E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Correlation between Acute Phase Symptoms with Neurological Long Covid Symptoms on COVID-19 Survivors
Get PDFObjective: To investigate prolonged neurological impacts of COVID-19 and establish a connection between initial COVID-19 symptom severity and chronic fatigue syndrome (CFS) development, poor sleep quality (PSQ), and cognitive impairment (CI) in individuals recovered from COVID-19.Methods: This cross-sectional study recruited COVID-19 survivors at Dr. Hasan Sadikin General Hospital Bandung, Indonesia, between June and December 2021. All participants gave informed consent and underwent interviews on demography, clinical features, long-COVID questionnaire, and neurological examination. Participants underwent cognitive examination (MOCA-INA), Chalder Fatigue Scale and Pittsburgh Sleep Quality Index (PSQI) to assess CI, CFS, and PSQ variables. Chi-Square analysis was performed to determine the probability of neurological long COVID-19 syndrome manifestations using SPSS 24.0.Results: Of the 127 participants recruited, 67.7% were women, median (IQR) age of 33 (21-65) years, and time from hospitalization to examination of nine months (1-13). The most common neurological Long COVID symptoms were PSQ (59.8. %), CFS (51.2%), and CI (33.9%). Participants with more than five acute phase COVID-19 symptoms had a higher probability of CFS and CI (OR 2.38 (1, 16-4.9, CI 95%); OR 2.20 (1.01-4.79, CI 95%)) than those with less than five symptoms. The study did not find a significant correlation between sleep quality and number of acute-phase COVID-19 symptoms (OR 1.56 (0.76-3.20, CI 95%)).Conclusion: Almost two-thirds of the COVID-19 survivors experienced PSQ, more than half had CFS, and almost one-third had CI. The study revealed an increasing likelihood of CFS and CI in COVID-19 survivors as the number of acute COVID-19 symptoms increases
Conservative Management of Pott's Spine and Its Outcome: An Institute-Based Observational Study
Get PDFObjective: To analyze the functional outcome of cases with Pott’s disease treated solely by antitubercular drugs.Methods: This observational study was conducted at the Department of Orthopedics of a tertiary care medical college. Sixty patients with Pott’s disease were included in this study based on predefined inclusion and exclusion criteria. All patients received antitubercular drugs for nine months. The Modified McCormick Scale (MSS) was used to assess the outcome of patients.Results: Out of 60 patients, 37 (61.67%) were females, and 23 (38.33%) were males, with an M: F ratio of 1:0.62. Most patients had some or the other risk factors and belonged to low socioeconomic status. The most common presenting complaint was low back pain, and the thoracolumbar spine was most commonly involved. There was a significant improvement in the patient’s functional status as assessed by the MSS score.Conclusion: If diagnosed early, patients with Pott’s disease can be treated solely by antitubercular treatment with excellent outcomes
Autoantibody Profile and Lung HRCT Scan in Systemic Sclerosis with Restrictive Lung Disease
No full textObjective: To identify auto-antibodies in systemic sclerosis with interstitial lung disease (ILD). Method: This was a descriptive categorical study on auto-antibody profile in systemic sclerosis patients visiting the Rheumatology Clinic of Dr. Hasan Sadikin General Hospital, West Java, and Bandung during the period of January 2018 to December 2019 who were registered in the West Java Systemic Sclerosis Registry. Auto-antibody identification was performed using the Euroline immunoblot assays.Results: Thirty six cases were identified during the study period with most of the cases involved women (n=35, 97.2%). The average age of patients participating in this study was 40 years, with an average duration of disease of 18 months. Diffuse cutaneous systemic sclerosis was found in 22 (61.1%) cases and limited cutaneous systemic sclerosis was observed in 14 (38.9%) cases. Specific autoantibodies were positive in 33 (91.6%) cases, with anti-topoisomerase I as the largest group, positive in 22 (52.9.3%) cases. This was followed by anti-Th/To in eight (15.7%) cases; anti-Ro52 in four (7.8%) cases; anti-centromere in three (5.9%) cases; anti-RNA polymerase in three (5.9%) cases; anti-fibrillarin in three (5.9%) cases; anti-Ku in two (3.9%) cases; and anti-PDGF in one (2.0%) case. High-resolution computed tomography of the lung showed 34 (94.4%) cases with ILD and 22 (61.1%) cases with severe lung fibrosis. Usual interstitial pneumonia was seen in 19 (52.8%) cases and non-specific interstitial pneumonia in 15 (41.7%) cases.Conclusion: Anti-topoisomerase I, anti-Th/To, and anti-Ro52 are the most common autoantibodies observed in systemic sclerosis patients with ILD as the most prevalent feature detected with lung HRCT
Risk Factors for Patients with Gonococcal Urethritis at Dr. Hasan Sadikin General Hospital Bandung, Indonesia in 2013–2019
Get PDFBackground: Gonorrhea is the second most common sexually transmitted infection in Southeast Asia. Many factors cause gonococcal urethritis, and each region has its characteristics. This study aimed to determine the risk factors among patients with gonococcal urethritis at Dr. Hasan Sadikin General Hospital Bandung. Methods: This was a descriptive study with a retrospective and total sampling method, reviewing the gonococcal urethritis patient medical records obtained from Dr. Hasan Sadikin General Hospital Bandung from 2013 to 2019. Sociodemographic, clinical manifestations, and sexual or risky behaviors data were collected.Results: Among 97 males with gonococcal urethritis, unmarried males (54.6%) and the age category of 20–24 years (35.1%) were predominant, with high school education/equivalent (58.8%). Based on their sexual behavior, the majority had more than one sexual partner in the past month (63.9%) and had never used a condom when having sex (55.7%). Additionally, there was also a group of man who had sex with man (MSM) (14.4%) and illicit drug users (19.5%).Conclusions: Males in the young adult age group, single, have a high education level, have multiple sexual partners, and never used a condom during having sex, have a higher risk of having gonococcal urethritis. Identifying these most reported risk factors may help health care providers design effective prevention strategies. Unmarried young adults should be a primary focus in receiving educational programs. They should be informed regarding the impact of multiple sexual partners, condom usage, and illicit drug on gonococcal urethritis infection among men
Continuous Ambulatory Peritoneal Dialysis Cost-Effectiveness in National Health Insurance Era of Indonesia
Get PDFEssential treatments for patients with end-stage renal disease include Renal Replacement Therapy (RRT) consisting of hemodialysis, peritoneal dialysis, and kidney transplantation. In 2014, dialysis coverage in Indonesia was more than 1.5 trillion, making it the second highest expense in the National Health Insurance (BPJS) expenses. This study compared the cost-effectiveness between Continuous Ambulatory Peritoneal Dialysis (CAPD) and Hemodialysis (HD) in patients treated in Dr. Hasan Sadikin General Hospital. Data were collected from the Urology Department from 2014 to 2017. This was a retrospective observational study on 3 groups of patients: patients with effective CAPD each year as the first group; patients who had experienced repair of CAPD and continued to use it as the second group; and patients who discontinued CAPD due to complications and returned to hemodialysis as the third group. Each group expense was calculated with standard cost insurance for one year in the hospital. The expense was then be compared to the expense of hemodialysis for one year. A total of 89 patients in the CAPD program from 2014–2017 were treated at the department. When compared to HD, the first, second, and third group of CAPD patients experienced a cost reduction of IDR 23.227.857/person, IDR 18.127.857/person, and IDR 1.661.972.000, respectively. Total savings from the CAPD program in the hospital was IDR 1.661.972.000 from 2014. It is then concluded that CAPD could reduce the burden of government insurance in a cost-effective manner and is considered a treatment of choice in the National Health Insurance Era
Anxiety (DASS21) and the Quality of Life (FertiQol) of Infertile Women Underwent In Vitro Fertilization
Get PDFInfertility affects physical and mental health and has various consequences. In vitro fertilization (IVF) is one of the Assisted Reproductive Technology (ART) programs that include several phases, requiring longer time, more patience, and is expensive. This may make women who undergo the ART program to have higher stress level, especially anxiety. This study aimed to determine the relationship between anxiety and quality of life in infertile patients undergoing assisted reproductive technology programs. This was a cross-sectional observational analytic study performed at Aster Fertility Clinic, Dr. Hasan Sadikin General Hospital and Bandung Fertility Center, Limijati Hospital Bandung, Indonesia, from February until April 2020. The analysis was performed using the DASS21 scale and FertiQol count on 27 subjects undergoing the IVF program and 30 control subjects who were pregnant without IVF program. The statistical analyses used to determine the condition of anxiety and the condition of quality of life were the Chi-square and the Mann-Whitney tests, while the relationship between anxiety and quality of life as the main subject was measured using the Spearman correlation test. The anxiety level as measured with the DASS21 instrument in the subject and control groups was 6.2 vs 0.7 with p<0.001. From the analysis of the FertiQol instrument in the subject and control groups, the scores were 79.6 vs. 98.9 for the mind-body domain (p<0.001); 68.8 vs 98.5 for the emotional domain (p < 0.001); 83.2 vs 95.7 for the relational domain (p<0.001); and 77.6 vs 97.6 for the social domain (p<0.001). For the overall FertiQol core domains, the score was 77.3 vs 97.7 (p<0.001). The correlation between anxiety and the FertiQol total core domains were evident from the results of the Spearman correlation test, with an r-value of -0.479 (p<0.001). Therefore, there is a significant negative correlation between anxiety and quality of life
Profile of Apoptotic Marker Genes and Histopathology of the Placenta in Pregnancies with Pre-Eclampsia
Get PDFBackground: Pre-eclampsia (PE) is a hypertensive disorder in pregnancy and a significant cause of maternal and perinatal mortality and morbidity. Failure of spiral artery remodeling due to abnormal apoptosis, triggers disturbances in the mother and the baby’s growth. This study aimed to identify the profile of apoptotic marker genes and histopathological features of the placenta in pregnancies with pre-eclampsia.Methods: This study had used case-control method. Samples were taken from normal pregnancies (n=25) and pregnant women with pre-eclampsia (n=25) using a purposive sampling method from several hospitals in Jambi. qRT-PCR was used to examine apoptotic gene expression from placental tissue and hematoxyline eosin staining to view the placenta’s microscopic appearance. The targeted genes were BCL2-associated X (BAX) and B-cell lymphoma 2 (BCL-2). Histopathological changes of the placenta observed were syncytial node, cytotrophoblast, villous edema, hypervascularization, fibrosis stroma, atherosis, infarction, and thrombosis.Results: Relative BAX genes expression were increased once in placenta pre-eclampsia compared to controls, but not statistically significant (p-value>0.05). There was no difference between the decline of BCL-2 gene expression in pre-eclampsia placenta compared to the control (p-value >0.05). Histopathological changes in the placenta were syncytial node and cytotrophoblast (25 of 25), villous edema (19 of 25), hypervascularization (24 of 25), fibrosis stroma (22 of 25), atherosis (12 of 25), infarction (17 of 25), and thrombosis (24 of 25).Conclusion: The expression of BAX genes in pre-eclampsia tends to increase compared to normal pregnancy, and the expression of BCL-2 decreases. The histopathological features of pre-eclampsia pregnancy placenta are mostly syncytial nodes, cytotrophoblasts, stromal fibrosis, and thrombosis
Hospital Management Information System Implementation Assessment Using HOT-FIT Model in Langsa General Hospital Aceh, Indonesia
Get PDFIn providing the best health care to the community, hospitals as health care facilities utilize technologies that are influenced by developments and advances in medical sciences and technologies. One of such technologies is the information management technology. Since the quality of information processing is an essential factor for succesful medical care of patients, Regulation of the Minister of Health of the Republic of Indonesia Number 82 of 2013 requires all hospitals to implement a hospital information management system (HIMS). To assess the successful implementation of HIMS, various models and frameworks have been developed, including the HOT-FIT model. This study aimed to analyze the implementation of the hospital management information system at Langsa General Hospital, Aceh, Indonesia, using the HOT-FIT model which applied the SEM-PLS method. This quantitative study was performed in approximately three months using the HOT-FIT (company, technology-FIT human,) framework that includes nine variables of system quality, information quality, service quality, organization structure, facility situations, support from leadership, system usage, user satisfaction, and net benefits. Data analysis was performed using the SEM-PLS analysis in SmartPLS application (V.3.2.9). Results showed that human, organization, and technology supports were factors that influence the successful implementation of HIMS. To conclude, the HOT-FIT model can be used to identify the factors that influence the successful implementation of HIMS to inform the HIMS improvement in the hospital that will eventually improve the hospital’s quality system, information, service quality, and user satisfaction
Correlation Analysis of Lactic Acid Level as A Predictor of Severity of Patients with Acute Appendicitis
Get PDFPerforated appendicitis is a leading cause of morbidity and mortality in all appendicitis cases, both for adults and children. Delay in preoperative diagnosis is the main reason for perforation. In previous studies, it was revealed that diagnostic modalities such as radiological examination and the current scoring system have not been able to predict the onset of perforated appendicitis. Serological biomarkers of lactic acid are associated with intestinal obstruction and ischemia. The increase in the serological value of lactic acid in perforated appendicitis compared to acute one was shown to increase significantly by 0.25 mmol/L (p<0.05) according to a previous study. This study aimed to determine the correlation between lactic acid level and the severity of appendicitis in patients visiting Dr. Hasan Sadikin General Hospital. This was a cross-sectional prospective analytic observational study on adult patients diagnosed with appendicitis who were admitted to the emergency room of Dr. Hasan Sadikin General Hospital from January 1, 2021 to June 1, 2021. Data analysis was performed using bivariate analysis and correlation tests of difference. This study involved 54 subjects with a mean lactic acid level of 2,5093 mmol/L (0.9 mmol/L - 11.8 mmol/L). In the complicated appendicitis group, 20 subjects (37%) was found to experience an increase in lactic acid (OR 1.07; 95% CI: -0.03-0.22; p=0.14). The correlation analysis showed the direction of negative correlation. Thus, it is concluded that there is no significant correlation between lactic acid level and the severity of appendicitis in patients with appendicitis
Adenosine Deaminase as Inflammatory Marker in Type II Diabetes Mellitus
Get PDFObjective: To evaluate the enzymatic activity of Adenosine Deaminase in type II diabetes mellitus (T2DM).Methods: This study was conducted on 60 clinically diagnosed type II diabetes mellitus patients, with 60 healthy subjects as the control group. Subjects were enrolled in the study only after their written consent was obtained. The inclusion of diabetes mellitus cases (DM) was conducted as per the WHO guidelines. Estimation of enzymatic activity of serum ADA was performed by Kinetic method using a commercial kit.Result: The observed serum ADA activity in DM patients was 48.34 ± 21.05 U/L, which was significantly higher in comparison to healthy controls (25.02 ± 5.78 U/L). The serum activity raised in about 80% of patients and they had higher values above the reference activity of 30 U/L. The increased activity of ADA among the diabetic subjects indicates inflammatory changes in these individuals.Conclusion: It is possible that in the coming years, a new therapeutic strategy based on anti-inflammatory properties with beneficial effects on diabetic complications can be translated into real clinical treatments