E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Association of Lower Urinary Tract Symptoms and Benign Prostatic Enlargement in Patients with Hypertension
Get PDFDevelopment of hyperplastic nodules in the transition zone of the prostate is the characteristic of Benign prostatic enlargement (BPE). Men with hypertension have a high risk of severe lower urinary tract syndrome (LUTS). This restrospective cohort analytic study investigated the association between LUTS and BPE in hypertension patients. Subjects were BPE patients with primary hypertension who visited the urology clinic of Dr. Hasan Sadikin General Hospital Bandung that were sampled consecutively from 2017 to 2020. Three hundred and twenty-four patients from the urology department participated in the study. These patients were categorized into mild LUTS (IPSS 1-7) (n=37, 11.4%), moderate LUTS (IPSS 8-19) (n=169, 52.2%), and severe LUTS (IPSS 20-35) (n=118, 36.4%). A positive correlation (r = 0.761, p = 0.000) and weak positive correlation (r = 0.152, p = 0.006) were found between systolic blood pressure and prostate volume and between LUTS and systolic blood pressure, respectively. In addition, there was also a weak positive correlation between diastolic blood pressure and prostate volume (r = 0.065, p = 0.245) and LUTS (r = 0.015, p = 0.784). Thus, there is an association between hypertension and prostate enlargement and the severity of lower urinary tract symptom
Perbandingan Mula Kerja Ropivacaine 0,75% dengan Levobupivacaine 0,5% untuk Blokade Peribulbar pada Pasien yang Menjalani Operasi Vitrektomi
Get PDFBlokade peribulbar merupakan salah satu teknik anestesi regional yang dapat digunakan untuk operasi vitrektomi. Ropivakain dan levobupivakain merupakan anestetik lokal yang memiliki keunggulan durasi kerja yang lama dan tingkat komplikasi lebih rendah dibanding dengan bupivakain. Penelitian ini bertujuan membandingkan mula kerja antara ropivakain dan levobupivakain pada blokade peribulbar. Jenis penelitian ini berupa eksperimental prospektif yang menggunakan desain double blind randomized controlled trial dengan analisis statistik menggunakan uji Mann Whitney. Subjek terdiri dari 34 orang yang menjalani operasi vitrektomi dengan blokade peribulbar. Penelitian dilakukan bulan Maret–April 2022 di di Netra Klinik Spesialis Mata Bandung. Enam belas subjek dilakukan blokade peribulbar dengan ropivakain 0,75% dan 18 subjek mendapatkan levobupivakain 0,5%. Mula kerja rerata pada grup ropivakain 0,75% didapatkan 11,3 menit, sedangkan grup levobupivakain 0,5% rerata 7,78 menit dengan perbedaan bermakna (p<0,05). Volume rerata grup ropivakain 0,75% adalah 8,06±1,44 mL, sedangkan grup levobupivakain 0,5% mendapatkan volume rerata 7,00±1,79 mL. Mula kerja levobupivakain 0,5% lebih cepat dibanding dengan ropivakain 0,75%, hal tersebut kemungkinan berhubungan dengan perbedaan lipid solubilitas, ropivakain 10 kali lebih rendah lipid solubilitasnya dibanding dengan levobupivakain. Simpulan penelitian ini adalah mula kerja levobupivakain 0,5% pada blokade peribulbar lebih cepat dibanding dengan ropivakain 0,75%. Pendahuluan. Blokade peribulbar merupakan salah satu teknik anestesi regional yang dapat digunakan untuk operasi vitrektomi. Ropivakain dan levobupivakain merupakan anestetik lokal yang memiliki keunggulan durasi kerja yang lama, dan tingkat komplikasi lebih rendah dibanding dengan bupivakain. Penelitian ini bertujuan mencari mula kerja dari ropivakain dan levobupivakain. Metode. Sebanyak 34 subjek dilakukan vitrektomi di Netra Klinik Spesialis Mata Bandung dengan blokade peribulbar. Enam belas subjek mendapatkan ropivakain 0,75% dan delapan belas subjek mendapatkan levobupivakain 0,5% untuk blokade peribulbar. Setelah penyuntikan dilakukan penilaian gerak bola mata untuk menilai akinesia, dinilai Cicendo Akinesia Score (CAS) setiap menit selama 10 menit, blokade tercapai bila skor CAS 2 atau 3. Hasil. Grup ropivakain 0,75% didapatkan mula kerja rerata 11,3 menit, sedangkan grup levobupivakain 0,5% rerata 7,78 menit setelah penyuntikan. Hasil statistik didapatkan nilai p <0,05 yang berarti bermakna dari mulai kerja kedua obat. Volume rerata grup ropivakain 0,75% 8,06±1,44 ml, sedangkan grup levobupivakain 0,5% mendapatkan volume rerata 7,00±1,79 ml. Diskusi. Mula kerja levobupivakain 0,5% lebih cepat dibanding dengan ropivakain 0,75%, hal tersebut kemungkinan berhubungan dengan perbedaan lipid solubilitas, ropivakain 10 kali lebih rendah lipid solubilitasnya dibanding levobupivakain. Anatomi bola mata diselubungi oleh jaringan lemak, kemungkinan penetrasi ropivakain lebih lambat dibanding dengan levobupvakain. Simpulan. Mula kerja levobupivakain 0,5% lebih cepat dibandingkan dengan ropivakain 0,75% pada blokade peribulbar. Kata Kunci: blokade peribulbar, levobupivakain, ropivakain, vitrektom
Presence of Multidrug Resistance (MDR) Escherichia coli in the Citarum River located in Greater Bandung Area, Indonesia
No full textBackground: One of the main problems of the Citarum River is the contamination of E. coli due to livestock activities, washing toilets, and industry. In addition, irrational use of antibiotics in the community and livestock can increase E. coli resistant strains to antibiotics. This study aimed to identify the presence of multidrug resistance (MDR) and extended-spectrum β-lactamase (ESBL) E. coli strains in Citarum river clusters, namely industrial, livestock, and residential clusters.Methods: This was a descriptive study. A sample of 100 mL surface water from each Citarum cluster. Culture, antibiotic sensitivity test, and PCR to identify blaCTX-M-15 gene carriers of ESBL E. coli were carried out in the sample.Results: There were 37 isolates of E. coli, with 24% of these isolates showing MDR properties, which can be found in industrial, livestock, and residential clusters at 13%, 8%, and 3% respectively. The most E. coli-resistant antibiotics found in these samples were ampicillin (45%), followed by tetracycline (37%), and azithromycin (29%). The PCR examination did not find the blaCTX-M-15 gene carrying ESBL properties in all three Citarum river clusters.Conclusion: The presence of E. coli isolates in each Citarum river cluster suggests the occurrence of river pollution due to animal, human or industrial waste. Therefore, it is necessary to make better government regulations regarding sanitation and education for the surrounding community regarding the importance of keeping the river clean
Patient Satisfaction with National Health Insurance and Public Health Center Accreditation: Lessons Learnt from Majalengka Regency, Indonesia
Get PDFBackground: Perceptions of patient satisfaction influence the quality of the public health center (Pusat Kesehatan Masyarakat, Puskesmas) services. This study aimed to determine the differences in the level of patient satisfaction with national health insurance and the accreditation status of Puskesmas.Methods: This quantitative analytical study using a cross-sectional method was conducted at four Puskesmas in Majalengka Regency from October to November 2021 using a purposive sampling technique. The instrument used was the community satisfaction instrument (IKM-29) questionnaire , with the variable measured being the level of satisfaction. Data was transformed into numerical form using Rasch modelling and analyzed using the Chi-Square, independent-t, and one-way ANOVA tests.Results: A total of 273 respondents consisted of insured (Jaminan Kesehatan Nasional, JKN) and non-insured (non-JKN) respondents, resulting in the satisfaction mean value between JKN and non-JKN patients of 2.50 and 2.51 (p-value= 0.926). Satisfaction at Puskesmas levels 1 (Dasar), 2 (Madya), 3 (Utama), and 4 (Paripurna) was 2.15, 2.23, 2.56, 3.03, respectively (p-value = 0.002), indicating an increase in the level of satisfaction at the Puskesmas accreditation level.Conclusion: There is no difference in satisfaction between respondents using JKN and non-JKN. However, there is an increase in satisfaction related to the Puskesmas accreditation level. It is recommended for each Puskesmas to maintain the same service to all patients and improve the quality of service, especially in service dimensions that are considered inferior. Additionally, it is necessary to review the minimum standard value for accreditation programs
Characteristics and Clinical Outcomes of COVID-19 Patients with Hyperglycemia: Retrospective Cohort Study from a COVID-19 Referral Hospital, Bandung, Indonesia
Get PDFBackground: COVID-19 often causes severe complications in patients with metabolic disorders such as diabetes mellitus. Conversely, inflammation caused by infection may also trigger insulin resistance, resulting in hyperglycemia and is related to the disease severity. This study aimed to describe the characteristics and clinical outcomes of COVID-19 patients with hyperglycemia at one of the COVID-19 referral hospitals in Bandung, Indonesia.Methods: This retrospective cohort study used secondary data from medical records of COVID-19 patients admitted to Dr. Hasan Sadikin General Hospital Bandung, Indonesia from March 2020 to March 2021. This study included all patients with confirmed COVID-19, aged >18 years, and had at least one blood glucose test at admission. Patients were grouped based on three possible types of hyperglycemia, namely diabetes mellitus, reactive hyperglycemia, and steroid-induced hyperglycemia; then their characteristics and disease outcomes were compared. Results: This study identified 1,114 patients’ medical records and included 1,013 data in the analysis. Hyperglycemia occurred in 45.1% of COVID-19 patients. The most common hyperglycemia types were diabetes mellitus (55.7%), reactive hyperglycemia (37.4%), and steroid-induced hyperglycemia (7%). The steroid-induced hyperglycemia group had similar characteristics as the diabetes group. The reactive hyperglycemia group exhibited a metabolic syndrome pattern resembling pre-diabetic conditions. The highest rates of severe disease and mortality were seen in the steroid-induced hyperglycemia group, followed by the diabetes group.Conclusions: There is an elevated prevalence of hyperglycemia in COVID-19 patients with diabetes. The steroid-induced hyperglycemia group has the most unfavorable outcomes. These observations emphasize the importance of identifying hyperglycemic conditions to improve management and outcomes
Crowned Dens Syndrome: A Rare Cause of Sudden Onset Neck Pain
Get PDFObjective: To report a case of Crowned Dens Syndrome (CDS), which is a rare disorder caused by crystal deposition by calcium pyrophosphate dihydrate in the peridontoid soft tissues surrounding the C1 and C2 vertebrae that presents in elderly with sudden onset neck pain, neck stiffness, fever, and elevated inflammatory markers, with periodontal calcification in a halo or crown configuration on radiography considered diagnostic.Methods: A 64-year-old diabetic and hypertensive female patient presented with a 6-day history of sudden onset posterior neck pain and stiffness. Movements of the cervical spine were equally limited in all directions, causing marked aggravation of pain. There was no focal neurologic loss. Her inflammatory markers were markedly raised.Results: Based on radiography, she was diagnosed with Crowned Dens syndrome and started on oral prednisolone, paracetamol, and tizanidine along with topical diclofenac. Oral NSAIDs were contraindicated due to her renal insufficiency.Conclusion: Crowned Dens Syndrome (CDS) is a rare cause of neck pain. Clinicians should consider this syndrome in their differential diagnosis. Timely diagnosis and treatment of CDS will lead to avoidance of unnecessary investigations and medications in such patients, along with a reduction in the length of stay
Removal Technique of Penetrating Nail in Head: A Case Report
Get PDFObjective: To present a unique case involving a 44-year-old man who sustained a penetrating head injury after nailing his head with a hammer. Despite the severity of his injury, the patient underwent successful surgical treatment and experienced a good recovery.Methods: Clinical and imagery review was performed on a cranial puncture trauma caused by a metal nail, which penetrated the cranium, dura mater, right parietal cerebral parenchyma, and right ventricle. The nail was lodging next to midline without damaging the superior sagittal sinus. The patient underwent craniotomy nail removal and debridement with normal saline and metronidazole antibiotics.Results: Craniotomy, careful nail extraction, wound debridement, and duraplasty remain the treatment standard for penetrating nail injury in the head. Patient in this case study did not exhibit any signs of neurologic deficit or infection.Conclusion: Proper diagnosis and treatment are required in patients with penetrating brain trauma, with head x-rays and CT scans help in evaluating vascular depth and damage. Craniotomy and debridement are the main treatments for this type of trauma
Perbandingan Terapi Albumin dari Ekstrak Channa Micropeltes Dan Channa Striata Terhadap Peningkatan Kadar Albumin pada Pasien Hipoalbuminemia
Get PDFSuplemen albumin yang selama ini sering digunakan adalah ekstrak ikan gabus (Channa striata). Ikan toman (channa micropeltes) diduga memiliki protein yang lebih tinggi dari pada ikan gabus. Tujuan penelitian ini adalah membandingkan peningkatan kadar albumin dari ekstrak ikan toman dan ikan gabus dengan peningkatan kadar albumin darah pada pasien hipoalbuminemia. Penelitian ini dilakukan di ICU RSUD Dr. Muwardi Surakarta pada bulan November 2019–Januari 2020. Penelitian menggunakan uji klinis acak tersamar tunggal pada 30 pasien yang menjalani perawatan intensif dengan hipoalbuminemia yang telah memenuhi kriteria inklusi dan tidak termasuk eksklusi. Sampel dibagi menjadi 2 kelompok, yaitu kelompok dengan pemberian albumin ekstrak ikan toman (A) dan kelompok pemberian albumin ekstrak ikan gabus (B). Kedua kelompok diberikan albumin dengan dosis 5 gram tiap 12 jam selama tiga hari berturut-turut. Dilakukan pencatatan kadar albumin darah sebelum perlakuan dan tiga hari berturut-turut sejak pemberian ekstrak albumin. Penelitian menunjukan hasil bahwa selisih perubahan kadar albumin hari ke 1-baseline kelompok A mengalami peningkatan rerata 0,17+0,12, sedangkan kelompok B 0,11+0,08 (p=0,163). Pada hari ke-2 baseline kelompok A mengalami peningkatan rerata 0,41+0,15, sedangkan kelompok B 0,39+0,21 (p=0,785); pada hari ke-3 baseline kelompok A mengalami peningkatan rerata 0,74+0,35, sedangkan kelompok B 0,55+0,23 (p=0,785). Simpulan, ekstrak ikan toman memberikan peningkatan albumin yang lebih baik dibanding dengan ikan gabus, meskipun tidak berbeda secara statistik. Hipoalbuminemia adalah kadar albumin darah kurang dari 3,5 g/dL. Pemberian suplemen peroral albumin selama ini menggunakan ekstrak dari ikan gabus (Channa striata). Ikan Toman (Channa micropeltes) diduga memiliki protein yang lebih tinggi dari ikan gabus. Tujuan ini adalah membandingkan peningkatan kadar albumin pada pemberian albumin teknologi nano dari ekstrak ikan toman dengan ekstrak ikan gabus pada penderita hypoalbuminemia. Penelitian menggunakan uji klinis acak tersamar tunggal pada 30 pasien yang menjalani perawatan intensif dengan hipoalbuminemia yang telah memenuhi kriteria inklusi dan ekslusi. Sampel dibagi menjadi 2 kelompok masing-masing 15 pasien, yaitu kelompok dengan pemberian albumin ekstrak Ikan Toman dan kelompok pemberian albumin ekstrak Ikan Gabus. Kedua kelompok diberikan albumin dengan dosis 5 gram tiap 12 jam selama tiga hari berturut-turut. Dilakukan pencatatan kadar albumin darah sebelum perlakuan dan tiga hari berturut-turut, serta efek samping dari pemberian ekstrak albumin. Penelitian menunjukan hasil bahwa selisih perubahan kadar albumin hari ke 1-Baseline kelompok A mengalami peningkatan rata-rata 0,17 +0,12, sedangkan kelompok B 0,11 +0,08 (p=0,163); pada hari ke 2 - Baseline kelompok A mengalami peningkatan rata-rata 0,41 +0,15, sedangkan kelompok B 0,39 +0,21 (p=0,785); pada hari ke 3 - Baseline kelompok A mengalami peningkatan rata-rata 0,74 +0,35, sedangkan kelompok B 0,55 +0,23 (p=0,785). Efek samping albumin hanya ditemukan keluhan mual muntah pada Kelompok A (2 pasien) dan Kelompok B (3 pasien). Simpulan, Albumin teknologi Nano Ekstrak Ikan Toman memberikan hasil peningkatan albumin yang lebih baik dibanding Ikan Gabus meskipun tidak berbeda signifikan secara statisti
Knowledge and Attitude of Short Stature and Its Treatment in Saudi Arabia
Get PDFBoth tall and short parents are concerned about their children's short stature. This study aimed to explore the knowledge about short stature (SS) and attitude towards its treatment among the general public of Saudi Arabia. This was a cross-sectional study that utilized an online-administered questionnaire distributed between August 2021 and March 2022. Binary logistic regression was conducted to identify factors that affect participants’ knowledge. This study included a total of 6,852 individuals. The vast majority of the participants (77.5%) expressed satisfaction with their height. A total of 40.4% of participants stated that they were aware of a treatment option for their low height. With a mean score of 13.0 (SD:5.8) out of 25, the participants demonstrated a moderate level of knowledge of short stature (52.0%). The majority of participants (78.0%) stated that if they have a problem with short stature or want to enhance their own or their children's height, they are willing to consult a doctor about it. Participants living in the northern and eastern areas, those with bachelor degree, and those working in the healthcare field were more likely to be knowledgeable about short stature compared to others (p≤0.01). Saudi Arabians have a moderate understanding of SS, which needs to be improved. Campaigns to increase the general public's and parents' knowledge about SS, which is ultimately connected to earlier diagnosis and better management outcomes, are needed. Additional research is required to examine the most effective strategies for raising public knowledge of SS