Decision-Making with Fuzzy Soft Matrix Using a Revised Method: A Case of Medical Diagnosis of Diseases

In this paper, we study the matrix representation of fuzzy soft sets, complement of fuzzy soft sets, product of fuzzy soft matrices and the application of fuzzy soft matrices in medical diagnosis presented by Lavanya and Akila. Additionally, a new method (max-min average) based on fuzzy reference function is introduced instead of the max-product method by Lavanya and Akila to extend Sanchez’s technique for decision making problems in medical diagnosis. Using the same data by Lavanya and Akila, the result shows that the new method gives more information about the medical status of the patients being considered in relation to a set of diseases.

COVID-19 infection mortality risk in Iranian patients with type 2 diabetes, hypertension and obesity

Background: Diabetes mellitus and hypertension are highly prevalent among patients with severe COVID-19. Aims: To study mortality risk of COVID-19 infection in patients with type 2 diabetes and additive effect of hypertension and obesity in the Iranian population. Methods: This was a cross-sectional survey of the national COVID-19 registry from the Iranian Ministry of Health. The medical status of 22 002 patients with COVID-19 between 1 March and 30 April 2020 was analysed. Results: Patients with type 2 diabetes had a higher risk of mortality with an odds ratio (OR) of 1.67 [95% confidence interval (CI): 1.53–1.82, P < 0.001]. The risk of mortality was also higher in patients with diabetes and hypertension, with an odds ratio of 1.76 (95% CI: 1.56–1.99, P < 0.001). The odds ratio of the risk of mortality in patients with diabetes, hypertension and obesity was 1.87 (95% CI: 1.35–2.58, P < 0.001). Conclusion: Type 2 diabetes, hypertension and obesity each predict mortality in Iranian patients with COVID-19, and when they are present together, patients have a greater risk of mortality.

Improving public health in the integrated healthcare center for elderly and cadres empowerment in Jetis Hamlet, Kalinegoro, Magelang Regency

There is a critical need to improve community health monitoring. A major mechanism is the development of the Integrated Healthcare Center for the Elderly. This government facility provides medical services for the elderly through the public health center program for the elderly, families, community leaders and social organizations. The cadres were formed to improve services and observe the health of aged persons in Jetis Hamlet, Kalinegoro, Mertoyudan. Consequently, the implementation was conducted by the process of recruitment, training and mentoring and the result was successful, the evaluation and monitoring activities were performed a month after the training and the Integrated Healthcare Center for the Elderly were effectively attained at a monthly basics. Finally, the medical status of the elderly and the cadres' knowledge have significantly increased, meanwhile the occurrence of illness and has been minimized.

Light, lighting and human health

Light can impact human health via the visual and non-visual systems originating in the retina of the eye or as optical radiation falling on eye or skin. This paper provides a summary of what is known about these impacts. Topics covered include aspects of lighting likely to cause eyestrain and headaches; increase the risk of falls; induce circadian disruption; enhance sleep; mitigate Alzheimer’s disease and depression; produce tissue damage; alleviate diseases through phototherapy and inactivate viruses through germicidal irradiation. It is concluded that human health is undoubtedly influenced by lighting, but there are four conditions that should be attached to such a simple assertion. First, the impact of lighting on human health can be either positive or negative. Second, human health is affected by many factors other than lighting. Third, the severity of the effects of light exposure can vary widely from the short-lived and trivial to the long-term and fatal. Fourth, the same lighting conditions can have very different health impacts for different individuals depending on their age and medical status. Taken together, these conditions imply that care is required when judging the veracity and relevance of broad assertions about the benefits of lighting for human health.

Social and legal patronage of HIV-infected and AIDS patients

Today people with HIV and AIDS are a social group, which is considered as an object of social work, an object of implementation of social technologies. The special characteristics of this group, their stigmatization and the peculiarities of the socio-legal and socio-medical status have led to the need for a legal and human rights approach in social practice, one of the possible social technologies where there can be social and legal patronage. This article is devoted to the disclosure of the features of the situation in the sphere of the spread of HIV and AIDS in Russia and the Perm Region, the analysis of the technology of social and legal patronage in the work with the group under consideration and the practice of its application in the Perm Region.

Is ventricular arrhythmias the end for all conditions ?

Dear Editor, We read the article entitled “Abnormal Dispersion of Ventricular Repolarization as a Risk Factor in Patients with Human Immunodeficiency Virus: Tp-e Interval, Tp-e/QTc Ratio” by Unal Evren et al. with interest[1]. The authors evaluated the changes in Tp-e interval, Tp-e/QT and Tp-e/corrected QT (QTc) ratios, and traditional electrocardiographic features of electrical dispersion in adults infected with Human Immunodeficiency Virus (HIV) and their study revealed that the cTp-e interval, Tp-e/QT and Tp-e/QTc ratios were prolonged and correlated to the severity of the disease in HIV-infected patients. Previous studies have revealed that the Tp–e interval, the Tpeak-Tend interval (Tpe), the interval from the T-wave peak to the end of the T wave, has been related to arrhythmogenesis, is specified as an index of totaldispersion of repolarization[2]. Prolonged Tp–e interval is predictable for ventricular arrhythmias and mortality [3]. Unal et al. showed that HIV-infected patients receiving combination antiretroviral therapy (cART) were associated withlonger Tp–e interval and Tp–e/QTc ratio and correlated positively with the duration of disease and the electrophysiologicalabnormalities, and negatively with CD4 count[4]. There were no informations about medical status of patients with HIV, duration of the disease and why hsCRP is higher in patients’ group. The patients were in active phases of infection. We think that these are important datas for results of the study. We thank the authors for adding this article to the literature

Faktor Penyebab Keterlambatan Pengajuan Klaim Pasien BPJS Rawat Inap di Rumah Sakit Umum Daerah Soe

Problems commonly found in submitting insurance claims are incomplete documents, follow-up claims, the mismatch of the rates submitted by the hospital with the INA-CBGs rates or those paid by BPJS Kesehatan, irregularities in the coding of disease diagnoses, and the delay in claiming payments by BPJS Kesehatan. Based on the preliminary study at Soe Public Hospital in October 2019, there were still several administrative problems in submitting claims for JKN program. It was proven by the fact that there were still patients with JKN who did not bring a copy of their BPJS Kesehatan cards and the referral letter determined by BPJS Kesehatan when registering for a treatment. The aim of this study is to determine the factors causing the delay in submitting claims for inpatients with BPJS at Soe Public Hospital in 2020.This was a qualitative descriptive study. The population in this study was staff who are directly involved in the insurance claiming process. The sample was selected using purposive sampling technique that consisted of one assembling staff, one coding staff, two internal verifiers and one BPJS Kesehatan verifier. The results of the study indicated that the process of submitting claims for patients with BPJS Kesehatan by Soe Public Hospital did not carry out in a comprehensive and integrated manner because of incomplete medical record status, lack of coordination and teamwork between staff who record medical status that involves assembling staff, coding staff, and hospital verifier. This made a delay in submitting claims for inpatients with BPJS Kesehatan. There were also other obstacles found in the process of submitting claims for inpatients with BPJS Kesehatan at Soe Public Hospital. It is suggested that hospital managers need to evaluate staff who are responsible for submitting claims for inpatients with BPJS Kesehatan regularly and to assess the strengths and weaknesses of each staff.

The affected factors of loss to follow up (LFU) among HIV patients with antiretroviral therapy (ART) in Dr. Sardjito General Hospital, Yogyakarta, Indonesia

HIV infection is a global issue which is related to the increasing cases of HIV and AIDS in various countries including in Indonesia. Antiretroviral therapy (ART) that addressed for reducing the virus proliferation is not always followed by good medication adherence among patients. The ART loss to follow up (LFU) is a common problem in Indonesia. However, information concerning the affected factors of LFU among HIV patients with ART is limited. This study aimed to investigate the affected factors of LFU among HIV patients in the early two years of ART. A retrospective cohort study was conducted in Dr. Sardjito General Hospital, Yogyakarta among 369 medical records of HIV patients that met the inclusion and exclusion criteria. The inclusion criteria were HIV patients who started ART in January 2008 to December 2012, aged > 17 years with a complete medical records. The data of sociodemography and medical status patients were obtained from medical record, ART, and pharmacy register of the patients. Patient characteristics observed in this study included demographic factors such as age, sex, residence, education level, risk factors, and also medical status factors such as clinical stage, tuberculosis (TB) co-infection, functional status, and CD4 cell counts. The data were analyzed using Kaplan Meier and Cox Proportional Hazard. The results showed that patients with TB co-infection in early therapy and working functional status were significant factors of LFU (p<0.05). Patients without TB co-infection were half as much protected from LFU compared to patients with TB infection (HR=0.50; 96%CI: 0.34-0.75). It can be concluded that TB coinfection in early therapy and working fuctional status are the significant factors that influenced the LFU incidents in the two years of early therapy.