E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Microbial Culture Characteristics and Antimicrobial Susceptibility Patterns Associated with Vesicovaginal Fistula
Get PDFVesicovaginal fistula (VVF) is commonly linked with recurrent urinary tract infection (UTI). Thus, the patterns of the pathogenic microorganism becomes important consideration in the management of this disease. This study aimed to describe patient profiles, disease etiology, and antimicrobial susceptibility patterns of microorganisms in VVF patients. This retrospective study was conducted on 49 medical records of vesicovaginal fistula patients seen from January 2016 to December 2020. The most prevalent age group of the patients was 40-50 years old. Analysis demonstrated that the leading etiology for VVF among these patients was malignancy (73.47%). The antimicrobial susceptibility was tested using the disc diffusion method and Escherichia coli (44.90%) and Proteus mirabilis (14.29%) were identified as the bacterial pathogens most frequently isolated from urine samples. Of the 39 patients with significant growth of organism cases, 29 (74.35%) had symptomatic UTIs. The isolated gram-negative bacteria had excellent sensitivity to aztreonam, ertapenem, and meropenem, with a more than 90% susceptibility rate, while the gram-positive bacteria had good sensitivity to amikacin, cefepime, tigecycline, aztreonam, ertapenem, and meropenem, with a more than 90% susceptibility. In conclusion, bacterial culture and antibiotic susceptibility test (AST) remains an essential part of managing VVF and their results can be used as a reference for empirical therapy. Amikacin, cefepime, tigecycline, aztreonam, ertapenem, and meropenem should be considered for treatment of UTIs associated with VVF
Characteristics of Non-Muscle Invasive Bladder Cancer (NMIBC) in Patients Treated in an Indonesian Tertiary Hospital from 2008 to 2019
Get PDFBladder cancer is the 10th most common cancer in both males and females with a ratio of 3:1. About 75% of bladder cancers are non-muscle invasive bladder cancers (NMIBC). The aim of this study was to identify the characteristics of Non-Muscle Invasive Bladder Cancer (NMIBC) patients treated in Dr. Hasan Sadikin General Hospital as one of the tertiary hospitals in Indonesia. This was a retrospective descriptive study that involved reviewing the medical records of patients diagnosed with NMIBC between January 2008 and December 2019. Characteristics reviewed were age, gender, body mass index (BMI), smoking history, urinary tract infection and stone history, intravesical chemotherapy and its side effects, and urinary cytology results. All data were tabulated and charted. Fifty-one out of 773 bladder cancer patients were diagnosed with NMIBC (6.59%). The mean age was 62.94 years old, with the majority of patients were in the 60-69 age group (31.37%). Males constituted the majority of the patients (n=44, 86.27%), with most patients had ideal BMI (66.66%), smoking history (72.54%), urinary tract infection history (56,86%), and urolithiasis history (5.88%). Thirty patients were given intravesical chemotherapy (58.82%), three patients experienced hematuria (10%), and four patients had painful urination (13.33%). Urinary cytology showed atypical cells (92.16%) in the majority of patients. The incidence of NMIBC in bladder cancer patients in our study was 6.59%, which differs from the incidence in developed countries of 75%, as shown in previous literature
Role of P27kip1 Protein, P45skp2 Coactivator, and P38jab1 Coactivator in Preventing Rhabdomyosarcoma (RMS) in Oral Cavity of Children
Get PDFRhabdomyosarcoma is a rare malignant tumor that attacks the differentiation of skeletal muscle and usually affects children, contributing to about 60% of all soft tissue sarcomas. The purpose of this study was to examine the relationship between p27Kip1 immunoexpression and p45Skp2 and p38Jab1 coactivators, as well as the relationship between p27Kip1 immunoexpression and p45Skp2 and p38Jab1 coactivators on stages and prognosis of oral RMS in children. This was a restrospective study on the immunoexpression of p27Kip1 and p45Skp2 and p38Jab1 coactivators on RMS cells. The RMS stage was determined according to the American Joint Committee of Cancer/AJCC of stages 1–4, and were divided into group I (stages 1 and 2) and group II (3 and 4). Samples were retrieved fromt he paraffin blocks of patients with embryonal RMS. Each paraffin block was cut, and 6 samples with 5 µm thickness from each block were examined using p27Kip1, p45Skp2, and p38Jab1 proteins. The analysis was performed using a linear regression test on the relationship between p27Kip1 and p45Skp2 and p38Jab1, resulting in a p-value of 0.000 (<0.05) and a coefficient value of b -1.36. Meanwhile, the stage was analyzed using the Wald test of 8.0688, resulting in a p-value of 0.0045 with a significant negative correlation. Analysis on the relationship between p45Skp2 and p38Jab1 and the RMS stage was performed using the Gamma test, resulting in a significant positive correlation (p<0.05)
Clinical Signs in Allergic Rhinitis Patients at Dr. Hasan Sadikin General Hospital Bandung 2017-2021
Get PDFBackground: The clinical diagnosis of allergic rhinitis requires comprehensive data from the history and physical examination. Despite being a substantial component of the diagnosis for allergic rhinitis, there is a paucity of studies about clinical signs of allergic rhinitis in Indonesia. This study aimed to describe the clinical signs in allergic rhinitis patients at Dr. Hasan Sadikin General Hospital Bandung.Methods: This cross-sectional study was conducted at Dr. Hasan Sadikin General Hospital Bandung in 2021, including secondary data of patients with allergic rhinitis from medical records registered from 2017 to 2021. Data of the characteristics, clinical signs, and allergic rhinitis comorbidities were collected and presented in tables.Results: The most common clinical sign was turbinate hypertrophy (74%), followed by pale nasal mucosa (59%) and clear nasal discharge (59%). The most prevalent comorbidities were chronic rhinosinusitis, adenoid hypertrophy, and asthma.Conclusions: The clinical signs observed from allergic rhinitis patients may vary, with the most common findings, including nasal turbinate hypertrophy, pale nasal mucosa, and clear nasal discharge. The findings may help the clinicians to diagnose allergic rhinitis needed for therapy management.
Correlation Between Diabetic Retinopathy, Depression Level and Quality of Life in Eye Clinic Zainoel Abidin Hospital
Get PDFDiabetic retinopathy (DR) is one of the eye disorders caused by complications of diabetes mellitus (DM). Indonesia has a high prevalence of DR (43.1%) compared to other Asia-Pacific countries. Damage and blockage of blood vessels in the retina causes impaired vision, which may lead to a total vision loss. DR requires special treatment, coupled with regular treatment, that is expensive and may result in depression and poor quality of life. This study aimed to determine the association between the degree of diabetic retinopathy with the level of depression and quality of life in people with DR in the eye clinic of Zainoel Abidin General Hospital Banda Aceh. This cross-sectional study was conducted from April 2018 to January 2019. Data were obtained through funduscopy reading, Hamilton Depression Rating Scale (HDRS) questionnaire, and Short-Form Health Survey (SF-36). The subjects of this study were all diabetic retinopathy patients who were sampled using the accidental sampling method. Based on the Spearman correlation analysis, there was a correlation between degree of DR and depression level (p value of 0.004) and quality of life (p value of 0,037). In conclusion, there is a moderate correlation between the degree of DR with depression level and quality of life among DM patients
Effect of High Fat Diet on Histopathological Appearance of Pregnant Wistar Rat’s Liver
Get PDFIndonesia is facing increased consumption of calorie-dense foods, such as fast food, among its society. Changes in diet and physical activities towards unhealthy ones can result in an imbalanced lifestyle, leading to various consequences, including hyperlipidemia. Pregnant women experience significant increases in plasma concentrations of lipids, lipoproteins, and apolipoproteins. Excessive cholesterol levels in pregnant women will result in the formation of fat in the liver. The purpose of this study was to determine the effect of a high-fat diet to pregnant Wistar rats (Rattus norvegicus) on the histopathological features of the liver. A true experimental with post test only control group design was applied in this study, which was conducted from August 2020 to November 2021. Fourteen (14) pregnant female rats were divided into two groups. The first group of rats was fed with a high-fat diet, while the second group, which was the control group, was given a standard diet. The high-fat diet used was 3 mL/rat/day beef brain. After the rats delivered their litters, the rats’ livers were retrieved, then examined histopathologically under a microscope. This research was conducted from No fatty liver was identified in the control group or the treatment group. Hence, a high-fat diet does not affect the liver histopathological features in pregnant Wistar rats
Mental Health Overview in Bullying Victim Students: A Descriptive Analysis
Get PDFObjective: To identify the impact of bullying behavior on the mental health of students who are victims of bullying.Methods: This was a cross-sectional descriptive quantitative study on 105 students in Medan Perjuangan district from November - December 2021. Sampling was performed using accidental sampling techniques on students living in the study area. A questionnaire was used to collect data and analysis was performed using univariate analysis with an estimated value of 95% confidence of 5%. Results: More than 70% of respondents received some forms of bullying such as body shaming, intelligence discrimination, and parental work shaming, discrimination based on their religion and beliefs, and abusive words. More than 60% of students were also discriminated, ridicule, and subjected to physical violence. About 50% of respondents were also bullied based on their financial, racial/ethnicity, and skin color traits and received physical abused.Conclusion: There is a link between mental health conditions and bullying behavior in students who are victims of bullying
Application of Replicate Organism Detection and Counting Method (RODAC) in Measuring Mycobacterium Tuberculosis Contamination in High Burden Laboratories
Get PDFBackground: Technicians working in high burden tuberculosis (TB) laboratories pose a higher risk of being infected by Mycobacterium tuberculosis from clinical samples. Contamination control is mandatory to detect the release of bacteria into the working environment and to minimize the risk of exposure to the workers. The contamination measurement is rarely performed due to the lack of standard methodology. This study optimized and applied a unique culture-based method named Replicate Organism Detection and Counting (RODAC) plates to assess the presence of M. tuberculosis contaminant in the laboratory with high burden of clinical samples. Methods: RODAC was applied on twenty working surfaces in the Mycobacteriology Laboratory of Universitas Padjadjaran. The results of RODAC were compared with DNA-based detection from the same working surfaces using in-house IS6110 real-time PCR (IS6110-qPCR). The detection limit of the RODAC plate was 19.6 CFU mL-1.Results: From all working surfaces tested, two distinct colonies were found on RODAC plate stamped on the Ziehl-Neelsen staining basin. Those colonies were identified as M. tuberculosis and non-tuberculous mycobacteria (NTM), as confirmed by the MPT64 antigen test and the presence of acid-fast bacilli. IS6110-qPCR detected the presence of M. tuberculosis DNA in ten sampling points, including the ZN staining basin, incubators, and microscopy areas. IS6110-qPCR detected more working surface contamination versus RODAC. However, it was noted that RODAC, which was a culture-based method, detected live bacteria, while PCR could not distinguish between live and dead bacteria.Conclusion: The application of the RODAC plate is more suitable for monitoring the contamination of live bacteria in the working environment and to inform a proper corrective action
Sensitifitas dan Spesifisitas Kuesioner Covid-19 untuk Skrining Pasien Praoperatif di RSUP dr. Hasan Sadikin
Get PDFPandemi Coronavirus disease 2019 (COVID-19) memberi dampak ke seluruh aspek, salah satunya dalam pelayanan kesehatan. Skrining praoperatif menjadi salah satu hal penting dalam persiapan dan pemilihan pasien yang akan menjalani operasi elektif di masa pandemi COVID-19. Tujuan penelitian ini adalah mengetahui sensitivitas dan spesifisitas kuesioner COVID-19 yang digunakan untuk skrining pasien praoperatif di RSUP Dr. Hasan Sadikin. Penelitian dilakukan di Unit Rekam Medis RSUP dr. Hasan Sadikin Bandung pada bulan Februari 2021 hingga Maret 2021. Penelitian ini merupakan studi deskriptif retrospektif dengan desain cross sectional (potong lintang) untuk membandingkan hasil kuesioner dengan hasil PCR COVID-19 yang diambil dari data pasien praoperatif bulan Juni 2020 hingga Agustus 2020. Hasil penelitian didapatkan bahwa sensitivitas kuesioner COVID-19 untuk skrining pasien praoperatif di RSUP Dr. Hasan Sadikin sangat lemah (36,4%), sedangkan spesifisitasnya sangat kuat (97,2%). Rasio kemungkinan positif sempurna (13), sedangkan rasio kemungkinan negatif cukup (0,65). Simpulan penelitian ini kuesioner COVID-19 kurang baik bila digunakan pada populasi dengan prevalensi yang rendah, tetapi cukup baik untuk menyaring pasien yang sehat, namun masih belum dapat dijadikan sebagai alat uji diagnostik, masih membutuhkan pemeriksaan penunjang lainnya untuk mendiagnosis COVID-19.Covid-19 Sensitivity and Specificity Questionnaire for Screening Preoperative Patients at Dr. Hasan Sadikin Hospital BandungThe 2019 Corona Virus Disease (COVID-19) pandemic impacts all aspects, one of which is health services. Preoperative screening is one of the essential things in the preparation and selection of patients who will undergo elective surgery during the COVID-19 pandemic. This study aimed to determine the sensitivity and specificity of the COVID-19 questionnaire used to screen preoperative patients at Dr. Hasan Sadikin Hospital. The study was conducted at the Medical Record Unit of Dr. Hasan Sadikin Hospital Bandung from February 2021 to March 2021. This study was a retrospective descriptive study with a cross-sectional design to compare the results of the questionnaire with the results of the COVID-19 PCR taken from preoperative patient data from June 2020 to August 2020. The results found that sensitivity in the COVID-19 questionnaire for screening preoperative patients at Dr. Hasan Sadikin Hospital was very weak (36.4%), while the specificity was very strong (97.2%). The positive likelihood ratio was perfect (13), while the negative likelihood ratio was moderate (0.65). This study concludes that the COVID-19 questionnaire is unsuitable for use in a low prevalence population but is good enough to screen healthy patients. However, it still cannot be used as a diagnostic test tool and requires other supporting tests to diagnose COVID-19.Pandemi Coronavirus disease 2019 (COVID-19) memberi dampak ke seluruh aspek, salah satunya dalam pelayanan kesehatan.Aspek penting yang perlu menjadi perhatian khusus yaitu menghindari potensi penularan dari pasien COVID-19. Skrining praoperatif menjadi salah satu hal penting dalam persiapan dan pemilihan pasien yang akan menjalani operasi elektif di masa pandemi COVID-19. Tujuan penelitian ini adalah mengetahui sensitivitas dan spesifisitas dari kuesioner COVID-19 yang digunakan untuk skrining pasien praoperatif di RSUP Dr. Hasan Sadikin. Penelitian dilakukan di Unit Rekam Medis RSUP dr. Hasan Sadikin Bandung pada bulan Februari 2021 hingga Maret 2021. Penelitian ini merupakan studi deskriptif retrospektif dengan desain cross sectional (potong lintang) untuk membandingkan hasil kuesioner dengan hasil PCR COVID-19 yang diambil dari data pasien praoperatif bulan Juni 2020 hingga Agustus 2020. Hasil penelitian didapatkan bahwa sensitivitas kuesioner COVID-19 untuk skrining pasien praoperatif di RSUP Dr. Hasan Sadikin sangat lemah (36,4%), sedangkan spesifisitasnya sangat kuat (97,2%). Rasio kemungkinan positif sempurna (13), sedangkan rasio kemungkinan negatif cukup (0,65). Simpulan penelitian ini kuesioner COVID-19 kurang baik bila digunakan pada populasi dengan prevalensi yang rendah, tapi cukup baik untuk menyaring pasien yang sehat namun masih belum dapat dijadikan sebagai alat uji diagnostik, masih membutuhkan pemeriksaan penunjang lainnya untuk mendiagnosis COVID-19
Profile of Medico-legal Cases and Body Injuries in a Tertiary Hospital in Padang, Indonesia 2010-2020
Get PDFForensic medicine is a branch of medicine that examines victims for the benefit of justice. Doctors play an important role in documenting injuries or abnormalities on the victim's body in the patient's medical record. This study aimed to determine the characteristics of cases and injuries of patients at M Djamil General Hospital during the period of 2010–2020. This was a descriptive retrospective study on secondary data from the medical records of patients who were examined and consulted to the Forensic Department of Dr. M. Djamil General Hospital, Padang during 2010–2020. During this period, 11.729 patients (victims) were examined by and consulted to the Department. Most of the victims were male (70.6%) aged 10–19 years old (29.2%). Most of the victims were involved in a traffic accident, followed by persecution. Victims of traffic accident dominated the forensic pathology cases after sudden death. Abrasions and open wound injury were the most frequent types of injury, with head and neck as the body parts mostly affected. In terms of the type of wound, most victims experienced injuries caused by blunt force (87%). This study concluded that the forensic cases managed at the Dr. M. Djamil General Hospital vary with blunt forces by a traffic accident as the most frequent cause of injuries while the head and neck become the body parts that are most susceptible to injury, both for survivors and those who died