E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Secondary Seizures in the Pediatric Population in Two Tertiary Hospitals in India
Get PDFObjective: To evaluate the clinical pattern of secondary seizures which includes acute and remote symptomatic seizures among hospitalized patients in two healthcare centers and to assess the outcomes among hospitalized patients having secondary seizures.Methods: This multicentric cross-sectional study was conducted in two tertiary hospitals in Odisha and Tamil Nadu, India, for a period of four years. A total of 274 patients in the age group between 6 months to 12 years participated in the study. A structured proforma was used to document the clinical pattern and causes of the secondary seizures.Results: Among the participants in Odisha and Tamil Nadu hospitals, focal seizures constituted 67.5%. Generalized seizures were present in 32.4%. The key causes of seizures in Odisha were malaria, cerebral palsy, and viral meningitis, while in Tamil Nadu, the causes were neurocysticercosis, cerebral palsy, and viral meningitis.Conclusion: Since the majority of the causes are preventable, it is important to address the issue at the public health level, by providing improved sanitation and adequate awareness on the secondary seizure and its causes. It is also important that the physicians are well conversant with the early case detection and treatment of primary diseases causing secondary seizures
Fetal Exposure to Risky Drugs: Analysis of Antenatal Clinic Prescriptions in a Nigerian Tertiary Care Hospital
Get PDFObjective: To assess fetal outcomes after in-utero exposure to unsafe drugs.Methods: This was a retrospective cohort study using data from medical records of pregnant women who received antenatal care over a two-year period (2019/2020). Inclusion was based on identification of prescription of potentially risky medications during pregnancy. Medication records, as well as delivery data, were extracted for analysis. The Australian drug evaluation committee classification system of risky medications was used for analysis.Results: Results showed that 44 – 65% of medicines prescribed in pregnancy carry significant risks to fetal wellbeing. Fetal outcomes showed high levels of low birth weight, still birth, and early neonatal death. The common medicines prescribed irrationally in pregnancy were, among others, antibiotics, ACEIs, NSAIDs, Biguanides, and opiates, all of which are associated with adverse fetal outcomes.Conclusion: There is a high level of fetal exposure to risky medications and adverse delivery outcomes. There is a need to improve prescription through prescriber training and awareness raising on existing guidelines on good prescribing practice for pregnant women
Low Bone Mineral Density, Sedentary Lifestyle, and Depression as Risk Factors for Frailty Syndrome at a Home Care Facility in West Jakarta, Indonesia
Get PDFBackground: The life expectancy in Indonesia is increasing. The rising number of the elderly people plays a vital role for a country to achieve development success. However, it has many consequences in the health sector, including a frailty syndrome. This study aimed to explore the association between frailty and related factors.Methods: This cross-sectional study was conducted at a home care facility in West Jakarta between September and October 2019, using a simple random sampling method. Data were analyzed using the chi-square test and multivariate logistic regression. The inclusion criteria were members of the home care aged ≥60 years and had signed a written informed consent.Results: In total, 97 respondents were included. Female gender and bone mineral density (BMD) were associated with frailty syndrome (p=0.018 and p=0.05, respectively). Multivariate logistic regression analysis showed the odds ratio of frailty for the female gender (OR= 3.319; 95% CI 1.045–10.543), low bone mineral density (OR= 4.939; 95% CI 1.516–16.090), depression (OR= 7.622; 95% CI 1.246 – 46.621), and low physical activity (OR = 3.639; 95% CI 1.096 – 12.079).Conclusions: There is a relationship between female gender and bone mineral density with frailty syndrome with the risk factors for frailty syndrome in this study are female gender, low bone mineral density, depression, and low physical activity
Oxygen Saturation Diagnostic Accuracy Against COVID-19 in Rural Areas of Indonesia
Get PDFAs a country with a high proportion of rural areas, Indonesia continues to struggle with a rapid and accurate diagnosis of COVID-19, necessitating the development of a diagnostic tool or parameter that is less expensive, easier to obtain, and produces rapid results. This retrospective study aimed to explore the diagnostic accuracy of oxygen saturation in detecting COVID-19 in rural areas of Indonesia. Data were collected consecutively from medical records of adult patient (30 – 90 years old) suspected of having COVID-19 based on the WHO criteria and underwent RT-PCR swab test in three (3) hospitals in one of the regions of Indonesia during the timeframe of May 1, 2020 to September 31, 2021. Analysis was conducted using the cross-table analysis with sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve (AUC) as the variables with their respective confidence interval. Results indicated that 548 of 700 patients included in the analysis were confirmed positive for COVID-19 based on the RT-PCR test results. The sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve (AUC) value of oxygen saturation for detecting COVID-19 were 33% (CI 95% 29 – 37%), 78% (CI 95% 72 – 85) %), 84% (CI 95% 80 – 89%), 24% (CI 95% 21 – 28%), and 56% (CI 95% 51– 61%), respectively. Thus, the oxygen saturation level alone does not have adequate diagnostic accuracy for the diagnosis of COVID-19 and, therefore, is not recommended to be used for diagnosing COVID-19
Gambaran Skor ANDC sebagai Prediktor Kematian pada Pasien COVID-19 di Ruang Intensif Isolasi RSUP Dr. Hasan Sadikin Bandung Periode Januari 2021 – Juni 2021
Get PDFCoronavirus disease 2019 (COVID-19) telah menjadi pandemi global yang menyebabkan angka mortalitas tinggi. Saat ini belum ada sistem skor yang digunakan untuk memprediksi angka mortalitas pada pasien COVID-19 yang dirawat di RSUP Dr. Hasan Sadikin Bandung. Penelitian ini menggunakan pendekatan deskriptif observasional retrospektif yang bertujuan mengetahui gambaran skor Age, Neutrophil to lymphocyte ratio, D-dimer, C-reactive protein (ANDC) sebagai prediktor kematian pasien COVID-19 yang dirawat di ruang intensif isolasi RSUP Dr. Hasan Sadikin, Bandung pada periode Januari–Juni 2021. Data ANDC dari 221 pasien COVID-19 derajat sedang dan berat dicatat di hari pertama dan diolah. Hasil penelitian didapatkan pasien COVID-19 derajat sedang memiliki angka mortalitas sebesar 5% untuk skor ANDC risiko rendah, 39,3% untuk skor risiko sedang, dan 50% untuk skor risiko tinggi. Sementara pada pasien COVID-19 derajat berat secara umum memiliki angka mortalitas yang tinggi, untuk skor ANDC risiko rendah sebesar 42,1%, skor risiko sedang sebesar 70,6% dan skor risiko tinggi sebesar 78,5%. Simpulan penelitian ini adalah semakin tinggi nilai skor ANDC maka semakin tinggi pula angka mortalitas pasien COVID-19. Coronavirus Disease 2019 (COVID-19) telah menjadi pandemi global yang menyebabkan tingginya angka mortalitas. Saat ini belum ada sistem skor yang digunakan untuk memprediksi angka mortalitas pada pasien COVID-19 yang dirawat di RSUP Dr. Hasan Sadikin Bandung. Penelitian ini menggunakan pendekatan deskriptif observasional retrospektif yang bertujuan untuk mengetahui gambaran skor ANDC (Age, Neutrophil to lymphocyte ratio, D-dimer, C-reactive protein) sebagai prediktor kematian pasien COVID-19 yang dirawat di ruang intensif isolasi RSUP Dr. Hasan Sadikin Bandung pada periode Januari-Juni 2021. Data ANDC dari 221 pasien COVID-19 derajat sedang dan berat dicatat di hari pertama dan diolah. Hasil penelitian didapatkan pasien COVID-19 derajat sedang memiliki angka mortalitas sebesar 5,0% untuk skor ANDC risiko rendah, 39,3% untuk skor risiko sedang, dan 50,0% untuk skor risiko tinggi. Sementara pada pasien COVID-19 derajat berat secara umum memiliki angka mortalitas yang tinggi, untuk skor ANDC risiko rendah sebesar 42,1%, skor risiko sedang sebesar 70,6% dan skor risiko tinggi sebesar 78,5%. Simpulan penelitian ini adalah semakin tinggi nilai skor ANDC maka semakin tinggi pula angka mortalitas pasien COVID-19 yang dirawat di ruang intensif isolasi RSUP Dr. Hasan Sadikin Bandung
Accuracy of Kampala Trauma Score as a Predictor in Assessing the Prognostic Value of Multiple Trauma
Get PDFDetermining a trauma scoring system appropriate for certain conditions will help in predicting mortality and morbidity, and can determine the need for treatment in patients. Kampala Trauma Score (KTS) is a trauma scoring system that uses a decent number of assessment variables and can be used in all general groups. This study was a retrospective prognostic test conducted in Dr. Hasan Sadikin Hospital Bandung, Indonesia, from December 2021 to July 2022. Data obtained was processed using Microsoft Excel and SPSS spreadsheets. The respondents were 66 people with multiple trauma. Results showed that this study was dominated by patients with blunt trauma (n=63, 95.45%). The mean KTS score in this study was 13.08±1.03. In 49 (74.24%) patients who survived, the mean KTS score was 13.41±0.89 and in 17 (25.76%) patients who died, the mean KTS score was 12.12±0.79. The greatest mortality accuracy was at the cutoff point of the KTS score >12 (81.82% accuracy; 70.59% sensitivity; 85.71% specificity). The accuracy value of the KTS score is in line with the ROC where the optimal KTS score is >12 (85.77%). In conclusion, the Kampala trauma score can be used as a predictor in assessing the prognostic value of multiple trauma patients with the obtained cut-point value as it has high accuracy, sensitivity, and specificity values
Non-Metallic and Metallic Toxicant Exposures from Personal Care Products in Indonesian Male and Female Medical Students
Get PDFStudents can gain various benefits from their daily personal care products. However, the chemicals contained in these products may have adverse health effects. Regardless the inspection performed by regulatory agencies on these products, the products circulating in the market may still contain toxicants thus may jeopardize their safety for use. This study evaluated toxicant ingredients contained in personal care products used by male and female college students. This study was conducted from September to December 2022 on 23 male and 46 female college students of the Faculty of Medicine, Universitas Andalas, Indonesia. Data were collected using a 69-items validated questionnaire. Results were then presented as a distribution of products used categorized by body areas and potentially toxic metallic and non-metallic ingredients identified from their labels. Female college students used at least 10 personal care products, with a median of 19 products. Male students used at least four products and a median of eight products. Investigation on the label of skin, hair, eye, dental and oral, lips, and nail personal care products demonstrated the presence of metallic and non-metallic toxicants. Five metallic toxicants (aluminum, titanium, zinc, copper, and chromium) and 15 non-metallic toxicants (triclosan, talc, fragrance, parabens, butylated hydroxyanisole, butylated hydroxytoluene, diethanolamine, triethanolamine, butylene glycol, propylene glycol, polyethylene glycol, phthalates, benzophenone-3, acetone, and fluoride) were identified. Thus, numerous toxicants are present in marketed personal care products, and females are exposed more than males to these toxicants. Consumers need to be more critical in their choice of personal care products
Antibacterial Activity of Terminalia mantaly Stem Ethanol Extract as Hand Sanitizer Gel
Get PDFBackground: Hand sanitizers generally contain alcohol. However, it can cause dry and irritated skin. Therefore, it is necessary to find antibacterial alternatives that are safe for the skin. One of the plants that has antibacterial activity is Terminalia mantaly (T. mantaly). This study aimed to investigate the antibacterial activity of ethanol extract and hand sanitizer gel of T. mantaly.Methods: The antibacterial activity test against gram-positive (Staphylococcus aureus and Streptococcus pyogenes) and gram-negative bacteria (Escherichia coli and Shigella dysenteriae) was carried out using the liquid micro dilution method. The phytochemical tests were also performed. This study was conducted at the Chemistry Laboratory, Faculty of Sains and Informatics, Universitas Jenderal Achmad Yani in April-June 2022.Results: The ethanol extract of T. mantaly stem contained secondary metabolites of alkaloids, tannins, quinones, saponins, steroids, and flavonoids. The minimum inhibitory concentration (MIC) values of T. mantaly stem ethanol extract against Escherichia coli, Shigella dysenteriae, Staphylococcus aureus, Streptococcus pyogenes were 0.63%, 0.63%, 0.16%, and 0.16%, whereas the hand sanitizer gel gave MIC values of 0.63%; 0.31%; 0.16%; and 0.16% respectively. The minimum bactericidal concentration (MBC) values of T. mantaly stem ethanol extract and hand sanitizer gel had the same results, namely 2.50%, 0.16%, 1.25%, and 1.25%. The physical stability of the hand sanitizer gel from the ethanol extract of T. mantaly stem met the physical stability standards of the gel. Conclusions: The ethanol extract of the T. mantaly stems has stronger antibacterial activity against gram-positive bacteria than against gram- negative bacteria.
Knowledge, Attitudes, and Healthy Feeding Behavior of Mothers on the Nutritional Status of Elementary School Students
No full textBackground: Some children aged 6-9 years have started to enter the pre-pubertal rapid growth period. Therefore, the need for nutritious food has begun to increase significantly. The role of mothers in providing food is very much needed. This study aimed to discover the relationship between knowledge, attitudes, and behavior of mothers in healthy feeding on the nutritional status of children.Methods: This study was a cross-sectional study conducted in July–August 2019. The sample was mothers and their children who were in grades I to III of public and private elementary schools in Penjaringan, Jakarta. The total sampling method was conducted, and data collected included age, gender, height, weight, and mother’s knowledge, attitudes and behavior in healthy feeding Data was analyzed using Chi-square. The nutritional status of the students was calculated using the 2010 anthropometric standards of the Ministry of Health.Results: Of the 348 mothers included, there were 310 mothers (89.1%) with high level of knowledge, 86.5% of mothers had a positive attitude, and 75.3% had good behavior in healthy feeding. The nutritional status of the children was predominantly normal (46.2%) and overweight (34.8%). There was a significant relationship between maternal behavior in giving healthy food and children nutritional status (p=0.046).Conclusions: There is a significant relationship between the mother's behavior in offering healthy food and the children nutritional status. Therefore, parents should pay more attention to behavior in providing healthy food to children
