against the virus. This study aims to elucidate the role of curcumin, a phytochemical with an immunoediting profile potentially able to boost immunity after vaccination. Eighty participants were enrolled to receive curcumin supplementation (n = 40) and without (n = 40) after the first vaccination until 4 weeks after the second vaccination. Total antibody formation for SARS-CoV-2 was measured using an enzyme-linked immunosorbent assay 4 weeks after the second vaccination. The average antibody formed in groups treated with curcumin supplementation showed a statistically significant increase compared to the control group (262.6 ± 324.2 vs. 42.8 ± 53.5, P < 0.01). Age, sex, and comorbidities did not affect the production of antibodies within groups. Curcumin showed potential as a complementary supplementation during the period of vaccination as it can increase antibodies produced post vaccinations. Further investigation should be conducted on more subjects and a longer period in concordance to vaccine boosters and emerging new variants.

The Effect of Hypoxia Inducible Factor -1 Alpha and Vascular Endothelial Growth Factor Level in Type 2 Diabetes Microvascular Complications and Development.

Background: Angiogenesis in diabetic patients is often caused by hyperglycemia induced by hypoxia. Objective: The aim of this study was to analyze the serum level of Hypoxia Inducible Factor -1α (HIF-1α) and Vascular Endothelial Growth Factor (VEGF) between March until Desember 2020. Methods: This is a cross-sectional analytic methods, 135 patients with Type 2 Diabetes 48 samples with Microvascular complication and 87 samples with non-microvascular complication were recruited from the various primary health care centers in Medan city and surrounding areas in North Sumatera. VEGF levels and HIF-1α tested were done with ELISA methods in the laboratory of Medical Faculty, Universitas Sumatera Utara. Statistical analysis was performed using the IBM SPSS Statistics version 24. The significance level was set up to 0.005. Results: The median HIF-1 levels in patients with microvascular complications were lower than those without microvascular complications, with a range of HIF-1α values in non-complicated samples (0.02-13.96) ng/ml and a range of HIF-1α values in vascular complications (0.52- 8.87) mg/dL. There was a significant difference in HIF-1α levels in patients with Type-2 DM with complications compared to those without complications (p<0.05). Median VEGF levels were higher in complicated Type-2 DM. There was no difference in VEGF levels in patients with Type-2 DM with complications compared to those without complications (p > 0.005). Conclusion: HIF-1α and VEGF levels showed the development in vascularity. With the higher level of HIF-1α, an increase in VEGF levels were found, indicating the angiogenesis is occurring. Although complications have not yet occurred, it is predicted that high VEGF values will cause vascular complications in the future.

What Contributes to Palliative Care Practice in Cancer Patients in Indonesia.

Background: Palliative care has an important role in cancer treatment. It has been established in Indonesia for years, however, palliative care does not give significant improvements which may due to the numerous components of palliative care. Objective: This research aims to identify factors affecting palliative care in Indonesia. Methods: This article is a literature review which was conducted through a systematic search from four online databases: Cochrane, Pubmed, Embase, EbscoHOST. The search revealed 45 studies then selected using PRISMA 2020 algoritm, leaving 8 studies to be analyzed. The factors affecting palliative care in Indonesia were then grouped into three points of view: the patients and caregiver; healthcare provider, further divided into healthcare personnel and system; as well as healthcare system. By knowing these factors it is expected that we can achieve optimal implementation palliative care in Indonesia, especially in cancer patient. Results: The factors influencing palliative care in Indonesia can be grouped into patients, healthcare provider and healthcare system. Conclusion: Palliative care improvement in Indonesia can be enhanced to achieve optimal implementation in cancer treatment.

Early detection of macrovascular complications in type 2 diabetes mellitus in Medan, North Sumatera, Indonesia: A cross-sectional study.

Background: Macrovascular complications occur very frequently in patients with type 2 diabetes mellitus (T2DM) with a high mortality rate, due to the development of cardiovascular disease (CVD), such as stroke, atherosclerosis acceleration, and atrial fibrillation. T2DM is a significant risk factor for CVD and has become the leading cause of death. The purpose of this study was to detect the early risk of macrovascular complications by using the ankle brachial index (ABI) as a marker. Methods: This study was an analytic study with a cross-sectional approach. The study population was patients with T2DM from several primary health care centers in Medan. In total, 89 subjects who met the inclusion and exclusion criteria were recruited with consecutive sampling. ABI was determined as the ratio of systolic blood pressure in the brachial artery to the posterior tibial artery after the subjects had been relaxed and felt comfortable in a supine position. Examination of vitamin D and lipid profile was derived from examination of venous blood.  Data were processed using SPSS and analyzed with one-way ANOVA. Results: The study found that there was a relationship between LDL-C, triglyceride, and vitamin D (25OH-D) based on the ABI (p > 0.05). Conclusions: ABI can be used for an early detection of macrovascular complications. Apart from being easy to perform, ABI was non-invasive. Some other risk factors that can also be used to assess complications and have relationships with ABI were LDL-C, triglyceride, and vitamin D (25OH-D). Complications in T2DM patients can be prevented with reasonable blood sugar control and lifestyle changes. Education and motivation need to be given to patients so that they become more independent in controlling their disease and improving their quality of life.

Positive Correlation Between General Public Knowledge and Attitudes Regarding COVID-19 Outbreak 1 Month After First Cases Reported in Indonesia.

The increasing number cases of coronavirus disease (COVID-19) infections in the general population in Indonesia raises questions concerning the public's knowledge and attitudes regarding this pandemic. To determine the correlation between the general public's knowledge and attitudes regarding the COVID-19 outbreak 1 month after the first cases were reported in Indonesia. This cross-sectional study was conducted between early March and the end of April 2020 in the general population of Indonesia, beginning with the North Sumatra region, where the spread of COVID-19 in Indonesia began. Questionnaires were randomly distributed online in the red zone in Indonesia. Data were collected by collecting people's responses to the questionnaire, which were distributed via WhatsApp (WA) application and were competed independently by the participants. A descriptive analysis was conducted to describe the demographic characteristics, knowledge, and attitudes of the general population. A total of 201 people had good knowledge (98%) and a positive attitude (96%) regarding the COVID-19 pandemic. The respondents had a negative attitude in relation to two aspects of the COVID-19 outbreak: having to always maintain a distance of 1.5 m when in crowds, and not being able to regularly exercise or eat nutritious food (78.6% and 79.1%, respectively). Most people in Indonesia have good knowledge and a positive attitude regarding the COVID-19 pandemic. However, negative attitudes were still found in this study, and as a result, transmission prevention measures cannot reach their maximum effectiveness by simply publicizing the increase in day-to-day cases to the general public.

Stroke among Type 2 Diabetes Mellitus Patients at Haji Adam Malik General Hospital, Medan, Indonesia.

BACKGROUND: Increasing Blood Sugar Level (BSL) in Diabetes Meletus can be various microvascular and macrovascular changes, in the end, will cause complications. The complications can occur in some organs, such as the heart, blood vessels, eyes, kidney, and nerves. Stroke is one of the complications from diabetes that is increasing in every year. AIM: The study aims to analyse the relationship between diabetes and the prevalence of stroke at Haji Adam Malik General Hospital Medan. METHODS: This study is an analytical study with a cross-sectional approach. The population was all Integrated Inpatient ward at Haji Adam Malik General Hospital Medan. The subjects were 180 people chosen by consecutive sampling technique. RESULTS: The results showed that diabetes has a relationship with the prevalence of stroke (p < 0.05; CI = 95%). The risk of diabetes is 1.34 times higher than those without diabetes at Haji Adam Malik General Hospital Medan. CONCLUSION: Based on the results, the diabetic patient has a higher risk of incidence of stroke. Excellent control for diabetic patients will prevent them from stroke and any complication.

Red Dragon Fruit (Hylocereus Polyrhizus) Extract Decreases Lactic Acid Level and Creatine Kinase Activity in Rats Receiving Heavy Physical Exercise.

BACKGROUND: Heavy physical exercise causes relative hypoxia. In hypoxic condition, the cell's energy comes from anaerobic metabolism that produces lactic acid. An increment of oxygen need leads to ischemia-reperfusion, triggers free radical formation and damages muscles. Creatine kinase (CK) is a marker of muscle tissue damage. Red dragon fruit (RDF) has potential as antioxidant to reduce free radical formation. AIM: This study aims to determine RDF extract potential to reduce the lactic acid level and CK activity after heavy physical exercise. METHODS: A total of 32 male rats (Rattus Norvegicus) were randomly divided into 4 groups: group NORDF, treated heavy physical exercise and distilled water; group RDF100, treated heavy physical exercise and at 100 mg/kg BW RDF extract; group RDF200, treated heavy physical exercise and at 200 mg/kg BW RDF extract and group RDF300, treated heavy physical exercise and at 300 mg/kg BW RDF extract. The rats swam for 20 minutes, 3 times a week for 3 weeks. RESULTS: RDF300 group showed lower lactic acid level and CK activity as compared to that of NORDF (p = 0.00) and RDF100 (p = 0.00) groups, but RDF300 are not significantly different for lactic acid (p = 0.45) and for CK (p = 0.68). CONCLUSION: Red dragon fruit extract has potential in lowering lactic acid level and CK activity in male rats receiving heavy physical exercise.

Validity and Reliability of an Instrument for Assessing Self-Care Behaviours in Diabetes Mellitus Type 2 Patients in Binjai City, Indonesia.

BACKGROUND: Self-care behaviour becomes very important for diabetic patients; good self-care behaviour will prevent complications and improving the quality of life. AIM: The aim of this study was to provide a preliminary assessment of the validity and reliability of a new measure of self-care behaviour of Diabetes Mellitus Type 2. METHODS: The research was a cross-sectional study. The study population was T2DM patients from Primary Health Centers (PHC) in Binjai City, Indonesia. Sample determination using a single simple formula for the hypothesis of one population with calculation is 115 patients; sampling was done by convenience sampling with inclusion and exclusion criteria. Research questionnaire Self-care behaviour of T2DM patients was forming by knowledge, attitudes, communication, family support, financing, motivation, and self-efficacy. Each of the predictors forms self-care behaviour and finally, the instrument consists of 28 questions. The data analysis techniques were Confirmatory Factor Analysis (CFA) tests with Structural Equation Models (SEM) with AMOS aids. RESULTS: Based on the results of the confirmatory analysis proved that the instrument is valid and reliable, the measure the self-care behaviour of T2DM. CONCLUSION: The new instrument for assessing self-care behaviour of T2DM patients is valid and reliable, besides being able to assess self-care behaviour, they can also know the components that make up self-care.

The effect of red-fleshed pitaya ( Hylocereus polyrhizus) on heat shock protein 70 and cortisol expression in strenuous exercise induced rats.

Background: Oxidative stress from exercise can contribute to damaging cells, increasing heat shock protein 70 (HSP70) and suppressing the immune system in the body. This research aimed to determine the antioxidant potential of red-fleshed pitaya extract on HSP70 and cortisol expression in rats which were subjected to strenuous exercise. Methods: The subjects of this research were 32 Sprague Dawley male rats, aged 3 months, with an average weight of 200 g. Red-fleshed pitaya extract was obtained from methanol extraction process; a maceration technique was performed and the extract was concentrated using an air-drying method. Rats were randomly divided into four groups. Group 1 were subjected to strenuous exercise and treated with distilled water only; while Groups 2, 3 and 4 were subjected to strenuous exercise and treated with 100 mg/kg body weight, 200 mg/kg body weight and 300 mg/kg body weight of red-fleshed pitaya extract, respectively. Strenuous exercises in rats was performed by intense swimming of 20 min/day, 3 days a week for 3 weeks. HSP70 expression and cortisol were measured with Enzyme-Linked Immune Sorbent Assay (ELISA) method. Results: There was a significant reduction of HSP70 (p=0.000) and cortisol expression (p=0.000) between the groups. Also, there was a significant difference in the average decreasing of HSP70 expression between group 4 and either groups 1 or 2 (p=0.000). However, a significant difference between groups 4 and 3 was not observed (p=0.813). Lastly, a significant difference was found in the average decrease of cortisol expression between groups 4 and 1 (p=0.000), 2 (p=0.000), and 3 (p=0.000) respectively. Conclusion: Red-fleshed pitaya is potential to be utilized as antioxidant to decrease the HSP70 and cortisol expression.

Diabetic Neuropathy among Type 2 Diabetes Mellitus Patients at Amplas Primary Health Care in Medan City.

BACKGROUND: Diabetic neuropathy is one of the most complicated complications of diabetes patients with Type 2 diabetes. AIM: The purpose of this study was to determine the diagnosis of diabetic neuropathy based on Clinical Neurological Examination (CNE) and the factors that influence the occurrence of diabetic neuropathy in Type 2 DM patients at Amplas Primary Health Care (PHC) in Medan City. METHODS: The research design was descriptive-analytic with the cross-sectional approach. The study population was all Type 2 DM patients who came to Amplas PHC with a total sample of 53 people using the consecutive sampling. The research data source is primary data, namely the assessment of diabetic neuropathy using the Clinical Neurological Examination (CNE) criteria. Data were processed using SPSS and analysis using the chi-square test. RESULTS: The results showed the majority of Type 2 DM patients had mild neuropathy as many as 24 people (45.3%). The Chi-square test results showed there was a relationship between age and duration of diabetes with the incidence of diabetic neuropathy in Type 2 DM patients at Amplas Primary Health Care. CONCLUSION: Education and early detection with proper management can prevent more severe complications so that the quality of life of patients can be maintained better.

The Difference of Educational Effectiveness Using Presentation Slide Method with Video About Prevention of Hypertension on Increasing Knowledge and Attitude in People with the Hypertension Risk in Amplas Health Center.

BACKGROUND: The prevalence of prehypertension in the world reaches 20-25% with a figure that is still high in Indonesia (48.4%). The role of health promotion is substantial in an effort of prevention and treatment of hypertension. AIM: This study aims to determine the difference of effect between health promotion using media slides presentation and with video in increasing knowledge and attitude regarding the prevention of hypertension in patients at risk hypertension at Puskesmas Amplas. METHODS: his study uses a Quasi-Experimental design which from 48 samples that meet the criteria inclusion will be immediately given health promotion interventions with slides presentation and video. Respondents will be asked to fill out a questionnaire about knowledge and attitudes before and after the intervention. Data processing is done using the SPSS version 20 application. RESULTS: Distribution level of the knowledge of respondents before the intervention (Pretest) and after the intervention (Posttest) is (9.8, 2.68 vs 13.2, 1.58). Distribution of the pretest vs respondent's attitude level. Post test is (29.7, 2.76 vs 33.2, 3.52). Based on the comparison of effectiveness between video and slide presentation, the significance value of knowledge was 0.072, and the significance value of attitude was 0.000. CONCLUSION: There was a significant difference in effectiveness between video with a slide presentation on improving attitudes towards hypertension prevention, and there were no significant differences in effectiveness between videos with slides presentation on increasing knowledge about prevention of hypertension.

The Model of Self Care Behaviour and the Relationship with Quality Of Life, Metabolic Control and Lipid Control of Type 2 Diabetes Mellitus Patients in Binjai City, Indonesia.

BACKGROUND: Diabetes is a type of chronic disease with exceptional medical care for a patient's lifetime, which ultimately requires lifestyle and behavioural adjustments to prevent complications to death. Patients with good self-care behaviour will cause diabetes to be controlled to avoid complications to death and make patients have a better quality of life. AIM: This study aims (1) to determine the model of self-care behaviour in Type 2 diabetes patients in Binjai City (2) to analyse the effect of self-care behaviour on quality of life, metabolic control and lipid control of Type 2 diabetes patients in Binjai City. METHODS: This type of research is survey-based and explanatory using a cross-sectional approach. The study population was Type 2 Diabetes Mellitus (T2DM) patients who remained patients in 8 primary health centres in Binjai City. The consecutive sampling yielded a sample size of 115 people. Data analysis method uses descriptive statistics and Structural Equation Modeling (SEM) using SPSS and Amos 16.0. RESULTS: The results showed that all factors that build T2DM patient self-care behaviour were able to be predictors that shape the patient's self-care behaviour. The self-care behaviour model consists of knowledge, attitudes, communication, financing, family support, motivation, and self-efficacy. Motivation is the most significant predictor of its contribution to the self-care behaviour of Type 2 diabetes patients. Self-care behaviour was also known to be significantly related to the quality of life, metabolic control and lipid control of T2DM patients (p < 0.05). CONCLUSION: Self-care behaviour in T2DM patients can have a substantial and significant impact on quality of life, metabolic control and lipid control possessed by Type 2 Diabetes patients.