Bioscientia Medicina - Journal of Biomedicine and Translational Research
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Correlation between the Serum Level of Interleukin-2 in Hemodialysis Patients and Severity of Renal Pruritus
Get PDFRenal pruritus (RP) is a condition or symptom that is often found in end-stage chronic kidney disease (CKD) undergoing hemodialysis (HD). The etiology of RP is multifactorial, one of it due to inflammation mediated by interleukin 2 (IL-2). Study on the correlation between serum level of IL-2 and the severity of RP is still limited. This study will analyze the correlation between serum level of IL-2 in patients undergoing HD and the severity of RP. Our method is cross sectional design at Hemodialysis Installation of Dr. Mohammad Hoesin Hospital. Serum level of IL-2 examined by ELISA, the severity of RP assessed by a 5 dimensional pruritus scale. Inclusion criteria in this study included HD patients with RP ≥ 9, age ≥ 18 years and willing to sign informed consent. The results from 28 male (59.6%) and 19 female (40.4%) are the mean serum level of IL-2 (pg/ml) is 0.424 ± 0.077. The mean RP severity score is 18.98 ± 2.74. A strong positive correlation between serum level of IL-2 and the severity of RP (r = 0.750, p = 0,000). Our conclusion is the increase of serum level IL-2 in line with severity of RP
Philogenetic Analysis of S. Scabiei Var. Hominis, Var. Cuniculi, and Var. Marmoota
Get PDFIntroduction: Based on data from the 2017 Global Burden of Disease, it is known that Indonesia is the country with the highest number of scabies incidences out of 195 countries in the world. In addition to humans, scabies is also an infectious disease in mammals with a prevalence of 300 million infestations every year, even in animals the mortality rate from scabies is very high. Until now, it is still unclear whether there is a cross-infestation between human and animal scabies. Morphologically, S. scabiei between variants cannot be distinguished, while research on genetic variation is still not much done. Therefore, it is necessary to conduct studies to enrich genetic information and phylogenetic analysis.
Methods: The samples tested were positive PCR results for ITS 2 and CO 1 genes, each on five amplicons, namely three S. scabiei var. hominis, one var. cuniculi, and one var. marmoota. Phylogenetics were arranged based on the closeness of the base arrangement in variants and geographically available in NCBI.
Results: Of the five sample isolates studied, the ITS 2 gene amplicon is located in the 417bp band and the phylogenetic analysis of its sequencing has two branches that are unable to distinguish var. hominis and var. animalia. The CO1 gene has electrophoretic results at 317 bp as well as phylogenetic analysis results that specifically divide branches between var. hominis and var. animalia.
Conclusion: S. scabiei var. hominis and var. marmoota, and var. cuniculi are distinct species and are host monospecific
The Effect of the Covid-19 Free Operation Path Protocol on the Incidence of Lung Complications in Postoperative Elective Patients at dr. Moewardi Hospital Surakarta
Get PDFThe pandemic that began in late 2019, COVID-19, affects all patients, including cancer patients. Patients with cancer that continues to spread and there is no other effective alternative treatment must undergo surgery so that cancer does not get worse. Given this problem, many health care centers have developed a protocol system in the form of a COVID-19-free surgical route. This study is a retrospective cohort study comparing the incidence of pulmonary complications in patients undergoing elective cancer surgery at dr. Moewardi Surakarta before and during the COVID-19 pandemic. The study sample was adult patients aged ≥ 18 years which underwent elective surgical procedures with the aim of curative cancer starting before COVID-19 (March 2019-February 2020) until the time the COVID-19 pandemic emerged (March 2020 - February 2021). The data obtained were 768 patients. Of these patients, 384 were classified as having a COVID19-free operation route during the pandemic, and 384 others underwent elective surgery in the pre-pandemic period. Based on the Chi-Square test, a p-value of 0.850 was obtained (P>0.05) which shows that there is significant difference between cases of pulmonary complications in surgical patients before and after the pandemic who were carried out through the COVID-19-free protocol route. In conclusion, there is no significant change in effect of the covid-19 free operation path protocol on the incidence of lung complications in postoperative elective patients at dr. Moewardi Hospital Surakarta, although this patented and mandatory protocol can reduce cancer patients’ morbidity and mortality who undergoing elective surgery during a pandemic
Maternal Death Cause by Antepartum Eclampsia, With HELPP Syndrome and AKI Stage III : A Preventable Recurrent Death
Get PDFBackground: Eclampsia and severe preeclampsia is of the most frequent cause of maternal death. We usually find the case like this in our daily practice. The case most likely could be prevented. Eclampsia defined as a generalized seizure following preeclampsia in pregnancy. Eclampsia/Preeclampsia (EPH-Gestosis) cause a multisystem dysfunction such as HELLP syndrome, microangiopathy hemolytic anemia, liver dysfunction, and thrombocytopenia. Eclampsia and HELLP syndrome lead to maternal mortality, which happened mostly during third trimester. Most of the patient came to the hospital in a bad condition where the multi organs failure were exist. EPH-Gestosis are due to maternal death in 43,75%. Even the case usually severe, it’s a preventable death. A proper strategy is needed to reduce or to avoid the maternal death.Objective: To analyse a maternal death with eclampsia and how to prevent this recurrent death.Case Report: A woman, 30 years old, G2P1A0 32 weeks pregnant not in labor with antepartum eclampsia was admitted to Mohammad Hoesin General Hospital (MHGH) Palembang, a referral case. Patient experienced generalized seizure six times before coming to MHGH which every seizure duration is less than five minutes and unconscious. On physical examination, patient was conscious, with blood pressure of 160/100 mmHg, pale, and cold extremities. By ultrasound examination, it showed 34 weeks pregnancy with single life fetus. Laboratory examination showed leukocytosis (25.000/mm3), thrombocytopenia (58.000/mm3), hyperbilirubinemia, elevated SGOT and SGPT (1691 and 861 U/L), elevated creatinine serum (2,46 mg/dl), and elevated LDH (3629 U/L). The patient was treated based on the protocol for stabilization with intramuscular injection of MgSO4 40%, nifedipin 10 mg per oral, intravenous injection of dexamethasone 12 mg, and plan to terminate the pregnancy by caesarean procedure. The male baby was born, 2000 g weight and APGAR score 4/6/8. After the cesarean the consciousness not so well. Collaborating therapy to handle the case, with the anesthesiologist, internist and neurologist. Maternal death occurred in 3 days hospitalized …caused by multi organ failure (MOF). Conclusion: The maternal death caused by antepartum eclampsia and the complication. The diagnosis of antepartum eclampsia and HELLP syndrome was decided based on history taking, physical examination, and supporting examination. Multiple organ failure exist in this case when the patient came to MHGH. Patient already treated and tried to overcome the complication but maternal death still occurred. This maternal death has a likely same story of previous death pattern. It is needed a strategy to prevent or to reduce the maternal death and how to make a good effort to cease the case become severe or worst
Factors Affecting Delivery Methods in Severe Preeclampsia Patients at Dr. RSUP. Mohammad Hoesin Palembang January 2018 – December 2019
Get PDFBackground: Hypertension in pregnancy (HIP) is the second highest cause of maternal death in Indonesia. Termination of pregnancy in patients with HIP or preeclampsia is the most common treatment to save both the mother and the fetus. There are two methods of delivery that can be done, namely vaginal or abdominal termination (sectio caesaria). Due to the high incidence of severe preeclampsia in Indonesia and the various determinants in choosing a delivery method for severe preeclampsia, the aim of this study is to analyze what factors influenced it in Dr. Mohammad Hoesin Palembang Hospital.
Method: This type of study is an analytic observational study with a cross-sectional study design. A total of 210 samples were taken using the simple random sampling technique from the medical records of severe preeclampsia patients who gave birth at Dr. Mohammad Hoesin Palembang Hospital during January 2018 – December 2019 and was analyzed by univariate, bivariate and multivariate analysis with SPSS ver.26.
Result: A total of 81 (38.6%) PEB patients underwent vaginal delivery and 129 (61.4%) underwent a caesarean section delivery. From the observations, 67 people (57.3%) were aged 20-34 years, 40 people (78.4%) with a gestational age of 34-36 weeks, 92 people (57.9%) multiparity, 104 people (62, 3%) without a history of hypertension, 86 people (53.4%) without a history of SC, 98 people (84,5%) with a bishop score ≤5, 116 people (59,5%) without PJT, 122 people (61%) without macrosomic fetuses, 108 people (63.5%) without PROM, and 84 people (75%) with complications underwent cesarean delivery. The factors of gestational age (p value = 0.001), history of sectio caesaria (p value = 0.000), bishop score (p value = 0.000), and complications or comorbidities (p value = 0.000) had a significant relationship to the method of delivery for patients with PEB with factors bishop score is the most influencing factor (OR = 10,299).
Conclusion: Therefore, gestational age, history of CS, bishop score, and complications or comorbidities are factors that influence the delivery method of PEB patients
Surgical Site Infection Post Caesarean Section: A Case Report
Get PDFBackground. Surgical site infection (SSI) is a major complication of surgery which can increase morbidity, mortality and cost of hospitality. Incidence of SSI at a healthcare provider/facility reflected a service quality of that institution.
Case presentation. A 28-years-old woman, a housewife, P2A1, post-caesarean section 12 days ago. Pasien datang dengan keluhan utama badan lemas dan terdapat nanah pada luka bekas operasi. Ia mengeluh perutnya terasa semakin panas, dan keluar cairan bening sebelum muncul nanah pada luka operasi. Pasien juga mengeluh demam, mual dan lemas akhir-akhir ini Laboratory investigations showed Hb 11,9 g/dL, Leukosit 11.100 m/L, trombosit 601.000. MCV 70,7 fL MCH 24 pg MCHC 32 g/dL TIBC 392 mg/dL serum Iron 54 mg/dL Ferritin 19,8 ng/mL, CRP reactive. Patient was wound dressing and given levofloxacin 500mg three times a day intravascular for three days and continue with ciprofloxacin three time a day oral. Patient was suggest to repeat laboratory test after therapy to evaluate therapy response.
Conclusion: The result showed that time of prophylactic antibiotics can used to minimize the occurrence of SSI in post-caesarean section patients
Relationship between 25-Hydroxy Vitamin D Levels and Type of Morbus Hansen
Get PDFBackground: Morbus Hansen is a chronic granulomatous infection of Mycobacterium leprae (M. leprae) which is characterized by cardinal signs in the form of numbness of the skin, thickening of peripheral nerves and acid-fast bacteria (AFB) were found on bacterioscopic examination. WHO has classified MH into paucibasilar MH (MH-PB) and multibasilar MH (MH-MB) based on the number of skin lesions or bacterial index (IB). Vitamin D in MH is known to act as an immunomodulator. This study aims to determine the relationship between serum 25(OH)D levels with Morbus Hansen type at RSUP Dr. Mohammad Hoesin and Leprosy Hospital Dr. Rivai Abdullah Palembang.
Methods: A laboratory observational study with a case series design was undertaken at the Dermatology and Venereology (DV) Polyclinic of Infectious Dermatology (DI) Mohammad Hoesin Hospital Palembang since December 2019 to January 2020. A sample of 33 patient MH met the inclusion criteria, consisting of 22 patients with Morbus Hansen (MH) type MB and 11 patients with Morbus Hansen (MH) type PB. Comparison of serum 25(OH)D levels between MB and PB type MH patients was analyzed using the Independent T Test, the relationship between serum 25(OH)D levels and MH type was analyzed using the Fisher Exact Test and the correlation between serum 25(OH)D levels with type of MH was analyzed using Spearman Rho's test. Data analysis using SPSS version 22.0.
Results: In this study, there were no differences in demographic characteristics of gender, age, age category, body mass index, education and occupation between MB and PB type MH patients (p > 0.05). There were no difference in duration of therapy (p = 0.155), ENL reaction (p = 0.276) and patient status (p = 0.304) between MB and PB type MH patients, but there were differences in bacterial index (p = 0.000) and clinical spectrum (p = 0.000) between MB and PB type MH patients. There is a difference in the mean level of 25(OH)D between MB and PB type MH patients (p = 0.006), there is a significant relationship between 25 (OH)D levels and MH type patients, (OR = 9.643 ; p = 0.010) and there is a significant moderate positive correlation between levels of 25 (OH)D and the type of MH (r = 0.467; p = 0.006).
Conclusion: It can be concluded that there are differences in serum 25(OH)D levels among Morbus Hansen type. In addition, there is a significant relationship between serum 25(OH)D levels with Morbus Hansen type
Correlation between Intraoperative Ossicular Status and Conductive Hearing Loss Degree among Chronic Suppurative Otitis Media Patients in Dr Mohammad Hoesin General Hospital Palembang
Get PDFBackground: Chronic suppurative otitis media (CSOM) is a chronic inflammation of the mucosa and periosteum of the middle ear and mastoid cavity that defined as a perforated tympanic membrane with persistent drainage for more than 2 months. Preoperative hearing threshold and air bone gap (ABG) assessment are expected to predict the ossicular status which can only be ascertained intraoperatively. This study aimed to determine the correlation between intra-operative ossicular status and the degree of conductive hearing loss assessed based on the hearing threshold and average ABG among CSOM patients in RSUP Dr. Mohammad Hoesin Palembang.
Methods: Observational research using a cross sectional design. The data were collected using medical record on 64 subjects with a diagnosis of CSOM who underwent mastoidectomy surgery at Dr. Mohammad Hoesin Hospital Palembang for the period of March 2019 to June 2021.
Results: From 64 samples conducted in the study, the average ossicular status score in CSOM patients was 1.84 ± 1.48, with the highest group scoring 0 being the malleus incus and intact stapes as many as 21 patients (31.3%). There was a strong positive correlation between hearing threshold scores and intra-operative ossicular status scores (p<0.005, R=0.5) and there was a strong positive correlation between ABG scores and intra-operative ossicular status scores (p <0.005, R=0.6). From the linear regression test, the most influential in predicting intra-operative ossicular status scores were gender, hearing threshold value, ABG value, and the presence of cholesteatoma
Conclusions: There is a significant relationship between intra-operative ossicular status and the degree of conductive hearing loss in CSOM patients
Risk Factors for Congenital Deafness in Pediatric Patients Who Underwent Otoaccoustic Emission (OAE) and Auditory Brainstem Response (ABR) Examinations in General Hospital Mohammad Hoesin Palembang, Indonesia
Get PDFIntroduction: Congenital deafness is a hearing loss that occurs at birth. Congenital deafness in neonates can be caused by risk factors during pregnancy and during the birth process. The tests carried out for hearing screening for neonates in hospital up to 1 month old are Otoaccoustic Emission (OAE) and Auditory Brainstem Response (ABR) examinations.
Objective: Determining the relationship between family history of deafness, syndromes associated with sensorineural hearing loss, TORCH infection and prenatal syphilis, use of ototoxic drugs during pregnancy, prematurity, low birth weight, asphyxia, and hyperbilirubinemia with the incidence of congenital deafness in children
Methods: This cross-sectional study was conducted based on medical record datas from children who underwent OAE and ABR examinations at Dr. Mohammad Hoesin Palembang hospital from January 2019 to February 2021.
Results: From the 349 children, 180 (51.6%) had bilateral OAE and ABR pass results, 161 (46.1%) had bilateral referrals and 8 (2.3%) children received unilateral refer results. From 122 children with risk factors, 38 (31.1%) children with bilateral passes, 81 (66.4%) children with bilateral referrals and 3 (2.5 %) children with unilateral refer. From 227 children without risk factors, 142 (62.6 %) children with a bilateral pass, 80 (35.2 %) children with bilateral referrals and 5 (2.2%) children with unilateral refer. The most common risk factor was LBW of 41 (11.7%) children. Chi square test and logistic regression analysis results showed a significant relationship between ototoxic drugs during pregnancy and congenital deafness (p = 0.001) with referral results, the value of Odd Ratio (OR) 9.651.
Conclusions: There is a significant relationship between risk factors for ototoxic drugs during pregnancy, TORCH and syphilis infection during pregnancy, asphyxia, congenital syndrome, LBWand hyperbilirubinemia with congenital deafness
Correlation of Peak Systolic Velocity Value with Wagner Score in Diabetic Foot Ulcer patients in RSUP Dr. M. Djamil Padang
Get PDFBackground: Diabetic foot ulcers are one of the chronic complications of diabetes mellitus (DM) in the form of wounds on the skin surface of the feet of DM patients accompanied by internal tissue damage or tissue death, either with or without infection, which is associated with the presence of neuropathy and or peripheral arterial disease in patients with DM. The World Health Organization (WHO) states that at least 422 million people suffer from DM A new alternative parameter for assessing the degree of peripheral ischemia is ankle peak systolic velocity (PSV). The rationale for PSV is based on the observation that in the ischemic limb, blood travels at a much slower rate in the distal leg arteries than in the nonischemic limb. PSV is a quick and easy test to assess the patient's vascular status and monitor the development of diabetic foot ulcers, and can assess the degree of ischemia and predict healing of diabetic foot ulcers. This study aims to determine the Correlation of Peak Systolic Velocity Value with Wagner Score in Diabetic Foot Ulcer patients in RSUP Dr. M. Djamil Padang.
Methods: This research is analytic observational with cross sectional design, the research uses primary data. This research will be conducted at the RSUP Dr. M. Djamil Padang from July 2021 to October 2021. The population in this study were diabetic foot ulcer patients who came for treatment at Dr. M. Djamil Padang. A sample of 32 patients Diabetic foot ulcer met the inclusion criteria. Univariate analysis was conducted to describe each of the variables studied. Numerical data is normally distributed, then it is presented in the form of mean ± standard deviation (SD), whereas if the numerical data is not normally distributed then it is presented in the form of median, minimum and maximum. Categorical data is presented in the form of frequency and percentage of each category. Bivariate analysis was started by using the data normality test using the Shapiro Wilk test (n<50). In testing the correlation between Peak Systolic Velocity and Wagner Score in diabetic foot ulcer patients, the Pearson correlation test is used if the data is normally distributed. Data analysis using SPSS version 22.0.
Results: more than half of the subjects (65.6%) are male. The mean age of the subjects was 60.46±10.06 years. More than half of the subjects (62.5%) had a normal body mass index. The average length of suffering from diabetes mellitus was 5.48 ± 2.26 years. Half had a history of smoking (59.4%), a small proportion of subjects had hypertension (21.9%), hypercholesterolemia (6.3%) and neuropathy (12.5%). More than half of the subjects (53.1%) had immunopathies. There is a correlation between the popliteal PSV value and the Wagner score in diabetic ulcer patients (p<0.05), with a moderate correlation strength (r=-0.463) and a negative direction. There is a correlation between the PSV dorsali pedis value and the Wagner score in diabetic ulcer patients (p<0.05), with a strong correlation strength (r=-0.720) and in a negative direction. Furthermore, there is a correlation between the posterior tibial PSV value and the Wagner score in diabetic ulcer patients (p<0.05), with a moderate correlation strength (r=-0.530) and a negative direction.
Conclusion: There is a correlation between the popliteal, tibialis posterior, dorsalis pedis PSV value and the Wagner score in diabetic foot ulcer patien