E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Association between Comorbidities and COVID-19 Mortality: a Cross-Sectional Study in a Community Health Center in Indonesia
Get PDFObjective: To analyze the risk factors for mortality and comorbidity of COVID-19 patients in a public health center work area in Indonesia.Methods: This was a cross-sectional observational analytic quantitative study using secondary data of 820 confirmed COVID-19 cases in Brebes Public Health Center work area during the period of June 2020–December 2021. Univariate and bivariate analyses were used to analyze the obtained data statistically with a p-value of 0.05), and diabetes (p=0.000, OR=2.87, 95% CI 19 1.24-0280) were significantly associated with mortality.Conclusion: Comorbidity status, diabetes, and the place quarantine are risk factors for mortality among COVID-19 confirmed cases, especially in Brebes Public Health Center work area. Thus, it is important to increase knowledge about COVID-19 prevention and risks to prevent transmission among those with higher risks for mortality. Further studies on factors related to sustainable supports for COVID-19 patients are also necessary
Diagnostic Value of Coproantigen for Detection of Giardia Infection in Stunted Children
Get PDFBackground: Giardiasis is a protozoa infection caused by Giardia intestinalis, which commonly infects children, impairing children’s growth, development, and cognitive function. Standard diagnosis is carried out by microscopic examination of stool. This study aimed to evaluate coproantigen examination in stunted children compared to microscopic examination.Methods: A cross-sectional study was performed on stools collected from a survey among stunted children in Bandung in 2019. Stools were preserved in 10% formaldehyde and kept at -20oC until used. Direct microscopy examination with 2% lugol solution and coproantigen ELISA test using Giardia Cryptosporidium (combo test) coproantigen test kit were performed in Parasitology Laboratory Faculty of Medicine, Universitas Indonesia.Result: A total of 99 stools originated from stunted children aged 2-6 years. with boys predominant (52.5%). Microscopic examination showed that 12.1% (12/99) of the children were harboring intestinal parasites, such as the protozoa Giardia intestinalis, Blastocystis spp, and Entamoeba coli (E. coli). Giardia was the primary infection (9.1%), of which single Giardia infection (n = 8) and mixed infection of Giardia and Blastocystis spp (n = 1). Interestingly, coproantigen examination resulted in 6 positive samples, and 4 samples agreed with the microscopy result. With a sensitivity of 44.4% and a specificity of 97.7%. The positive and negative predictive values were 66.7% and 94.7%, respectively.Conclusion: A moderate prevalence of Giardia in stunted children in Bandung regency has been observed. The combo coproantigen test method has high specificity and is suitable for use as a confirmation test to exclude Giardia infection
Reliability of RT-qPCR Pooling Method for COVID-19 Detection in Various Cycle Threshold Values
Get PDFBackground: Reverse Transcriptase Quantitative Real-time Polymerase Chain Reaction (RT-qPCR) is a standard method to detect SARS-CoV-2, the cause of COVID-19 disease, albeit expensive for some laboratory settings. The pooling test is widely used for large-scale screening to speed up the turn-around time and reduce the cost of the RT-qPCR. However, the pooling test involves mixing a certain number of specimens which theoretically increases the possibility of false-negative results. This study aimed to evaluate the accuracy of the pooling test compared with the non-pooling test in different Ct values as a surrogate for viral load.Methods: RT-qPCR was performed in three groups of samples: non-pooling (individual samples), pooling of 5 samples and 11 samples, with various ranges of Ct value in the respective group: x<25 (n=4); 25<x<30 (n=5), x<30 (n=16), and negative sample (n=5). Agreement and kappa values were calculated. Four of twenty-five individual samples resulted in false-negative after pooling.Results: By taking all samples without applying the cut-off value to the calculation, the agreement in pooling of 5 samples was 0.86 (Kappa 0.31) and of 11 samples was 0.64 (Kappa 0.96). When the cut-off value of Ct<37 was applied, percent agreement and kappa were 1.00, respectively, for both pooling methods.Conclusions: Pooling up to 11 samples shows high concordance with RT-qPCR with individual samples with Ct<37. Interpreting pooling results in a very low viral load (Ct≥37) must be considered due to the increased possibility of inconclusive results
Prevalence of Gastroesophageal Reflux Disease among Diabetic Patients at Sharif Medical City Hospital, Lahore, Pakistan
Get PDFBackground: Diabetes mellitus has been linked to various gastrointestinal motility disorders, including gastroesophageal reflux disease (GERD).This study aimed to determine the proportion of GERD in patients with diabetes mellitus.Method: This descriptive cross-sectional study was conducted at the medical outpatient department of Sharif Medical City Hospital, Lahore, from October to December, 2020. Patients previously diagnosed with type II diabetes were included using non-probability consecutive sampling, and the GERDQ questionnaire was used to determine the frequency. IBM SPSS statistics version 23 was used for the analysis of data.Results: Of the 273 participants, 183 (67.0%) were male and the mean age was 51.13±12.8 years. The mean duration of diabetes was 6.97±4.76 years and oral hypoglycemic agents were used by 133 (48.7%) participants. Overall, 133 (48.7%) of the participants had GERD with a mean GERDQ score of 10.8(±1.4).Conclusion: Almost half (48.7%) of the participants have GERD; the most common symptom is regurgitation of stomach contents. Awareness should be raised, and early screening should be done to prevent long-term complications.
Monitoring Obstacles of Toddlers Growth in Public Health Center Margahayu Raya Bandung City during the COVID-19 Pandemic: From Cadre Perspective
Get PDFBackground:Toddler growth monitoring is one of the specific nutritional interventions used to accelerate stunting reduction. The COVID-19 pandemic has reduced various ‘Minimum Service Standards‘coverages, including toddler growth monitoring. This study aimed to explore the obstacles of toddler growth monitoring at the Integrated Service Center (Pusat pelayanan terpadu, Posyandu) during the COVID-19 pandemic. Methods: This was a qualitative study with an interpretivism paradigm. The unit of analysis was Posyandu of Margahayu Raya Public Health Center, Bandung City, West Java. Primary data were obtained through in-depth interviews with 10 cadres from different Posyandu from September-December 2021. The data were collected using a semi-structured interview guide and a recorder, and analyzed using NVivo software.Results: During the COVID-19 pandemic, toddler weighing had been suspended for several months. Starting in August 2020, cadres and public health center officers worked to ensure that toddlers’ weight, body length, and height could be monitored despite the numerous obstacles.Conclusion: The obstacles to toddler growth monitoring are inadequate instruments of toddler body height measuring during home visits, minimum cadre skills, a lack of toddlers’ mother awareness to bring their toddlers to Posyandu, and a lack of public awareness to follow health protocols.
Korelasi Kadar Limfosit dengan Nilai P/F Rasio Pada Pasien Covid-19 Derajat Berat
Get PDFVirus SARS-CoV-2 menyebabkan penyakit pernapasan akut yang disebut COVID-19 dan menyebabkan pandemi global. Limfopenia adalah salah satu kelainan laboratorium utama pada pasien COVID-19 derajat berat yang mengalami ARDS dengan penurunan P/F rasio. Penelitian ini bertujuan menganalisis korelasi kadar limfosit dengan P/F rasio pada pasien COVID-19 derajat berat. Penelitian dilakukan di ICU COVID-19 RSUP Dr. Hasan Sadikin Bandung dengan menelusuri rekam medik pada periode Januari hingga Juli 2021. Penelitian ini adalah penelitian observasional analitik dengan rancangan kohort retrospektif menggunakan model pendekatan waktu secara longitudinal atau time period approach. Penilaian dilakukan pada saat subjek dirawat pada hari ke-1, 3, dan ke-7 di ICU COVID-19 RSUP Dr. Hasan Sadikin Bandung. Uji normalitas data numerik menggunakan uji Shapiro Wilk didapatkan hasil data berdistribusi tidak normal. Selanjutnya, pada penelitian ini dilakukan uji korelasi Spearman. Tidak terdapat korelasi antara kadar limfosit dan P/F rasio pada pasien COVID-19 derajat berat (p=0,125; R=0,126). Didapatkan sebagian besar pasien COVID-19 derajat berat memiliki kadar limfosit <1.000 uL dan P/F rasio <150 mmHg (p<0,05). Simpulan, tidak terdapat korelasi antara kadar limfosit dan P/F rasio pada COVID-19 derajat berat, walaupun pada sebagian besar kasus COVID-19 derajat berat didapatkan penurunan limfosit dan P/F rasio. Virus SARS-CoV-2 menyebabkan penyakit pernapasan akut yang disebut COVID-19 dan menyebabkan pandemi global. Limfopenia adalah salah satu kelainan laboratorium utama pada pasien COVID-19 derajat berat yang mengalami ARDS dengan penurunan P/F rasio. Penelitian ini bertujuan untuk mengetahui korelasi kadar limfosit dengan P/F rasio pada pasien COVID-19 derajat berat sebagai prediktor terjadinya kerusakan paru atau ARDS. Penelitian dilakukan di ICU COVID-19 RSUP Dr. Hasan Sadikin Bandung dengan menelusuri rekam medik pada periode Januari hingga Juli 2021. Penelitian ini adalah penelitian observasional analitik dengan rancangan kohort retrospektif menggunakan model pendekatan waktu secara longitudinal atau time period approach. Penilaian dilakukan pada saat subjek di rawat pada hari ke-1, 3, dan ke-7 di ICU COVID-19 RSUP Dr. Hasan Sadikin Bandung. Uji normalitas data numerik menggunakan uji Shapiro Wilk didapatkan hasil data berdistribusi tidak normal. Selanjutnya, pada penelitian ini dilakukan uji korelasi Spearman. Tidak terdapat korelasi antara kadar limfosit dan P/F rasio pada pasien COVID-19 derajat berat (p=0,125 dan R=0,126). Didapatkan sebagian besar pasien COVID-19 derajat berat memiliki kadar limfosit <1000 uL dan P/F rasio <150 mmHg (p<0,05)
Pneumonia Clinical Features in Under-Five Children Treated in Atma Jaya Hospital in 2017-2020
Get PDFPneumonia is the leading cause of infection-related death among children and still remains a global health problem, especially for children under five. This study aimed to identify the clinical features of pneumonia in under-five chilren treated at Atma Jaya Hospital during the period of 2017-2020. This was a cross-sectional retrospective descriptive study on all under-five patients diagnosed with pneumonia treated in Atma Jaya Hospital. Data were collected from November 2021-January 2022 from the medical records of these children (n=148) and analyzed using the univariate analysis. Results showed that most subjects of this study were boys (60.8%), in the age group of 1-4 years old (62.2%), with fever as the most common pnemonia clinical symptom (93.9%). Physical examinations revealed that the average pulse of the subjects were 131.2 beats/minute and the average temperature was 37.1°C. Other signs and symptoms identified during physical examinations were tachypnea (20,3%), retractions (56.1%), crackles (82.4%), and wheezing (22,3%). The laboratory findings presented a mean hemoglobin of 11.0 g/dL, a mean hematocrit of 32.5%, and a mean CRP of 13.2 mg/dL, while most subjects had normal leukocyte (58.1%) and platelet counts (52.0%). The most common chest X-ray finding of pneumonia in these children was infiltrate (92.6%) and the average length of stay was 4 days. Most under-five children experiencing pneumonia recovered after treatment (97.3%)
Predictors of Urethral Stricture After Transurethral Resection of the Prostate Procedure
Get PDFTransurethral resection of the prostate (TURP) is the most frequently used urology surgical method to manage benign prostate hyperplasia (BPH). Despite the relatively efficacious treatment, urethral stricture (US) may form after TURP. The prevalence of the urethral strictures (US) following TURP ranges from 2.2% to 9.8%. The study aimed to identify the predictors of urethral strictures in patients receiving TURP. This study was a retrospective cohort study on patients underwent TURP in Dr. Hasan Sadikin General Hospital Bandung, Indonesia, between 2015 and 2019. Data were obtained from medical records and urology registry of a minimum 12-month follow-up period. Data on patient demographics, estimated volume of the prostate, total resected prostate, and operating time were extracted. Multiple logistic regression was utilized to determine the odds ratio difference between groups. A total of 451 TURP cases were performed between 2015 and 2019, with 22 (4.87%) cases of post TURP US identified. The mean estimated prostate weight was 45.6 g and resected prostate weight was 20.4 g, with a 0.37 gr/min resection rate. Prostate weight, operating time, and duration of catheterization after surgery were not significantly different statistically. Slower resection rate and smaller resected volume are the statistically significant predictors of increased occurrence of urethral stricture (p<0.05). Lower resection rate is also a predictor for urethral stricture after TURP procedure
Antioxidant Gel from Brown Algae (Ascophyllum nodosum) and Binahong Leaves for Diabetic Wound Healing
Get PDFBackground: Diabetic wounds are difficult to treat, causing persistent infections and often leading to limb amputation. One convenient way to manage diabetic wounds is by applying wound dressings. This study aimed to develop a wound dressing in form of a gel containing brown algae and binahong leaf extract for diabetic wound dressings.Methods: This study was an experimental study conducted in the Organic Chemistry Laboratory of Universitas Pendidikan Indonesia from June to September 2022. As many as 33 mice induced by alloxan were divided into 9 groups consisting of application of brown algae extract gel, binahong lead extract gel and a mixture of brown algae, and binahong leaf extract gel with the concentration of 2.5%, 5%, and 10% respectively. All treatments were given within 7 days. Laboratory data collected included phytochemical screening, total phenolic compound, antioxidant activity and organoleptic test.Results: Brown algae and binahong leaf extracts had a high total phenolic content of 331.25 mg GAE/g and 207.01 mg GAE/g, respectively with antioxidant activity of IC50 = 327.33 µg/mL and 209.30 µg/mL, respectively. It was found that brown algae and binahong leaf extracts could accelerate wound closure in a diabetic mouse model. Gel formulation with 10% w/w brown algae extracts presented 91.66% of wound closure, two times greater than treatment with commercial drugs.Conclusion: The developed gel containing brown algae and binahong leaf extracts can be a promising wound dressing for healing diabetic wounds
Perbedaan Nilai Near Infrared Spectroscopic Terhadap Posisi Head Up 15° Dan Head Up 30° Pada Pasien Yang Dirawat Di Ruang Intensive Care Unit
Get PDFOksigenasi serebral sangat dipengaruhi oleh autoregulasi serebri yang dapat mengatur aliran darah ke otak sehingga menyebabkan masuknya oksigen dapat bertambah maupun berkurang. Perubahan postur selama anestesi memiliki efek kompleks pada sirkulasi sistemik dan serebral yang berpotensi menurunkan aliran darah otak dan oksigenasi. Penelitian ini bertujuan meneliti perbandingan nilai near-infrared spectroscopy (NIRS) dengan posisi head up 15o dan 30o. Penelitian ini dilakukan di ICU RSUP H. Adam Malik Medan mulai bulan Agustus sampai Oktober 2022. Desain penelitian eksperimental dengan rancangan single blind randomized controlled trial. Analisis statistik variabel numerik menggunakan uji T-independen pada data berdistribusi normal dan uji Mann Whitney pada data tidak berdistribusi normal. Analisis statistik untuk data kategorik dengan uji chi-square atau uji Fisher Exact. Rerata nilai NIRS baik kanan maupun kiri pada kelompok Head Up 15o lebih rendah dibanding dengan kelompok Head Up 30o dengan perbedaan yang signifikan (p<0,05). Kesimpulan, nilai rerata near-infrared spectroscopy (NIRS) pada posisi Head Up 15° lebih rendah dibanding dengan posisi head up 30°.Kata kunci: Oksigenasi cerebral sangat dipengaruhi oleh autoregulasi serebri yang dapat mengatur aliran darah ke otak sehingga menyebabkan masuknya oksigen bisa bertambah maupun berkurang. Perubahan postur selama anestesi memiliki efek kompleks pada sirkulasi sistemik dan cerebral yang berpotensi menurunkan aliran darah otak dan oksigenasi. Penelitian ini bertujuan untuk meneliti tentang perbandingan nilai near-infrared spectroscopy (NIRS) terhadap posisi head up 15o dan 30o pada pasien yang di rawat di ICU RSUP H Adam Malik Medan. Desain penelitian analitik dengan desain eksperimental untuk mengetahui perbedaan nilai NIRS pada berbagai posisi head up pada pasien dirawat di ICU RSUP H. Adam Malik Medan. Pada penelitian ini didapatkan usia rerata sampel sebesar 53,45 ± 14,44 tahun dan rerata indeks massa tubuh sampel sebesar 23,92 ± 2,18 kg/m2. Tekanan darah sistolik dan diastolik sampel penelitian didapati sebesar 122,68 ± 17,76 dan 73,50 ± 10,25secara berurutan. nilai NIRS Head Up 15° dan 30° kiri didapatkan rerata nilai NIRS 56,27 ± 13,32 dan 65,45 ± 15,14 didapatkan nilai P sebesar 0,01 < 0,05, maka didapatkan adanya perbedaan yang signifikan antara Head Up 15° dan 30°. Terdapat perbedaan nilai near-infrared spectroscopy (NIRS) antara Head Up 15° dan 30°.pada pasien yang dirawat di ruang ICU