Treatment Motivation in Lung Tuberculosis Patients at Public Health Centres in Denpasar City during COVID-19 Pandemic

Treatment motivation among patients were heavily influenced by duration of therapy and existing side effects. TB supervisors motivated patients in their therapy. Limited communication from TB supervisors due to COVID-19 pandemic risked lowering treatment motivation in TB patients. Objective: get a general description of treatment motivation in TB patients from PHC in Denpasar. Method: descriptive observational with cross-sectional design in March – August 2021 at five PHC in Denpasar area. This study was done online using questionnaire with Google Forms application. Motivation is grouped into low, moderate, and high based on scores from internal factors, external factors, confidence in treatment, and interpersonal help seeking. Results: 86% of patients (43 people) had high treatment motivation, 12% of patients (6 people) have moderate treatment motivation, and two percent of patients (1 people) had low treatment motivation. Summary: Most of TB patients had high treatment motivation (86%). Communication between TB supervisors and patients are highly advised to motivate patients and increase success rate of therapy. Keywords: [Anti tuberculosis drugs, Lung tuberculosis, Treatment motivation].

Epigenetic Mechanisms in Parenchymal Lung Diseases: Bystanders or Therapeutic Targets?

Epigenetic responses due to environmental changes alter chromatin structure, which in turn modifies the phenotype, gene expression profile, and activity of each cell type that has a role in the pathophysiology of a disease. Pulmonary diseases are one of the major causes of death in the world, including lung cancer, idiopathic pulmonary fibrosis (IPF), chronic obstructive pulmonary disease (COPD), pulmonary hypertension (PH), lung tuberculosis, pulmonary embolism, and asthma. Several lines of evidence indicate that epigenetic modifications may be one of the main factors to explain the increasing incidence and prevalence of lung diseases including IPF and COPD. Interestingly, isolated fibroblasts and smooth muscle cells from patients with pulmonary diseases such as IPF and PH that were cultured ex vivo maintained the disease phenotype. The cells often show a hyper-proliferative, apoptosis-resistant phenotype with increased expression of extracellular matrix (ECM) and activated focal adhesions suggesting the presence of an epigenetically imprinted phenotype. Moreover, many abnormalities observed in molecular processes in IPF patients are shown to be epigenetically regulated, such as innate immunity, cellular senescence, and apoptotic cell death. DNA methylation, histone modification, and microRNA regulation constitute the most common epigenetic modification mechanisms.

The Relationship Of Energy Intake, Protein, Vitamin B6, Vitamin C With The Nutritional Status Of Lung Tuberculosis Patients In The Kemuning Room, Dr. M. Yunus Bengkulu In 2020

Penurunan berat badan dan nafsu makan seringkali terjadi pada pasien TB paru. Determinan penyakit TB paru salah satunya infeksi dan status gizi.Pasien TB paru mengalami penurunan status gizi disebabkan tingkat perilaku terhadap makanan dan kesehatan, khususnya kecukupan energi dan protein. Tujuan penelitian untuk mengetahui hubungan asupan energi, protein, vitamin B6, vitamin C dengan status gizi pada pasien tuberkulosis paru di RSUD Dr M Yunus Bengkulu tahun 2020. Metode penelitian merupakan observasional analitik dengan pendekatan cross sectional. Teknik pengambilan sampel dengan metode accidental sampling dengan jumlah sampel 35 pasien. Pengumpulan data asupan zat gizi dengan metode semi food frequency quesitonaire (FFQ) dan recall 1x24 jam. Analisis data secara univariat dan bivariat menggunakan uji spearman corelation. Hasil penelitian menunjukan rata-rata asupan energi, protein, vitamin B6, dan vitamin C kategori kurang dari angka kecukupan gizi (AKG). Terdapat hubungan antara asupan energi dan status gizi, tidak terdapat hubungan antara asupan protein dan status gizi, tidak terdapat hubungan antara asupan vitamin B6 dengan status gizi, tidak terdapat hubungan antara asupan vitamin C dan status gizi. Diharapkan kepada pasien TB paru dapat meningkatkan asupan energi dari sumber karbohidrat, protein, dan lemak agar terhindar dari kekurangan gizi.

Analysis of Factors Affecting Druging Compliance in Lung Tuberculosis Patients: Theory of Health Belief Model (HBM) in the Working Area of the Health Center, Dompu City

Tuberculosis is an infectious disease caused by TB bacteria called Mycobacterium tuberculosis, which mostly attacks the lungs (80%), but can also attack other organs such as bones, lymph glands, joints, lining of the brain, intestines, kidneys. , genitals, and others. The purpose of this study in general was to determine the effect of the Health Belief Model theory on medication adherence to tuberculosis patients. This research is a quantitative study with the method of observation and cross sectional approach. The research sample was 119 tuberculosis sufferers. The independent variables are perceived vulnerability, severity, barriers, cues for action, perceived benefits and self-efficacy. Adherence to taking medication in tuberculosis patients as the dependent variable. The results showed that simultaneously there was an effect of variable X on Y with a significance value of 0.000 and a large effect of 10.2%. And simultaneously it shows that there is an influence of variables X and Y with a significance value of 0.000 and a large influence of 12.8%. Data analysis using path analysis. Simultaneously there is an effect of the application of the Health Belief Model theory on adherence to taking medication in tuberculosis patients.

Rectal Tuberculosis - A Complete Review

Tuberculosis (TB) is a communicable disease caused mainly by Mycobacterium tuberculosis and its most frequent location is lung. Tuberculosis which affects the rectum is a rare extra-pulmonary sort of the disease that needs recognition because it requires specific treatment. Clinical and endoscopic presentations of intestinal TB are often almost like those of other diseases, like neoplasias and regional enteritis. Therefore, a high level of suspicion is required, as well as the performance of microbiologic studies, to confirm the diagnosis. Tuberculosis which affects the rectum is called rectal tuberculosis. Most common symptoms of rectal tuberculosis are abdominal pain, hematochezia, bowel habit change, episodes of rectal bleeding. The causative organisms of the disease include Mycobacterium tuberculosis and Bovis. Diagnosis of rectal tuberculosis is based on characteristic endoscopic appearance of lesions, histopathologic features of tuberculosis in biopsy/ resected material, and response to antitubercular therapy. It is still a great challenge even for experienced clinicians to diagnose the abdominal tuberculosis since it is an excellent mimicker that has unusual presentations. A high index of suspicion is important for reaching its diagnosis. Keywords: Rectal tuberculosis, Tuberculosis, Rectal TB.

Analysis of Diagnosis Delay on Lung Tuberculosis Patient in Porong Primary Health Care, East Java, Indonesia

Introduction: The duration of diagnosis delay in tuberculosis (TB) control strategy is one of the problems in TB control program. There are a lot of adverse effects, such as increasing the risk of people to become more prone to TB transmission, infectivity period, and worsening the patient’s condition that can furthermore increase the mortality and morbidity numbers. This study aimed to analyze the delay behavior in the society, specifically in Porong, East Java. Methods: The respondents filled a questionnaire, the answer was crosschecked and complemented with the medical record on the clinic. The data collected then were analyzed with binary logistic regression using SPSS.Results: From the total of 22 samples in this study, 11 of them were classified to be delayed (patients checked their symptoms 2 weeks after the symptoms started to appear). Some factors that might have an effect on the patient’s delay were education level, the patient’s knowledge about TB, and occupation that lead to the patient’s business. Meanwhile, factors like age, gender, and the distance between the patient’s house and the health facility might have an insignificant effect.Conclusion: Duration of patient delay contributed significantly to the duration of diagnosis delay, with the median duration of 29 days. Meanwhile, the duration of system delay that was found only ranging at 0-3 days. In this study, however, evidence of the independent factors might have an effect on the patient’s tendencies to delay treatment that had not yet proven by statistical analysis.