E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Canaliculotomy as A Canalicular Obstruction Management Approach: a Case Series
Get PDFLacrimal drainage obstruction is a common disorder of lacrimal system. This obstruction could affect lacrimal punctum, canaliculi, lacrimal sac, and lacrimal duct. The etiology could be congenital or acquired, such as triggered by infection or other conditions. This case series illustrates the procedure of canaliculotomy to reduce the epiphora symptom caused by lacrimal drainage obstruction, specifically in punctum and canaliculi. The aim of this case series was to report the management of punctal and canaliculi obstruction with canaliculotomy procedure. Case 1, an eighty-two years old woman with chronic canaliculitis on the right eye due to Actynomyces sp. infection, underwent canaliculotomy and curetage of canalicular area of the right eye. Case 2, a sixty-years old man with chronic canaliculitis with canalicular fistula on the left eye underwent canaliculotomy with silicone tube procedure on the left eye. Case 3, a sixty-seven years old man with recurrent punctal obstruction due to punctal stenosis of the left eye, previous punctoplasty, underwent canaliculotomy with silicone tube. Identification of the patient's symptoms is very important in determining the diagnosis and management plan for the patient. Canaliculotomy procedure with antimicrobial and steroid medication after procedure leads to a good result in reducing symptoms caused by lacrimal drainage obstruction due to various etiology
Hematoma Evacuation Outcome in Patients with Spontaneous Supratentorial Intracerebral Hemorrhage
Get PDFThe mortality rate of spontaneous supratentorial intracerebral hemorrhage evacuation is still high and varies in all neurosurgical centers. Currently, minimally invasive surgery to evacuate bleeding has become an option, but not all neurosurgical centers can perform the procedures due to limited resources. In addition, there are several guidelines for determining which patients will undergo a surgery. This study assessed the outcome of selected patients who were operated on using micro neurosurgical procedures or external ventricular drainage for intraventricular hemorrhage between 2016 and 2021. Patients included in this study were recruited from a hospital in Jakarta, Indonesia and selected based on the guideline of the 2015 American Heart Association/American Stroke Association (AHA/ASA). The outcome was assessed by a modified Rankin scale (mRS). There were 301 patients with hemorrhagic stroke but only fifty patients were matched the criteria in the guideline. Male patients constituted the majority of the patients (n=28, 56%) and hypertension has occurred in 37 (74%) patients. The hematoma was mostly located in the intracerebral with intraventricular extension (n=27, 54%) patients. The pre-operative Glasgow Coma Scale (GCS) of 23 (46%) patients were comatose and the other was 9–13. Postoperatively, there were 37 (74%) patients with a scale of 13–15, but 10 (20%) patients died. Pair t-test of the preoperative and postoperative scales showed a significant difference, p < 0.01. The outcome of 40 (80%) patients was good (modified Rankin scale of 0–3), and the Spearman’s rank correlation coefficient was -0.739 with the Sig.2-tailed was <0.01. The outcome of spontaneous supratentorial intracerebral hemorrhage evacuation is good when selecting patients following the 2015 AHA/ASA guideline and there is a strong correlation between postoperative GCS with 3-month mRS results
Mosquito Nets Use in South Central Timor District is Significantly Liked to Incidence of Malaria
Get PDFNinety percent of malaria cases in Indonesia come from Papua, West Papua, and East Nusa Tenggara provinces. The country has declared a target of malaria elimination by 2030. Malaria elimination efforts have been performed through case finding, treatment, surveillance, and risk factor prevention and control. Personal protection is crucial in preventing and reducing the risk for malaria infection. This study aimed to assess the significance of personal protection against mosquitoes in eastern Indonesia. This was a cross-sectional study using the secondary data from a previous study of malaria in eastern Indonesia in 2013–2014. Data were collected using a questionnaires and direct observation and analyzed using the chi-square with α 0.05 and 95% CI. A total of 551 data were collected (180 positive vs 371 negative). The use of mosquito nets at night (p-value: 0.038; OR: 3.127) has a significant relationship with the incidence of malaria while the use of ventilation screen (p-value: 0.191; OR: 0.839), vector shelter (p-value: 0.493; OR: 0.852), and mosquito repellent (p-value: 0.564; OR: 1.585) did not have significant relationships to the incidence of malaria. Mass distribution of mosquito nets by the local governments can constitute one of the efforts to prevent and control malaria in South Central Timor District
Relationship between Vitamin C and Length of Hospital Stay for Covid-19 Patients with Comorbidities
Get PDFCovid-19 patients with comorbidities, such as hypertension, diabetes, and respiratory diseases, have a higher risk for severe disease and mortality compared to patients without comorbidities. Some data shows that the administration of high dose vitamin C (1–2 g/day) can reduce the amount of the inflammatory mediators and shorten the length of hospital stay. This study aimed to determine the relationship between vitamin C administration and of length of hospital stay for Covid-19 patients with comorbidities. This study was a retrospective observational study on consecutively sampled medical record data of UNS Hospital patients from July 2020 to January 2021. A total of 78 patient medical records were included of this study. The inclusion criteria were all medical records of patients who suffered from Covid-19 with comorbidities admitted to the hospital while the exclusion criteria were medical records of patients who did not get oral or intravenous vitamin C. The chi-square bivariate test was used to determine the relationship between the administration of vitamin C and the length of hospital stay for Covid-19 patients with comorbidities. Of the 78 subjects only 52 subjects were included in the statistical analysis. Medical records were divided into two groups: group 1, that consisted of medical records of patient who received more than 1,000 mg Vitamin C, and group 2, who received less than 1,000 mg Vitamin C. Results demonstrated that the administration of high dose vitamin C of more than 1,000 mg was not associated with the length of hospital stay (p=0.677). Thus, high dose of vitamin C is not associated with the length of hospital stay for Covid-19 patients with comorbidities, such as hypertension, diabetes, and respiratory disease.
Protein and Phosphate Intakes are Associated with Hyperphosphatemia in Hemodialysis Patients at Sanglah Hospital, Bali, Indonesia
Get PDFIncreased chronic kidney disease (CKD) mortality rate is significantly associated with increased blood phosphate levels. Hyperphosphatemia control is one of the main focuses in the management of hemodialysis (HD) patients. A high protein diet has been suggested to prevent malnutrition in hemodialysis patients. However, a high protein and phosphorus diet has the risk of increasing the phosphate level in the blood circulation, leading to a higher mortality rate of hemodialysis patients. This study aimed to prove that the level of protein and phosphate intake is associated with hyperphosphatemia in CKD patients with routine HD. This was cross-sectional analytical study conducted from September to October 2020 on 66 CKD patients who underwent hemodialysis. Subject characteristics and phosphorus and protein intake data were obtained from a questionnaire food recall adapted from the Food and Agriculture Organization of the United Nations. Data consumption patterns were processed using the nutritional survey software to obtain the nutritional values. Data were analyzed using the Chi-Square test to identify the relationship and risk between hyperphosphatemia and diet protein, phosphorus, and protein-phosphorus ratio. The confidence level in this study was 95%. There was a significant relationship between protein and phosphorus intake in hyperphosphatemia in CKD patients. The risk factors for hyperphosphatemia were high phosphorus intake (p=0.018; OR=3.886;95% CI: 1.212–12.460) and adequate protein intake (p=0.035; OR=3.674; 95% CI: 1.049-12.865). This study showed no significant relationship between phosphorus-protein ratio, protein-phosphorus ratio, and hyperphosphatemia incidence. In conclusion, high protein intake and excessive phosphorus intake provide a significant relationship to the incidence of hyperphosphatemia in CKD patients undergoing routine hemodialysis
Prevalence of Smoking among Male Medical Students at Majmaah University, Saudi Arabia
Get PDFSmoking is defined as burning dry tobacco leaves and inhaling smoke from the burn. This process may be done using different forms of tobbaco products, including cigarettes (Cigars, Little Cigars, Cigarillos), electronic cigarettes, and hookah (shisha). Smoking can give rise to lung diseases such as chronic obstructive pulmonary disease (COPD) and has been proven to be the underlying cause in 84% of deaths in lung cancer and 83% mortalities in COPD. This study was conducted to determine the prevalence of tobacco smoking among male students of the Majmaah University, Saudi Arabia. This cross-sectional study was performed from January to February 2020 on among medical students of Majmaah University, Saudi Arabia. A pretested questionnaire was used to collect data while the SPSS was used for data analysis. From 256 male medical students, only 113 responded to the questionnaire. The prevalence of smoking was found to be 19.5% (n=22) with most smoked cigarettes (50%). Most smokers (50 %) were in the lowest age group, 19-21 years. There was an increase in smoking with an increase in income. Of the 22 respondents who smoked, 10 started smoking when they were 14 to 17 years old. In conclusion, the study shows a low prevalence of smoking among male medical students in the College of Medicine of Majmaah University. Most smokers consume cigarettes, and the majority are not considering quitting
Under-Two Children Hunger Levels in Indonesia
Get PDFObjective: To analyze the hunger level of toddlers under 2 years old using the Under-two Children Hunger Index (CHI). Methods: This study used secondary data from the Indonesian Basic Health Survey 2018. This study focused on the development of measurement for under-two children hunger index (CHI) using six indicators of the prevalence of chronic energy deficiency in pregnant women; the prevalence of risk height of pregnant women; the prevalence of under-two children who never being breastfeed; the prevalence of malnutrition for under-two children; the prevalence of wasting for under-two children; and the prevalence of stunting for under-two children. These six indicators were weighted differently and were calculated using the Principal Component Analysis (PCA) method.Results: The calculation of CHI using loading factors as weighted indicators has a higher precision with the percentage of 94.12 percent. With a 2018 CHI score of 46.40, Indonesia is at a serious CHI level. From the 34 provinces in Indonesia, 47.06% of provinces are at an extremely alarming level, 8.82% are at an alarming level, 17.65% are at a serious level, 17.65% are at a moderate level, and 8.82% are at a low level. Efforts can be performed by the government to increase the CHI based on the 6 indicators mentioned above.Conclusion: Based on this analysis, 25 provinces need attention in terms of the CHI level with six, three, and sixteen provinces suffered from a serious, alarming, and extremely alarming levels of CHI, respectively. Nevertheless, CHI is dynamic and should be updated annually to assess the province’s achievement in eradicating hunger. This time-series data is very important to evaluate government programs and programs to accelerate the eradication of under-two children's hunger should focus on the six indicators in this study.
Maternal Characteristics and Histopathological Features of Placenta Accreta Spectrum in Dr. Hasan Sadikin General Hospital Bandung, Period 2015–2020
Get PDFBackground: The placenta accreta spectrum (PAS) incidence has inclined today. The PAS is divided into three histopathological classifications, including accreta, increta, and percreta, associated with maternal, fetal morbidity, and mortality. This study aimed to explore the maternal characteristics and histopathological features in PAS at Dr. Hasan Sadikin General Hospital Bandung.Methods: This descriptive observational study involved 135 cases from January 2015–December 2020 at Dr. Hasan Sadikin General Hospital that met the inclusion criteria. The PAS histopathological classification was evaluated based on maternal characteristics such as age, parity, cesarean section (CS), and miscarriage. Results: The incidence of placenta accreta from 2015 to 2020 was 37.0%, whereas increta was 43.4%, followed by percreta at 19.3%. The maternal age of placenta accreta and increta mainly occurred at the age of 30–34 years with the prevalence of 40% and 46%, respectively, whereas percreta was aged 35–39 yo (27%). Most parities in placenta accreta, increta, percreta were three. Interestingly, 93% of cases had a CS history. Furthermore, the miscarriage history for accreta was 18%, increta 29% and percreta 38%. Conclusion: The highest incidence of PAS in Dr. Hasan Sadikin General Hospital is placenta increta, which mainly occurs at the age of 30–34 years. Almost all PAS patients have a history of CS; however, most of the patients do not have a miscarriage history
Four-Meter Gait Speed Cut-off and Correlation with 6-Minute Walk Test in Adults
Get PDFIn facilities where a track required is not available for gait speed test, a simpler method using a shorter track and test duration is needed. One of such methods is the 4-meter gait speed. This study aimed to determine the cut off values for 4MGS and its correlation with the 6-minute walk test (6MWT), a more common functional performance test with shorter track and time. Data for this study were collected at the Department of Rehabilitation of Dr. Cipto Mangunkusumo General Hospital during the period of August 2016 to March 2017. The consecutive sampling approach was used to recruit healthy Indonesian adults (n=61) aged 18–50 years into this cross sectional study. The anthropometric and respiratory variables were measured as descriptive data and the cut-off values were determined by calculating the mean 4-meter gait speed (4MGS)-2SD for each gender. The 6MWT was performed afterwards to assess the correlation between 4MGS and 6-minute walk distance (6MWD). Results presented a mean 4MGS value of 2.114±0.309 m/s (male) and 1.908±0.227m/s (female) with the cut-off values for normal gait speed of 1.496 m/s and 1.454m/s for male and female, respectively. Factors affecting 4MGS were body height, body weight, forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV1). The 4MGS is only shown to be weakly correlated with 6MWD (r=0.314, p=0.014). The cut-off values for 4MGS can be used as a reference to assess the normality of gait speed as a parameter of functional mobility in healthy Indonesian adults and should be used in adjunct to 6MWT to represent a comprehensive functional capacity status